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1. Prevalence of carbapenem-resistant gram-negative bacteria among neonates suspected for sepsis in Africa: a systematic review and meta-analysis

Author: Assefa Sisay, Zelalem Asmare, Getinet Kumie, Yalewayker Gashaw, Ermias Getachew, Agenagnew Ashagre, Marye Nigatie, Sisay Ayana, Tadesse Misganaw, Zelalem Dejazmach, Wagaw Abebe, Solomon Gedfie, Selamyhun Tadesse, Muluken Gashaw, Abdu Jemal, Woldeteklehymanot Kassahun, Atitegeb Abera Kidie, Biruk Beletew Abate, Chalie Mulugeta, Abebaw Alamrew, and Melese Abate Reta
Subjects: Carbapenem-resistant, Gram-negative bacteria, Neonates, Sepsis, Africa, Systematic review and meta-analysis, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Background The emergence and rapid spread of gram-negative bacteria resistant to carbapenems among newborns is concerning on a global scale. Nonetheless, the pooled estimate of gram-negative bacteria resistant to carbapenem that cause neonatal sepsis in developing nations remains unknown. Thus, this study aimed to determine the combined prevalence of gram-negative bacteria resistant to carbapenem in African newborns who were suspected of having sepsis. Methods All studies published from January 1, 2010, up to December 30, 2023, from PubMed, Science Direct, Scopus electronic databases, and the Google Scholar search engine were researched. Isolates tested for carbapenem from neonates with sepsis, English language papers conducted in Africa, and cross-sectional and cohort studies papers were included. Using PRISMA guidelines, we systematically reviewed and meta-analyzed studies that assessed the prevalence of carbapenem-resistant gram-negative bacteria. The “Joanna Briggs Institute” was used critically to evaluate the quality of the included studies. The data analysis was carried out using STATA™ version 17. Heterogeneity across the studies was evaluated using Q and I 2 tests. The subgroup analysis was done and, funnel plot and Egger’s regression test were used to detect publication bias. A sensitivity analysis was conducted. Results All 36 studies were included in the meta-analysis and systematic review. The pooled prevalence of carbapenem resistance in Africa was 30.34% (95% CI 22.03–38.64%). The pooled estimate of gram-negative bacteria resistant to imipenem, and meropenem was 35.57% (95% CI 0.67–70.54%) and 34.35% (95% CI 20.04% – 48.67%), respectively. A. baumannii and Pseudomonas spp. had pooled prevalence of 45.9% (95% CI 33.1–58.7%) and 43.0% (95% CI 23.0–62.4%), respectively. Similarly, Pseudomonas spp. and A. baumannii also exhibited strong meropenem resistance, with a pooled prevalence of 29.2% (95% CI 4.8–53.5%) and 36.7% (95% CI 20.1–53.3%), respectively. E. coli and K. pneumoniae were the two most common isolates. Conclusion There should be urgent antimicrobial stewardship practices, strengthened surveillance systems and effective treatment for neonates with sepsis. There was remarkable variation in resistance across the continent.
Published: 2024
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2. Genetic diversity of Mycobacterium tuberculosis strains isolated from spiritual holy water site attendees in Northwest Ethiopia. A cross-sectional study

Author: Melese Abate Reta, Halima M. Said, Nontuthuko Excellent Maningi, Gizachew Yismaw Wubetu, Mulualem Agonafir, and P. Bernard Fourie
Subjects: Mycobacterium tuberculosis complex, Genetic diversity, Lineages, Drug-susceptibility, Holy water site attendees, Ethiopia, Infectious and parasitic diseases, RC109-216
Abstract: Background: The genetic diversity of Mycobacterium tuberculosis complex (MTBC) strains was characterized among isolates from individuals with pulmonary tuberculosis (PTB) symptoms attended holy water sites (HWSs) in the Amhara region, Ethiopia. Methods: A cross-sectional study was done from June 2019 to March 2020 to describe the genetic diversity and drug-resistance profiles of MTBC isolates. Sputum specimens were collected and cultured in the Löwenstein-Jensen culture medium. Line Probe Assay, MTBDRplus VER 2.0, and MTBDRsl VER 2.0 were used to detect first-and second-line anti-TB drug-resistance patterns. A spoligotyping technique was utilized to characterize the genetic diversity. Statistical analysis was performed using STATA 15. Results: Of 560 PTB-symptomatic participants, 122 (21.8%) were culture-positive cases. Spoligotyping of 116 isolates revealed diverse MTBC sublineages, with four major lineages: Euro-American (EA) (Lineage 4), East-African-Indian (EAI) (Lineage 3), Ethiopian (ETH) (Lineage 7), East Asian (EA) (Lineage 2). The majority (96.6%) of the isolates were EA (lineage 4) and EAI, with proportions of 54.3% and 42.2%, respectively. A total of 31 spoligotype patterns were identified, 26 of which were documented in the SITVIT2 database. Of these, there were 15 unique spoligotypes, while eleven were grouped with 2-17 isolates. SIT149/T3-ETH (n = 17), SIT26/CAS1-DELHI (n = 16), SIT25/CAS1-DELHI (n = 12), and SIT52/T2 (n = 11) spoligotypes were predominant. A rare spoligotype pattern: SIT41/Turkey and SIT1/Beijing, has also been identified in North Shewa. The overall clustering rate of sub-lineages with known SIT was 76.4%.Of the 122 culture-positive isolates tested, 16.4% were resistant to rifampicin (RIF) and/or isoniazid (INH). Multidrug-resistant TB (MDR-TB) was detected in 12.3% of isolates, five of which were fluoroquinolones (FLQs) resistant. SIT149/T3-ETH and SIT21/CAS1-KILI sublineages showed a higher proportion of drug resistance. Conclusions: Diverse MTBC spoligotypes were identified, with the T and CAS families and EA (lineage 4) predominating. A high prevalence of drug-resistant TB, with SIT149/T3-ETH and CAS1-KILI sublineages comprising a greater share, was observed. A study with large sample size and a sequencing method with stronger discriminatory power is warranted to understand better the genetic diversity of circulating MTBC in this cohort of study, which would help to adopt targeted interventions.
Published: 2024
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3. Patterns and profiles of drug resistance-conferring mutations in Mycobacterium tuberculosis genotypes isolated from tuberculosis-suspected attendees of spiritual holy water sites in Northwest Ethiopia

Author: Melese Abate Reta, Nontuthuko Excellent Maningi, and P. Bernard Fourie
Subjects: drug-resistant TB, rpoB, katG, gyrA, mutations, spoligotypes, Public aspects of medicine, RA1-1270
Abstract: PurposeThis study examined the patterns and frequency of genetic changes responsible for resistance to first-line (rifampicin and isoniazid), fluoroquinolones, and second-line injectable drugs in drug-resistant Mycobacterium tuberculosis (MTB) isolated from culture-positive pulmonary tuberculosis (PTB) symptomatic attendees of spiritual holy water sites (HWSs) in the Amhara region.Patients and methodsFrom June 2019 to March 2020, a cross-sectional study was carried out. A total of 122 culture-positive MTB isolates from PTB-suspected attendees of HWSs in the Amhara region were evaluated for their drug resistance profiles, and characterized gene mutations conferring resistance to rifampicin (RIF), isoniazid (INH), fluoroquinolones (FLQs), and second-line injectable drugs (SLIDs) using GenoType®MTBDRplus VER2.0 and GenoType®MTBDRsl VER2.0. Drug-resistant MTB isolates were Spoligotyped following the manufacturer’s protocol.ResultsGenetic changes (mutations) responsible for resistance to RIF, INH, and FLQs were identified in 15/122 (12.3%), 20/122 (16.4%), and 5/20 (25%) of MTB isolates, respectively. In RIF-resistant, rpoB/Ser531Lue (n = 12, 80%) was most frequent followed by His526Tyr (6.7%). Amongst INH-resistant isolates, katG/Ser315Thr1 (n = 19, 95%) was the most frequent. Of 15 MDR-TB, the majority (n = 12, 80%) isolates had mutations at both rpoB/Ser531Leu and katG/Ser315Thr1. All 20 INH and/or RIF-resistant isolates were tested with the MTBDRsl VER 2.0, yielding 5 FLQs-resistant isolates with gene mutations at rpoB/Ser531Lue, katG/Ser315Thr1, and gyrA/Asp94Ala genes. Of 20 Spoligotyped drug-resistant MTB isolates, the majority (n = 11, 55%) and 6 (30%) were SIT149/T3-ETH and SIT21/CAS1-Kili sublineages, respectively; and they were any INH-resistant (mono-hetero/multi-). Of 15 RIF-resistant (RR/MDR-TB) isolates, 7 were SIT149/T3-ETH, while 6 were SIT21/CAS1-Kili sublineages. FLQ resistance was detected in four SIT21/CAS1-Kili lineages.ConclusionIn the current study, the most common gene mutations responsible for resistance to INH, RIF, and FLQs were identified. SIT149/T3-ETH and SIT21/CAS1-Kili constitute the majority of drug-resistant TB (DR-TB) isolates. To further understand the complete spectrum of genetic changes/mutations and related genotypes, a sequencing technology is warranted.
Published: 2024
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4. Prevalence of pulmonary tuberculosis among key and vulnerable populations in hotspot settings of Ethiopia. A systematic review and meta-analysis.

Author: Melese Abate Reta, Zelalem Asmare, Assefa Sisay, Yalewayker Gashaw, Ermias Getachew, Muluken Gashaw, Zelalem Dejazmach, Abdu Jemal, Solomon Gedfie, Getinet Kumie, Marye Nigatie, Wagaw Abebe, Agenagnew Ashagre, Tadesse Misganaw, Woldeteklehaymanot Kassahun, Selamyhun Tadesse, Alene Geteneh, Atitegeb Abera Kidie, Biruk Beletew Abate, Nontuthuko Excellent Maningi, and P Bernard Fourie
Subjects: Medicine, Science
Abstract: BackgroundDespite the decline in tuberculosis (TB) incidence across many regions worldwide, including Ethiopia, the disease remains highly concentrated among vulnerable or socially marginalized populations and in high-risk settings. This systematic review and meta-analysis aims to estimate the pooled prevalence of pulmonary tuberculosis (PTB) among key and vulnerable populations (KVPs) residing in hotspot settings in Ethiopia.MethodsPotential papers were searched systematically in PubMed, Scopus, ScienceDirect databases, Google Scholar search engine, and institutional electronic repositories/registrars. A total of 34 potential articles that provide necessary information on the prevalence of PTB were reviewed and data were analyzed to determine the pooled prevalence of PTB among KVPs. The relevant data were recorded and analyzed using STATA 17.0. Cohen's kappa was computed to determine the agreement between reviewers, the Inverse of variance (I2) to evaluate heterogeneity across studies, and Egger's test to identify publication bias. A random effect model was used to determine the pooled prevalence of PTB, subgroup analysis was computed by types of hotspot settings and year of publication.ResultsThis meta-analysis demonstrates that the pooled prevalence of PTB among populations residing in hotspot settings in Ethiopia was 11.7% (95% confidence interval (95CI): 7.97-15.43) with an I2 of 99.91% and a p< 0.001. Furthermore, the subgroup analysis unveiled the pooled prevalence of PTB among KVPs residing in different hotspot settings as follows: Prison inmates 8.8% (95CI: 5.00-12.55%), University students 23.1% (95CI: 15.81-30.37%), Refugees 28.4% (95CI: -1.27-58.15%), Homeless peoples 5.8% (95CI: -0.67-12.35%), Healthcare settings 11.1% (95CI: 0.58-21.63%), Spiritual holy water sites attendees 12.3% (95CI: -6.26-30.80%), and other high-risk settings 4.3% (95CI: 0.47-8.09%). Besides, the subgroup analysis revealed that the pooled prevalence of PTB post-2015 was 10.79% (95CI: 5.94-15.64%), whereas it stood at 14.04% (95CI: 10.27-17.82%) before 2015.ConclusionThe prevalence of PTB among KVPs residing in the hotspot settings in Ethiopia remains significant, with a weighted pooled prevalence of 11.7%. Thus, the national TB control programs should give due attention and appropriate control measures should be instituted that include regular systematic TB screening, compulsory TB testing for presumptive TB cases among KVPs, and tightened infection control at hotspot settings.
Published: 2024
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5. Antimicrobial resistance profile of Pseudomonas aeruginosa clinical isolates from healthcare-associated infections in Ethiopia: A systematic review and meta-analysis.

Author: Zelalem Asmare, Melese Abate Reta, Yalewayker Gashaw, Ermias Getachew, Assefa Sisay, Muluken Gashaw, Ephrem Tamrat, Atitegeb Abera Kidie, Wagaw Abebe, Tadesse Misganaw, Agenagnew Ashagre, Zelalem Dejazmach, Getinet Kumie, Marye Nigatie, Sisay Ayana, Abdu Jemal, Solomon Gedfie, Woldeteklehaymanot Kassahun, Mulat Awoke Kassa, Selamyhun Tadesse, and Biruk Beletew Abate
Subjects: Medicine, Science
Abstract: BackgroundAntimicrobial-resistant (AMR) bacterial infection is a significant global threat to the healthcare systems. Pseudomonas aeruginosa, the leading infectious agent in the healthcare setting is now one of the major threats due to AMR. A comprehensive understanding of the magnitude of AMR, particularly highly public health important pathogens such as P. aeruginosa, is necessary for the management of infections based on local information.ObjectiveThis systematic review and meta-analysis aimed to determine the country-wide AMR of P. aeruginosa.MethodsSystematic searches were performed to retrieve articles from PubMed, Scopus, Web of Science, ScienceDirect electronic databases, Google Scholar search engine, and repository registrars from 2015 to 31st December 2023. Twenty-three studies that provided important data on AMR in P. aeruginosa were systematically reviewed and analyzed to determine the country-wide magnitude of P. aeruginosa AMR profile from healthcare-associated infections. AMR of P. aeruginosa to 10 different antibiotics were extracted separately into Microsoft Excel and analyzed using STATA 17.0. Cohen's kappa was computed to determine the agreement between reviewers, the Inverse of variance (I2) was used to evaluate heterogeneity across studies, and Egger's test to identify publication bias. A random effect model was used to determine the pooled resistance to each antibiotic. Subgroup analysis was performed by infection type and year of publication.ResultsThis systematic review and meta-analysis revealed that the pooled prevalence of P. aeruginosa in clinical specimens associated with HAI was 4.38%(95%CI: 3.00-5.76). The pooled prevalence of AMR in P. aeruginosa for different antibiotics varies, ranging from 20.9% (95%CI: 6.2-35.8) for amikacin to 98.72% (95%CI: 96.39-101.4) for ceftriaxone. The pooled resistance was higher for ceftriaxone (98.72%), Trimethoprim-sulfamethoxazole (75.41), and amoxicillin-clavulanic acid (91.2). In contrast relatively lower AMR were observed for amikacin (20.9%) and meropenem (28.64%). The pooled multi-drug resistance (MDR) in P. aeruginosa was 80.5% (95%CI: 66.25-93.84). Upon subgroup analysis by infection types and year of publication, P. aeruginosa isolated from healthcare-associated infections exhibited higher resistance to ceftazidime (94.72%) compared to isolates from mixed types of healthcare-associated infections (70.84%) and surgical site infections (57.84%). Antimicrobial resistance in gentamicin was higher during the periods of 2018-2020 (73.96%), while comparatively lower during 2021-2023 (42.69%) and 2015-2017 (29.82%).ConclusionsSignificantly high AMR and MDR were observed from this systematic review and meta-analysis. AMR obtained from this systematic review and meta-analysis urges the need for improved infection control, antimicrobial stewardship practices, and strengthened surveillance systems to control the spread of AMR and ensure effective treatment of P. aeruginosa infections.Protocol registrationThis systematic review and meta-analysis was registered on PROSPERO (Registration ID: CRD42024518145).
Published: 2024
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6. Spiritual Holy Water Sites in Ethiopia: Unrecognized High-Risk Settings for Transmission of Pulmonary Tuberculosis

Author: Melese Abate Reta, Nontuthuko Excellent Maningi, Gizachew Yismaw Wubetu, Steve A. S. Olorunju, and P. Bernard Fourie
Subjects: Microbiology, QR1-502
Abstract: Ethiopia is a high-tuberculosis (TB) burden country with 157 new cases per 100,000 people, with 23,800 TB-related deaths in 2020. In Ethiopia, TB patients have different healthcare-seeking behaviors. They frequently visit spiritual places, such as holy water sites (HWSs), to seek treatment for their illness spiritually. This study examined the prevalence of pulmonary TB (PTB) and drug susceptibility profiles of Mycobacterium tuberculosis (MTB) isolates among spiritual HWS attendees in Northwest Ethiopia. A cross-sectional study was conducted from June 2019 to March 2020. Sputum samples were collected, processed, and cultured using Löwenstein–Jensen (LJ) culture medium. Second-generation line probe assays (LPAs), GenoType®MTBDRplus VER2.0 and GenoType®MTBDRsl VER2.0, were used to detect anti-TB drug-resistant isolates. STATA 17 was utilized to perform descriptive statistics, bivariate, and multivariate regression analyses. Of 560 PTB-symptomatic participants, 21.8% ((95% confidence interval (95 CI): 18.4–25.2%)) were culture-positive, resulting in a point prevalence of 1,183/100,000 attendees. Amongst HWS attendees, culture-positive TB occurred most commonly in persons 18–33 years of age (28.5% (95 CI 23.4–34.3%)). Other participant characteristics significantly associated with culture-positive PTB were as follows: rural residents (adjusted odds ratio (aOR) 2.65; 95 CI 1.38–5.10), married participants (aOR 2.43; 95 CI 1.28–4.63), family members >5 per household (aOR 1.84; 95 CI 1.04–3.24), and sharing living space (aOR 10.57; 95 CI 3.60–31.13). Also, among 438 participants followed for 12 months after showing negative TB culture results while at the HWS, 6.8% (95 CI 4.4–9.4%) developed or contracted culture-positive TB post-residency at the HWSs. Of the 122 tested isolates, 20 (16.4%) were isoniazid (INH) and/or rifampicin (RIF) resistant. Multidrug-resistant (MDR) TB was detected in 15 cases (12.3%), five of which were fluoroquinolones (FLQs) resistant. The findings from this study should raise a concern about HWSs as potential high-risk settings for TB transmission. It is recommended that appropriate control measures be instituted that include compulsory TB testing and tightened infection control at HWSs, where an increased risk exists for transmission of TB.
Published: 2024
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7. Genetic diversity of Mycobacterium tuberculosis isolates from the central, eastern and southeastern Ethiopia

Author: Mulualem Agonafir, Gurja Belay, Nontuthuko E. Maningi, Adey Feleke, Melese Abate Reta, Sharon L. Olifant, Mohammed Suaudi Hassen, Tewodros Girma, and P. Bernard Fourie
Subjects: Spoligotyping, Genetic diversity, Lineage, Sub-lineage, Mycobacterium tuberculosis complex, Ethiopia, Science (General), Q1-390, Social sciences (General), H1-99
Abstract: Introduction: The population structure of Mycobacterium tuberculosis complex (MTBC) in Ethiopia is diverse but dominated by Euro-American (Lineage 4) and East-African-Indian (Lineage 3) lineages. The objective of this study was to describe the genetic diversity of MTBC isolates in Central, Eastern and Southeastern Ethiopia. Methods: A total of 223 MTBC culture isolates obtained from patients referred to Adama and Harar TB reference laboratories were spoligotyped. Demographic and clinical characteristics were collected. Results: Six major lineages: Euro-American (Lineage 4), East-African-Indian (Lineage 3), East Asian (Lineage 2), Indo-Oceanic (Lineage 1), Mycobacterium africanum (Lineage 5 and Lineage 6) and Ethiopian (Lineage 7) were identified. The majority (94.6 %) of the isolates were Euro-American and East-African-Indian, with proportions of 75.3 % and 19.3 %, respectively. Overall, 77 different spoligotype patterns were identified of which 42 were registered in the SITVIT2 database. Of these, 27 spoligotypes were unique, while 15 were clustered with 2–49 isolates. SIT149/T3_ETH (n = 49), SIT53/T1 (n = 33), SIT21/CAS1_Kili (n = 24) and SIT41/Turkey (n = 11) were the dominant spoligotypes. A rare Beijing spoligotype pattern, SIT541, has also been identified in Eastern Ethiopia. The overall clustering rate of sub-lineages with known SIT was 71.3 %. Age group (25–34) was significantly associated with clustering. Conclusion: We found a heterogeneous population structure of MTBC dominated by T and CAS families, and the Euro-American lineage. The identification of the Beijing strain, particularly the rare SIT541 spoligotype in Eastern Ethiopia, warrants a heightened surveillance plan, as little is known about this genotype. A large-scale investigation utilizing a tool with superior discriminatory power, such as whole genome sequencing, is necessary to gain a thorough understanding of the genetic diversity of MTBC in the nation, which would help direct the overall control efforts.
Published: 2023
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8. Prevalence of drug resistance-conferring mutations associated with isoniazid- and rifampicin-resistant Mycobacterium tuberculosis in Ethiopia: a systematic review and meta-analysis

Author: Melese Abate Reta, Birhan Alemnew, Biruk Beletew Abate, and P. Bernard Fourie
Subjects: Mycobacterium tuberculosis, Gene mutation, Drug resistance, Meta-analysis, Ethiopia, Microbiology, QR1-502
Abstract: ABSTRACT: Objectives: Globally, the incidence and mortality of tuberculosis (TB) are declining; however, low detection of drug-resistant disease threatens to reverse current progress toward global TB control. Multiple rapid molecular diagnostic tests have recently been developed to detect genetic mutations in Mycobacterium tuberculosis (Mtb) known to confer drug resistance. However, their utility depends on the frequency and distribution of resistance-associated mutations in the pathogen population. This review aimed to assess the prevalence of gene mutations associated with rifampicin (RIF)- and isoniazid (INH)-resistant Mtb in Ethiopia.Methods: We searched the literature in PubMed/MEDLINE, Web of Science, Scopus and Cochrane Library. Data analysis was conducted in Stata 11.Results: Totally, 909 (95.8%) of 949 INH-resistant Mtb isolates had detectable gene mutations: 95.8% in katG315 and 5.9% in the inhA promoter region. Meta-analysis resulted in an estimated pooled prevalence of katGMUT1(S315T1) of 89.2% (95% CI 81.94–96.43%) and a pooled prevalence of inhAMUT1(C15T) of 77.5% (95% CI 57.84–97.13%). Moreover, 769 (90.8%) of 847 RIF-resistant strains had detectable rpoB gene mutations. Meta-analysis resulted in a pooled prevalence of rpoBMUT3(S531L) of 74.2% (95% CI 66.39–82.00%).Conclusion: RIF-resistant Mtb were widespread, particularly those harbouring rpoB(S531L) mutation. Similarly, INH-resistant Mtb with katG(S315T1) and inhA(C15T) mutations were common. Tracking S531L, S315T1 and C15T mutations among RIF- and INH-resistant isolates, respectively, would be diagnostically and epidemiologically valuable. Rapid diagnosis of RIF- and INH-resistant Mtb would expedite modification of TB treatment regimens, and proper timely infection control interventions could reduce the risk of development and transmission of multidrug-resistant TB.
Published: 2021
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9. Residence and young women’s comprehensive HIV knowledge in Ethiopia

Author: Biruk Beletew Abate, Ayelign Mengesha Kassie, Melese Abate Reta, Gillian H. Ice, and Zelalem T. Haile
Subjects: Comprehensive HIV knowledge, Young women, Residence, Demographic and health survey, Ethiopia, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Human immunodeficiency virus (HIV) infection is a global health problem. The epidemic is very serious in sub-Saharan Africa with approximately 70% of the global cases. The disease particularly affects youth, accounting for half of the new HIV infections yearly. Inadequate knowledge may contribute to the high rates among youth. Hence, the main aim of this study was to examine the association between residence and comprehensive HIV knowledge among women aged 15–24 years in Ethiopia. Methods This cross-sectional study used nationally representative data from the 2016 Ethiopian demographic health survey (n = 5926). Chi-square tests and multivariable logistic regression modeling were performed. Results Approximately 23.9% of the study participants had a comprehensive HIV knowledge and 74.7% were rural residents. In the multivariable-adjusted model, we found a significant interaction between place of residence and HIV testing on comprehensive HIV knowledge (P for interaction = 0.005). In the subgroup analysis, a statistically significant associations between place of residence and comprehensive HIV knowledge was found only in women who have never been tested for HIV. In this subgroup, rural women had lower odds of having a comprehensive HIV knowledge compared to their urban counterparts (OR 0.42, 95% CI: 0.23–0.74; P = 0.003). Furthermore, in the subgroup of women who have never been tested for HIV, education and region were significantly associated with comprehensive HIV knowledge. Compared to women with no education, the odds of having a comprehensive HIV knowledge were higher in women who had primary (OR 2.86, 95% CI: 1.63–5.02; P
Published: 2020
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10. Prevalence of multidrug-resistant tuberculosis in East Africa: A systematic review and meta-analysis.

Author: Kindu Alem Molla, Melese Abate Reta, and Yonas Yimam Ayene
Subjects: Medicine, Science
Abstract: BackgroundThe rate of multidrug-resistant tuberculosis is increasing at an alarming rate throughout the world. It is becoming an emerging public health problem in East Africa. The prevalence of multidrug-resistant tuberculosis among pulmonary tuberculosis positive individuals in the region has not been thoroughly investigated.AimThe aim of this systematic review and meta-analysis is to estimate the pooled prevalence of multidrug-resistant tuberculosis among newly diagnosed and previously treated pulmonary tuberculosis cases in East African countries.MethodsEnglish published articles were systematically searched from six electronic databases: PubMed, EMBASE, Scopus, Science direct, Web of Science, and Google scholar. The pooled prevalence of multidrug-resistant tuberculosis and associated risk factors were calculated using Der Simonian and Laird's random Effects model. Funnel plot symmetry visualization confirmed by Egger's regression asymmetry test and Begg rank correlation methods was used to assess publication bias. A total of 16 articles published from 2007 to 2019 were included in this study. STATA 14 software was used for analysis.ResultsOut of 1025 articles identified citations, a total of 16 articles were included in final meta-analysis. The pooled prevalence of multidrug-resistant tuberculosis among newly diagnosed tuberculosis cases and previously treated tuberculosis patients was 4% (95%CI = 2-5%) and 21% (95%CI: 14-28%), respectively. Living conditions, lifestyles (smoking, alcohol use, and drug abuse), previous medical history, diabetes history, and human immunodeficiency virus infection were risk factors contributing to the higher prevalence of multidrug-resistant tuberculosis in East Africa.ConclusionThe review found a significant prevalence of multidrug-resistant tuberculosis in the region. An early diagnosis of tuberculosis and rapid detection of drug-resistant Mycobacterium tuberculosis is a critical priority to identify patients who are not responding to the standard treatment and to avoid transmission of resistant strains. It is also very important to strengthen tuberculosis control and improve monitoring of chemotherapy.
Published: 2022
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11. Mycobacterium tuberculosis Drug Resistance in Ethiopia: An Updated Systematic Review and Meta-Analysis

Author: Melese Abate Reta, Birhan Alemnew Tamene, Biruk Beletew Abate, Eric Mensah, Nontuthuko Excellent Maningi, and P. Bernard Fourie
Subjects: Mycobacterium tuberculosis, drug-resistance, MDR-TB, meta-analysis, Ethiopia, Medicine
Abstract: Background: Tuberculosis (TB) remains a significant global public health issue, despite advances in diagnostic technologies, substantial global efforts, and the availability of effective chemotherapies. Mycobacterium tuberculosis, a species of pathogenic bacteria resistant to currently available anti-TB drugs, is on the rise, threatening national and international TB-control efforts. This systematic review and meta-analysis aims to estimate the pooled prevalence of drug-resistant TB (DR-TB) in Ethiopia. Materialsand Methods: A systematic literature search was undertaken using PubMed/MEDLINE, HINARI, the Web of Science, ScienceDirect electronic databases, and Google Scholar (1 January 2011 to 30 November 2020). After cleaning and sorting the records, the data were analyzed using STATA 11. The study outcomes revealed the weighted pooled prevalence of any anti-tuberculosis drug resistance, any isoniazid (INH) and rifampicin (RIF) resistance, monoresistance to INH and RIF, and multidrug-resistant TB (MDR-TB) in newly diagnosed and previously treated patients with TB. Results: A total of 24 studies with 18,908 patients with TB were included in the final analysis. The weighted pooled prevalence of any anti-TB drug resistance was 14.25% (95% confidence interval (CI): 7.05–21.44%)), whereas the pooled prevalence of any INH and RIF resistance was found in 15.62% (95%CI: 6.77–24.47%) and 9.75% (95%CI: 4.69–14.82%) of patients with TB, respectively. The pooled prevalence for INH and RIF-monoresistance was 6.23% (95%CI: 4.44–8.02%) and 2.33% (95%CI: 1.00–3.66%), respectively. MDR-TB was detected in 2.64% (95%CI: 1.46–3.82%) of newly diagnosed cases and 11.54% (95%CI: 2.12–20.96%) of retreated patients with TB, while the overall pooled prevalence of MDR-TB was 10.78% (95%CI: 4.74–16.83%). Conclusions: In Ethiopia, anti-tuberculosis drug resistance is widespread. The estimated pooled prevalence of INH and RIF-monoresistance rates were significantly higher in this review than in previous reports. Moreover, MDR-TB in newly diagnosed cases remained strong. Thus, early detection of TB cases, drug-resistance testing, proper and timely treatment, and diligent follow-up of TB patients all contribute to the improvement of DR-TB management and prevention. Besides this, we urge that a robust, routine laboratory-based drug-resistance surveillance system be implemented in the country.
Published: 2022
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12. Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning.

Author: Elizabeth A Cromwell, Joshua C P Osborne, Thomas R Unnasch, Maria-Gloria Basáñez, Katherine M Gass, Kira A Barbre, Elex Hill, Kimberly B Johnson, Katie M Donkers, Shreya Shirude, Chris A Schmidt, Victor Adekanmbi, Olatunji O Adetokunboh, Mohsen Afarideh, Ehsan Ahmadpour, Muktar Beshir Ahmed, Temesgen Yihunie Akalu, Ziyad Al-Aly, Fahad Mashhour Alanezi, Turki M Alanzi, Vahid Alipour, Catalina Liliana Andrei, Fereshteh Ansari, Mustafa Geleto Ansha, Davood Anvari, Seth Christopher Yaw Appiah, Jalal Arabloo, Benjamin F Arnold, Marcel Ausloos, Martin Amogre Ayanore, Atif Amin Baig, Maciej Banach, Aleksandra Barac, Till Winfried Bärnighausen, Mohsen Bayati, Krittika Bhattacharyya, Zulfiqar A Bhutta, Sadia Bibi, Ali Bijani, Somayeh Bohlouli, Mahdi Bohluli, Oliver J Brady, Nicola Luigi Bragazzi, Zahid A Butt, Felix Carvalho, Souranshu Chatterjee, Vijay Kumar Chattu, Soosanna Kumary Chattu, Natalie Maria Cormier, Saad M A Dahlawi, Giovanni Damiani, Farah Daoud, Aso Mohammad Darwesh, Ahmad Daryani, Kebede Deribe, Samath Dhamminda Dharmaratne, Daniel Diaz, Hoa Thi Do, Maysaa El Sayed Zaki, Maha El Tantawi, Demelash Abewa Elemineh, Anwar Faraj, Majid Fasihi Harandi, Yousef Fatahi, Valery L Feigin, Eduarda Fernandes, Nataliya A Foigt, Masoud Foroutan, Richard Charles Franklin, Mohammed Ibrahim Mohialdeen Gubari, Davide Guido, Yuming Guo, Arvin Haj-Mirzaian, Kanaan Hamagharib Abdullah, Samer Hamidi, Claudiu Herteliu, Hagos Degefa de Hidru, Tarig B Higazi, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Olayinka Stephen Ilesanmi, Milena D Ilic, Irena M Ilic, Usman Iqbal, Seyed Sina Naghibi Irvani, Ravi Prakash Jha, Farahnaz Joukar, Jacek Jerzy Jozwiak, Zubair Kabir, Leila R Kalankesh, Rohollah Kalhor, Behzad Karami Matin, Salah Eddin Karimi, Amir Kasaeian, Taras Kavetskyy, Gbenga A Kayode, Ali Kazemi Karyani, Abraham Getachew Kelbore, Maryam Keramati, Rovshan Khalilov, Ejaz Ahmad Khan, Md Nuruzzaman Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Neda Kianipour, Kelemu Tilahun Kibret, Yun Jin Kim, Soewarta Kosen, Kris J Krohn, Dian Kusuma, Carlo La Vecchia, Van Charles Lansingh, Paul H Lee, Kate E LeGrand, Shanshan Li, Joshua Longbottom, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Afshin Maleki, Abdullah A Mamun, Ali Manafi, Navid Manafi, Mohammad Ali Mansournia, Francisco Rogerlândio Martins-Melo, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Walter Mendoza, Endalkachew Worku Mengesha, Desalegn Tadese Mengistu, Seid Tiku Mereta, Tomislav Mestrovic, Ted R Miller, Mohammad Miri, Masoud Moghadaszadeh, Abdollah Mohammadian-Hafshejani, Reza Mohammadpourhodki, Shafiu Mohammed, Salahuddin Mohammed, Masoud Moradi, Rahmatollah Moradzadeh, Paula Moraga, Jonathan F Mosser, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Gurudatta Naik, Ionut Negoi, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Rajan Nikbakhsh, Bogdan Oancea, Tinuke O Olagunju, Andrew T Olagunju, Ahmed Omar Bali, Obinna E Onwujekwe, Adrian Pana, Hadi Pourjafar, Fakher Rahim, Mohammad Hifz Ur Rahman, Priya Rathi, Salman Rawaf, David Laith Rawaf, Reza Rawassizadeh, Serge Resnikoff, Melese Abate Reta, Aziz Rezapour, Enrico Rubagotti, Salvatore Rubino, Ehsan Sadeghi, Abedin Saghafipour, S Mohammad Sajadi, Abdallah M Samy, Rodrigo Sarmiento-Suárez, Monika Sawhney, Megan F Schipp, Amira A Shaheen, Masood Ali Shaikh, Morteza Shamsizadeh, Kiomars Sharafi, Aziz Sheikh, B Suresh Kumar Shetty, Jae Il Shin, K M Shivakumar, Biagio Simonetti, Jasvinder A Singh, Eirini Skiadaresi, Amin Soheili, Shahin Soltani, Emma Elizabeth Spurlock, Mu'awiyyah Babale Sufiyan, Takahiro Tabuchi, Leili Tapak, Robert L Thompson, Alan J Thomson, Eugenio Traini, Bach Xuan Tran, Irfan Ullah, Saif Ullah, Chigozie Jesse Uneke, Bhaskaran Unnikrishnan, Olalekan A Uthman, Natalie V S Vinkeles Melchers, Francesco S Violante, Haileab Fekadu Wolde, Tewodros Eshete Wonde, Tomohide Yamada, Sanni Yaya, Vahid Yazdi-Feyzabadi, Paul Yip, Naohiro Yonemoto, Hebat-Allah Salah A Yousof, Chuanhua Yu, Yong Yu, Hasan Yusefzadeh, Leila Zaki, Sojib Bin Zaman, Maryam Zamanian, Zhi-Jiang Zhang, Yunquan Zhang, Arash Ziapour, Simon I Hay, and David M Pigott
Subjects: Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract: Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.
Published: 2021
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13. Genomic and Resistance Epidemiology of Gram-Negative Bacteria in Africa: a Systematic Review and Phylogenomic Analyses from a One Health Perspective

Author: John Osei Sekyere and Melese Abate Reta
Subjects: One Health, antibiotic resistance, molecular epidemiology, diagnostics, genomics, resistome, Microbiology, QR1-502
Abstract: ABSTRACT Antibiotic resistance (AR) remains a major threat to public and animal health globally. However, AR ramifications in developing countries are worsened by limited molecular diagnostics, expensive therapeutics, inadequate numbers of skilled clinicians and scientists, and unsanitary environments. The epidemiology of Gram-negative bacteria, their AR genes, and geographical distribution in Africa are described here. Data were extracted and analyzed from English-language articles published between 2015 and December 2019. The genomes and AR genes of the various species, obtained from the Pathosystems Resource Integration Center (PATRIC) and NCBI were analyzed phylogenetically using Randomized Axelerated Maximum Likelihood (RAxML) and annotated with Figtree. The geographic location of resistant clones/clades was mapped manually. Thirty species from 31 countries and 24 genera from 41 countries were analyzed from 146 articles and 3,028 genomes, respectively. Genes mediating resistance to β-lactams (including blaTEM-1, blaCTX-M, blaNDM, blaIMP, blaVIM, and blaOXA-48/181), fluoroquinolones (oqxAB, qnrA/B/D/S, gyrA/B, and parCE mutations, etc.), aminoglycosides (including armA and rmtC/F), sulfonamides (sul1/2/3), trimethoprim (dfrA), tetracycline [tet(A/B/C/D/G/O/M/39)], colistin (mcr-1), phenicols (catA/B, cmlA), and fosfomycin (fosA) were mostly found in Enterobacter spp. and Klebsiella pneumoniae, and also in Serratia marcescens, Escherichia coli, Salmonella enterica, Pseudomonas, Acinetobacter baumannii, etc., on mostly IncF-type, IncX3/4, ColRNAI, and IncR plasmids, within IntI1 gene cassettes, insertion sequences, and transposons. Clonal and multiclonal outbreaks and dissemination of resistance genes across species and countries and between humans, animals, plants, and the environment were observed; Escherichia coli ST103, K. pneumoniae ST101, S. enterica ST1/2, and Vibrio cholerae ST69/515 were common strains. Most pathogens were of human origin, and zoonotic transmissions were relatively limited. IMPORTANCE Antibiotic resistance (AR) is one of the major public health threats and challenges to effective containment and treatment of infectious bacterial diseases worldwide. Here, we used different methods to map out the geographical hot spots, sources, and evolutionary epidemiology of AR. Escherichia coli, Klebsiella pneumoniae, Salmonella enterica, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp., Neisseria meningitis/gonorrhoeae, Vibrio cholerae, Campylobacter jejuni, etc., were common pathogens shuttling AR genes in Africa. Transmission of the same clones/strains across countries and between animals, humans, plants, and the environment was observed. We recommend Enterobacter spp. or K. pneumoniae as better sentinel species for AR surveillance.
Published: 2020
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14. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Author: Kirsten E Wiens, Paulina A Lindstedt, Brigette F Blacker, Kimberly B Johnson, Mathew M Baumann, Lauren E Schaeffer, Hedayat Abbastabar, Sr, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R M Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Maryam Adabi, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Sr, Victor Adekanmbi, Olatunji O Adetokunboh, Sr, Beyene Meressa Adhena, Mohsen Afarideh, Sohail Ahmad, Keivan Ahmadi, Anwar E Ahmed, Muktar Beshir Ahmed, Rushdia Ahmed, Temesgen Yihunie Akalu, Fares Alahdab, Ziyad Al-Aly, Noore Alam, Sr, Samiah Alam, Genet Melak Alamene, Turki M Alanzi, Jacqueline Elizabeth Alcalde-Rabanal, Beriwan Abdulqadir Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Sr, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Saeed Amini, Sr, Arianna Maever L Amit, Sr, Catalina Liliana Andrei, Sr, Mina Anjomshoa, Amir Anoushiravani, Sr, Fereshteh Ansari, Carl Abelardo T Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Sr, Olatunde Aremu, Bahram Armoon, Amit Arora, Sr, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Hagos Tasew Atalay, Seyyed Shamsadin Athari, Sr, Seyyede Masoume Athari, Sachin R Atre, Marcel Ausloos, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Sr, Yared Asmare Aynalem IV, Samad Azari, Peter S Azzopardi, Ebrahim Babaee, Tesleem Kayode Babalola, Alaa Badawi, Sr, Mohan Bairwa, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Ayele Geleto Bali, Maciej Banach, Sr, Joseph Adel Mattar Banoub, Sr, Aleksandra Barac, Till Winfried Bärnighausen, Huda Basaleem, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Estifanos Baye, Neeraj Bedi, Mahya Mahya Beheshti Beheshti, Masoud Behzadifar, Meysam Behzadifar, Bayu Begashaw Bekele, Yaschilal Muche Belayneh, Michellr L Bell, Sr, Derrick A Bennett, Sr, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Sr, Krittika Bhattacharyya, Sr, Suraj Bhattarai, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Binyam Minuye Birihane IV, Raaj Kishore Biswas, Somayeh Bohlouli, Hunduma Amensisa Amensisa Bojia I, Soufiane Boufous, Oliver J Brady, Nicola Luigi Bragazzi, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Sharath Burugina Nagaraja, Sr, Reinhard Busse, Sr, Zahid A Butt, Luis LA Alberto Cámera, Sr, Ismael R Campos-Nonato, Sr, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Sr, Carlos A Castañeda-Orjuela, Sr, Franz Castro, Wagaye Fentahun Chanie, Sr, Pranab Chatterjee, Vijay Kumar Chattu, Tesfaye Yitna Yitna Chichiabellu, Jr, Ken Lee Chin, Sr, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Carlos Culquichicon, Matiwos Soboka Daba, Giovanni Damiani, Sr, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Sr, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Gail Davey, Claudio Alberto Dávila-Cervantes, Adrian C Davis, Sr, Dragos Virgil Davitoiu, Fernando Pio De la Hoz, Asmamaw Bizuneh Demis, Dereje Bayissa Demissie, Getu Debalkie Demissie, Gebre Teklemariam Demoz, Sr, Edgar Denova-Gutiérrez, Sr, Kebede Deribe, Sr, Assefa Desalew, Aniruddha Deshpande, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Sr, Isaac Oluwafemi Dipeolu, Shirin Djalalinia, Kerrie E Doyle, Eleonora Dubljanin, Bereket Duko, Andre Rodrigues Duraes, Mohammad Ebrahimi Kalan, Hisham Atan Edinur, Sr, Andem Effiong, Sr, Aziz Eftekhari, Nevine El Nahas, Iman El Sayed, Maysaa El Sayed Zaki, Maha El Tantawi, Teshome Bekele Elema I, Hala Rashad Elhabashy, Sr, Shaimaa I El-Jaafary, Hajer Elkout, Aisha Elsharkawy, Iqbal RF Elyazar, Aklilu Endalamaw, Daniel Adane Endalew, Sr, Sharareh Eskandarieh, Alireza Esteghamati, Sadaf Esteghamati, Sr, Arash Etemadi, Oluchi Ezekannagha, Mohammad Fareed, Roghiyeh Faridnia, Farshad Farzadfar, Mehdi Fazlzadeh, Valery L Feigin, Sr, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Nataliya A Foigt, Morenike Oluwatoyin Folayan, Sr, Masoud Foroutan, Richard Charles Franklin, Takeshi Fukumoto, Mohamed M Gad, Reta Tsegaye Gayesa, Teshome Gebre, Sr, Ketema Bizuwork Gebremedhin, Gebreamlak Gebremedhn Gebremeskel, Sr, Hailay Abrha Gesesew, Kebede Embaye Gezae, Keyghobad Ghadiri, Sr, Ahmad Ghashghaee, Pramesh Raj Ghimire, Sr, Paramjit Singh Gill, Sr, Tiffany K Gill, Themba G G Ginindza, Nelson G M Gomes, Sameer Vali Gopalani, Alessandra C Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Sr, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Sr, Rajeev Gupta, Nima Hafezi-Nejad, Dessalegn H Haile, Sr, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Sr, Ninuk Hariyani, Ahmed I Hasaballah, Md Mehedi Hasan, Edris Hasanpoor, Amir Hasanzadeh, Hadi Hassankhani, Hamid Yimam Hassen, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Sr, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru I, Thomas R Hird, Chi Linh Hoang, Enayatollah Homaie Rad, Praveen Hoogar, Mohammad Hoseini, Naznin Hossain, Mostafa Hosseini, Mehdi Hosseinzadeh, Mowafa Househ, Mohamed Hsairi, Sr, Guoqing Hu, Mohammedaman Mama Hussen, Segun Emmanuel Ibitoye, Ehimario U Igumbor, Sr, Olayinka Stephen Ilesanmi, Milena D Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Chinwe Juliana Iwu, Neda Izadi, Sr, Anelisa Jaca, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Sr, Jost B Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Sr, Amaha Kahsay, Hamed Kalani, Tanuj Kanchan, Behzad Karami Matin, André Karch, Mohd Anisul Karim, Hamidreza Karimi-Sari, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Yawukal chane Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A Kayode, Ali Kazemi Karyani, Mihiretu M Kebede, Peter Njenga Keiyoro, Abraham Getachew Kelbore, Sr, Andre Pascal Kengne, Sr, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Sr, Junaid Khan, Md Nuruzzaman Khan I, Muhammad Shahzeb Khan, Khaled Khatab, Sr, Amir M Khater, Mona M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Salman Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Niranjan Kissoon, Sr, Shivakumar KM Marulasiddaiah M KMShivakumar, Sr, Sonali Kochhar, Tufa Kolola, Sr, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Moritz U G Kraemer, Kewal Krishan, Nuworza Kugbey, G Anil Kumar, Manasi Kumar, Sr, Pushpendra Kumar, Vivek Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Sheetal D Lad, Dharmesh Kumar Lal, Felix Lam, Faris Hasan Lami, Sr, Prabhat Lamichhane, Van Charles Lansingh, Savita Lasrado, Avula Laxmaiah, Paul H Lee, Sr, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Sr, Aubrey J Levine, Shanshan Li, Sr, Shai Linn, Shiwei Liu, Simin Liu, Rakesh Lodha, Joshua Longbottom, Jaifred Christian F Lopez, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, D R Mahadeshwara Prasad, Phetole Walter Mahasha, Sr, Narayan B Mahotra, Azeem Majeed, Reza Malekzadeh, Sr, Deborah Carvalho Malta, Abdullah A Mamun, Sr, Navid Manafi, Sr, Ana Laura Manda, Narendar Dawani Dawanu Manohar, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Joemer C Maravilla, Gabriel Martinez, Sr, Santi Martini, Francisco Rogerlândio Martins-Melo, Anthony Masaka, Benjamin Ballard Massenburg, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Sr, Kala M Mehta, Tefera C Chane Mekonnen, Gebrekiros Gebremichael Meles, Peter T N Memiah, Ziad A Memish, Sr, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Sr, Tomislav Mestrovic, Bartosz Miazgowski, Kebadnew Mulatu Mihretie, Sr, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Amjad Mohamadi-Bolbanabad, Dara K Mohammad, Karzan Abdulmuhsin Mohammad, Yousef Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Noushin Mohammadifard, Jemal Abdu Mohammed, Sr, Shafiu Mohammed, Farnam Mohebi, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Yoshan Moodley, Sr, Catrin E Moore, Sr, Ghobad Moradi, Masoud Moradi, Mohammad Moradi-Joo, Maziar Moradi-Lakeh, Paula Moraga, Linda Morales, Ilais Moreno Velásquez, Abbas Mosapour, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor I, Kindie Fentahun Muchie, Sr, Getahun Fentaw Mulaw, Sr, Sandra B Munro, Moses K Muriithi, Christopher J L Murray, GVS Murthy, Kamarul Imran Musa, Ghulam Mustafa, Sr, Saravanan Muthupandian, Sr, Ashraf F Nabhan, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Kovin S Naidoo, Gurudatta Naik, Farid Najafi, Vinay Nangia, Sr, Jobert Richie Nansseu, Bruno Ramos Nascimento, Sr, Javad Nazari, Duduzile Edith Ndwandwe, Sr, Ionut Negoi, Sr, Henok Biresaw Netsere Netsere, Sr, Josephine W Ngunjiri, Sr, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Dabere Nigatu, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Vuong Minh Nong, Ole F Norheim, Sr, Jean Jacques Noubiap, Soraya Nouraei Motlagh, Bogdan Oancea, Okechukwu Samuel Ogah, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Tinuke O Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Obinna E Onwujekwe, Sr, Eyal Oren, Doris V V Ortega-Altamirano, Sr, Osayomwanbo Osarenotor, Frank B Osei, Sr, Mayowa O Owolabi, Mahesh P A, Sr, Jagadish Rao Padubidri, Smita Pakhale, Sangram Kishor Patel, Angel J Paternina-Caicedo, Sr, Ashish Pathak, Sr, George C Patton, Deepak Paudel, Sr, Kebreab Paulos, Sr, Veincent Christian Filipino Pepito, Alexandre Pereira, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Bakhtiar Piroozi, Meghdad Pirsaheb, Maarten J Postma, Hadi Pourjafar, Farshad Pourmalek, Sr, Akram Pourshams, Hossein Poustchi, Sergio I Prada, Sr, Narayan Prasad, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Afarin Rahimi-Movaghar, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, SHAFIUR Rahman, Fatemeh Rajati, Sr, Saleem Muhammad Rana, Sr, Chhabi Lal Ranabhat, Davide Rasella, David Laith Rawaf, Salman Rawaf, Sr, Lal Rawal, Wasiq Faraz Rawasia, Vishnu Renjith, Andre M N Renzaho, Sr, Serge Resnikoff, Sr, Melese Abate Reta, Negar Rezaei, Mohammad sadegh Rezai, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Sr, Maria Rios-Blancas, Leonardo Roever, Luca Ronfani, Elias Merdassa Roro, Sr, Jennifer M Ross, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Yogesh Damodar Sabde, Siamak Sabour, Ehsan Sadeghi, Sr, Yahya Safari, Roya Safari-Faramani, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, S Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Sr, Payman Salamati, Hosni Salem, Marwa R Rashad Salem I, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Sr, Milena M Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Kaushik Sarkar, Sr, Abdur Razzaque Sarker, Nizal Sarrafzadegan I, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Monika Sawhney, Sonia Saxena, Sr, David C Schwebel, Sr, Anbissa Muleta Senbeta IV, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Sr, Hosein Shabaninejad, Azadeh Shafieesabet, Sr, Masood Ali Shaikh, Ali S Shalash, Sr, Seifadin Ahmed Shallo, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Hamid Sharifi, Hatem Samir Shehata, Sr, Aziz Sheikh, B Suresh Kumar Shetty, Sr, Kenji Shibuya, Sr, Wondimeneh Shibabaw Shiferaw, Sr, Desalegn Markos Shifti, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Sr, Reza Shirkoohi, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Ambrish Singh, Jasvinder A Singh, Narinder Pal Singh, Virendra Singh, Malede Mequanent Sisay, Eirini Skiadaresi, Mohammad Reza Sobhiyeh, Sr, Anton Sokhan, Shahin Soltani, Ranjani Somayaji, Moslem Soofi, Muluken Bekele Sorrie, Sr, Ireneous N Soyiri, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Sr, Hafiz Ansar Rasul Suleria, Marufa Sultana, Bruno Fokas Sunguya, Bryan L Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Jr, Ingan Ukur Tarigan, Aberash Abay Tasew, Yonatal Mesfin Tefera, Sr, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay I, Fisaha Haile Haile Tesfay, Belay Tessema, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Nihal Thomas, Alemayehu Toma Toma, Sr, Roman Topor-Madry, Marcos Roberto Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Sr, Benjamin S Chudi Uzochukwu, Sr, Pascual R Valdez, Santosh Varughese, Sr, Francesco S Violante, Sr, Sebastian Vollmer, Sr, Feleke Gebremeskel W/hawariat, Sr, Yasir Waheed, Mitchell Taylor Wallin, Yafeng Wang, Yuan-Pang Wang, Marcia Weaver, Bedilu Girma Weji, Girmay Teklay Weldesamuel, Catherine A Welgan, Andrea Werdecker, Ronny Westerman, Sr, Taweewat Wiangkham, Charles Shey Wiysonge, Sr, Haileab Fekadu Wolde, Sr, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Sr, Getasew Taddesse Worku, Sr, Ai-Min Wu, Gelin Xu, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Sr, Hiroshi Yatsuya, Alex Yeshaneh, Christopher Sabo Yilgwan, Mekdes Tigistu Yilma, Paul Yip, Sr, Engida Yisma, Naohiro Yonemoto, Sr, Seok-Jun Yoon, Mustafa Z Younis, Mahmoud Yousefifard, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Nejimu Biza Zepro, Taddese Alemu Zerfu, Yunquan Zhang, Xiu-Ju George Zhao, Arash Ziapour, Sanjay Zodpey, Sr, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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15. Bacterial Profile among Patients with Suspected Bloodstream Infections in Ethiopia: A Systematic Review and Meta-Analysis

Author: Birhan Alemnew, Habtamu Biazin, Asmamaw Demis, and Melese Abate Reta
Subjects: Microbiology, QR1-502
Abstract: Introduction. The burden of bloodstream infections (BSIs) has been warranted in Ethiopia. Globally, the emergency and raised resistance rate of bacterial antimicrobial resistance is becoming a prominent problem, and it is difficult to treat patients having sepsis. In this review, we aimed to determine the pooled prevalence of bacterial isolates among presumptive patients with bloodstream infections in Ethiopia. Methods. A systematic search was performed from PubMed/MEDLINE, Scopus, HINARI, ScienceDirect, and Google Scholar electronic databases using PRISMA guidelines. The data analysis was carried out using STATATM version 14 after the records were cleaned and sorted out. Results. A total of 26 studies with 8,958 blood specimens and 2,382 culture-positive bacterial isolates were included for systematic review and meta-analysis. The meta-analysis derived a pooled culture-positive bacterial prevalence which was 25.78% (95% CI: 21.55–30.01%). The estimated pooled prevalence of Gram-positive and Gram-negative bacterial isolates was 15.50% (95% CI: 12.84–18.15%) and 10.48 % (95% CI: 8.32–12.63%), respectively. The two common Gram-positive bacteria isolated from patients suspected of BSIs were coagulase-negative Staphylococcus with a pooled prevalence of 5.75% (95% CI: 4.58–6.92%) and S. aureus 7.04 % (95% CI: 5.37–8.72%). Similarly, the common Gram-negative bacterial isolates and their estimated pooled prevalence were E. coli 1.69% (95% CI: 1.21–2.16%), Klebsiella species 7.04 % (95% CI: 5.37–8.72%), Pseudomonas species 0.39% (95% CI: 0.08–0.70%), Salmonella species 1.09% (95% CI: 0.79–1.38%), and Streptococcus pyogenes 0.88% (95% CI: 0.54–1.22%). Conclusion. The prevalence of bacterial isolates among presumptive patients suspected to BSIs in Ethiopia remains high. Furthermore, we found a remarkable variation in the pathogen distribution across the study setting.
Published: 2020
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16. Low level of knowledge about neonatal danger signs and its associated factors among postnatal mothers attending at Woldia general hospital, Ethiopia

Author: Mekdes Mengesha Jemberia, Elsa Tesfa Berhe, Hawi Bersisa Mirkena, Destaw Molla Gishen, Abera Endale Tegegne, and Melese Abate Reta
Subjects: Knowledge, Neonates, Danger signs, Associated factors, Postnatal mothers, Woldia, Medicine
Abstract: Abstract Background Neonatal mortality has persisted high in Ethiopia in spite of many efforts being applied to decrease this adverse trend. Early detection of neonatal illness is an important step towards improving newborn survival. Toward this end, there is a need for the mothers to be able to identify signs in neonates that signify severe illnesses. The aim of this study was to assess knowledge about neonatal danger signs and its associated factors among postnatal mothers attending at Woldia general hospital, Ethiopian. Methods Institutional based cross-sectional study design was conducted from January–May, 2017. The hospital that provides antenatal care (ANC), delivery, and postnatal services was purposively sampled. Structured interviewer managed questionnaire was administered to postnatal mothers attending Woldia general hospital. Frequencies, bivariate and multivariate logistic regression were determined using the SPSS software (Version 20). Results During the study period 197 mothers attending postnatal care (PNC) service at Woldia general hospital were interviewed. Information on different neonatal danger signs was not provided to 92(46.7%) postnatal mothers during their antenatal clinic attendance by the healthcare providers. The majority of mothers, 174(88.3%) identified less than six neonatal danger signs. The hotness of the body of neonates was the commonly recognized danger sign by 106(53.8%) postnatal mothers. Of the total mothers, 67(34%), 60(30.5%), 56(28.4%), 44(22.3%) recognized unable to breastfeeding, convulsion, lethargy, difficulty in breathing as newly born danger signs, respectively. Out of 197 mothers, 32(16.2%) were giving birth at home. Mother’s age(AOR = 1.33, 95% CI: 1.99–3.08), marital status(AOR = 2.50, 95% CI: 0.29–4.31), mother’s education status(AOR = 3.48, 95% CI:1.57–8.72), husband’s education(AOR = 4.92, 95% CI: 1.29–12.81), attending ANC (AOR = 2.88, 95% CI: 1.15, 4.85), mother’s residence(AOR = 0.78, 95% CI: 0.47–1.65), information about neonatal danger signs(AOR = 3.48, 95% CI 1.40–9.49) had positive association with maternal level of knowledge to identify different neonatal danger signs. Conclusion Maternal knowledge level about neonatal danger signs was very low. Therefore, intervention modalities that focus on increasing level of parental education, access to ANC and PNC service are needed.
Published: 2018
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17. Adolescent-parent communication on sexual and reproductive health issues and associated factors among high school students in Woldia town, Northeastern Ethiopia

Author: Molla Temere Mekonen, Hana Abebe Dagnew, Tesfay Ambaye Yimam, Hayat Nuradis Yimam, and Melese Abate Reta
Subjects: adolescent, parent, communication, srh issues, associated factors, woldia town, Medicine
Abstract: INTRODUCTION: Sexual and reproductive health (SRH) communication is most likely to promote healthy sexual practices and to reduce risky sexual behavior among adolescents. Communication is the principal means for parents to transmit sexual values and knowledge to their children. This study aimed to assess adolescent-parent communication on SRH issues among high school students in Woldia town. METHODS: A cross-sectional study was conducted from December 15-31, 2016. Systematic random sampling technique was used to select 693 students from Grades 9 and 10. Data were entered into Epi-info version 3.5.1 and analyzed by usingSPSS version 20. Logistic regression with OddsRatios(OR) and 95% Confidence intervals (CI) was used to identify the independent predictors of adolescent-parent communication. RESULTS: 674 students accepted to participate in this study giving a response rate of 97.3%.Only 205(30.4%) had discussed on two or more SRH topics with their parents. In logistic regression analyses, mothers who could read and write [AOR=2.0; 95% CI=1.3-3.1] and had diploma certificate [AOR=2.0; 95% CI=1.4-2.9] were more likely to discuss on SRH issues with their children. Adolescents who agreed on the importance of discussion on SRH issues [AOR=2.5; 95% CI=1.3-4.5], whoever gotSRH information [AOR=2.0; 95% CI=1.4-2.9] and those whoever had sexual intercourse [AOR=1.7; 95% CI=1.1-2.6] were more likely to discuss on different SRH issues with their parents. CONCLUSION: This study revealed that parent-adolescent communication on SRH issues was inadequate.Therefore, there is a need to equip and educate parents on different adolescents' SRH issues.
Published: 2018
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18. Global mortality associated with 33 bacterial pathogens in 2019

Author: Kevin S Ikuta, Lucien R Swetschinski, Gisela Robles Aguilar, Fablina Sharara, Tomislav Mestrovic, Authia P Gray, Nicole Davis Weaver, Eve E Wool, Chieh Han, Anna Gershberg Hayoon, Amirali Aali, Semagn Mekonnen Abate, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Sherief Abd-Elsalam, Getachew Abebe, Aidin Abedi, Amir Parsa Abhari, Hassan Abidi, Richard Gyan Aboagye, Abdorrahim Absalan, Hiwa Abubaker Ali, Juan Manuel Acuna, Tigist Demssew Adane, Isaac Yeboah Addo, Oyelola A Adegboye, Mohammad Adnan, Qorinah Estiningtyas Sakilah Adnani, Muhammad Sohail Afzal, Saira Afzal, Zahra Babaei Aghdam, Bright Opoku Ahinkorah, Aqeel Ahmad, Araz Ramazan Ahmad, Rizwan Ahmad, Sajjad Ahmad, Sohail Ahmad, Sepideh Ahmadi, Ali Ahmed, Haroon Ahmed, Jivan Qasim Ahmed, Tarik Ahmed Rashid, Marjan Ajami, Budi Aji, Mostafa Akbarzadeh-Khiavi, Chisom Joyqueenet Akunna, Hanadi Al Hamad, Fares Alahdab, Ziyad Al-Aly, Mamoon A Aldeyab, Alicia V Aleman, Fadwa Alhalaiqa Naji Alhalaiqa, Robert Kaba Alhassan, Beriwan Abdulqadir Ali, Liaqat Ali, Syed Shujait Ali, Yousef Alimohamadi, Vahid Alipour, Atiyeh Alizadeh, Syed Mohamed Aljunid, Kasim Allel, Sami Almustanyir, Edward Kwabena Ameyaw, Arianna Maever L Amit, Nivedita Anandavelane, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Dewi Anggraini, Adnan Ansar, Anayochukwu Edward Anyasodor, Jalal Arabloo, Aleksandr Y Aravkin, Demelash Areda, Timur Aripov, Anton A Artamonov, Judie Arulappan, Raphael Taiwo Aruleba, Muhammad Asaduzzaman, Tahira Ashraf, Seyyed Shamsadin Athari, Daniel Atlaw, Sameh Attia, Marcel Ausloos, Tewachew Awoke, Beatriz Paulina Ayala Quintanilla, Tegegn Mulatu Ayana, Sina Azadnajafabad, Amirhossein Azari Jafari, Darshan B B, Muhammad Badar, Ashish D Badiye, Nayereh Baghcheghi, Sara Bagherieh, Atif Amin Baig, Indrajit Banerjee, Aleksandra Barac, Mainak Bardhan, Francesco Barone-Adesi, Hiba Jawdat Barqawi, Amadou Barrow, Pritish Baskaran, Saurav Basu, Abdul-Monim Mohammad Batiha, Neeraj Bedi, Melaku Ashagrie Belete, Uzma Iqbal Belgaumi, Rose G Bender, Bharti Bhandari, Dinesh Bhandari, Pankaj Bhardwaj, Sonu Bhaskar, Krittika Bhattacharyya, Suraj Bhattarai, Saeid Bitaraf, Danilo Buonsenso, Zahid A Butt, Florentino Luciano Caetano dos Santos, Jiao Cai, Daniela Calina, Paulo Camargos, Luis Alberto Cámera, Rosario Cárdenas, Muge Cevik, Joshua Chadwick, Jaykaran Charan, Akhilanand Chaurasia, Patrick R Ching, Sonali Gajanan Choudhari, Enayet Karim Chowdhury, Fazle Rabbi Chowdhury, Dinh-Toi Chu, Isaac Sunday Chukwu, Omid Dadras, Fentaw Teshome Dagnaw, Xiaochen Dai, Saswati Das, Anna Dastiridou, Sisay Abebe Debela, Fitsum Wolde Demisse, Solomon Demissie, Diriba Dereje, Msganaw Derese, Hardik Dineshbhai Desai, Fikadu Nugusu Dessalegn, Samuel Abebe A Dessalegni, Belay Desye, Kartik Dhaduk, Meghnath Dhimal, Sameer Dhingra, Nancy Diao, Daniel Diaz, Shirin Djalalinia, Milad Dodangeh, Deepa Dongarwar, Bezabih Terefe Dora, Fariba Dorostkar, Haneil Larson Dsouza, Eleonora Dubljanin, Susanna J Dunachie, Oyewole Christopher Durojaiye, Hisham Atan Edinur, Habtamu Bekele Ejigu, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Hassan El-Abid, Muhammed Elhadi, Mohamed A Elmonem, Amir Emami, Luchuo Engelbert Bain, Daniel Berhanie Enyew, Ryenchindorj Erkhembayar, Babak Eshrati, Farshid Etaee, Adeniyi Francis Fagbamigbe, Shahab Falahi, Aida Fallahzadeh, Emerito Jose A Faraon, Ali Fatehizadeh, Ginenus Fekadu, João C Fernandes, Allegra Ferrari, Getahun Fetensa, Irina Filip, Florian Fischer, Masoud Foroutan, Peter Andras Gaal, Muktar A Gadanya, Abhay Motiramji Gaidhane, Balasankar Ganesan, Mesfin Gebrehiwot, Reza Ghanbari, Mohammad Ghasemi Nour, Ahmad Ghashghaee, Ali Gholamrezanezhad, Abdolmajid Gholizadeh, Mahaveer Golechha, Pouya Goleij, Davide Golinelli, Amador Goodridge, Damitha Asanga Gunawardane, Yuming Guo, Rajat Das Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Alemu Guta, Parham Habibzadeh, Atlas Haddadi Avval, Rabih Halwani, Asif Hanif, Md. Abdul Hannan, Harapan Harapan, Shoaib Hassan, Hadi Hassankhani, Khezar Hayat, Behzad Heibati, Golnaz Heidari, Mohammad Heidari, Reza Heidari-Soureshjani, Claudiu Herteliu, Demisu Zenbaba Heyi, Kamal Hezam, Praveen Hoogar, Nobuyuki Horita, Md Mahbub Hossain, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Soodabeh Hoveidamanesh, Junjie Huang, Salman Hussain, Nawfal R Hussein, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Mohammad Tarique Imam, Mustapha Immurana, Leeberk Raja Inbaraj, Arnaud Iradukunda, Nahlah Elkudssiah Ismail, Chidozie C D Iwu, Chinwe Juliana Iwu, Linda Merin J, Mihajlo Jakovljevic, Elham Jamshidi, Tahereh Javaheri, Fatemeh Javanmardi, Javad Javidnia, Sathish Kumar Jayapal, Umesh Jayarajah, Rime Jebai, Ravi Prakash Jha, Tamas Joo, Nitin Joseph, Farahnaz Joukar, Jacek Jerzy Jozwiak, Salah Eddine Oussama Kacimi, Vidya Kadashetti, Laleh R Kalankesh, Rohollah Kalhor, Vineet Kumar Kamal, Himal Kandel, Neeti Kapoor, Samad Karkhah, Bekalu Getnet Kassa, Nicholas J Kassebaum, Patrick DMC Katoto, Mohammad Keykhaei, Himanshu Khajuria, Abbas Khan, Imteyaz A Khan, Maseer Khan, Md Nuruzzaman Khan, Moien AB Khan, Moawiah Mohammad Khatatbeh, Mona M Khater, Hamid Reza Khayat Kashani, Jagdish Khubchandani, Hanna Kim, Min Seo Kim, Ruth W Kimokoti, Niranjan Kissoon, Sonali Kochhar, Farzad Kompani, Soewarta Kosen, Parvaiz A Koul, Sindhura Lakshmi Koulmane Laxminarayana, Fiorella Krapp Lopez, Kewal Krishan, Vijay Krishnamoorthy, Vishnutheertha Kulkarni, Naveen Kumar, Om P Kurmi, Ambily Kuttikkattu, Hmwe Hmwe Kyu, Dharmesh Kumar Lal, Judit Lám, Iván Landires, Savita Lasrado, Sang-woong Lee, Jacopo Lenzi, Sonia Lewycka, Shanshan Li, Stephen S Lim, Wei Liu, Rakesh Lodha, Michael J Loftus, Ayush Lohiya, László Lorenzovici, Mojgan Lotfi, Ata Mahmoodpoor, Mansour Adam Mahmoud, Razzagh Mahmoudi, Azeem Majeed, Jamal Majidpoor, Alaa Makki, Galana Ayana Mamo, Yosef Manla, Miquel Martorell, Clara N Matei, Barney McManigal, Entezar Mehrabi Nasab, Ravi Mehrotra, Addisu Melese, Oliver Mendoza-Cano, Ritesh G Menezes, Alexios-Fotios A Mentis, Georgia Micha, Irmina Maria Michalek, Ana Carolina Micheletti Gomide Nogueira de Sá, Neda Milevska Kostova, Shabir Ahmad Mir, Mojgan Mirghafourvand, Seyyedmohammadsadeq Mirmoeeni, Erkin M Mirrakhimov, Mohammad Mirza-Aghazadeh-Attari, Abay Sisay Misganaw, Awoke Misganaw, Sanjeev Misra, Esmaeil Mohammadi, Mokhtar Mohammadi, Abdollah Mohammadian-Hafshejani, Shafiu Mohammed, Syam Mohan, Mohammad Mohseni, Ali H Mokdad, Sara Momtazmanesh, Lorenzo Monasta, Catrin E Moore, Maryam Moradi, Mostafa Moradi Sarabi, Shane Douglas Morrison, Majid Motaghinejad, Haleh Mousavi Isfahani, Amin Mousavi Khaneghah, Seyed Ali Mousavi-Aghdas, Sumaira Mubarik, Francesk Mulita, Getaneh Baye B Mulu, Sandra B Munro, Saravanan Muthupandian, Tapas Sadasivan Nair, Atta Abbas Naqvi, Himanshi Narang, Zuhair S Natto, Muhammad Naveed, Biswa Prakash Nayak, Shumaila Naz, Ionut Negoi, Seyed Aria Nejadghaderi, Sandhya Neupane Kandel, Che Henry Ngwa, Robina Khan Niazi, Antonio Tolentino Nogueira de Sá, Nafise Noroozi, Hasti Nouraei, Ali Nowroozi, Virginia Nuñez-Samudio, Jerry John Nutor, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, Rahman Md Obaidur, Vivek Anand Ojha, Akinkunmi Paul Okekunle, Osaretin Christabel Okonji, Andrew T Olagunju, Bolajoko Olubukunola Olusanya, Ahmed Omar Bali, Emad Omer, Nikita Otstavnov, Bilcha Oumer, Mahesh P A, Jagadish Rao Padubidri, Keyvan Pakshir, Tamás Palicz, Adrian Pana, Shahina Pardhan, Jose L Paredes, Utsav Parekh, Eun-Cheol Park, Seoyeon Park, Ashish Pathak, Rajan Paudel, Uttam Paudel, Shrikant Pawar, Hamidreza Pazoki Toroudi, Minjin Peng, Umberto Pensato, Veincent Christian Filipino Pepito, Marcos Pereira, Mario F P Peres, Norberto Perico, Ionela-Roxana Petcu, Zahra Zahid Piracha, Indrashis Podder, Nayanum Pokhrel, Ramesh Poluru, Maarten J Postma, Naeimeh Pourtaheri, Akila Prashant, Ibrahim Qattea, Mohammad Rabiee, Navid Rabiee, Amir Radfar, Saber Raeghi, Sima Rafiei, Pankaja Raghav Raghav, Leila Rahbarnia, Vafa Rahimi-Movaghar, Mosiur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Vahid Rahmanian, Pradhum Ram, Muhammad Modassar Ali Nawaz Ranjha, Sowmya J Rao, Mohammad-Mahdi Rashidi, Azad Rasul, Zubair Ahmed Ratan, Salman Rawaf, Reza Rawassizadeh, Mohammad Sadegh Razeghinia, Elrashdy Moustafa Mohamed Redwan, Misganu Teshoma Regasa, Giuseppe Remuzzi, Melese Abate Reta, Nazila Rezaei, Aziz Rezapour, Abanoub Riad, Rezaul Karim Ripon, Kristina E Rudd, Basema Saddik, Saeid Sadeghian, Umar Saeed, Mohsen Safaei, Azam Safary, Sher Zaman Safi, Maryam Sahebazzamani, Amirhossein Sahebkar, Harihar Sahoo, Saina Salahi, Sarvenaz Salahi, Hedayat Salari, Sana Salehi, Hossein Samadi Kafil, Abdallah M Samy, Nima Sanadgol, Senthilkumar Sankararaman, Francesco Sanmarchi, Brijesh Sathian, Monika Sawhney, Ganesh Kumar Saya, Subramanian Senthilkumaran, Allen Seylani, Pritik A Shah, Masood Ali Shaikh, Elaheh Shaker, Murad Ziyaudinovich Shakhmardanov, Mequannent Melaku Sharew, Athena Sharifi-Razavi, Purva Sharma, Rahim Ali Sheikhi, Ali Sheikhy, Pavanchand H Shetty, Mika Shigematsu, Jae Il Shin, Hesamaddin Shirzad-Aski, K M Shivakumar, Parnian Shobeiri, Seyed Afshin Shorofi, Sunil Shrestha, Migbar Mekonnen Sibhat, Negussie Boti Sidemo, Mustafa Kamal Sikder, Luís Manuel Lopes Rodrigues Silva, Jasvinder A Singh, Paramdeep Singh, Surjit Singh, Md Shahjahan Siraj, Samarjeet Singh Siwal, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Bogdan Socea, Damtew Damtew Solomon, Yimeng Song, Chandrashekhar T Sreeramareddy, Muhammad Suleman, Rizwan Suliankatchi Abdulkader, Saima Sultana, Miklós Szócska, Seyed-Amir Tabatabaeizadeh, Mohammad Tabish, Majid Taheri, Elahe Taki, Ker-Kan Tan, Sarmila Tandukar, Nathan Y Tat, Vivian Y Tat, Belay Negash Tefera, Yibekal Manaye Tefera, Gebremaryam Temesgen, Mohamad-Hani Temsah, Samar Tharwat, Arulmani Thiyagarajan, Imad I Tleyjeh, Christopher E Troeger, Krishna Kishore Umapathi, Era Upadhyay, Sahel Valadan Tahbaz, Pascual R Valdez, Jef Van den Eynde, H. Rogier van Doorn, Siavash Vaziri, Georgios-Ioannis Verras, Harimadhav Viswanathan, Bay Vo, Abdul Waris, Gizachew Tadesse Wassie, Nuwan Darshana Wickramasinghe, Sajad Yaghoubi, Gahin Abdulraheem Tayib Yahya Yahya, Seyed Hossein Yahyazadeh Jabbari, Arzu Yigit, Vahit Yiğit, Dong Keon Yon, Naohiro Yonemoto, Mazyar Zahir, Burhan Abdullah Zaman, Sojib Bin Zaman, Moein Zangiabadian, Iman Zare, Mikhail Sergeevich Zastrozhin, Zhi-Jiang Zhang, Peng Zheng, Chenwen Zhong, Mohammad Zoladl, Alimuddin Zumla, Simon I Hay, Christiane Dolecek, Benn Sartorius, Christopher J L Murray, Mohsen Naghavi, Ikuta, Kevin S, Swetschinski, Lucien R, Robles Aguilar, Gisela, Sharara, Fablina, Mestrovic, Tomislav, Gray, Authia P, Davis Weaver, Nicole, Wool, Eve E, Han, Chieh, Gershberg Hayoon, Anna, Aali, Amirali, Abate, Semagn Mekonnen, Abbasi-Kangevari, Mohsen, Abbasi-Kangevari, Zeinab, Abd-Elsalam, Sherief, Abebe, Getachew, Abedi, Aidin, Abhari, Amir Parsa, Abidi, Hassan, Aboagye, Richard Gyan, Absalan, Abdorrahim, Abubaker Ali, Hiwa, Acuna, Juan Manuel, Adane, Tigist Demssew, Addo, Isaac Yeboah, Adegboye, Oyelola A, Adnan, Mohammad, Adnani, Qorinah Estiningtyas Sakilah, Afzal, Muhammad Sohail, Afzal, Saira, Aghdam, Zahra Babaei, Ahinkorah, Bright Opoku, Ahmad, Aqeel, Ahmad, Araz Ramazan, Ahmad, Rizwan, Ahmad, Sajjad, Ahmad, Sohail, Ahmadi, Sepideh, Ahmed, Ali, Ahmed, Haroon, Ahmed, Jivan Qasim, Ahmed Rashid, Tarik, Ajami, Marjan, Aji, Budi, Akbarzadeh-Khiavi, Mostafa, Akunna, Chisom Joyqueenet, Al Hamad, Hanadi, Alahdab, Fare, Al-Aly, Ziyad, Aldeyab, Mamoon A, Aleman, Alicia V, Alhalaiqa, Fadwa Alhalaiqa Naji, Alhassan, Robert Kaba, Ali, Beriwan Abdulqadir, Ali, Liaqat, Ali, Syed Shujait, Alimohamadi, Yousef, Alipour, Vahid, Alizadeh, Atiyeh, Aljunid, Syed Mohamed, Allel, Kasim, Almustanyir, Sami, Ameyaw, Edward Kwabena, Amit, Arianna Maever L, Anandavelane, Nivedita, Ancuceanu, Robert, Andrei, Catalina Liliana, Andrei, Tudorel, Anggraini, Dewi, Ansar, Adnan, Anyasodor, Anayochukwu Edward, Arabloo, Jalal, Aravkin, Aleksandr Y, Areda, Demelash, Aripov, Timur, Artamonov, Anton A, Arulappan, Judie, Aruleba, Raphael Taiwo, Asaduzzaman, Muhammad, Ashraf, Tahira, Athari, Seyyed Shamsadin, Atlaw, Daniel, Attia, Sameh, Ausloos, Marcel, Awoke, Tewachew, Ayala Quintanilla, Beatriz Paulina, Ayana, Tegegn Mulatu, Azadnajafabad, Sina, Azari Jafari, Amirhossein, B, Darshan B, Badar, Muhammad, Badiye, Ashish D, Baghcheghi, Nayereh, Bagherieh, Sara, Baig, Atif Amin, Banerjee, Indrajit, Barac, Aleksandra, Bardhan, Mainak, Barone-Adesi, Francesco, Barqawi, Hiba Jawdat, Barrow, Amadou, Baskaran, Pritish, Basu, Saurav, Batiha, Abdul-Monim Mohammad, Bedi, Neeraj, Belete, Melaku Ashagrie, Belgaumi, Uzma Iqbal, Bender, Rose G, Bhandari, Bharti, Bhandari, Dinesh, Bhardwaj, Pankaj, Bhaskar, Sonu, Bhattacharyya, Krittika, Bhattarai, Suraj, Bitaraf, Saeid, Buonsenso, Danilo, Butt, Zahid A, Caetano dos Santos, Florentino Luciano, Cai, Jiao, Calina, Daniela, Camargos, Paulo, Cámera, Luis Alberto, Cárdenas, Rosario, Cevik, Muge, Chadwick, Joshua, Charan, Jaykaran, Chaurasia, Akhilanand, Ching, Patrick R, Choudhari, Sonali Gajanan, Chowdhury, Enayet Karim, Chowdhury, Fazle Rabbi, Chu, Dinh-Toi, Chukwu, Isaac Sunday, Dadras, Omid, Dagnaw, Fentaw Teshome, Dai, Xiaochen, Das, Saswati, Dastiridou, Anna, Debela, Sisay Abebe, Demisse, Fitsum Wolde, Demissie, Solomon, Dereje, Diriba, Derese, Msganaw, Desai, Hardik Dineshbhai, Dessalegn, Fikadu Nugusu, Dessalegni, Samuel Abebe A, Desye, Belay, Dhaduk, Kartik, Dhimal, Meghnath, Dhingra, Sameer, Diao, Nancy, Diaz, Daniel, Djalalinia, Shirin, Dodangeh, Milad, Dongarwar, Deepa, Dora, Bezabih Terefe, Dorostkar, Fariba, Dsouza, Haneil Larson, Dubljanin, Eleonora, Dunachie, Susanna J, Durojaiye, Oyewole Christopher, Edinur, Hisham Atan, Ejigu, Habtamu Bekele, Ekholuenetale, Michael, Ekundayo, Temitope Cyru, El-Abid, Hassan, Elhadi, Muhammed, Elmonem, Mohamed A, Emami, Amir, Engelbert Bain, Luchuo, Enyew, Daniel Berhanie, Erkhembayar, Ryenchindorj, Eshrati, Babak, Etaee, Farshid, Fagbamigbe, Adeniyi Franci, Falahi, Shahab, Fallahzadeh, Aida, Faraon, Emerito Jose A, Fatehizadeh, Ali, Fekadu, Ginenu, Fernandes, João C, Ferrari, Allegra, Fetensa, Getahun, Filip, Irina, Fischer, Florian, Foroutan, Masoud, Gaal, Peter Andra, Gadanya, Muktar A, Gaidhane, Abhay Motiramji, Ganesan, Balasankar, Gebrehiwot, Mesfin, Ghanbari, Reza, Ghasemi Nour, Mohammad, Ghashghaee, Ahmad, Gholamrezanezhad, Ali, Gholizadeh, Abdolmajid, Golechha, Mahaveer, Goleij, Pouya, Golinelli, Davide, Goodridge, Amador, Gunawardane, Damitha Asanga, Guo, Yuming, Gupta, Rajat Da, Gupta, Sapna, Gupta, Veer Bala, Gupta, Vivek Kumar, Guta, Alemu, Habibzadeh, Parham, Haddadi Avval, Atla, Halwani, Rabih, Hanif, Asif, Hannan, Md. Abdul, Harapan, Harapan, Hassan, Shoaib, Hassankhani, Hadi, Hayat, Khezar, Heibati, Behzad, Heidari, Golnaz, Heidari, Mohammad, Heidari-Soureshjani, Reza, Herteliu, Claudiu, Heyi, Demisu Zenbaba, Hezam, Kamal, Hoogar, Praveen, Horita, Nobuyuki, Hossain, Md Mahbub, Hosseinzadeh, Mehdi, Hostiuc, Mihaela, Hostiuc, Sorin, Hoveidamanesh, Soodabeh, Huang, Junjie, Hussain, Salman, Hussein, Nawfal R, Ibitoye, Segun Emmanuel, Ilesanmi, Olayinka Stephen, Ilic, Irena M, Ilic, Milena D, Imam, Mohammad Tarique, Immurana, Mustapha, Inbaraj, Leeberk Raja, Iradukunda, Arnaud, Ismail, Nahlah Elkudssiah, Iwu, Chidozie C D, Iwu, Chinwe Juliana, J, Linda Merin, Jakovljevic, Mihajlo, Jamshidi, Elham, Javaheri, Tahereh, Javanmardi, Fatemeh, Javidnia, Javad, Jayapal, Sathish Kumar, Jayarajah, Umesh, Jebai, Rime, Jha, Ravi Prakash, Joo, Tama, Joseph, Nitin, Joukar, Farahnaz, Jozwiak, Jacek Jerzy, Kacimi, Salah Eddine Oussama, Kadashetti, Vidya, Kalankesh, Laleh R, Kalhor, Rohollah, Kamal, Vineet Kumar, Kandel, Himal, Kapoor, Neeti, Karkhah, Samad, Kassa, Bekalu Getnet, Kassebaum, Nicholas J, Katoto, Patrick DMC, Keykhaei, Mohammad, Khajuria, Himanshu, Khan, Abba, Khan, Imteyaz A, Khan, Maseer, Khan, Md Nuruzzaman, Khan, Moien AB, Khatatbeh, Moawiah Mohammad, Khater, Mona M, Khayat Kashani, Hamid Reza, Khubchandani, Jagdish, Kim, Hanna, Kim, Min Seo, Kimokoti, Ruth W, Kissoon, Niranjan, Kochhar, Sonali, Kompani, Farzad, Kosen, Soewarta, Koul, Parvaiz A, Koulmane Laxminarayana, Sindhura Lakshmi, Krapp Lopez, Fiorella, Krishan, Kewal, Krishnamoorthy, Vijay, Kulkarni, Vishnutheertha, Kumar, Naveen, Kurmi, Om P, Kuttikkattu, Ambily, Kyu, Hmwe Hmwe, Lal, Dharmesh Kumar, Lám, Judit, Landires, Iván, Lasrado, Savita, Lee, Sang-woong, Lenzi, Jacopo, Lewycka, Sonia, Li, Shanshan, Lim, Stephen S, Liu, Wei, Lodha, Rakesh, Loftus, Michael J, Lohiya, Ayush, Lorenzovici, László, Lotfi, Mojgan, Mahmoodpoor, Ata, Mahmoud, Mansour Adam, Mahmoudi, Razzagh, Majeed, Azeem, Majidpoor, Jamal, Makki, Alaa, Mamo, Galana Ayana, Manla, Yosef, Martorell, Miquel, Matei, Clara N, McManigal, Barney, Mehrabi Nasab, Entezar, Mehrotra, Ravi, Melese, Addisu, Mendoza-Cano, Oliver, Menezes, Ritesh G, Mentis, Alexios-Fotios A, Micha, Georgia, Michalek, Irmina Maria, Micheletti Gomide Nogueira de Sá, Ana Carolina, Milevska Kostova, Neda, Mir, Shabir Ahmad, Mirghafourvand, Mojgan, Mirmoeeni, Seyyedmohammadsadeq, Mirrakhimov, Erkin M, Mirza-Aghazadeh-Attari, Mohammad, Misganaw, Abay Sisay, Misganaw, Awoke, Misra, Sanjeev, Mohammadi, Esmaeil, Mohammadi, Mokhtar, Mohammadian-Hafshejani, Abdollah, Mohammed, Shafiu, Mohan, Syam, Mohseni, Mohammad, Mokdad, Ali H, Momtazmanesh, Sara, Monasta, Lorenzo, Moore, Catrin E, Moradi, Maryam, Moradi Sarabi, Mostafa, Morrison, Shane Dougla, Motaghinejad, Majid, Mousavi Isfahani, Haleh, Mousavi Khaneghah, Amin, Mousavi-Aghdas, Seyed Ali, Mubarik, Sumaira, Mulita, Francesk, Mulu, Getaneh Baye B, Munro, Sandra B, Muthupandian, Saravanan, Nair, Tapas Sadasivan, Naqvi, Atta Abba, Narang, Himanshi, Natto, Zuhair S, Naveed, Muhammad, Nayak, Biswa Prakash, Naz, Shumaila, Negoi, Ionut, Nejadghaderi, Seyed Aria, Neupane Kandel, Sandhya, Ngwa, Che Henry, Niazi, Robina Khan, Nogueira de Sá, Antonio Tolentino, Noroozi, Nafise, Nouraei, Hasti, Nowroozi, Ali, Nuñez-Samudio, Virginia, Nutor, Jerry John, Nzoputam, Chimezie Igwegbe, Nzoputam, Ogochukwu Janet, Oancea, Bogdan, Obaidur, Rahman Md, Ojha, Vivek Anand, Okekunle, Akinkunmi Paul, Okonji, Osaretin Christabel, Olagunju, Andrew T, Olusanya, Bolajoko Olubukunola, Omar Bali, Ahmed, Omer, Emad, Otstavnov, Nikita, Oumer, Bilcha, P A, Mahesh, Padubidri, Jagadish Rao, Pakshir, Keyvan, Palicz, Tamá, Pana, Adrian, Pardhan, Shahina, Paredes, Jose L, Parekh, Utsav, Park, Eun-Cheol, Park, Seoyeon, Pathak, Ashish, Paudel, Rajan, Paudel, Uttam, Pawar, Shrikant, Pazoki Toroudi, Hamidreza, Peng, Minjin, Pensato, Umberto, Pepito, Veincent Christian Filipino, Pereira, Marco, Peres, Mario F P, Perico, Norberto, Petcu, Ionela-Roxana, Piracha, Zahra Zahid, Podder, Indrashi, Pokhrel, Nayanum, Poluru, Ramesh, Postma, Maarten J, Pourtaheri, Naeimeh, Prashant, Akila, Qattea, Ibrahim, Rabiee, Mohammad, Rabiee, Navid, Radfar, Amir, Raeghi, Saber, Rafiei, Sima, Raghav, Pankaja Raghav, Rahbarnia, Leila, Rahimi-Movaghar, Vafa, Rahman, Mosiur, Rahman, Muhammad Aziz, Rahmani, Amir Masoud, Rahmanian, Vahid, Ram, Pradhum, Ranjha, Muhammad Modassar Ali Nawaz, Rao, Sowmya J, Rashidi, Mohammad-Mahdi, Rasul, Azad, Ratan, Zubair Ahmed, Rawaf, Salman, Rawassizadeh, Reza, Razeghinia, Mohammad Sadegh, Redwan, Elrashdy Moustafa Mohamed, Regasa, Misganu Teshoma, Remuzzi, Giuseppe, Reta, Melese Abate, Rezaei, Nazila, Rezapour, Aziz, Riad, Abanoub, Ripon, Rezaul Karim, Rudd, Kristina E, Saddik, Basema, Sadeghian, Saeid, Saeed, Umar, Safaei, Mohsen, Safary, Azam, Safi, Sher Zaman, Sahebazzamani, Maryam, Sahebkar, Amirhossein, Sahoo, Harihar, Salahi, Saina, Salahi, Sarvenaz, Salari, Hedayat, Salehi, Sana, Samadi Kafil, Hossein, Samy, Abdallah M, Sanadgol, Nima, Sankararaman, Senthilkumar, Sanmarchi, Francesco, Sathian, Brijesh, Sawhney, Monika, Saya, Ganesh Kumar, Senthilkumaran, Subramanian, Seylani, Allen, Shah, Pritik A, Shaikh, Masood Ali, Shaker, Elaheh, Shakhmardanov, Murad Ziyaudinovich, Sharew, Mequannent Melaku, Sharifi-Razavi, Athena, Sharma, Purva, Sheikhi, Rahim Ali, Sheikhy, Ali, Shetty, Pavanchand H, Shigematsu, Mika, Shin, Jae Il, Shirzad-Aski, Hesamaddin, Shivakumar, K M, Shobeiri, Parnian, Shorofi, Seyed Afshin, Shrestha, Sunil, Sibhat, Migbar Mekonnen, Sidemo, Negussie Boti, Sikder, Mustafa Kamal, Silva, Luís Manuel Lopes Rodrigue, Singh, Jasvinder A, Singh, Paramdeep, Singh, Surjit, Siraj, Md Shahjahan, Siwal, Samarjeet Singh, Skryabin, Valentin Yurievich, Skryabina, Anna Aleksandrovna, Socea, Bogdan, Solomon, Damtew Damtew, Song, Yimeng, Sreeramareddy, Chandrashekhar T, Suleman, Muhammad, Suliankatchi Abdulkader, Rizwan, Sultana, Saima, Szócska, Mikló, Tabatabaeizadeh, Seyed-Amir, Tabish, Mohammad, Taheri, Majid, Taki, Elahe, Tan, Ker-Kan, Tandukar, Sarmila, Tat, Nathan Y, Tat, Vivian Y, Tefera, Belay Negash, Tefera, Yibekal Manaye, Temesgen, Gebremaryam, Temsah, Mohamad-Hani, Tharwat, Samar, Thiyagarajan, Arulmani, Tleyjeh, Imad I, Troeger, Christopher E, Umapathi, Krishna Kishore, Upadhyay, Era, Valadan Tahbaz, Sahel, Valdez, Pascual R, Van den Eynde, Jef, van Doorn, H. Rogier, Vaziri, Siavash, Verras, Georgios-Ioanni, Viswanathan, Harimadhav, Vo, Bay, Waris, Abdul, Wassie, Gizachew Tadesse, Wickramasinghe, Nuwan Darshana, Yaghoubi, Sajad, Yahya, Gahin Abdulraheem Tayib Yahya, Yahyazadeh Jabbari, Seyed Hossein, Yigit, Arzu, Yiğit, Vahit, Yon, Dong Keon, Yonemoto, Naohiro, Zahir, Mazyar, Zaman, Burhan Abdullah, Zaman, Sojib Bin, Zangiabadian, Moein, Zare, Iman, Zastrozhin, Mikhail Sergeevich, Zhang, Zhi-Jiang, Zheng, Peng, Zhong, Chenwen, Zoladl, Mohammad, Zumla, Alimuddin, Hay, Simon I, Dolecek, Christiane, Sartorius, Benn, Murray, Christopher J L, and Naghavi, Mohsen
Subjects: Male, Bacteria, Syndrome, Bacterial Infections, General Medicine, Global Health, Global Burden of Disease, Risk Factors, Sepsis, Humans, Female, Mortality, Child, Africa South of the Sahara
Abstract: Background: Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. Methods: We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. Findings: From an estimated 13·7 million (95% UI 10·9–17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7–10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2–18·1) of all global deaths and 56·2% (52·1–60·1) of all sepsis-related deaths in 2019. Five leading pathogens—Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa—were responsible for 54·9% (52·9–56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185–285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4–71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. Interpretation: The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development. Funding: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care, using UK aid funding managed by the Fleming Fund.
Published: 2022

19. Prevalence of drug resistance-conferring mutations associated with isoniazid- and rifampicin-resistant Mycobacterium tuberculosis in Ethiopia: a systematic review and meta-analysis

Author: Birhan Alemnew, Melese Abate Reta, Biruk Beletew Abate, and P. Bernard Fourie
Subjects: 0301 basic medicine, Microbiology (medical), Tuberculosis, 030106 microbiology, Immunology, Population, Microbial Sensitivity Tests, Drug resistance, Gene mutation, Microbiology, Mycobacterium tuberculosis, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Tuberculosis, Multidrug-Resistant, Isoniazid, Prevalence, medicine, Humans, Immunology and Allergy, 030212 general & internal medicine, education, education.field_of_study, biology, business.industry, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, medicine.disease, bacterial infections and mycoses, Virology, QR1-502, Meta-analysis, Mutation, Ethiopia, Rifampin, business, Rifampicin, medicine.drug
Abstract: Objectives Globally, tuberculosis (TB) incidence and mortality are declining; however, low detection of drug-resistant disease threatens to reverse current progress toward global TB control. Multiple, rapid molecular diagnostic tests have recently been developed to detect genetic mutations in Mycobacterium tuberculosis (Mtb) known to confer anti-TB drug resistance. Their utility, though, depends on the frequency and distribution of the resistance-associated mutations in the pathogen population. Therefore, this review aimed to assess the prevalence of the gene mutations associated with rifampicin (RIF) and isoniazid (INH) resistant Mtb in Ethiopia. Methods Using PRISMA guidelines, we searched the literature on PubMed/MEDLINE, Web of Science, Scopus, and Cochrane library databases. Data analysis was conducted in STATA 11. Results In total, 909 (95.8%) of 949 INH resistant Mtb isolates had detectable gene mutations: 95.8% in katG315 and 5.9% in the inhA-promoter region. The meta-analysis resulting an estimated prevalence of katGMUT1(S315T1) was 89.2% (95%CI:81.94-96.43%), while a pooled prevalence of inhAMUT1 (C15T) was 77.5% (95%CI:57.84-97.13%). Besides, 769 (90.8%) of 847 RIF resistant strains had detectable rpoB gene mutations, and the meta-analysis resulting in a pooled prevalence of rpoBMUT3 (S531L) was 74.2% (95%CI: 66.39-82.00%). Conclusions RIF-resistant Mtb isolates were spread widely, particularly those harboring S531L mutations. Similarly, INH-resistant Mtb strains with S315T1 and C15T mutations were common. Tracking S531L, S315T1, and C15T mutations among RIF and INH resistant isolates, respectively, would be diagnostically and epidemiologically valuable. Rapid diagnosis of RIF and INH-resistant Mtb in TB patients would expedite alteration of treatment regimens, and proper timely infection control interventions could reduce the risk of progression and transmission of multidrug-resistant TB (MDR-TB).
Published: 2021

20. Risk factors for, and molecular epidemiology and clinical outcomes of, carbapenem‐ and polymyxin‐resistant Gram‐negative bacterial infections in pregnant women, infants, and toddlers: a systematic review and meta‐analyses

Author: P.B. Fourie, John Osei Sekyere, and Melese Abate Reta
Subjects: Adult, Carbapenem, medicine.medical_specialty, Adolescent, medicine.drug_class, Polymyxin, Antibiotics, Risk Assessment, General Biochemistry, Genetics and Molecular Biology, Young Adult, Antibiotic resistance, History and Philosophy of Science, Pregnancy, Risk Factors, Drug Resistance, Multiple, Bacterial, Internal medicine, medicine, Humans, Infection control, Polymyxins, Mortality, Pregnancy Complications, Infectious, Molecular Epidemiology, biology, business.industry, General Neuroscience, Infant, Newborn, Infant, Middle Aged, biology.organism_classification, Anti-Bacterial Agents, Acinetobacter baumannii, Low birth weight, Carbapenems, Child, Preschool, Colistin, Female, medicine.symptom, Gram-Negative Bacterial Infections, business, medicine.drug
Abstract: In the following systematic review and meta-analyses, we report several conclusions about resistance to carbapenem and polymyxin last-resort antibiotics for treating multidrug-resistant bacterial infections among pregnant women and infants. Resistance to carbapenems and polymyxins is increasing, even in otherwise vulnerable groups such as pregnant women, toddlers, and infants, for whom therapeutic options are limited. In almost all countries, carbapenem-/polymyxin-resistant Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii infect and/or colonize neonates and pregnant women, causing periodic outbreaks with very high infant mortalities. Downregulation of plasmid-borne blaNDM , blaKPC , blaOXA-48 , blaIMP, blaVIM , blaGES-5 , and ompK35/36 in clonal strains accelerates the horizontal and vertical transmissions of carbapenem resistance among these pathogens. New Delhi metallo-β-lactamase (NDM)-positive isolates in infants/neonates have been mainly detected in China and India, while OXA-48-positive isolates in infants/neonates have been mainly detected in Africa. NDM-positive isolates in pregnant women have been found only in Madagascar. Antibiotic therapy, prolonged hospitalization, invasive procedures, mechanical ventilation, low birth weight, and preterm delivery have been common risk factors associated with carbapenem/polymyxin resistance. The use of polymyxins to treat carbapenem-resistant infections may be selecting for resistance to both agents, restricting therapeutic options for infected infants and pregnant women. Currently, low- and middle-income countries have the highest burden of these pathogens. Antibiotic stewardship, periodic rectal and vaginal screening, and strict infection control practices in neonatal ICUs are necessary to forestall future outbreaks and deaths.
Published: 2021

21. Food handling practices and associated factors among food handlers working in public food and drink service establishments in Woldia town, Northeast Ethiopia

Author: Mekonnin Tesfa Lemma, Melese Abate Reta, Getasew Assefa Lemlem, and Ashete Adere Gemeda
Subjects: Adult, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Food handlers, Food Handling, Developing country, Woldia, Logistic regression, Foodborne Diseases, Young Adult, Environmental health, Global health, Medicine, Humans, Service (business), Descriptive statistics, business.industry, Public health, Research, Food Services, determinants, General Medicine, Odds ratio, food handling practices, catering establishments, Work experience, Cross-Sectional Studies, Female, Ethiopia, business
Abstract: Introduction:foodborne disease (FBD) is a major public health problem globally. Inadequate food workers' knowledge, attitude, and low level of food handling practices (FHPs) may all contribute to the possibility of FBD outbreaks in public food service establishments. This study aimed to assess FHPs and associated factors among food handlers working in public food and drink service establishments in Woldia town, Northeast Ethiopia. Methods:an institutional-based cross-sectional study was conducted from 01stto 29th, January 2017. A total of 288 food handlers were recruited through a simple random selection method. A structured interviewer-administered questionnaire and observation checklists were used to collect the respondents' socio-demographic characteristics, knowledge status on FHPs, and food handling working practices data. Descriptive statistics, bivariate and multivariate logistic regression analysis were employed using SPSS version 20 software. Those variables with a p< 0.05 were considered statistically significant. Results:out of 288 participants, 91.7% were female, and 82.3% were single, while 69.8% were literate. One hundred eighty-four (63.9%) of them were under 15-25 years of age, with a median age of 23.3 years. The proportion of good FHP was (n=134, 46.5%) (95% CI:41.00-52.4%). Advanced age (adjusted odds ratio (AOR) =12.01, 95% CI:1.96-73.52), education (participants who attend grades 7-12 (AOR=2.33, 95% CI:1.14-4.79), and above secondary education (AOR=2.29, 95% CI:1.05-4.61), work experience above six years (AOR=2.43, 95% CI:2.08-3.17), received formal training (AOR=1.79, 95% CI:1.68-4.71), and inspection visits by a concerned body (AOR=2.24, 95% CI:1.05-3.09) were factors positively associated with handling practices. Conclusion:the study revealed that FHP in the study area was low. Age, education, service year, training received and sanitary inspection visits by the regulatory personnel were factors significantly associated with FHPs. This finding highlights the importance of employing regular sanitary inspection visits to public food service establishments by the concerned authority to ensure that all food handlers have the knowledge and the skill to provide safe food.
Published: 2021

22. Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990–2019: results from the Global Burden of Disease Study 2019

Author: Akram Pourshams, Mostafa Dianatinasab, Alberto L. García-Basteiro, Seyed Sina Naghibi Irvani, Patrick D. M. C. Katoto, Daiane Borges Machado, Alireza Rafiei, Aziz Rezapour, Khaled Khatab, Chukwudi A Nnaji, Fatemeh Javanmardi, Asrat Arja, Asif Hanif, Arianna Maever L. Amit, Min Seo Kim, Tomislav Mestrovic, Razique Anwer, Gulrez Shah Azhar, Milena Ilic, Jost B. Jonas, Sreenivas Narasimha Swamy, Fisaha Haile Tesfay, Fakher Rahim, Christopher J L Murray, Molly H Biehl, Hesam Alizade, Souranshu Chatterjee, Jalal Arabloo, Mariam Molokhia, Sachin R Atre, Maciej Banach, Ashwin Kamath, Gebiyaw Wudie Tsegaye, Irina Filip, Mohammad Sadegh Rezai, Robert Reiner, Shrikant Pawar, Anasthasia Zastrozhina, Vardhmaan Jain, Shafiu Mohammed, Benn Sartorius, Sindhura Lakshmi Koulmane Laxminarayana, Harapan Harapan, Hiba Jawdat Barqawi, Tahvi Frank, Yasir Waheed, Seyed Hossein Yahyazadeh Jabbari, Shaun Wen Huey Lee, Jorge R. Ledesma, Yosef Alemayehu, Sajjad Ahmad, Deepak Dhamnetiya, Khezar Hayat, Preetam Bhalchandra Mahajan, Ramesh Holla, Atif Amin Baig, Azeem Majeed, Darshan B B, Catherine M. Antony, Allen Seylani, Avinash Kumar, Alimuddin Zumla, Irena Ilic, Sofia Androudi, Liaqat Ali, Rafael Lozano, Carl Abelardo T. Antonio, Sanjay M Pattanshetty, Bach Xuan Tran, Eduarda Fernandes, Marissa B Reitsma, Ramaiah Itumalla, Catrin E. Moore, Amir Masoud Rahmani, Daniel Diaz, Mohsen Naghavi, R V Polibin, Nithin Kumar, Archith Boloor, Norberto Perico, Vahit Yigit, Emma Elizabeth Spurlock, Zaheer-Ud-Din Babar, Veer Bala Gupta, Nima Rezaei, Arief Hargono, Maarten J. Postma, Jitendra Singh, Sandhya Neupane Kandel, Sapna Gupta, Omid Dadras, Takahiro Tabuchi, Sanjeev Misra, Salman Rawaf, Devasahayam J. Christopher, Francisco Rogerlândio Martins-Melo, Omid Shafaat, Florian Fischer, Satish Saroshe, Simon I. Hay, Mosiur Rahman, Mohammad Ali Moni, Sathish Kumar Jayapal, Jalil Jaafari, Walter Mendoza, Sepideh Ahmadi, Deepak Madi, Alexander Kwarteng, Omid Rezahosseini, Segun Emmanuel Ibitoye, Hassan Mehmood Lak, Iván Landires, Mahesh P A, Biniyam Sahiledengle Geberemariyam, Hayimro Edemealem Merie, Himanshu Khajuria, Kathryn H. Jacobsen, Magdalene K. Walters, Ali H. Mokdad, Sharath Burugina Nagaraja, Avina Vongpradith, Mehrnoosh Samaei, Shubha Jayaram, Beriwan Abdulqadir Ali, Giang Thu Vu, Chukwuma David Umeokonkwo, Adnan Kisa, Mehdi Hosseinzadeh, Danilo Buonsenso, Nitin Joseph, G Anil Kumar, Rekha Thapar, Sanjeev Nair, Eyayou Girma Tadesse, Joanna L Whisnant, Amanual Getnet Mersha, Savita Lasrado, Pintu Paul, Burcu Kucuk Bicer, Dharmesh Kumar Lal, Mowafa Househ, Vivek Gupta, Chandrashekhar T Sreeramareddy, Sanjay Basu, Andre M. N. Renzaho, Saira Afzal, Nahlah Elkudssiah Ismail, Akine Eshete Abosetugn, Jennifer M. Ross, Ai Koyanagi, Tushar Garg, Chythra R Rao, Sezer Kisa, Yigizie Yeshaw, Paschalis Steiropoulos, Brijesh Sathian, Zemenu Tamir, Amene Abebe Kerbo, Christine Lin, Dana Bryazka, Jason A. Anderson, Majid Pirestani, Austin Carter, Chuanhua Yu, Berhan Tsegaye, Elvis Enowbeyang Tarkang, Mareli M Claassens, Hmwe H Kyu, Lorenzo Ferro Desideri, Akila Prashant, Smriti Sinha, Linh Phuong Doan, Befikadu Legesse Wubishet, Fabio Barra, Rovshan Khalilov, Joshua A. Salomon, Virginia Núñez-Samudio, Imad I. Tleyjeh, David Laith Rawaf, Mikhail Sergeevich Zastrozhin, Dimas Ria Angga Pribadi, Kamal Hezam, Shilpashree Madhava Kunjathur, Nasir Salam, Wei-Chen Lee, Stephen S Lim, Bay Vo, Mahaveer Golechha, K. M. Saif-Ur-Rahman, Sahel Valadan Tahbaz, Muhammed Elhadi, Fatemeh Pashazadeh Kan, Fares Alahdab, Vafa Rahimi-Movaghar, Subramanian Senthilkumaran, Boris Bikbov, Addis Aklilu, Ritesh G. Menezes, Amare Belachew Dagnew, Ravi Prakash Jha, Tanuj Kanchan, Siamak Sabour, Theo Vos, Amir Radfar, Amir Emami, João Pedro Silva, Uzma Belgaumi, Vijay Kumar Chattu, Parnaz Daneshpajouhnejad, Ahmed Al Montasir, Oladimeji Adebayo, Rabia Hussain, Masoud Moghadaszadeh, Suma Nair, Ahmed I. Hasaballah, Félix Carvalho, Yun Jin Kim, Hanadi Al Hamad, Valentin Yurievich Skryabin, Mu'awiyyah Babale Sufiyan, Farahnaz Joukar, Krittika Bhattacharyya, Farshad Farzadfar, Hadi Hassankhani, Aso Mohammad Darwesh, Kefyalew Addis Alene, Himal Kandel, Susan M Sawyer, Soosanna Kumary Chattu, Keyghobad Ghadiri, Zahid A Butt, Mokhtar Mohammadi, Belay Tessema, Nikha Bhardwaj, Hossein Samadi Kafil, Kiomars Sharafi, Siyan Yi, Jianing Ma, Denis O Roshchin, Pankaj Bhardwaj, Jagdish Khubchandani, Rajaa Al-Raddadi, Shymaa Enany, Akshaya Srikanth Bhagavathula, Andrew T Olagunju, Parkes J Kendrick, Amador Goodridge, Zhi-Jiang Zhang, Mulusew A Asemahagn, Saeed Amini, Ziad A. Memish, Ruoyan Tobe-Gai, Ali Bijani, Nour Mheidly, Priyanga Ranasinghe, Abdallah M. Samy, Mahfuzar Rahman, Giuseppe Remuzzi, Abdullah T Khoja, Biswa Prakash Nayak, Samer Hamidi, Javad Nazari, Ramakrishnan Parthasarathi, Lalit Dandona, Molly R Nixon, Parvaiz A Koul, Mika Shigematsu, Gbenga A. Kayode, Rachel Feldman, Mohammad Rifat Haider, Nelson Alvis-Guzman, Mesfin Agachew Woldekidan, Deepa Jahagirdar, Kate E. LeGrand, Yusra Ahmed Salih, Nikolay Ivanovich Briko, Xuefeng Liu, Qorinah Estiningtyas Sakilah Adnani, Christian Garcia-Calavaro, Dinh-Toi Chu, Mihaela Hostiuc, Yohannes Tekalegn, Rajan Paudel, Prasanna Mithra, Narinder Kumar, Masood Ali Shaikh, Zubair Kabir, Natalia V. Bhattacharjee, Chisom Joyqueenet Akunna, Masoud Foroutan, Bogdan Oancea, Anayat Ullah, Saurabh Mehta, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Vahid Alipour, Tarik A. Rashid, Melese Abate Reta, Atta Abbas Naqvi, Emilie R Maddison, Mpiko Ntsekhe, Naohiro Yonemoto, Ahmad Ghashghaee, Mohamed Kamal Mesregah, Amadou Barrow, Ismaeel Yunusa, Gholamreza Roshandel, Ahamarshan Jayaraman Nagarajan, Hassan Abolhassani, Ahmad Azam Malik, Xiaochen Dai, Trang Huyen Nguyen, Eyal Oren, Bright Opoku Ahinkorah, Taklo Simeneh Yazie Yazie, Kewal Krishan, Ranjitha S Shetty, Emerito Jose A. Faraon, Jae Il Shin, Shafiul Haque, Veincent Christian Filipino Pepito, Sahar Eftekharzadeh, Bhawna Gupta, Platon D. Lopukhov, Abdiwahab Hashi, Amanda Novotney, Eman Abu-Gharbieh, Oluwakemi Ololade Odukoya, Anna Aleksandrovna Skryabina, Shoaib Hassan, Rakhi Dandona, Jaykaran Charan, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), and Collaborators, GBD 2019 Tuberculosis
Subjects: Male, PNEUMONIA, COUNTRIES, Tuberculosis, Population, HIV Infections, CHILDREN, Genders, Mortalities, Global Health, DIAGNOSIS, Microbiology, Global Burden of Disease, 1117 Public Health and Health Services, Acquired immunodeficiency syndrome (AIDS), Risk Factors, 1108 Medical Microbiology, Sex differences, INFECTION, medicine, Global health, Humans, education, Sex Characteristics, education.field_of_study, Global disease burdens, business.industry, Mortality rate, GBD 2019 Tuberculosis Collaborators, HIV, Bayes Theorem, 1103 Clinical Sciences, DIABETES-MELLITUS, medicine.disease, Verbal autopsy, Tuberculosis treatment, PREVALENCE, Infectious Diseases, Attributable risk, Coinfection, Female, INJURIES, GENDER, HEALTH, business, Demography
Abstract: Background Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019. Methods We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital registration data, 705 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, and 680 site-years of mortality surveillance data to estimate mortality due to tuberculosis among HIV-negative individuals. We used a population attributable fraction approach to estimate mortality related to HIV and tuberculosis coinfection. A compartmental meta-regression tool (DisMod-MR 2.1) was then used to synthesise all available data sources, including prevalence surveys, annual case notifications, population-based tuberculin surveys, and tuberculosis cause-specific mortality, to produce estimates of incidence, prevalence, and mortality that were internally consistent. We further estimated the fraction of tuberculosis mortality that is attributable to independent effects of risk factors, including smoking, alcohol use, and diabetes, for HIV-negative individuals. For individuals with HIV and tuberculosis coinfection, we assessed mortality attributable to HIV risk factors including unsafe sex, intimate partner violence (only estimated among females), and injection drug use. We present 95% uncertainty intervals for all estimates. Findings Globally, in 2019, among HIV-negative individuals, there were 1·18 million (95% uncertainty interval 1·08–1·29) deaths due to tuberculosis and 8·50 million (7·45–9·73) incident cases of tuberculosis. Among HIV-positive individuals, there were 217 000 (153 000–279 000) deaths due to tuberculosis and 1·15 million (1·01–1·32) incident cases in 2019. More deaths and incident cases occurred in males than in females among HIV-negative individuals globally in 2019, with 342 000 (234 000–425 000) more deaths and 1·01 million (0·82–1·23) more incident cases in males than in females. Among HIV-positive individuals, 6250 (1820–11 400) more deaths and 81 100 (63 300–100 000) more incident cases occurred among females than among males in 2019. Age-standardised mortality rates among HIV-negative males were more than two times greater in 105 countries and age-standardised incidence rates were more than 1·5 times greater in 74 countries than among HIV-negative females in 2019. The fraction of global tuberculosis deaths among HIV-negative individuals attributable to alcohol use, smoking, and diabetes was 4·27 (3·69–5·02), 6·17 (5·48–7·02), and 1·17 (1·07–1·28) times higher, respectively, among males than among females in 2019. Among individuals with HIV and tuberculosis coinfection, the fraction of mortality attributable to injection drug use was 2·23 (2·03–2·44) times greater among males than females, whereas the fraction due to unsafe sex was 1·06 (1·05–1·08) times greater among females than males. Interpretation As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis. This strategy will be crucial in reaching both equity and burden targets outlined by global health milestones. Funding Bill & Melinda Gates Foundation.
Published: 2021

23. Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Author: Elizabeth A. Cromwell, Joshua C.P. Osborne, Thomas R. Unnasch, María Gloria Basáñez, Katherine M. Gass, Kira A. Barbre, Elex Hill, Kimberly B. Johnson, Katie M. Donkers, Shreya Shirude, Chris A. Schmidt, Victor Adekanmbi, Olatunji O. Adetokunboh, Mohsen Afarideh, Ehsan Ahmadpour, Muktar Beshir Ahmed, Temesgen Yihunie Akalu, Ziyad Al-Aly, Fahad Mashhour Alanezi, Turki M. Alanzi, Vahid Alipour, Catalina Liliana Andrei, Fereshteh Ansari, Mustafa Geleto Ansha, Davood Anvari, Seth Christopher Yaw Appiah, Jalal Arabloo, Benjamin F. Arnold, Marcel Ausloos, Martin Amogre Ayanore, Atif Amin Baig, Maciej Banach, Aleksandra Barac, Till Winfried Bärnighausen, Mohsen Bayati, Krittika Bhattacharyya, Zulfiqar A. Bhutta, Sadia Bibi, Ali Bijani, Somayeh Bohlouli, Mahdi Bohluli, Oliver J. Brady, Nicola Luigi Bragazzi, Zahid A. Butt, Félix Carvalho, Souranshu Chatterjee, Vijay Kumar Chattu, Soosanna Kumary Chattu, Natalie Maria Cormier, Saad M.A. Dahlawi, Giovanni Damiani, Farah Daoud, Aso Mohammad Darwesh, Ahmad Daryani, Kebede Deribe, Samath Dhamminda Dharmaratne, Daniel Diaz, Hoa Thi Do, Maysaa El Sayed Zak, Maha El Tantawi, Demelash Abewa Elemineh, Anwar Faraj, Majid Fasihi Harandi, Yousef Fatahi, Valery L. Feigin, Eduarda Fernandes, Nataliya A. Foigt, Masoud Foroutan, Richard Charles Franklin, Mohammed Ibrahim Mohialdeen Gubari, Davide Guido, Yuming Guo, Arvin Haj‐mirzaian, Kanaan Hamagharib Abdullah, Samer Hamidi, Claudiu Herteliu, Hagos Degefa De Hidru, Tarig B. Higazi, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Olayinka Stephen Ilesanmi, Milena D. Ilic, Irena M. Ilic, Usman Iqbal, Seyed Sina Naghibi Irvani, Ravi Prakash Jha, Farahnaz Joukar, Jacek Jerzy Jozwiak, Zubair Kabir, Leila R. Kalankesh, Rohollah Kalhor, Behzad Karami Matin, Salah Eddin Karimi, Amir Kasaeian, Taras Kavetskyy, Gbenga A. Kayode, Ali Kazemi Karyani, Abraham Getachew Kelbore, Maryam Keramati, Rovshan Khalilov, Ejaz Ahmad Khan, Md Nuruzzaman Nuruzzaman Khan, Khaled Khatab, Mona M. Khater, Neda Kianipour, Kelemu Tilahun Kibret, Yun Jin Kim, Soewarta Kosen, Kris J. Krohn, Dian Kusuma, Carlo La Vecchia, Charles Lansingh Van, Paul H. Lee, Kate E. Legrand, S. (Shanshan) Li, Joshua Longbottom, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Afshin Maleki, Abdullah Mamun, Ali Manafi, Navid Manafi, Mohammad Ali Mansournia, Francisco Rogerlândio Martins-Melo, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Walter Mendoza, Endalkachew Worku Mengesha, Desalegn Tadese Mengistu, Seid Tiku Mereta, Tomislav Mestrovic, Ted R. Miller, Mohammad Miri, Masoud Moghadaszadeh, Abdollah Mohammadian Hafshejani, Reza Mohammadpourhodki, Shafiu Mohammed, Salahuddin Mohammed, Masoud Moradi, Rahmatollah Moradzadeh, Paula Moraga, Jonathan F. Mosser, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Gurudatta Naik, Ionut Negoi, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Rajan Nikbakhsh, Bogdan Oancea, Tinuke O. Olagunju, Andrew T. Olagunju, Ahmed Omar Bali, Obinna E. Onwujekwe, Adrian Pana, Hadi Pourjafar, Fakher Rahim, Mohammad Hifz Ur Rahman, Priya Rathi, Salman Rawaf, David Laith Rawaf, Reza Rawassizadeh, Serge Resnikoff, Melese Abate Reta, Aziz Rezapour, Enrico Rubagotti, Salvatore Rubino, Ehsan Sadeghi, Abedin Saghafipour, S. Mohammad Sajadi, Abdallah M. Samy, Rodrigo Sarmiento-Suárez, Monika Sawhney, Megan F. Schipp, Amira A. Shaheen, Masood Ali Shaikh, Morteza Shamsizadeh, Kiomars Sharafi, A (Aziz) Sheikh, B. Suresh Kumar Shetty, Jae Il Shin, K. M. Shivakumar, Biagio Simonetti, Jasvinder A. Singh, Eirini Skiadaresi, Amin Soheili, Shahin Soltani, Emma Elizabeth Spurlock, Mu'awiyyah Babale Sufiyan, Takahiro Tabuchi, Leili Tapak, Robert L. Thompson, Alan J. Thomson, Eugenio Traini, Bach Xuan Tran, Irfan Ullah, Saif Ullah, Chigozie Jesse Uneke, Bhaskaran Unnikrishnan, Olalekan A. Uthman, Natalie V.S.Vinkeles Melchers, Francesco S. Violante, Haileab Fekadu Wolde, Tewodros Eshete Wonde, Tomohide Yamada, Sanni Yaya, Vahid Yazdi Feyzabadi, Paul Yip, Naohiro Yonemoto, Hebat Allah Salah A. Yousof, Chuanhua Yu, Yong Yu, Hasan Yusefzadeh, Leila Zaki, Sojib Bin Zaman, Maryam Zamanian, Zhi Jiang Zhang, Yunquan Zhang, Arash Ziapour, Simon I. Hay, David M. Pigott, Elizabeth A. Cromwell, Joshua C.P. Osborne, Thomas R. Unnasch, María Gloria Basáñez, Katherine M. Gass, Kira A. Barbre, Elex Hill, Kimberly B. Johnson, Katie M. Donkers, Shreya Shirude, Chris A. Schmidt, Victor Adekanmbi, Olatunji O. Adetokunboh, Mohsen Afarideh, Ehsan Ahmadpour, Muktar Beshir Ahmed, Temesgen Yihunie Akalu, Ziyad Al-Aly, Fahad Mashhour Alanezi, Turki M. Alanzi, Vahid Alipour, Catalina Liliana Andrei, Fereshteh Ansari, Mustafa Geleto Ansha, Davood Anvari, Seth Christopher Yaw Appiah, Jalal Arabloo, Benjamin F. Arnold, Marcel Ausloos, Martin Amogre Ayanore, Atif Amin Baig, Maciej Banach, Aleksandra Barac, Till Winfried Bärnighausen, Mohsen Bayati, Krittika Bhattacharyya, Zulfiqar A. Bhutta, Sadia Bibi, Ali Bijani, Somayeh Bohlouli, Mahdi Bohluli, Oliver J. Brady, Nicola Luigi Bragazzi, Zahid A. Butt, Félix Carvalho, Souranshu Chatterjee, Vijay Kumar Chattu, Soosanna Kumary Chattu, Natalie Maria Cormier, Saad M.A. Dahlawi, Giovanni Damiani, Farah Daoud, Aso Mohammad Darwesh, Ahmad Daryani, Kebede Deribe, Samath Dhamminda Dharmaratne, Daniel Diaz, Hoa Thi Do, Maysaa El Sayed Zak, Maha El Tantawi, Demelash Abewa Elemineh, Anwar Faraj, Majid Fasihi Harandi, Yousef Fatahi, Valery L. Feigin, Eduarda Fernandes, Nataliya A. Foigt, Masoud Foroutan, Richard Charles Franklin, Mohammed Ibrahim Mohialdeen Gubari, Davide Guido, Yuming Guo, Arvin Haj‐mirzaian, Kanaan Hamagharib Abdullah, Samer Hamidi, Claudiu Herteliu, Hagos Degefa De Hidru, Tarig B. Higazi, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Olayinka Stephen Ilesanmi, Milena D. Ilic, Irena M. Ilic, Usman Iqbal, Seyed Sina Naghibi Irvani, Ravi Prakash Jha, Farahnaz Joukar, Jacek Jerzy Jozwiak, Zubair Kabir, Leila R. Kalankesh, Rohollah Kalhor, Behzad Karami Matin, Salah Eddin Karimi, Amir Kasaeian, Taras Kavetskyy, Gbenga A. Kayode, Ali Kazemi Karyani, Abraham Getachew Kelbore, Maryam Keramati, Rovshan Khalilov, Ejaz Ahmad Khan, Md Nuruzzaman Nuruzzaman Khan, Khaled Khatab, Mona M. Khater, Neda Kianipour, Kelemu Tilahun Kibret, Yun Jin Kim, Soewarta Kosen, Kris J. Krohn, Dian Kusuma, Carlo La Vecchia, Charles Lansingh Van, Paul H. Lee, Kate E. Legrand, S. (Shanshan) Li, Joshua Longbottom, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Afshin Maleki, Abdullah Mamun, Ali Manafi, Navid Manafi, Mohammad Ali Mansournia, Francisco Rogerlândio Martins-Melo, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Walter Mendoza, Endalkachew Worku Mengesha, Desalegn Tadese Mengistu, Seid Tiku Mereta, Tomislav Mestrovic, Ted R. Miller, Mohammad Miri, Masoud Moghadaszadeh, Abdollah Mohammadian Hafshejani, Reza Mohammadpourhodki, Shafiu Mohammed, Salahuddin Mohammed, Masoud Moradi, Rahmatollah Moradzadeh, Paula Moraga, Jonathan F. Mosser, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Gurudatta Naik, Ionut Negoi, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Rajan Nikbakhsh, Bogdan Oancea, Tinuke O. Olagunju, Andrew T. Olagunju, Ahmed Omar Bali, Obinna E. Onwujekwe, Adrian Pana, Hadi Pourjafar, Fakher Rahim, Mohammad Hifz Ur Rahman, Priya Rathi, Salman Rawaf, David Laith Rawaf, Reza Rawassizadeh, Serge Resnikoff, Melese Abate Reta, Aziz Rezapour, Enrico Rubagotti, Salvatore Rubino, Ehsan Sadeghi, Abedin Saghafipour, S. Mohammad Sajadi, Abdallah M. Samy, Rodrigo Sarmiento-Suárez, Monika Sawhney, Megan F. Schipp, Amira A. Shaheen, Masood Ali Shaikh, Morteza Shamsizadeh, Kiomars Sharafi, A (Aziz) Sheikh, B. Suresh Kumar Shetty, Jae Il Shin, K. M. Shivakumar, Biagio Simonetti, Jasvinder A. Singh, Eirini Skiadaresi, Amin Soheili, Shahin Soltani, Emma Elizabeth Spurlock, Mu'awiyyah Babale Sufiyan, Takahiro Tabuchi, Leili Tapak, Robert L. Thompson, Alan J. Thomson, Eugenio Traini, Bach Xuan Tran, Irfan Ullah, Saif Ullah, Chigozie Jesse Uneke, Bhaskaran Unnikrishnan, Olalekan A. Uthman, Natalie V.S.Vinkeles Melchers, Francesco S. Violante, Haileab Fekadu Wolde, Tewodros Eshete Wonde, Tomohide Yamada, Sanni Yaya, Vahid Yazdi Feyzabadi, Paul Yip, Naohiro Yonemoto, Hebat Allah Salah A. Yousof, Chuanhua Yu, Yong Yu, Hasan Yusefzadeh, Leila Zaki, Sojib Bin Zaman, Maryam Zamanian, Zhi Jiang Zhang, Yunquan Zhang, Arash Ziapour, Simon I. Hay, and David M. Pigott
Abstract: Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0.71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50.2% exceed this threshold for suitability in at least one 5×5-km location. The for
Published: 2021
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24. Molecular Epidemiology, Risk Factors and Clinical Outcomes of Carbapenem- and Polymyxin-Resistant Gram-negative Bacterial Infections in Pregnant Women and Infants: A Systematic Review

Author: John Osei Sekyere and Melese Abate Reta
Subjects: Carbapenem, medicine.medical_specialty, biology, business.industry, medicine.drug_class, Klebsiella pneumoniae, Transmission (medicine), Polymyxin, Antibiotics, Outbreak, biology.organism_classification, Acinetobacter baumannii, Internal medicine, medicine, Infection control, business, medicine.drug
Abstract: BackgroundCarbapenems and polymyxins are last-resort antibiotics used to treat multidrug-resistant bacterial infections. However, resistance is increasing, even in vulnerable groups such as pregnant women and infants, for whom therapeutic options are limited.MethodUsing a diversity of databases, the literature was searched for studies investigating carbapenem and polymyxin resistance in pregnant women and infants (< 5 years).ResultA final set of 73 manuscripts were used. In almost all countries, carbapenem/polymyxin-resistant Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii infect and/or colonizes neonates and pregnant women, causing periodic outbreaks with very high infant mortalities. Plasmid-borne blaNDM, blaKPC, blaOXA-48, blaIMP,blaVIM and blaGES-5 and ompK35/36 downregulation in clonal strains accelerate the horizontal and vertical transmission of carbapenem resistance in these pathogens. High prevalence of carbapenem/polymyxin resistance and carbapenemases were present in India, China, Pakistan, Thailand, Taiwan, Turkey, Egypt, Italy, USA, South Africa, Algeria, Ghana, and Madagascar. Factors such as antibiotic therapy, prolonged hospitalization, invasive procedures, mother/infant colonization, mechanical ventilation, low-birth weight and preterm state placed infants at high risk of carbapenem/polymyxin-resistant infections. Infant mortalities ranged from 0.2% to 36.8% in different countries.ConclusionUse of polymyxins to treat carbapenem-resistant infections is selecting for resistance to both agents, restricting therapeutic options for infected infants and pregnant women. However, appropriate infection control and antibiotic therapy can contain outbreaks and clear these infections. Antibiotic stewardship, periodic rectal and vaginal screening, and strict infection control practices in neonatal ICUs are necessary to forestall future outbreaks and deaths.HighlightsCarbapenems & polymyxins are last-resort antibiotics used for multidrug-resistant infectionsResistance to these two agents are reported in infants & pregnant womenK. pneumoniae, E. coli, and A. baumannii are the most common pathogensCarbapenem & polymyxin resistance cause outbreaks with high infant mortalitiesAppropriate treatment & infection control can outbreaks & save lives
Published: 2020

25. Genomic and Resistance Epidemiology of Gram-Negative Bacteria in Africa: a Systematic Review and Phylogenomic Analyses from a One Health Perspective

Author: Melese Abate Reta and John Osei Sekyere
Subjects: 0301 basic medicine, antibiotic resistance, Physiology, Klebsiella pneumoniae, 030106 microbiology, Biochemistry, Campylobacter jejuni, molecular epidemiology, Microbiology, Clinical Science and Epidemiology, 03 medical and health sciences, Antibiotic resistance, Genetics, mobilome, diagnostics, genomics, One Health, resistome, Molecular Biology, Ecology, Evolution, Behavior and Systematics, Molecular epidemiology, biology, Enterobacter, biology.organism_classification, QR1-502, Computer Science Applications, Resistome, Acinetobacter baumannii, 030104 developmental biology, Salmonella enterica, Modeling and Simulation, Africa, Research Article
Abstract: Antibiotic resistance (AR) is one of the major public health threats and challenges to effective containment and treatment of infectious bacterial diseases worldwide. Here, we used different methods to map out the geographical hot spots, sources, and evolutionary epidemiology of AR. Escherichia coli, Klebsiella pneumoniae, Salmonella enterica, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp., Neisseria meningitis/gonorrhoeae, Vibrio cholerae, Campylobacter jejuni, etc., were common pathogens shuttling AR genes in Africa. Transmission of the same clones/strains across countries and between animals, humans, plants, and the environment was observed. We recommend Enterobacter spp. or K. pneumoniae as better sentinel species for AR surveillance., Antibiotic resistance (AR) remains a major threat to public and animal health globally. However, AR ramifications in developing countries are worsened by limited molecular diagnostics, expensive therapeutics, inadequate numbers of skilled clinicians and scientists, and unsanitary environments. The epidemiology of Gram-negative bacteria, their AR genes, and geographical distribution in Africa are described here. Data were extracted and analyzed from English-language articles published between 2015 and December 2019. The genomes and AR genes of the various species, obtained from the Pathosystems Resource Integration Center (PATRIC) and NCBI were analyzed phylogenetically using Randomized Axelerated Maximum Likelihood (RAxML) and annotated with Figtree. The geographic location of resistant clones/clades was mapped manually. Thirty species from 31 countries and 24 genera from 41 countries were analyzed from 146 articles and 3,028 genomes, respectively. Genes mediating resistance to β-lactams (including blaTEM-1, blaCTX-M, blaNDM, blaIMP, blaVIM, and blaOXA-48/181), fluoroquinolones (oqxAB, qnrA/B/D/S, gyrA/B, and parCE mutations, etc.), aminoglycosides (including armA and rmtC/F), sulfonamides (sul1/2/3), trimethoprim (dfrA), tetracycline [tet(A/B/C/D/G/O/M/39)], colistin (mcr-1), phenicols (catA/B, cmlA), and fosfomycin (fosA) were mostly found in Enterobacter spp. and Klebsiella pneumoniae, and also in Serratia marcescens, Escherichia coli, Salmonella enterica, Pseudomonas, Acinetobacter baumannii, etc., on mostly IncF-type, IncX3/4, ColRNAI, and IncR plasmids, within IntI1 gene cassettes, insertion sequences, and transposons. Clonal and multiclonal outbreaks and dissemination of resistance genes across species and countries and between humans, animals, plants, and the environment were observed; Escherichia coli ST103, K. pneumoniae ST101, S. enterica ST1/2, and Vibrio cholerae ST69/515 were common strains. Most pathogens were of human origin, and zoonotic transmissions were relatively limited. IMPORTANCE Antibiotic resistance (AR) is one of the major public health threats and challenges to effective containment and treatment of infectious bacterial diseases worldwide. Here, we used different methods to map out the geographical hot spots, sources, and evolutionary epidemiology of AR. Escherichia coli, Klebsiella pneumoniae, Salmonella enterica, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp., Neisseria meningitis/gonorrhoeae, Vibrio cholerae, Campylobacter jejuni, etc., were common pathogens shuttling AR genes in Africa. Transmission of the same clones/strains across countries and between animals, humans, plants, and the environment was observed. We recommend Enterobacter spp. or K. pneumoniae as better sentinel species for AR surveillance.
Published: 2020

26. Global evolutionary epidemiology and resistome dynamics of Citrobacter species, Enterobacter hormaechei, Klebsiella variicola, and Proteeae clones

Author: Melese Abate Reta and John Osei Sekyere
Subjects: medicine.drug_class, Antibiotics, Enterobacter, Microbial Sensitivity Tests, Providencia, Microbiology, Klebsiella variicola, 03 medical and health sciences, Citrobacter, Morganella, Klebsiella, medicine, Animals, Clade, Ecology, Evolution, Behavior and Systematics, 030304 developmental biology, Genetics, 0303 health sciences, biology, 030306 microbiology, biology.organism_classification, Resistome, Anti-Bacterial Agents, Clone Cells, Proteus
Abstract: Citrobacter spp., Enterobacter hormaechei subsp., Klebsiella variicola and Proteae tribe members are rarely isolated Enterobacterales increasingly implicated in nosocomial infections. Herein, we show that these species contain multiple genes encoding resistance to important antibiotics and are widely and globally distributed, being isolated from human, animal, plant, and environmental sources in 67 countries. Certain clones and clades of these species were internationally disseminated, serving as reservoirs and mediums for the global dissemination of antibiotic resistance genes. As they can easily transmit these genes to more pathogenic species, additional molecular surveillance studies should be undertaken to identify and contain these antibiotic-resistant species.
Published: 2020

27. Prevalence of drug resistance-conferring mutations associated with isoniazid and rifampicin resistant Mycobacterium tuberculosis in Ethiopia: A systematic review and meta-analysis

Author: Biruk Beletew Abate, Birhan Alemnew, and Melese Abate Reta
Subjects: Tuberculosis, biology, business.industry, Isoniazid, Drug resistance, Gene mutation, biochemical phenomena, metabolism, and nutrition, respiratory system, rpoB, medicine.disease, biology.organism_classification, bacterial infections and mycoses, Virology, Multiple drug resistance, Mycobacterium tuberculosis, medicine, heterocyclic compounds, business, Rifampicin, medicine.drug
Abstract: BackgroundDrug resistance tuberculosis (DR-TB) continues to be a major public health threat globally. Due to the development of many rapid molecular diagnostic tools to detect gene mutations in M.tuberculosis (Mtb), specific genes conferring resistance to different anti-TB drugs have been identified. The aim of this meta-analysis was to assess the prevalence of the gene mutations associated with rifampicin (RIF) and isoniazid (INH) resistant Mtb in Ethiopia.MethodsUsing PRISMA guideline, we systematically searched a literature on PubMed/MEDLINE, Web of Science, Scopus electronic databases, Cochrane library, and other database sources. The data analysis was done using STATA 11. The pooled prevalence of the gene mutations associated with resistance to RIF and INH were estimated using the random effect model. Heterogeneity was measured by the I2 statistical test, and the publication bias through the funnel plot and the Egger’s regression test.ResultsAmong all antimycobacterial resistance tested TB patients, prevalence of resistance to any anti-TB drug was 31.3%, while multidrug resistance TB (MDR-TB), any RIF and INH resistance were 22.2%, 24.9%, and 27.9%, respectively. In total, 909 (95.8%) of 949 INH resistant Mtb isolates had detectable gene mutation in katG315 and 5.9% in the inhA gene. The meta-analysis derived an estimated pooled prevalence of katGMUT1(S315T1) in INH resistant Mtb was 89.18% (95%CI 81.94-96.43%), while a pooled inhAMUT1 (C15T) resistant Mtb prevalence was 77.48% (95% CI 57.84-97.13%). Besides, 769 (90.8%) of 847 RIF resistant strains had detectable rpoB gene mutation, commonly in rpoBMUT3(S531L) probe (550 cases). The meta-analysis resulting a pooled rpoBMUT3(S531L) resistant Mtb prevalence of 74.20 % (95%CI 66.39-82.00%).ConclusionsRIF resistant Mtb isolates were spread widely, mainly with S531L mutation. Similarly, INH resistant Mtb isolates were spread with S315T1 and C15T mutations. It is significant to detect S531L among RIF resistant and S315T1 and C15T mutations among INH resistant isolates as it may be a determinant for subsequent development of MDR-TB. Rapid diagnosis of RIF and INH resistant Mtb strains in TB patients would expedite modification of treatment regimens, and proper infection control interventions could be taken on time to reduce the risk of further development and transmission of MDR-TB.HighlightsTuberculosis(TB), particularly drug resistance TB (DR-TB) continues to be a major public health threat globally. Herein, we used a systematic literature search on reliable electronic databases, and perform a meta-analysis to assess the prevalence of the gene mutations associated with rifampicin (RIF) and isoniazid (INH) resistant Mtb in Ethiopia. The meta-analysis derived an estimated pooled prevalence of katGMUT1 (S315T1) in INH resistant Mtb was 89.18% (95%CI 81.94-96.43%), while inhAMUT1(C15T) resistant Mtb prevalence was 77.48% (95% CI 57.84-97.13%). Besides, among 90.8% of RIF resistant strains which had detectable rpoB gene mutation, a pooled S531L resistant Mtb prevalence was 74.20% (95%CI 66.39-82.00%). This review revealed that the RIF resistant Mtb strains were spread widely, mainly with S531L mutation, while the INH resistant Mtb isolates were spread widely with S315T1 and C15T mutations. So, it is significant to detect S531L among RIF resistant and S315T1 and C15T mutations among INH resistant isolates as it may be a determinant for subsequent development of MDR-TB. Rapid diagnosis of RIF and INH resistant Mtb strains in TB patients would expedite alteration of treatment regimens, and proper infection control interventions could be taken on time to reduce the risk of further development and transmission of MDR-TB.
Published: 2020
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28. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017

Author: Manisha Dubey, Fatemeh Rajati, Mehran Shams-Beyranvand, Amir Khater, Reza Shirkoohi, Segun Emmanuel Ibitoye, David C. Schwebel, Milena Ilic, Kebede Embaye Gezae, Ali Akbar Fazaeli, Ronny Westerman, Taye Abuhay Zewale, Ravi Mehrotra, Sezer Kisa, Junaid Khan, Jost B. Jonas, Dian Kusuma, Marcel Ausloos, Getnet Gedefaw, Hamed Zandian, Edward J Mills, Aparna Lal, Atalay Goshu Muluneh, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Jacqueline Elizabeth Alcalde Rabanal, Yousef Veisani, Sharath Burugina Nagaraja, Christopher Troeger, Ismael R. Campos-Nonato, Kidane Tadesse Gebremariam, Maysaa El Sayed Zaki, Oliver J. Brady, David Laith Rawaf, Tamer H. Farag, Simin Mouodi, Hafiz Ansar Rasul Suleria, Saleh Salehi Zahabi, Soumyadeep Bhaumik, Samad Azari, Getinet Ayano, Faris Lami, Raaj Kishore Biswas, Maryam Adabi, Alaa Badawi, Saravanan Muthupandian, Amir Hasanzadeh, Martin Amogre Ayanore, Maziar Moradi-Lakeh, Mohamad-Hani Temsah, Kavumpurathu Raman Thankappan, Bineyam Taye, Nader Jafari Balalami, Hamid Yimam Hassen, Karzan Abdulmuhsin Mohammad, Paul H. Lee, Emerito Jose A. Faraon, Kewal Krishan, Muhammad Ali, Ehsan Sadeghi, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Lal B. Rawal, Alyssa N. Sbarra, Behnam Heidari, Dietrich Rothenbacher, Hagos Tasew Atalay, Eric L. Ding, Noushin Mohammadifard, Nihal Thomas, Man Mohan Mehndiratta, Sanghamitra Pati, Addisu Melese, Niranjan Kissoon, Farzad Manafi, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Mohammad Reza Sobhiyeh, Frank B. Osei, Koku Sisay Tamirat, Yahya Salimi, Pranab Chatterjee, Gebreamlak Gebremedhn Gebremeskel, Olatunji O. Adetokunboh, Benjamin K. Mayala, Bhaskaran Unnikrishnan, Zahid A Butt, Olufemi Ajumobi, Fiseha Wadilo Wada, Shafiu Mohammed, Charles Shey Shey Wiysonge, Félix Carvalho, Masresha Tessema Anegago, Yun Jin Kim, Ai-Min Wu, Ketema Bizuwork Gebremedhin, Paulina A. Lindstedt, Ana-Laura Manda, Aziz Eftekhari, Rakhi Dandona, Mehdi Fazlzadeh, Nicole Davis Weaver, Muluken Bekele Sorrie, Marwa Rashad Salem, Kassawmar Angaw Bogale, Dongyu Zhang, Saeed Safari, Vivekanand Jha, Keivan Ahmadi, Turki Alanzi, Amir Jalali, Hamidreza Haririan, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Lucas Guimarães Abreu, Gessessew Bugssa Hailu, Surendra Karki, Kirsten E. Wiens, Boikhutso Tlou, Soraya Siabani, Muluken Azage Yenesew, Asnakew Achaw Ayele, Ayalew Jejaw Zeleke, Osayomwanbo Osarenotor, Susanna Dunachie, Marcos Roberto Tovani-Palone, Daniel Bekele Ketema, Tissa Wijeratne, Dessalegn Ajema Berbada, André Karch, Ebrahim Babaee, Akram Pourshams, Seyyed Meysam Mousavi, Bal Govind Chauhan, Giuseppe Remuzzi, Vera Marisa Costa, Mehdi Yaseri, Tahereh Pashaei, Benn Sartorius, Helen Derara Diro, Anelisa Jaca, Mostafa Hosseini, Nikolay Ivanovich Briko, Franz Castro, Cuong Tat Nguyen, Chalachew Genet Akal, Natalie Maria Cormier, Ghulam Mustafa, Sonia Lewycka, Achala Upendra Jayatilleke, David L. Smith, Ibrahim A Khalil, Genet Melak Alamene, George C Patton, Andem Effiong, Gebrekiros Gebremichael Meles, Collins Chansa, Tsegaye Lolaso Lenjebo, Van C. Lansingh, Chabila C Mapoma, Olayinka Stephen Ilesanmi, Aso Mohammad Darwesh, Aubrey J. Levine, Miliva Mozaffor, Till Bärnighausen, Ali Rostami, André Faro, Rushdia Ahmed, Colm McAlinden, Duduzile Ndwandwe, Neeraj Bedi, Irfan Ullah, Winfried März, Rajeev Gupta, Masood Ali Shaikh, Catalina Liliana Andrei, Ali Kazemi Karyani, Shaimaa I. El-Jaafary, Abbas Mosapour, Javad Nazari, Obinna Onwujekwe, Narinder Pal Singh, Dabere Nigatu, Tanuj Kanchan, Jagdish Khubchandani, Aklilu Endalamfaw, Hajer Elkout, Michelle L. Bell, Beyene Meressa Adhena, Evanson Z. Sambala, Nelson Alvis-Guzman, Nefsu Awoke, Mohammad Ali Sahraian, Muki Shey, Christiane Dolecek, Kedir Hussein Abegaz, Syed Ather Hussain, Birhan Tamene Alemnew, Arash Etemadi, Anwar E. Ahmed, Vinay Nangia, Sachin R Atre, Roghiyeh Faridnia, Robert C. Reiner, Rajat Das Gupta, Aniruddha Deshpande, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Muktar Beshir Ahmed, Kiana Ramezanzadeh, Jacek Jerzy Jozwiak, Chi Linh Hoang, Bahram Armoon, Manfred Accrombessi, Christopher J L Murray, Ebrahim M Yimer, Rashmi Gupta, Ahmed Omar Bali, Dadi Marami, Arash Tehrani-Banihashemi, Getnet Mengistu, Govinda Prasad Dhungana, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Ali S. Akanda, Satar Rezaei, Wondimeneh Shibabaw Shiferaw, Irina Filip, Mohammad Fareed, Hagos Degefa Hidru, Morteza Shamsizadeh, Mojtaba Hoseini-Ghahfarokhi, Yared A Asmare Aynalem, Gelin Xu, Zubair Kabir, Khalid A Altirkawi, Beatriz Paulina Ayala Quintanilla, Kenean Getaneh Tlaye, Devasahayam J. Christopher, Malede Mequanent Sisay, Yibeltal Alemu Bekele, Mika Shigematsu, Bryan L. Sykes, Quique Bassat, Jemal Abdu Mohammed, Seyed Mostafa Mir, Moslem Soofi, Nuruzzaman Khan, Ensiyeh Jenabi, Seyed-Mohammad Fereshtehnejad, Alireza Esteghamati, Paramjit Gill, Nathaniel J Henry, Meghnath Dhimal, Hosein Shabaninejad, Trang Huyen Nguyen, Amjad Mohamadi-Bolbanabad, Eugenio Traini, Mohammad Zamani, Arianna Maever L. Amit, Mehran Alijanzadeh, Florian Fischer, Rafael Moreira Claro, Pushpendra Kumar, Shai Linn, Lucas Earl, Haileab Fekadu Wolde, Getenet Dessie, Doris D. V. Ortega-Altamirano, John S. Ji, Moritz U. G. Kraemer, Saeed Amini, Ziad A. Memish, Aisha Elsharkawy, Ken Lee Chin, Mustafa Z. Younis, Daniel Diaz, Hebat Allah Salah A. Yousof, Seifadin Ahmed Shallo, Tomohide Yamada, Adrian Pana, Salman Rawaf, Amir Almasi-Hashiani, Platon D. Lopukhov, Alireza Rafiei, Dragos Virgil Davitoiu, Hossein Poustchi, Ayele Geleto Bali, Francesco Saverio Violante, Leonardo Roever, Giovanni Damiani, Maha El Tantawi, Nuworza Kugbey, Hadi Pourjafar, Michael R.M. Abrigo, Dinh-Toi Chu, Farkhonde Salehi, Phetole Walter Mahasha, Farnam Mohebi, Sathish Thirunavukkarasu, Dharmesh Kumar Lal, Senbagam Duraisamy, Demelash Woldeyohannes Handiso, Eleonora Dubljanin, Takeshi Fukumoto, Biruck Desalegn Yirsaw, Fakher Rahim, Jasvinder A. Singh, Jai K Das, Savita Lasrado, Ana Isabel Ribeiro, Santosh Varughese, Adnan Kisa, Laurie B. Marczak, Amira Shaheen, Peter Njenga Keiyoro, Nader Jahanmehr, Yuming Guo, Arash Ziapour, Alex Yeshaneh, Ninuk Hariyani, Seyed Sina Naghibi Irvani, Sameer Vali Gopalani, Joel M. Francis, Asmamaw Demis, Ahamarshan Jayaraman Nagarajan, Praveen Hoogar, Nicola Luigi Bragazzi, Yunquan Zhang, Yousef Mohammad, Iman El Sayed, Vafa Rahimi-Movaghar, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Marzieh Nojomi, Tewodros Eshete Wonde, Sameh Magdeldin, Anton Sokhan, Nauman Khalid, Nima Hafezi-Nejad, Ben Lacey, Luca Ronfani, James Albright, Senthilkumar Balakrishnan, Ejaz Ahmad Khan, Khanh Bao Tran, Guoqing Hu, Yousef Khader, Parvaneh Mirabi, Boris Bikbov, Feleke Mekonnen Demeke, Assefa Desalew, Yasir Waheed, Berhe Etsay Tesfay, Julio Cesar Campuzano Rincon, Ernoiz Antriyandarti, Brian J. Hall, James A Platts-Mills, Gbenga A. Kayode, Jan-Walter De Neve, Maria Jesus Rios-Blancas, Navid Manafi, Ravi Prakash Jha, Yilma Chisha Dea Geramo, Hamideh Salimzadeh, Fisaha Haile Tesfay, Abdullah Al Mamun, Ali Bijani, Hedley Quintana, Shanshan Li, Kebreab Paulos, Joan B. Soriano, Victor Adekanmbi, Oladimeji Adebayo, David Teye Doku, Brijesh Sathian, Bakhtiar Piroozi, MohammadBagher Shamsi, Netsanet Fentahun, Shymaa Enany, Ayman Grada, Salvatore Rubino, Kenji Shibuya, Norberto Perico, Sergio I. Prada, Andrea Farioli, Gebremicheal Gebreslassie Kasahun, Mohsen Afarideh, Maciej Banach, Andrey Nikolaevich Briko, Mohsen Asadi-Lari, Rakesh Lodha, David M. Pigott, Bárbara Niegia Garcia de Goulart, Hadi Hassankhani, Daniel Adane Endalew, Siamak Sabour, Yoshan Moodley, Preeti Dhillon, Dilaram Acharya, Anas M. Saad, Ibrahim Abdelmageed Ginawi, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Hasan Yusefzadeh, Mohammad Rabiee, Ajay Patle, Rahman Shiri, Girmay Teklay Weldesamuel, Sivan Yegnanarayana Iyer Saraswathy, Mekdes Tigistu Yilma, Davide Guido, Chuanhua Yu, Abdallah M. Samy, Ali Talha Khalil, Ashish Awasthi, Pascual R. Valdez, Nelson G.M. Gomes, Nejimu Biza Zepro, Taweewat Wiangkham, Anthony Masaka, Afsaneh Arzani, Ayesha Humayun, Michael Tamene Haile, Huyen Phuc Do, Krittika Bhattacharyya, Maryam Khayamzadeh, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Farah Daoud, QuynhAnh P Nguyen, Suleman Atique, Sheikh Mohammed Shariful Islam, Indang Trihandini, Mario Poljak, Bartosz Miazgowski, Huda Basaleem, Rafael Alves Guimares, Mina Anjomshoa, Peng Jia, Yafeng Wang, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Itamar S. Santos, Alireza Khatony, Desalegn Tadese Mengistu, Samath D Dharmaratne, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Konrad Pesudovs, Tina Beyranvand, Liliana Preotescu, Leticia Avila-Burgos, Enrico Rubagotti, Amira Hamed Darwish, Mahdi Safdarian, Ali Yadollahpour, Vijay Kumar Chattu, Moses K. Muriithi, Azmeraw T. Amare, Si Si, Joshua Longbottom, Somayeh Bohlouli, Khaled Khatab, Masoud Behzadifar, Anusha Ganapati Bhat, G Anil Kumar, Margaret Kosek, Mona M. Khater, Reta Tsegaye Gayesa, Ghobad Moradi, Srinivas Goli, Ruth W Kimokoti, Jalal Arabloo, Kimberly B. Johnson, Andrew T Olagunju, Mowafa Househ, In-Hwan Oh, Arya Haj-Mirzaian, Desta Haftu Hayelom, Jae Il Shin, Ahmed Abdelalim, Catherine A. Welgan, Veincent Christian Filipino Pepito, Andre Rodrigues Duraes, Yuan-Pang Wang, Rosario Cárdenas, Mohammad Khazaei, Sebastian Vollmer, Xiu-Ju Zhao, Mihajlo Jakovljevic, Degu Abate, Ali S. Shalash, Davide Rasella, Melese Abate Reta, Hedayat Abbastabar, Manu Raj Mathur, Aliasghar Ahmad Kiadaliri, Ritesh G. Menezes, Molly K. Miller-Petrie, Beriwan Abdulqadir Ali, Ahmed I. Hasaballah, Joseph Frostad, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Deborah Carvalho Malta, Brigette F. Blacker, Carlo La Vecchia, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Zewdie Aderaw Alemu, Foad Abd-Allah, Elias Merdassa Roro, Agus Sudaryanto, Fariba Ghassemi, Behzad Karami Matin, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Maheswar Satpathy, Mahesh P A, Carlos Miguel Rios González, Pallab K. Maulik, Amir Kasaeian, Ali H. Mokdad, Alemayehu Toma Mena, Tamirat Tesfaye Dasa, Abdur Razzaque Sarker, Andre M. N. Renzaho, Muhammad Aziz Rahman, Ali Kabir, Josephine W. Ngunjiri, Aberash Abay Tassew, Kala M. Mehta, Ionut Negoi, Hosni Salem, Hesham M. Al-Mekhlafi, Sharareh Eskandarieh, Rufus A. Adedoyin, Saleem M Rana, Engida Yisma, Sahel Valadan Tahbaz, Hossein Farzam, Krishna K. Aryal, Lalit Dandona, Masoud Moradi, Juan Sanabria, Gebre Teklemariam Demoz, Naser Mohammad Gholi Mezerji, Shirin Djalalinia, Suraj Bhattarai, Ammas Siraj Mohammed, Claudiu Herteliu, Dawit Zewdu Wondafrash, Mohsen Bayati, Arvin Haj-Mirzaian, Gulfaraz Khan, Mostafa Leili, Nasir Salam, Ehsan Khodamoradi, Jean Jacques Noubiap, Vahid Alipour, Mohammad Ali Mansournia, Rajesh Sagar, Jagadish Rao Padubidri, Manasi Kumar, Mehdi Sharif, Fatemeh Heydarpour, Navid Rabiee, Gvs Murthy, Hamed Kalani, Mayowa O. Owolabi, Claudio Alberto Davila, Oluchi Okpala, Shivakumar K.M. Kondlahalli, Mathew M. Baumann, Bereket Duko Adema, Lorenzo Monasta, Paul S. F. Yip, Mohammad Hossein Khosravi, Rizwan Suliankatchi Abdulkader, Ibrahim Abdollahpour, Dhirendra N Sinha, Farid Najafi, Kebede Deribe, Paula Moraga, Mehedi Hasan, Mohammad Moradi-Joo, Melkamu Merid Mengesha, Temesgen Yihunie Akalu, Vishnu Renjith, Syed Mohamed Aljunid, Zemenu Tadesse Tessema, Amir Radfar, Nuno Taveira, Masoud Foroutan, Demelash Abewa Elemineh, Chinwe Juliana Iwu, Kamarul Imran Musa, Getaneh Alemu Abebe, Farshad Pourmalek, Olatunde Aremu, Mohammad Reza Salahshoor, Derrick A Bennett, Ahmad Daryani, Alebachew Fasil Ashagre, Apurba Shil, Narayan Bahadur Mahotra, Nelson J. Alvis-Zakzuk, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Mehdi Hosseinzadeh, Rovshan Khalilov, Ai Koyanagi, Salman Khazaei, Jennifer Rickard, Ali Almasi, Sandra B. Munro, Carlos Zambrana-Torrelio, Naohiro Yonemoto, Ahmad Ghashghaee, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Instituto de Saúde Pública da Universidade do Porto, Local Burden Dis Diarrhoea, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, Reiner, Robert C, Wiens, Kirsten E, Deshpande, Aniruddha, Baumann, Mathew M, Adema, Bereket Duko, Yirsaw, Biruck Desalegn, Yisma, Engida, Hay, Simon I, Local Burden of Disease Diarrhoea Collaborators, Tampere University, Health Sciences, University of Helsinki, Institute for Molecular Medicine Finland, Clinicum, HUS Comprehensive Cancer Center, Local Burden of Disease Diarrhoea Collaborator, and Violante FS
Subjects: Low income countries, medicine.medical_treatment, 030204 cardiovascular system & hematology, Global Health, THERAPY, Global Burden of Disease, 0302 clinical medicine, Prevalence, Global health, Medicine, WATER, 030212 general & internal medicine, Children, 11 Medical and Health Sciences, Incidence, Mortality rate, Incidence (epidemiology), 1. No poverty, General Medicine, 3142 Public health care science, environmental and occupational health, Diarrhoea, 3. Good health, Child, Preschool, Middle income countries, A990 Medicine and Dentistry not elsewhere classified, TERRITORIES, Life Sciences & Biomedicine, Infants, Diarrhea, AFRICA, medicine.medical_specialty, Childhood deaths, RJ, sanitation, Developing country, Childhood diarrhoeal morbidity, ITC-HYBRID, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, Environmental health, SYSTEMATIC ANALYSIS, Life Science, Humans, Healthcare Disparities, Oral rehydration therapy, Risk factor, hand washing, Developing Countries, Disease burden, Global Nutrition, Wereldvoeding, Science & Technology, SEX-SPECIFIC MORTALITY, business.industry, CHOLERA, Public health, Bayes Theorem, diarrheal disease, Local Burden of Disease Diarrhoea Collaborators, ITC-ISI-JOURNAL-ARTICLE, NA, Human medicine, Diarrea, business
Abstract: Background: Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods: We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings: The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation: By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. This work was primarily supported by a grant from the Bill & Melinda Gates Foundation (OPP1132415). S Aljunid reports additional funding from the International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia and Department of Health Policy and Management, Faculty of Public Health, Kuwait University for the approval and support to participate in this research project outside of the study. A Awasthi is supported by the Department of Science and Technology, Government of India, New Delhi, through the INSPIRE Faculty Program outside of the study. A Badawi reports additional funding from the Public Health Agency of Canada outside of the study. A Barac reports additional funding from the Project of Ministry of Education, Science and Technology of the Republic of Serbia (no III45005) outside of the study. T Bärnighausen reports additional funding by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research outside of the study. F Carvalho and E Fernandez report additional funding from the Portuguese national funds (UID/MULTI/04378/2019 and UID/QUI/50006/2019) outside of the study. V M Costa reports additional funding from Fundação da Ciência e Tecnologia (FCT) for her grant (SFRH/BPD/110001/2015), which was funded by national funds through FCT – Fundação para a Ciência e a Tecnologia, IP, under the Norma Transitória – DL57/2016/CP1334/CT0006 outside of the study. J De Neve reports additional funding from the Alexander von Humboldt Foundation outside of the study. K Deribe reports additional funding from the Wellcome Trust (grant number 201900) as part of his International Intermediate Fellowship outside of the study. D Endalew and M Moradi report additional funding from Wolkite University. M Ausloos, C Herteliu, and A Pana report additional funding from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI (project number PN-III-P4-ID-PCCF-2016-0084) outside of the study. C Herteliu reports additional funding from the European Fund for Regional Development through Operational Program for Competitiveness (Project ID P_40_382) and the European Fund for Regional Development, through InterReg Romania-Hungary (project code EMS ROHU 217) outside of the study. P Hoogar reports additional funding from the Centre for Holistic Development and Research (CHDR), Kalaghatagi and The Department of Studies in Anthropology, Karnatak University, D S Islam reports additional funding from the National Heart Foundation of Australia and the Institute for Physical Activity and Nutrition, Deakin University outside of the study. A Khatony reports additional funding from the Clinical Research Development Center of Imam Reza Hospital in Kermanshah outside of the study. J Khubchandani reports additional funding from Merck Research Laboratories outside of the study. K Krishan reports additional funding from the UGC Center of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India outside of the study. M Kumar reports additional funding from the Fogarty Foundation/NIH through a K43 award (TW010716-01A1) outside of the study. B Lacey reports additional funding from the National Institute for Health Research Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence (Oxford, UK) outside of the study. A M Samy reports additional funding from the Egyptian Fulbright Mission Program (EFMP) outside of the study. S Seyedmousavi reports additional funding from the Intramural Program of National Institute of Health Clinical Center, Bethesda, MD, USA outside of the study. M Shey reports additional funding from the Wellcome Trust Kenji Shibuya reports additional funding from Japan's Ministry of Health, Labour and Welfare and Japan's Ministry of Education, Culture, Sport, Science and Technology outside of the study. M Sobhiyeh reports additional funding from the Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences outside of the study. J Soriano reports additional funding from Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain outside of the study. N Taveira reports additional funding from the LIFE study (RIA2016MC-1615) of the European and Developing Countries Clinical Trials Partnership (EDCTP) program supported by the European Union outside of the study. B Unnikrishnan reports additional funding from the Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India outside of the study. T Wijeratne reports additional funding from the Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Sri Lanka outside of the study. C S Wiysonge reports additional funding from the South African Medical Research Council and the National Research Foundation of South Africa outside of the study.
Published: 2020

29. Global evolutionary epidemiology, phylogeography and resistome dynamics of Citrobacter species, Enterobacter hormaechei, Klebsiella variicola, and Proteeae clones: A One Health analyses

Author: John Osei Sekyere and Melese Abate Reta
Subjects: Genetics, Citrobacter, Phylogenetics, Biology, biology.organism_classification, Providencia, Morganella morganii, Klebsiella variicola, Proteus mirabilis, Citrobacter freundii, Resistome
Abstract: Background.The global epidemiology and resistomes dynamics of multidrug-resistant Citrobacter spp., Enterobacter hormaechei, Klebsiella variicola, morganella morganii, Proteus mirabilis and Providencia spp. have not been described, despite their importance as emerging opportunistic clinical pathogens.Methods.The genomes of the above-mentioned organisms were curated from PATRIC and NCBI and used for evolutionary epidemiology, phylogeography and resistome analyses. The phylogeny trees were drawn using RAXmL and edited with Figtree. The resistomes were curated from GenBank and the phylogeography was manually mapped.Results and conclusion.Mcr-9 and other mcr variants were highly prevalent in E. hormaechei subsp. and substantial in C. freundii whilst KPC, OXA-48, NDM, IMP, VIM, TEM, OXA and SHV were abundant in global E. hormaechei subsp., Citrobacter freundii, P. mirabilis, P. stuartii and P. rettgeri clones/clades. Species-specific ampCs were highly conserved in respective species whilst fluoroquinolones, aminoglycosides, macrolides, fosfomycin, chloramphenicol, tetracycline, sulphamethoxazole and trimethoprim resistance mechanisms were abundantly enriched in almost all clades of most of the species, making them extensively and pandrug resistant; K. variicola, C. amalonaticus and C, koseri had relatively few resistance genes. Vertical and horizontal resistome transmissions as well as local and international dissemination of strains evolving from common ancestors were observed, suggesting the anthroponotic, zoonotic, and food-/water-borne infectiousness of these pathogens. There is a global risk of pandrug resistant strains escalating local and international outbreaks of antibiotic-insensitive infections, initiating the dawn of a post-antibiotic era.
Published: 2020

30. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17

Author: Ninuk Hariyani, Benjamin Uzochukwu, Anas M. Saad, Sivan Yegnanarayana Iyer Saraswathy, Amirhossein Sahebkar, Behzad Karami Matin, Abdallah M. Samy, Roman Topor-Madry, Nelson G.M. Gomes, Afsaneh Arzani, Simin Liu, Maryam Khayamzadeh, Ejaz Ahmad Khan, Asmamaw Bizuneh Demis, Anelisa Jaca, Amir Kasaeian, Fereshteh Ansari, Abdur Razzaque Sarker, Ali Kabir, Jorge Cano, Marcos Roberto Tovani-Palone, Tufa Kolola, Josephine W. Ngunjiri, Roghiyeh Faridnia, Kedir Hussein Abegaz, Hosni Salem, Sharareh Eskandarieh, Norberto Perico, Sergio I. Prada, Fisaha Haile Tesfay, Jai K Das, Ana Isabel Ribeiro, Sameer Vali Gopalani, Dessalegn Haile, Shivakumar Km Marulasiddaiah M. KMShivakumar, Narayan Prasad, Pranab Chatterjee, Shafiu Mohammed, Ravi Prakash Jha, Xiu Ju George Zhao, Farshad Farzadfar, Ahmad Daryani, Pramesh Raj Ghimire, Abbas Mosapour, Ebrahim Babaee, Rajat Das Gupta, Jean Jacques Noubiap, Daniel Bekele Ketema, Teshome Bekele Elema I, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Muktar Beshir Ahmed, Wondimeneh Shibabaw Shiferaw, Mehran Asadi-Aliabadi, Mohamed M. Gad, Eugenio Traini, Milena Santric-Milicevic, Bakhtiar Piroozi, Mohsen Afarideh, Duduzile Ndwandwe, Ibrahim Abdollahpour, Aisha Elsharkawy, Bárbara Niegia Garcia de Goulart, Soufiane Boufous, Obinna Onwujekwe, Seyyed Meysam Mousavi, Azeem Majeed, Meghnath Dhimal, Bruno F. Sunguya, Daniel Adane Endalew, Hosein Shabaninejad, Siddhesh Zadey, Takahiro Tabuchi, Gebrekiros Gebremichael Meles, Davide Guido, Trang Huyen Nguyen, Yonatal Mesfin Tefera, Hala Elhabashy, Devasahayam J. Christopher, Malede Mequanent Sisay, Davide Rasella, Hedayat Abbastabar, Maziar Moradi-Lakeh, Anthony Masaka, Wagaye Fentahun Chanie, B. Suresh Kumar Shetty, Matiwos Soboka Daba, Tesfaye Yitna Yitna Chichiabellu, Arianna Maever L. Amit, Tomohide Yamada, Alireza Rafiei, Reinhard Busse, Abdullah Al Mamun, Genet Melak Alamene, George C Patton, Andem Effiong, Rushdia Ahmed, Jagadish Rao Padubidri, Mohamad-Hani Temsah, Nizal Sarrafzadegan I, Francesco Saverio Violante, Monika Sawhney, Eyal Oren, Kimberly B. Johnson, Benn Sartorius, Shirin Djalalinia, Mohsen Bayati, Merhawi Gebremedhin Tekle, Navid Rabiee, Javad Nazari, Krishna K. Aryal, Kavumpurathu Raman Thankappan, Yoshan Moodley, Anh Kim Dang, Mohammad Khazaei, Parvaiz A Koul, Edson Serván-Mori, Foad Abd-Allah, Seyed Mohammad Riahi, Nader Jahanmehr, Yuming Guo, Sonia Saxena, Bayu Begashaw Bekele, Hagos Degefa de Hidru I, Enayatollah Homaie Rad, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Oliver J. Brady, Natalie Maria Cormier, Ghulam Mustafa, Samiah Alam, Guoqing Hu, Yousef Khader, Mohsen Mazidi, Hamed Kalani, Hamideh Salimzadeh, Mayowa O. Owolabi, Ali Bijani, Getu Debalkie Demissie, Tsegaye Lolaso Lenjebo, German Martinez, Elias Merdassa Roro, Hamidreza Komaki, Giovanni Damiani, Nelson Alvis-Guzman, Reza Shirkoohi, Aditya Prasad Dash, Benny Antony, Cheru Tesema Leshargie, Josip Car, Turki Alanzi, Amir Jalali, Shahin Soltani, Arvin Haj-Mirzaian, John S. Ji, Nima Hafezi-Nejad, S. Mohammad Sajadi, Khalid A Altirkawi, Shanshan Li, Hunduma Amensisa Amensisa Bojia I, Estifanos Baye, Hany Aref, Kebreab Paulos, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Felix Lam, Themba G.G. Ginindza, Behnam Heidari, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Mostafa Leili, Sohail Ahmad, Babak Moazen, Samad Azari, Feleke Gebremeskel W, Jacqueline Elizabeth Alcalde-Rabanal, Khanh Bao Tran, Okechukwu S Ogah, Bruno Ramos Nascimento, Tefera Chane Mekonnen, Irina Filip, Bogdan Oancea, Lalit Dandona, Desalegn Markos Shifti, Nasir Salam, Binyam Minuye Birihane, Mohammad Ali Mansournia, Mohammad Ebrahimi Kalan, Sheetal D. Lad, Michael R.M. Abrigo, Ken Lee Chin, Masoud Moradi, Temesgen Yihunie Akalu, Behzad Heibati, Ole Frithjof Norheim, Man Mohan Mehndiratta, Mahya Beheshti, Ali Yadollahpour, Gelin Xu, Siamak Sabour, Neda Izadi, Carlos Culquichicón, Tuomo J. Meretoja, Ireneous N. Soyiri, Jacob Olusegun Olusanya, Félix Carvalho, Hamid Yimam Hassen, Dereje Bayissa Demissie, Yun Jin Kim, Rajesh Sagar, Fakher Rahim, Catrin E. Moore, Thomas R. Hird, Amjad Mohamadi-Bolbanabad, Naser Mohammad Gholi Mezerji, Ahamarshan Jayaraman Nagarajan, Anton Sokhan, Faris Lami, Masoud Behzadifar, Ritesh G. Menezes, Amira Hamed Darwish, Mohammad Zamani, Tesleem Kayode Babalola, Navid Manafi, Charles Shey Wiysonge, Diego Augusto Santos Silva, Daniel Diaz, Eleonora Dubljanin, Soraya Nouraei Motlagh, Suraj Bhattarai, Getasew Taddesse Worku, Noore Alam, Jasvinder A. Singh, Catalina Liliana Andrei, Ali Kazemi Karyani, Robert C. Reiner, Mohammedaman Mama Hussen, Fatemeh Heydarpour, Nuruzzaman Khan I, Bach Xuan Tran, Lal B. Rawal, Bereket Duko, Joemer C. Maravilla, Rakhi Dandona, Sandra B. Munro, Jae Il Shin, Julia Moreira Pescarini, Claudiu Herteliu, Ahmed Abdelalim, Manasi Kumar, Pushpendra Kumar, Saleem Muhammad Rana, Hedley Quintana, Akram Pourshams, Franz Castro, Muhammad Aziz Rahman, Beyene Meressa Adhena, Aberash Abay Tasew, Linda Morales, Dawit Zewdu Wondafrash, Wasiq Faraz Rawasia, David Laith Rawaf, Zoubida Zaidi, Tomislav Mestrovic, Rajeev Gupta, Seyyede Masoume Athari, Peter Njenga Keiyoro, Andrea Werdecker, Santi Martini, Fatemeh Rajati, Andre Pascal Kengne, Victor Adekanmbi, Seid Tiku Mereta, Yared Asmare Aynalem, Kewal Krishan, Marzieh Nojomi, Yves Miel H Zuniga, Mohammad Reza Sobhiyeh, Frank B. Osei, Nefsu Awoke, Randah R. Hamadeh, G. K. Mini, Edris Hasanpoor, Ayele Geleto Bali, Moslem Soofi, Prabhat Lamichhane, Peter Azzopardi, Amir Khater, G Anil Kumar, Catherine A. Welgan, Abraham Getachew Kelbore, Jaifred Christian F. Lopez, Senthilkumar Balakrishnan, Mohammad Ali Sahraian, Ahmed I. Hasaballah, Virendra Singh, Arash Ziapour, Zahid A Butt, Hebat Allah Salah A. Yousof, Tewodros Eshete Wonde, Sanjay Zodpey, Amaha Kahsay, Achala Upendra Jayatilleke, Segun Emmanuel Ibitoye, Beriwan Abdulqadir Ali, Simin Mouodi, Salman Rawaf, Iqbal R. F. Elyazar, Ai-Min Wu, Seyed Sina Naghibi Irvani, Yasir Waheed, Delia Hendrie, Hadi Pourjafar, Farnam Mohebi, Naohiro Yonemoto, Ahmad Ghashghaee, Veincent Christian Filipino Pepito, Paulina A. Lindstedt, Nauman Khalid, Sezer Kisa, Chi Linh Hoang, Niranjan Kissoon, Kindie Fentahun Muchie, Valery L. Feigin, Mathew M. Baumann, Alemayehu Toma, Andre Rodrigues Duraes, Benjamin B. Massenburg, Santosh Varughese, Yuan-Pang Wang, Ingan Ukur Tarigan, Ali Kiadaliri, Hamed Zandian, Demelash Woldeyohannes Handiso, Hassan Magdy Abd El Razek, Ketema Bizuwork Gebremedhin, Hafiz Ansar Rasul Suleria, Oluchi Ezekannagha, Getinet Ayano, Bolajoko O. Olusanya, Manu Raj Mathur, Manfred Accrombessi, Christopher J L Murray, Moritz U. G. Kraemer, Saeed Amini, Ziad A. Memish, Yousef Mohammad, Luis Camera, Ernoiz Antriyandarti, Ronny Westerman, Meghdad Pirsaheb, Negar Rezaei, Ted R. Miller, Aziz Eftekhari, Nevine El Nahas, Sebastian Vollmer, Sanjay Basu, Hesham M. Al-Mekhlafi, D. R. Mahadeshwara Prasad, Rufus A. Adedoyin, Miliva Mozaffor I, Mihiretu Kebede, Preeti Dhillon, Dilaram Acharya, Iman El Sayed, Narendar Manohar, Paul S. F. Yip, Ben Lacey, Felix Akpojene Ogbo, Adrian Davis, Dinh-Toi Chu, Ranjani Somayaji, Raaj Kishore Biswas, Taddese Alemu Zerfu, Claudio Alberto Dávila-Cervantes, Sharath Burugina Nagaraja, Getachew Mullu Kassa, Mohan Bairwa, Gurudatta Naik, André Karch, Gudlavalleti V S Murthy, Avula Laxmaiah, Farid Najafi, Birhanu Geta Meharie, Lorenzo Monasta, Amit Arora, Christopher S Yilgwan, Samer Hamidi, Keivan Ahmadi, Kebede Deribe, Ehimario U. Igumbor, Engida Yisma, Henok Biresaw Netsere, Mihajlo Jakovljevic, Ali S. Shalash, Thirunavukkarasu Sathish, Sachin R Atre, Mohamed I Hegazy, Mehedi Hasan, Hamidreza Haririan, Lucas Guimarães Abreu, Nejimu Biza Zepro, Surendra Karki, Krittika Bhattacharyya, Hiroshi Yatsuya, Gbenga A. Kayode, Osayomwanbo Osarenotor, Paul H. Lee, Deepak Paudel, Hagos Tasew Atalay, Hatem S Shehata, Mohammad Fareed, Adnan Kisa, Hisham Atan Edinur, Mehran Alijanzadeh, Shafiur Rahman, Mohammad Hossein Khosravi, Anusha Ganapati Bhat, Bahram Mohajer, Narinder Pal Singh, Shai Linn, Savita Lasrado, Joseph Adel Mattar Banoub, Amir Almasi-Hashiani, Mohd Anisul Karim, Praveen Hoogar, Kerrie E. Doyle, Bedilu Girma Weji, Juan Sanabria, Olatunji O. Adetokunboh, Mohamed Hsairi, Alireza Esteghamati, Seok Jun Yoon, Paramjit Gill, Dabere Nigatu, Tariq Jamal Siddiqi, Muhammad Usman, Rafael Alves Guimarães, Zemenu Tadesse Tessema, Aziz Sheikh, Florian Fischer, Peter Memiah, Rakesh Lodha, Nihal Thomas, Karzan Abdulmuhsin Mohammad, Mohammad Sadegh Rezai, Tanuj Kanchan, Vinay Nangia, Ashraf Nabhan, Gebre Teklemariam Demoz, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Sadaf G. Sepanlou, Michellr L. Bell, Nicola Luigi Bragazzi, Aklilu Endalamaw, Vishnu Renjith, Chinwe Juliana Iwu, Gabrielle B. Britton, Colm McAlinden, Ayenew Negesse Abejie, Smita Pakhale, Doris V.V. Ortega-Altamirano, Noushin Mohammadifard, Deborah Carvalho Malta, Vo Dinh Bay, Kirsten E. Wiens, Hamidreza Karimi-Sari, Mustafa Z. Younis, Shaimaa I. El-Jaafary, Morenike Oluwatoyin Folayan, Phetole Walter Mahasha, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Mohammad Hifz Ur Rahman, Sheikh Mohammed Shariful Islam, Maarten J. Postma, Usman Iqbal, Abdu A. Adamu, Marwa R.Rashad Salem I, Fares Alahdab, Vafa Rahimi-Movaghar, Zulfiqar A. Bhutta, Masoud Foroutan, Muhammad Shahzeb Khan, In-Hwan Oh, Yahya Salimi, Takeshi Fukumoto, Chhabi Lal Ranabhat, Tiffany K. Gill, Angel Paternina-Caicedo, Walter Mendoza, Sojib Bin Zaman, Olayinka Stephen Ilesanmi, Brigette F. Blacker, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Ambrish Singh, Mehdi Fazlzadeh, Mahesh P A, Carlo La Vecchia, Alex Yeshaneh, Benjamin K. Mayala, Aniruddha Deshpande, Agus Sudaryanto, Neeraj Bedi, Morteza Shamsizadeh, Jemal Abdu Mohammed, Vahid Alipour, Haileab Fekadu Wolde, Boris Bikbov, Ahmed Abualhasan, Ali H. Mokdad, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Jacek Jerzy Jozwiak, Alessandra C. Goulart, Mahmoud Yousefifard, Masood Ali Shaikh, Roya Safari-Faramani, MohammadBagher Shamsi, Aso Mohammad Darwesh, Amir Anoushiravani, Kebede Embaye Gezae, Degena Bahrey Tadesse, Paula Moraga, Maha El Tantawi, Rosario Cárdenas, Assefa Desalew, Vivek Kumar, Mina Anjomshoa, Junaid Khan, Jagdish Khubchandani, Marcel Ausloos, Soraya Siabani, Anwar E. Ahmed, Mohammed Ibrahim Mohialdeen Gubari, Andre M. N. Renzaho, Vuong Minh Nong, Kaushik Sarkar, Bruno Piassi Sao Jose, Yafeng Wang, Mitchell T. Wallin, Edgar Denova-Gutiérrez, Mohammad Hasan Imani-Nasab, Melese Abate Reta, Kala M. Mehta, Yahya Safari, Marufa Sultana, David C. Schwebel, Roghayeh Mohammadibakhsh, Samath D Dharmaratne, Maysaa El Sayed Zaki, Shiwei Liu, Gail Davey, Milena Ilic, Yunquan Zhang, Bahram Armoon, Seyed-Mohammad Fereshtehnejad, Jost B. Jonas, Dian Kusuma, Yawukal chane Kasahun, Beatriz Paulina Ayala Quintanilla, Mohammad Moradi-Joo, Gebrehiwot G. Kassa, Maria Jesus Rios-Blancas, Serge Resnikoff, Seifadin Ahmed Shallo, Bartosz Miazgowski, Huda Basaleem, Jobert Richie Nansseu, Enrico Rubagotti, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Maryam Adabi, Saravanan Muthupandian, Soumyadeep Bhaumik, hawariat, Carlos A Castañeda-Orjuela, Bhaskaran Unnikrishnan, Martin Amogre Ayanore, Dragos Virgil Davitoiu, Hossein Poustchi, Moses K. Muriithi, Dharmesh Kumar Lal, Ayman Grada, Rafael Tabarés-Seisdedos, Seyyed Shamsadin Athari, Ashish Pathak, Salvatore Rubino, Kenji Shibuya, Ana Laura Manda, Muluken Bekele Sorrie, Vivekanand Jha, Habtamu Kebebe Kasaye, Mohammad Hoseini, Sonali Kochhar, Van C. Lansingh, Ali Almasi, Amir Radfar, Till Bärnighausen, Marcia R. Weaver, Mowafa Househ, Arya Haj-Mirzaian, Gebremicheal Gebreslassie Kasahun, Arash Etemadi, Getahun Fentaw Mulaw, Zubair Kabir, Cuong Tat Nguyen, Chabila C Mapoma, Aubrey J. Levine, Solomon Gedlu Nigatu, Aslam Pervaiz, Muhammed Magdy Abd El Razek, Nataliya A. Foigt, Andrey Nikolaevich Briko, Sadaf Esteghamati, Chuanhua Yu, Pascual R. Valdez, Jennifer Rickard, Jennifer M. Ross, Ionut Negoi, Hailay Abrha Gesesew, Kamarul Imran Musa, Farshad Pourmalek, Kiomars Sharafi, Sangram Kishor Patel, Vera Marisa Costa, Mostafa Hosseini, Hajer Elkout, Mika Shigematsu, Bryan L. Sykes, Afarin Rahimi-Movaghar, Nuworza Kugbey, Vijay Kumar Chattu, Payman Salamati, Mona M. Khater, Reta Tsegaye Gayesa, Ehsan Sadeghi, Andrew T Olagunju, Govinda Prasad Dhungana, Dina Nur Anggraini Ningrum, Yaschilal Muche Belayneh, Leonardo Roever, Luca Ronfani, Nathaniel J. Henry, Brijesh Sathian, Hamid Sharifi, Liliana Preotescu, Joshua Longbottom, Somayeh Bohlouli, Huong Lan Thi Nguyen, Khaled Khatab, Ziyad Al-Aly, Ghobad Moradi, Ruth W Kimokoti, Jalal Arabloo, Mariam Molokhia, Maciej Banach, Hasan Yusefzadeh, Rahman Shiri, Girmay Teklay Weldesamuel, Mekdes Tigistu Yilma, Taweewat Wiangkham, Soewarta Kosen, Kovin Naidoo, Fernando de la Hoz, Mohammed Shannawaz, Berhe Etsay Tesfay I, Yogesh Sabde, Syed Mohamed Aljunid, Belay Tessema, Reza Malekzadeh, Tinuke O Olagunju, Olatunde Aremu, Mohammad Reza Salahshoor, Derrick A Bennett, Oladimeji M. Adebayo, Teshome Gebre, Narayan Bahadur Mahotra, Nelson J. Alvis-Zakzuk, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Mehdi Hosseinzadeh, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Rovshan Khalilov, Ai Koyanagi, Salman Khazaei, Ismael R. Campos-Nonato, Alaa Badawi, Amir Hasanzadeh, Gebreamlak Gebremedhn Gebremeskel, Gessessew Bugssa Hailu, Dessalegn Ajema Berbada, Kate E. LeGrand, Azadeh Shafieesabet, Nikolay Ivanovich Briko, Robert S. Bernstein, Irfan Ullah, Isaac Oluwafemi Dipeolu, Hadi Hassankhani, Keyghobad Ghadiri, Local Burden of Disease Diarrhoea Collaborator, Violante FS, Wiens, KE, Lindstedt, PA, Blacker, BF, Johnson, KB, Yisma, E, Ahmed, Muktar Beshir, Reiner, Robert C, Duko, Bereket, Local Burden of Disease Diarrhoea Collaborators, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Local Burden Dis Diarrhoea, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, HUS Comprehensive Cancer Center, Clinicum, Institute for Molecular Medicine Finland, Department of Oncology, University of Helsinki, and Instituto de Saúde Pública da Universidade do Porto
Subjects: RJ101, medicine.medical_treatment, CHILDREN, ZINC, 0302 clinical medicine, 030212 general & internal medicine, media_common, Geography, lcsh:Public aspects of medicine, 1. No poverty, Low income and middle income countries, General Medicine, 3142 Public health care science, environmental and occupational health, 3. Good health, Child, Preschool, A990 Medicine and Dentistry not elsewhere classified, Geographical inequalities, 0605 Microbiology, Diarrhea, AFRICA, Inequality, DEATHS, media_common.quotation_subject, 030231 tropical medicine, Developing country, Article, RS, 1117 Public Health and Health Services, 03 medical and health sciences, MORBIDITY, Environmental health, DIARRHEAL DISEASE, medicine, Humans, Oral rehydration therapy, Healthcare Disparities, Developing Countries, Models, Statistical, CHOLERA, MORTALITY, Infant, Newborn, Infant, lcsh:RA1-1270, Bayes Theorem, Middle income, GLOBAL BURDEN, Child mortality, 0605 Microbiology, 1117 Public Health and Health Services, Health Care Surveys, ITC-ISI-JOURNAL-ARTICLE, Fluid Therapy, NA, Human medicine, ITC-GOLD
Abstract: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000-17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000-7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910-68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. This work was primarily supported by a grant from the Bill & Melinda Gates Foundation (OPP1132415). L G Abreu has received support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance Code 001), Conselho Nacional de Desenvolvimento Científico e Tecnológico and Fundação de Amparo à Pesquisa do Estado de Minas Gerais. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. H T Atalay acknowledges Aksum University. M Ausloos and C Herteliu are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. P S Azzopardi was supported by an Australian National Health and Medical Research Council (NHMRC) early career fellowship. A Badawi is supported by the Public Health Agency of Canada. T W Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research; the EU; the Wellcome Trust; and from National Institute of Child Health and Human Development of National Institutes of Health (NIH; R01-HD084233), National Institute on Aging of NIH (P01-AG041710), National Institute of Allergy and Infectious Diseases of NIH (R01-AI124389 and R01-AI112339), as well as Fogarty International Center of NIH (D43-TW009775). G B Britton is supported by Sistema Nacional de Investigación (SNI) de la Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) of Panamá. A Barac is funded by the Project of Ministry of Education, Science and Technology of the Republic of Serbia (number III45005). D A Bennett was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the UK Department of Health and Social Care. V M Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/Ministério da Ciência, Tecnologia e Ensino Superior through national funds. K Deribe is supported by a Wellcome Trust grant (number 201900/Z/16/Z) as part of his International Intermediate Fellowship. C Herteliu is partially supported by a grant co-funded by European Fund for Regional Development through the Operational Program for Competitiveness (project ID P_40_382). P Hoogar thanks Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education, Manipal and Centre for Holistic Development and Research, Kalaghatgi-Karnataka. S M S Islam is funded by a Fellowship from National Heart Foundation of Australia and Deakin University. M Jakovljevic and the Serbian part of this GBD contribution was co-funded through grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. A P Kengne is supported by the South African Medical Research Council. Y J Kim's work was supported by the Research Management Centre, Xiamen University Malaysia, grants number XMUMRF/2018-C2/ITCM/0001. K Krishan is supported by a DST PURSE grant and UGC Center of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar acknowledges K43 TW010716-03. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence, Oxford. P T N Memiah acknowledges the Council for the Development of Social Science Research in Africa. M Molokhia is supported by the NIHR Biomedical Research Center at Guy's and St Thomas' National Health Service Foundation Trust and King's College London. I Moreno Velásquez is supported by the Sistema Nacional de Investigación (SENACYT, Panamá). G C Patton is funded by an NHMRC Fellowship. A M Samy received a fellowship from the Egyptian Fulbright Mission programme. M M Santric-Milicevic acknowledges the support of the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). A Sheikh acknowledges the support of Health Data Research UK. M R Sobhiyeh acknowledges the Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences for their wise advice. R Tabarés-Seisdedos was supported in part by grant PI17/00719 from Instituto de Salud Carlos III–FEDER. B Unnikrishnan acknowledges Manipal Academy of Higher Education, Manipal. M R Weaver was supported by the Bill & Melinda Gates Foundation grant OPP1127433. C S Wiysonge was supported by the South African Medical Research Council.
Published: 2020

31. Bacterial Profile among Patients with Suspected Bloodstream Infections in Ethiopia: A Systematic Review and Meta-Analysis

Author: Habtamu Biazin, Asmamaw Demis, Birhan Alemnew, and Melese Abate Reta
Subjects: 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Salmonella species, business.industry, 030106 microbiology, Klebsiella species, Review Article, medicine.disease, medicine.disease_cause, Microbiology, QR1-502, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Pseudomonas species, Meta-analysis, Internal medicine, Streptococcus pyogenes, Medicine, 030212 general & internal medicine, business, Staphylococcus
Abstract: Introduction. The burden of bloodstream infections (BSIs) has been warranted in Ethiopia. Globally, the emergency and raised resistance rate of bacterial antimicrobial resistance is becoming a prominent problem, and it is difficult to treat patients having sepsis. In this review, we aimed to determine the pooled prevalence of bacterial isolates among presumptive patients with bloodstream infections in Ethiopia. Methods. A systematic search was performed from PubMed/MEDLINE, Scopus, HINARI, ScienceDirect, and Google Scholar electronic databases using PRISMA guidelines. The data analysis was carried out using STATATM version 14 after the records were cleaned and sorted out. Results. A total of 26 studies with 8,958 blood specimens and 2,382 culture-positive bacterial isolates were included for systematic review and meta-analysis. The meta-analysis derived a pooled culture-positive bacterial prevalence which was 25.78% (95% CI: 21.55–30.01%). The estimated pooled prevalence of Gram-positive and Gram-negative bacterial isolates was 15.50% (95% CI: 12.84–18.15%) and 10.48 % (95% CI: 8.32–12.63%), respectively. The two common Gram-positive bacteria isolated from patients suspected of BSIs were coagulase-negative Staphylococcus with a pooled prevalence of 5.75% (95% CI: 4.58–6.92%) and S. aureus 7.04 % (95% CI: 5.37–8.72%). Similarly, the common Gram-negative bacterial isolates and their estimated pooled prevalence were E. coli 1.69% (95% CI: 1.21–2.16%), Klebsiella species 7.04 % (95% CI: 5.37–8.72%), Pseudomonas species 0.39% (95% CI: 0.08–0.70%), Salmonella species 1.09% (95% CI: 0.79–1.38%), and Streptococcus pyogenes 0.88% (95% CI: 0.54–1.22%). Conclusion. The prevalence of bacterial isolates among presumptive patients suspected to BSIs in Ethiopia remains high. Furthermore, we found a remarkable variation in the pathogen distribution across the study setting.
Published: 2020

32. Low level of knowledge about neonatal danger signs and its associated factors among postnatal mothers attending at Woldia general hospital, Ethiopia

Author: Destaw Molla Gishen, Melese Abate Reta, Abera Endale Tegegne, Mekdes Mengesha Jemberia, Elsa Tesfa Berhe, and Hawi Bersisa Mirkena
Subjects: Postnatal Care, medicine.medical_specialty, 030231 tropical medicine, Breastfeeding, lcsh:Medicine, Woldia, Logistic regression, Danger sign, 03 medical and health sciences, Lethargy, 0302 clinical medicine, medicine, 030212 general & internal medicine, Obstetrics, business.industry, Associated factors, lcsh:R, Attendance, Neonates, Knowledge, Marital status, Residence, business, Danger signs, Postnatal mothers, Research Article
Abstract: Background Neonatal mortality has persisted high in Ethiopia in spite of many efforts being applied to decrease this adverse trend. Early detection of neonatal illness is an important step towards improving newborn survival. Toward this end, there is a need for the mothers to be able to identify signs in neonates that signify severe illnesses. The aim of this study was to assess knowledge about neonatal danger signs and its associated factors among postnatal mothers attending at Woldia general hospital, Ethiopian. Methods Institutional based cross-sectional study design was conducted from January–May, 2017. The hospital that provides antenatal care (ANC), delivery, and postnatal services was purposively sampled. Structured interviewer managed questionnaire was administered to postnatal mothers attending Woldia general hospital. Frequencies, bivariate and multivariate logistic regression were determined using the SPSS software (Version 20). Results During the study period 197 mothers attending postnatal care (PNC) service at Woldia general hospital were interviewed. Information on different neonatal danger signs was not provided to 92(46.7%) postnatal mothers during their antenatal clinic attendance by the healthcare providers. The majority of mothers, 174(88.3%) identified less than six neonatal danger signs. The hotness of the body of neonates was the commonly recognized danger sign by 106(53.8%) postnatal mothers. Of the total mothers, 67(34%), 60(30.5%), 56(28.4%), 44(22.3%) recognized unable to breastfeeding, convulsion, lethargy, difficulty in breathing as newly born danger signs, respectively. Out of 197 mothers, 32(16.2%) were giving birth at home. Mother’s age(AOR = 1.33, 95% CI: 1.99–3.08), marital status(AOR = 2.50, 95% CI: 0.29–4.31), mother’s education status(AOR = 3.48, 95% CI:1.57–8.72), husband’s education(AOR = 4.92, 95% CI: 1.29–12.81), attending ANC (AOR = 2.88, 95% CI: 1.15, 4.85), mother’s residence(AOR = 0.78, 95% CI: 0.47–1.65), information about neonatal danger signs(AOR = 3.48, 95% CI 1.40–9.49) had positive association with maternal level of knowledge to identify different neonatal danger signs. Conclusion Maternal knowledge level about neonatal danger signs was very low. Therefore, intervention modalities that focus on increasing level of parental education, access to ANC and PNC service are needed.
Published: 2018

33. Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Author: Fereshteh Ansari, Richard C. Franklin, Naznin Hossain, Rodrigo Sarmiento-Suárez, Mahdi Bohluli, Irena Ilic, Anwar Faraj, Soosanna Kumary Chattu, Sanni Yaya, Hagos Degefa Hidru, Morteza Shamsizadeh, Ehsan Sadeghi, Bach Xuan Tran, Leila Zaki, Mohammad Miri, Maha El Tantawi, Maciej Banach, Hasan Yusefzadeh, Kira A Barbre, Chigozie Jesse Uneke, Mehdi Naderi, Behzad Karami Matin, Yunquan Zhang, Vahid Yazdi-Feyzabadi, Emma Elizabeth Spurlock, Zahid A Butt, Nuruzzaman Khan, Robert L. Thompson, Mehdi Hosseinzadeh, Rovshan Khalilov, Usman Iqbal, K M Shivakumar, Leili Tapak, Chris A Schmidt, Priya Rathi, Shanshan Li, Bhaskaran Unnikrishnan, Chuanhua Yu, Elizabeth A. Cromwell, Davood Anvari, Hoa Thi Do, Abdullah Al Mamun, Obinna Onwujekwe, Serge Resnikoff, Majid Fasihi Harandi, Joshua C. P. Osborne, Farahnaz Joukar, Aso Mohammad Darwesh, Rohollah Kalhor, Turki Alanzi, Katie M Donkers, Amir Kasaeian, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Paul S. F. Yip, Tomislav Mestrovic, Zhi-Jiang Zhang, Katherine Gass, Cuong Tat Nguyen, Gurudatta Naik, Joshua Longbottom, Somayeh Bohlouli, Aziz Rezapour, Huong Lan Thi Nguyen, Khaled Khatab, Mohammed Ibrahim Mohialdeen Gubari, Ahmed Omar Bali, Temesgen Yihunie Akalu, Paul H. Lee, Vahid Alipour, Kebede Deribe, Megan F. Schipp, Ziyad Al-Aly, Biagio Simonetti, Masoud Moradi, Jalal Arabloo, Reza Rawassizadeh, Saif Ullah, Seth Christopher Yaw Appiah, Demelash Abewa Elemineh, Abedin Saghafipour, Fakher Rahim, Tinuke O Olagunju, Kimberly B. Johnson, Souranshu Chatterjee, Salvatore Rubino, Nataliya Foigt, Olayinka Stephen Ilesanmi, Taras Kavetskyy, Carlo La Vecchia, Eduarda Fernandes, Mohsen Mazidi, Claudiu Herteliu, Sojib Bin Zaman, Aziz Sheikh, Yong Yu, David Laith Rawaf, Hassan Magdy Abd El Razek, Natalie V S Vinkeles Melchers, Samath D Dharmaratne, Enrico Rubagotti, Fahad Alanezi, Masood Ali Shaikh, Masoud Foroutan, B. Suresh Kumar Shetty, Milena Ilic, Melese Abate Reta, Dian Kusuma, Ali Manafi, Krittika Bhattacharyya, Giovanni Damiani, Kanaan Hamagharib Abdullah, Desalegn Tadese Mengistu, Van C. Lansingh, Till Bärnighausen, Benjamin F. Arnold, Natalie Maria Cormier, Zulfiqar A Bhutta, Ahmad Daryani, Ali Bijani, Jae Il Shin, Samer Hamidi, Jasvinder A. Singh, Mohsen Bayati, Tomohide Yamada, Zubair Kabir, Muhammed Magdy Abd El Razek, Jonathan F. Mosser, Gbenga A. Kayode, Martin Amogre Ayanore, Shahin Soltani, Arvin Haj-Mirzaian, Mohammad Ali Mansournia, Salah Eddin Karimi, Alan J Thomson, Daniel Diaz, Ahamarshan Jayaraman Nagarajan, Adrian Pana, Salman Rawaf, Oliver J. Brady, Birhanu Geta Meharie, Yousef Fatahi, Sadia Bibi, Bogdan Oancea, Masoud Moghadaszadeh, Kelemu Tilahun Kibret, Valery L. Feigin, Saad M.A. Dahlawi, Ted R. Miller, Nicola Luigi Bragazzi, Atif Amin Baig, Maryam Zamanian, Kate E. LeGrand, Salahuddin Mohammed, Yuming Guo, Irfan Ullah, Hebat Allah Salah A. Yousof, Mowafa Househ, Ionut Negoi, Naohiro Yonemoto, Reza Mohammadpourhodki, Hadi Pourjafar, Navid Manafi, Neda Kianipour, Abraham Getachew Kelbore, Victor Adekanmbi, Seid Tiku Mereta, Olalekan A. Uthman, Arash Ziapour, Olatunji O. Adetokunboh, Trang Huyen Nguyen, Seyed Sina Naghibi Irvani, Francesco Saverio Violante, Monika Sawhney, Paula Moraga, Rahmatollah Moradzadeh, Mu'awiyyah Babale Sufiyan, Mohammad Hifz Ur Rahman, María-Gloria Basáñez, Vijay Kumar Chattu, Mustafa Geleto Ansha, Mona M. Khater, Andrew T Olagunju, Ejaz Ahmad Khan, Davide Guido, Kiomars Sharafi, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Tarig B. Higazi, Afshin Maleki, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Amin Soheili, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Ali Kazemi Karyani, Ehsan Ahmadpour, Thomas R. Unnasch, Mohsen Afarideh, Takahiro Tabuchi, Shreya Shirude, Marcel Ausloos, Maysaa El Sayed Zaki, Haileab Fekadu Wolde, Amira Shaheen, Shafiu Mohammed, Rajan Nikbakhsh, Tewodros Eshete Wonde, Endalkachew Worku Mengesha, Jacek Jerzy Jozwiak, Muktar Beshir Ahmed, Eugenio Traini, Leila R Kalankesh, Kris J. Krohn, Colm McAlinden, Walter Mendoza, Maryam Keramati, Ravi Prakash Jha, David M. Pigott, Elex Hill, Abdallah M. Samy, Farah Daoud, Wanji, Samuel, Public Health, Bill & Melinda Gates Foundation, Medical Research Council (Reino Unido), Department for International Development (Reino Unido), Unión Europea, Cromwell E.A., Osborne J.C.P., Unnasch T.R., Basanez M., Gass K.M., Barbre K.A., Hill E., Johnson K.B., Donkers K.M., Shirude S., Schmidt C.A., Adekanmbi V., Adetokunboh O.O., Afarideh M., Ahmadpour E., Beshir Ahmed M., Yihunie Akalu T., Al-Aly Z., Alanezi F.M., Alanzi T.M., Alipour V., Andrei C.L., Ansari F., Ansha M.G., Anvari D., Yaw Appiah S.C., Arabloo J., Arnold B.F., Ausloos M., Ayanore M.A., Amin Baig A., Banach M., Barac A., Barnighausen T.W., Bayati M., Bhattacharyya K., Bhutta Z.A., Bibi S., Bijani A., Bohlouli S., Bohluli M., Brady O.J., Bragazzi N.L., Butt Z.A., Carvalho F., Chatterjee S., Chattu V.K., Chattu S.K., Cormier N.M., Dahlawi S.M.A., Damiani G., Daoud F., Darwesh A.M., Daryani A., Deribe K., Dharmaratne S.D., Diaz D., Do H.T., El Sayed Zak M., El Tantawi M., Elemineh D.A., Faraj A., Harandi M.F., Fatahi Y., Feigin V.L., Fernandes E., Foigt N.A., Foroutan M., Franklin R.C., Mohialdeen Gubari M.I., Guido D., Guo Y., Haj-Mirzaian A., Abdullah K.H., Hamidi S., Herteliu C., De Hidru H.D., Higazi T.B., Hossain N., Hosseinzadeh M., Househ M., Ilesanmi O.S., Ilic M.D., Ilic I.M., Iqbal U., Naghibi Irvani S.S., Jha R.P., Joukar F., Jozwiak J.J., Kabir Z., Kalankesh L.R., Kalhor R., Matin B.K., Karimi S.E., Kasaeian A., Kavetskyy T., Kayode G.A., Karyani A.K., Kelbore A.G., Keramati M., Khalilov R., Khan E.A., Nuruzzaman Khan M.N., Khatab K., Khater M.M., Kianipour N., Kibret K.T., Kim Y.J., Kosen S., Krohn K.J., Kusuma D., Vecchia C.L., Lansingh Van C., Lee P.H., Legrand K.E., Li S., Longbottom J., Abd El Razek H.M., Abd El Razek M.M., Maleki A., Mamun A.A., Manafi A., Manafi N., Mansournia M.A., Martins-Melo F.R., Mazidi M., McAlinden C., Meharie B.G., Mendoza W., Mengesha E.W., Mengistu D.T., Mereta S.T., Mestrovic T., Miller T.R., Miri M., Moghadaszadeh M., Hafshejani A.M., Mohammadpourhodki R., Mohammed S., Moradi M., Moradzadeh R., Moraga P., Mosser J.F., Naderi M., Nagarajan A.J., Naik G., Negoi I., Nguyen C.T., Nguyen H.L.T., Nguyen T.H., Nikbakhsh R., Oancea B., Olagunju T.O., Olagunju A.T., Bali A.O., Onwujekwe O.E., Pana A., Pourjafar H., Rahim F., Ur Rahman M.H., Rathi P., Rawaf S., Rawaf D.L., Rawassizadeh R., Resnikoff S., Reta M.A., Rezapour A., Rubagotti E., Rubino S., Sadeghi E., Saghafipour A., Sajadi S.M., Samy A.M., Sarmiento-Suarez R., Sawhney M., Schipp M.F., Shaheen A.A., Shaikh M.A., Shamsizadeh M., Sharafi K., Sheikh A., Kumar Shetty B.S., Shin J.I., Shivakumar K.M., Simonetti B., Singh J.A., Skiadaresi E., Soheili A., Soltani S., Spurlock E.E., Sufiyan M.B., Tabuchi T., Tapak L., Thompson R.L., Thomson A.J., Traini E., Tran B.X., Ullah I., Ullah S., Uneke C.J., Unnikrishnan B., Uthman O.A., Melchers N.V.S.V., Violante F.S., Wolde H.F., Wonde T.E., Yamada T., Yaya S., Yazdi Feyzabadi V., Yip P., Yonemoto N., Yousof H.-A.S.A., Yu C., Yu Y., Yusefzadeh H., Zaki L., Zaman S.B., Zamanian M., Zhang Z.-J., Zhang Y., Ziapour A., Hay S.I., Pigott D.M., and Cuidado de la Salud y Desarrollo Sostenible
Subjects: Oncocercosis, Decision Analysis, RC955-962, Onchocerciasis, law.invention, Geographical Locations, Medical Conditions, 0302 clinical medicine, law, Arctic medicine. Tropical medicine, Medicine and Health Sciences, 030212 general & internal medicine, Onchocerca, 11 Medical and Health Sciences, Data Management, biology, Pharmaceutics, wc_695, Enfermedades Parasitarias, Onchocerciasi, 3. Good health, Infectious Diseases, Geography, Transmission (mechanics), Helminth Infections, Engineering and Technology, Mass Drug Administration, Public aspects of medicine, RA1-1270, Management Engineering, Cartography, Human, Research Article, Neglected Tropical Diseases, Computer and Information Sciences, Drug Administration, 030231 tropical medicine, Decision tree, wa_395, Dermatology, wc_765, Environment, wc_885, Research and Analysis Methods, Skin Diseases, 03 medical and health sciences, Drug Therapy, SDG 3 - Good Health and Well-being, Diagnostic Medicine, Tropical Medicine, Parasitic Diseases, medicine, Humans, Disease Eradication, Spatial analysis, Ivermectin, Data collection, Receiver operating characteristic, Data Visualization, Decision Trees, Public Health, Environmental and Occupational Health, 06 Biological Sciences, Elimination planning, Africa, Implementation units, Public health, Tropical Diseases, medicine.disease, biology.organism_classification, Health Care, ROC Curve, People and Places, Health Statistics, Morbidity, Scale (map), Forecasting
Abstract: Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify., Author summary As of 2018, it was unknown if onchocerciasis transmission occurred among approximately 2 400 implementation units (IUs; typically, second administrative-level units, such as districts) considered potentially endemic. These IUs have either never been surveyed for onchocerciasis or historical data are not sufficient to define contemporary endemicity status. Given the large number of IUs for which baseline data collection is likely required to achieve continental elimination, there is a need to prioritise areas for surveys to ensure that those suitable for endemic transmission, and therefore potentially eligible for mass drug administration, are able to initiate interventions as soon as possible. We used boosted regression trees to predict environmental suitability for onchocerciasis, with corresponding measures of uncertainty. We summarized the fine scale spatial predictions at the IU level by using receiver operating characteristic (ROC) curve analysis to identify a threshold that maximized agreement with the occurrence locations to identify IUs that may warrant prioritisation for mapping surveys. This analysis suggests that approximately half of the IUs considered for surveys could be classified as environmentally suitable for onchocerciasis. In order to develop an elimination strategy, many national onchocerciasis elimination programmes (NOEPs) need a mechanism to synthesise historical data to define priority areas for surveys.
Published: 2021

34. Food handling practice and associated factors among food handlers working in food establishments in Woldia town, Northeast Ethiopia

Author: Ashete Adere Gemeda, Melese Abate Reta, Mekonnin Tesfa Lemma, and Getasew Assefa Lemlem
Subjects: Food handlers, Environmental health, Business, Food handling
Abstract: Purpose: The food safety issue is a major public health concern. Inadequate food handler's knowledge and food safety practices are the utmost mentioned contributing factors for potential foodborne disease outbreaks. This study aimed to assess food handling practices and determinants among food handlers working in catering establishments in Woldia town.Design/methodology/approach: In total, 288 food handlers were recruited through a simple random selection method. A structured and interviewer-administered questionnaire was used as a data collection tool. Data were analyzed using frequencies and through applying bivariate and multivariate logistic regressions. P < 0.05 was considered statistically significance.Findings: Of total 288 participants, 91.7% were females, and 69.8% were literate. This study revealed that good food handling practice was 46.5% (95%CI:37.01-56.20). In the subgroup analysis, advanced age (adjusted odds ratio (aOR)=12.01; 95%CI:1.96-17.52), married couples (aOR=2.09; 95%CI:1.05-4.78), education (participants who attend grade 7-12 (aOR=2.33; 95%CI:1.14-4.79), and above secondary education (aOR=2.29; 95%CI:1.05-4.61)), monthly income (aOR=2.29; 95%CI:1.14-5.61), work experience above six years (aOR=2.43; 95%CI:2.08-3.17), received training (aOR=1.79; 95%CI:1.68-4.71), inspected by concerned authority (aOR=2.24; 95%CI:1.05-3.09) and knowledge (aOR=3.15; 95%CI:1.02-6.04) were factors associated with food handling practices.Originality/value: Comprehensive and continuous food handling and safety training to food handlers and/or food establishment owners, regular sanitary inspection visits of public food and drink services establishments by concerned authority is compulsory to ensure that all food handlers have the knowledge and the skill to provide safe food.
Published: 2019

35. Neonatal hypothermia and its associated factors in East Africa: a systematic review and meta-analysis

Author: Biruk Abate Beletew, Ayelign Mengesha Kasie, Mesfin Wudu Kassaw, and Melese Abate Reta
Abstract: Background : Neonatal hypothermia is a global health problem and a major contributing factor for neonatal morbidity, mortality, and for new-born survival, especially in low and middle-income countries. High prevalence of hypothermia has been reported from countries with the highest burden of neonatal mortality. Therefore, the aim of this systematic review and meta-analysis was to assess the prevalence of neonatal hypothermia and its associated factors in Eastern Africa. Methods: Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of neonatal hypothermia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Result: A total of 12 potential studies with 20,911 participants were used for analysis. The pooled prevalence of neonatal hypothermia in East Africa was found to be 57.22% (95%CI; 39.48–74.95).Delay in initiation of breastfeeding (AOR=2.83; 95%CI: 1.398-4.259; I 2 = 49.2%; P=0.097), having neonatal health problem (AOR=2.68; 95%CI: 1.21-4.15; I 2 = 0.0%; P=0.98), being low birth weight (AOR =2.16; 95%CI: 1.03-3.29; I 2 =3.3%; P=0.005), being preterm(AOR=4.01; 95%CI: 3.02-5.00; I 2 = 0.0%; P=0.457), and night time delivery (AOR=4.01; 95%CI:3.02-5.00; I 2 =0.0%; P=0.457) were identified associated factors which significantly increase the risk of neonatal hypothermia. Conclusions : The prevalence of neonatal hypothermia in Eastern Africa remains high. Delay in initiation of breastfeeding, having neonatal health problem, being low birth weight, preterm, and nighttime delivery were identified associated factors which significantly increase the risk of neonatal hypothermia. It is recommended that early initiation of breast feeding should be promoted and emphasis should be given towards low birth weight, preterm and neonates with neonatal problems to prevent burdens of hypothermia in East Africa.
Published: 2019

36. Molecular Epidemiology, Diagnostics and Mechanisms of Antibiotic Resistance in Mycobacterium tuberculosis complex in Africa: A Systematic Review of Current Reports

Author: Nontuthuko Excellent Maningi, Melese Abate Reta, John Osei Sekyere, and P.B. Fourie
Subjects: GeneXpert MTB/RIF, Tuberculosis, biology, Molecular epidemiology, business.industry, INHA, rpoB, medicine.disease, biology.organism_classification, Virology, Mycobacterium tuberculosis complex, PncA, Medicine, business, Rifampicin, medicine.drug
Abstract: BackgroundTuberculosis (TB) remains a main global public health problem. However, a systematic review of TB resistance epidemiology in Africa is wanting.MethodsA comprehensive systematic search of PubMed, Web of Science and ScienceDirect for English research articles reporting on the molecular epidemiology of Mycobacterium tuberculosis complex resistance in Africa from January 2007 to December 2018 was undertaken.Results and conclusionQualitative and quantitative synthesis were respectively undertaken with 232 and 186 included articles, representing 32 countries. TB monoresistance rate was highest for isoniazid (59%) and rifampicin (27%), particularly in Zimbabwe (100%), Swaziland (100%), and Sudan (67.9%) whilst multidrug resistance (MDR) rate was substantial in Zimbabwe (100%), Sudan (34.6%), Ivory Coast (24.5%) and Ethiopia (23.9%). Resistance-conferring mutations were commonly found in katG (n=3694), rpoB (n=3591), rrs (n=1272), inhA (n=1065), pncA (n=1063) and embB (n=705) in almost all included countries: S315G/I/N/R/T, V473D/F/G/I, Q471H/Q/R/Y, S303C/L etc. in katG; S531A/F/S/G, H526A/C/D/G, D516A/E/G etc. in rpoB; A1401G, A513C etc. in rrs; C15T, G17A/T, -A16G etc. in inhA; Ins456C, Ins 172G, L172P, C14R, Ins515G etc in pncA. Commonest lineages and families such as T (n=8139), LAM (n=5243), Beijing (n=5471), Cameroon (n=3315), CAS (n=2021), H (n=1773) etc., with the exception of T, were not fairly distributed; Beijing, Cameroon and CAS were prevalent in South Africa (n=4964), Ghana (n=2306), and Ethiopia/Tanzania (n=799/635) respectively. Resistance mutations were not lineage-specific and sputum (96.2%) were mainly used for diagnosing TB resistance using the LPA (38.5%), GeneXpert (17.2%), whole-genome sequencing (12.3%) and PCR/amplicon sequencing (9%/23%). Intercountry spread of strains were limited while intra-country dissemination was common. TB resistance and its diagnosis remain a major threat in Africa, necessitating urgent action to contain this global menace.
Published: 2019
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37. Adherence to Antiretroviral Therapy and Associated Factors among People Living with HIV/AIDS in Hara Town and Its Surroundings, North-Eastern Ethiopia: A Cross-Sectional Study

Author: Tesfaye Aychew Legesse and Melese Abate Reta
Subjects: Adult, Male, Adolescent, Cross-sectional study, Anti-HIV Agents, Adherence, ART, HIV/AIDS, Associated factors, Hara Town, Ethiopia, HIV Infections, Drug resistance, Logistic regression, Medication Adherence, Young Adult, Acquired immunodeficiency syndrome (AIDS), Statistical significance, Environmental health, Medicine, Humans, Hara Town, Marital Status, business.industry, Associated factors, General Medicine, Odds ratio, Middle Aged, medicine.disease, Confidence interval, CD4 Lymphocyte Count, Cross-Sectional Studies, Adherence, Population study, HIV/AIDS, Educational Status, Original Article, Female, Ethiopia, business, ART
Abstract: BACKGROUND: Adherence is the most important factor in determining Antiretroviral Therapy (ART) treatment success and long-term viral suppression. Nonadherence to ART led to the human Immunodeficiency Virus (HIV) related morbidity and mortality. Moreover, it intensifies the risk of the emerging drug resistant HIV strains. This study aimed to assess the level of ART adherence and to identify its predictive associated factors among people living with HIV/AIDS in Hara Town and its surroundings, North-Eastern Ethiopia.METHODS: An institutional facility based cross-sectional study was conducted from April-May 2017. A total of 454 individuals were on ART follow-up in the selected ART-clinic, and only 418 patients were recruited. Bivariate and multivariate logistic regression analyses were carried out to identify associated factors. Odds ratio and 95% Confidence Interval (CI) were calculated to determine the level of significance.RESULTS: The level of ART adherence in the study setting was 300 (71.8%). Participants who had not disclosed their HIV status to their families were 88% less likely to adhere to their ART medication than those who had disclosed their HIV status ((Odds ratio (OR): 0.12, 95%CI:0.05-0.58; p
Published: 2019

38. Global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017

Author: Ephrem Tsegay Asfaw, Irina Filip, Maciej Banach, Amjad Mohamadi-Bolbanabad, Girmay Teklay Weldesamuel, Joshua A. Salomon, Anemaw A Asrat, Zahra Jorjoran Shushtari, Hamidreza Komaki, Mekdes Tigistu Yilma, Reza Shirkoohi, Mostafa Qorbani, Ahamarshan Jayaraman Nagarajan, Don C. Des Jarlais, Adnan Kisa, Gebreamlak Gebremedhn Gebremeskel, Kidu Gidey Weldegwergs, Amir Kasaeian, Peter Memiah, Son Hoang Nguyen, Segun Emmanuel Ibitoye, Ali Kabir, Subash Thapa, Diego Augusto Santos Silva, Kefyalew Addis Alene, Alireza Rafiei, Huong Lan Thi Nguyen, Erlyn Rachelle King Macarayan, Kelali Kalaye Gebreyohannes, Khaled Khatab, Ghobad Moradi, Noore Alam, Aletta E. Schutte, Sharareh Eskandarieh, H. Dean Hosgood, Rakhi Dandona, Taye Abuhay Zewale, Sezer Kisa, Gessessew Bugssa Hailu, Hedayat Abbastabar, Ketema Bizuwork Gebremedhin, Smita Pakhale, Govinda Prasad Dhungana, Dina Nur Anggraini Ningrum, Bakhtiar Piroozi, Yaschilal Muche Belayneh, Tesfaye Dessale Kassa, Irfan Ullah, Sahar Saeedi Moghaddam, Jean Jacques Noubiap, Mojtaba Bagherzadeh, Akram Pourshams, Alberto L. García-Basteiro, Helen Bitew, Kindie Fentahun Muchie, Mehdi Sayyah, Kevin S Ikuta, Moses K. Muriithi, Aliasghar Ahmad Kiadaliri, Zerihun Menlkalew Zenebe, Cesar Reis, Themba G. Ginindza, Jagadish Rao Padubidri, Yoosik Youm, Saba Abraham Belay, Olayinka Stephen Ilesanmi, Neeraj Bedi, Maziar Moradi-Lakeh, Hamid Sharifi, Nefsu Awoke, Manasi Kumar, Carlos Magis-Rodriguez, Muhammad Shahdaat Bin Sayeed, Maheswar Satpathy, Andrew Blinov, Fiseha Wadilo Wada, Babak Moazen, Hadi Hassankhani, Jae Il Shin, Sanjay Basu, Aziz Eftekhari, Masood Ali Shaikh, Arya Haj-Mirzaian, Laura Dwyer-Lindgren, Haileab Fekadu Wolde, Habtamu Abera Areri, Krista M. Steuben, Lalit Dandona, Keivan Ahmadi, Aso Mohammad Darwesh, Belete Kassa, Keyghobad Ghadiri, Arash Ziapour, Raquel Crider, Alaa Badawi, Tahvi Frank, Amir Hasanzadeh, Marcel Yotebieng, Jemal Abdu Mohammed, Marcos Roberto Tovani-Palone, Emmanuel Peprah, Mekonnen Sisay, Ghulam Mustafa, Oghenowede Eyawo, Seyed Sina Naghibi Irvani, Vahid Alipour, Reza Malekzadeh, Bereket Duko Adema, Direslgne Misker Abyu, Tinuke O Olagunju, Olatunde Aremu, Roghayeh Mohammadibakhsh, Linh Phuong Doan, Mihiretu Kebede, Aman Yesuf Endries, Amira Shaheen, Belete Biadgo, Ali Rostami, Marwa Rashad Salem, Getnet Gedefaw, Stein Emil Vollset, Gurudatta Naik, Veincent Christian Filipino Pepito, Duduzile Ndwandwe, Melese Abate Reta, Aleksandra Barac, Simon I. Hay, Vishnu Renjith, Seifadin Ahmed Shallo, Kebede Deribe, Malihe Nourollahpour Shiadeh, Tewodros Eshete Wonde, Nuno Taveira, Mohammad Ali Sahraian, Marilita M Moschos, Masoud Foroutan, Alebachew Fasil Ashagre, Félix Carvalho, Yun Jin Kim, Farid Najafi, Tukur Dahiru, Chinwe Juliana Iwu, Dharmesh Kumar Lal, Varshil Mehta, Molly R Nixon, Nahla Anber, Seyedmojtaba Seyedmousavi, Mohammad Rabiee, Nauman Khalid, Felix Akpojene Ogbo, Anselm Okoro, Sanjay Zodpey, Birhanu Geta, Kebede Embaye Gezae, Shirin Djalalinia, Amanda E. Smith, Naser Mohammad Gholi Mezerji, Arvin Haj-Mirzaian, Birkneh Tilahun Tadesse, Yared Belete Belay, Saeed Amini, Ziad A. Memish, Stephanie M. Topp, Eduarda Fernandes, Mohammed Suleiman Obsa, Junaid Khan, Andem Effiong, Jane Jean-Hee Lee, Emmanuel Ngassa Laurent Mayenga, Abdallah M. Samy, Anton Sokhan, Rajesh Sagar, Dawit Zewdu Wondafrash, Atalay Goshu Muluneh, Birhan Alemnew, Asmamaw Demis, Samer Hamidi, Getnet Mengistu, Michael Tamene Haile, Gbenga A. Kayode, Huyen Phuc Do, Yoshan Moodley, Mehdi Hosseinzadeh, Moslem Mohammadi, Dayane Gabriele Alves Silveira, Samad Azari, Gulfaraz Khan, Maysaa El Sayed Zaki, Emmanuel Ankrah Odame, Anusha Ganapati Bhat, Louisa Degenhardt, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Sadaf G. Sepanlou, Ai Koyanagi, Ebrahim M Yimer, Maryam Adabi, Javad Nazari, Saravanan Muthupandian, Evanson Z. Sambala, Salman Khazaei, Nelson Alvis-Guzman, Hunduma Amensisa Bojia, Anwar Rafay, Richard Ofori-Asenso, Ehsan Ahmadpour, José Neves, Desalegn Tadese Mengistu, Shafiu Mohammed, Hamid Yimam Hassen, Navid Rabiee, Dinh-Toi Chu, Zoubida Zaidi, Sajjad Ur Rahman, Tilahun Belete Mossie, Olanrewaju Oladimeji, Krittika Bhattacharyya, Gebrekiros Gebremichael Meles, Hassan Magdy Abd El Razek, Stanislav S. Otstavnov, Shaimaa I. El-Jaafary, Habtamu Temesgen, Lolemo Kelbiso Hanfore, Milad Mohammadoo-Khorasani, Muktar Beshir Ahmed, Karzan Abdulmuhsin Mohammad, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Spencer L. James, Bhaskaran Unnikrishnan, Morteza Shamsizadeh, Kenean Getaneh Tlaye, Ziad El-Khatib, Zohreh Anbari, Aisha Elsharkawy, Nancy Fullman, Cuong Tat Nguyen, Chalachew Genet Akal, Chabila C Mapoma, Amir H. Pakpour, Rafael Alves Guimarães, Jalal Arabloo, Eyasu Ejeta Duken, Hailay Abrha Gesesew, Koku Sisay Tamirat, Batool Fatima, Tissa Wijeratne, Addisu Gize Yeshanew, Benn Sartorius, Kathryn H. Jacobsen, Abdullah T Khoja, Morenike Oluwatoyin Folayan, Phetole Walter Mahasha, Takeshi Fukumoto, Maryam Moossavi, Bahram Mohajer, Ravi Prakash Jha, Oladimeji Adebayo, Farshad Farzadfar, Francisco Rogerlândio Martins-Melo, Solomon Sisay, Ensiyeh Jenabi, Bach Xuan Tran, Eleonora Dubljanin, Farnam Mohebi, Jasvinder A. Singh, Barthelemy Kuate Defo, Masoud Behzadifar, Yousef Mohammad, Feleke Mekonnen Demeke, G Anil Kumar, Jan-Walter De Neve, Afshin Zarghi, Hosein Shabaninejad, Trang Huyen Nguyen, Degena Bahrey Tadesse, Monika Sawhney, Eyal Oren, Bayu Begashaw Bekele, Saeed Safari, Salvatore Rubino, Kenji Shibuya, Daniel Diaz, Salman Rawaf, Demelash Woldeyohannes Handiso, Ted R. Miller, Fares Alahdab, Vafa Rahimi-Movaghar, Seyyed Meysam Mousavi, Sonali Kochhar, Azeem Majeed, Till Bärnighausen, Zubair Kabir, Devasahayam J. Christopher, Malede Mequanent Sisay, Adane Teshome Kefale, Shishay Wahdey Tekelemedhin, Tsegaye Lolaso Lenjebo, Yousef Khader, Ali Bijani, Kebreab Paulos, Hagazi Gebre Meles, Euripide Frinel G Arthur Avokpaho, Alireza Ahmadi, Tuomo J. Meretoja, Padukudru Anand Mahesh, Florian Fischer, Mulugeta Melku, Fakher Rahim, Manisha Dubey, Cheru Tesema Leshargie, Vijay Kumar Chattu, Yasir Waheed, Mehdi Noroozi, Austin Carter, Chuanhua Yu, Ronny Westerman, Andualem Henok, Yousef Veisani, Sharath Burugina Nagaraja, Reta Tsegaye Gayesa, Mina Anjomshoa, Andrew T Olagunju, Getachew Mullu Kassa, Belayneh K Gelaw, Jost B. Jonas, Ejaz Ahmad Khan, Adugnaw Berhane, Chukwudi A Nnaji, Daniel Asmelash, Tomislav Mestrovic, Addisu Melese, Stephen S Lim, Yahya Salimi, Chi Linh Hoang, Christopher J L Murray, Mohammad Sadegh Rezai, Bruno F. Sunguya, Herbert C. Duber, Senad Handanagic, Ashish Awasthi, Anthony Masaka, Megha Arora, Sergey Soshnikov, Sangram Kishor Patel, Kwaku Oppong Asante, Haidong Wang, Rajendra Kadel, Bryan L. Sykes, Lucero Cahuana-Hurtado, Afarin Rahimi-Movaghar, Deepa Jahagirdar, Manaye Yihune Teshale, Samantha Leigh Larson, Martin Amogre Ayanore, Sergey K Vladimirov, Gebre Teklemariam Demoz, Fisaha Haile Tesfay, Mohsen Naghavi, Chhabi Lal Ranabhat, Walter Mendoza, Kassawmar Angaw Bogale, Khanh Bao Tran, Berhanu Yazew Wondmagegn, Carlos Miguel Rios González, Ahmad Daryani, Ali H. Mokdad, Julio Cesar Campuzano Rincon, Alemayehu Toma Mena, Navid Manafi, Andre Pascal Kengne, Victor Adekanmbi, Netsanet Fentahun, Olalekan A. Uthman, Desmond Kuupiel, Olatunji O. Adetokunboh, Zahid A Butt, Mohamed Hsairi, Bulat Idrisov, Ranjani Somayaji, Dan J. Stein, Molly H Biehl, Samuel B. Albertson, Laith J. Abu-Raddad, Parvaiz A Koul, Elias Merdassa Roro, Marek Majdan, Dereje Bayissa Demissie, Emilie R Maddison, Naohiro Yonemoto, Ahmad Ghashghaee, Young-Ho Khang, Solomon Olum, Hmwe H Kyu, Amir Radfar, Dirk Douwes-Schultz, Elham Ahmadian, Graduate School, AII - Infectious diseases, APH - Global Health, APH - Methodology, GBD 2017 HIV Collaborators, Clinicum, Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Staff Services, University of Helsinki, Department of Oncology, Adema, Bereket Duko, GBD 2017 HIV collaborators, and Public Health
Subjects: 0301 basic medicine, A300 Clinical Medicine, Epidemiology, CITIES, HIV Infections, Mortalities, Global Burden of Disease, 0302 clinical medicine, Risk Factors, Seroepidemiologic Studies, Cause of Death, Prevalences, Prevalence, Global health, LIFE EXPECTANCY, 030212 general & internal medicine, 10. No inequality, education.field_of_study, CHALLENGES, Incidence, Incidence (epidemiology), Incidences, 1. No poverty, MEN, 3. Good health, AIDS, Infectious Diseases, Life Sciences & Biomedicine, GBD 2017 HIV collaborators, medicine.medical_specialty, Forecasts, Immunology, Population, Cause of Death/trends, UNITED-STATES, Context (language use), History, 21st Century, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Acquired immunodeficiency syndrome (AIDS), Virology, Environmental health, medicine, Humans, education, Global Burden of Disease/trends, Estimation, Science & Technology, SEX-SPECIFIC MORTALITY, business.industry, DISABILITY, Public health, HIV, coverage of antiretroviral therapy, History, 20th Century, medicine.disease, mortality, R1, PREVENTION, TRENDS, 030112 virology, HIV Infections/mortality, 3121 General medicine, internal medicine and other clinical medicine, Life expectancy, Human medicine, business, Forecasting
Abstract: BACKGROUND: Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980-2017 and forecast these estimates to 2030 for 195 countries and territories.METHODS: We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package-a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections.FINDINGS: Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87-2·04) and has since decreased to 0·95 million deaths (0·91-1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79-3·67) and since then have gradually decreased to 1·94 million (1·63-2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8-39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets.INTERPRETATION: Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact.FUNDING: Bill & Melinda Gates Foundation, National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH.
Published: 2019

39. Microbiological Safety of Street Vended Foods in Jigjiga City, Eastern Ethiopia

Author: Melese Abate Reta, Henok Sileshi Asfaw, Yohannes Mekonnen Emerie, and Tesfaye Wolde Bereda
Subjects: 0301 basic medicine, Adult, Male, Staphylococcus aureus, Food Safety, Sanitation, Cross-sectional study, 030106 microbiology, Isolation, 03 medical and health sciences, Salmonella, Environmental health, Escherichia coli, Medicine, Food microbiology, Humans, Food science, Street vended foods, Salmonella species, Street foods, business.industry, Incidence (epidemiology), digestive, oral, and skin physiology, General Medicine, Middle Aged, Food safety, Food Inspection, Bacterial Load, Microbiological safety, Jigjiga, Cross-Sectional Studies, Quality standard, Microbiological safety, Street vended foods, Isolation, Jigjiga, Food Microbiology, Original Article, Female, Ethiopia, business
Abstract: Background: Food safety problems are particularly becoming an increasingly serious threat to public health in developing countries. This study was conducted to assess microbiological safety of street vended foods from May to November, 2014 in Jigjiga City.Methods: A cross-sectional design was used to answer questions concerning the current status of food hygiene and sanitation practire of street food vending sites. Interview and observational assessments were used to collect socio-demographic data about street food venders. One hundred thirty-two samples of street foods were aseptically collected from four ‘kebeles’ of Jigjiga City. Both descriptive and analytical statistical methods were applied.Results: The majority of the street food vendors were women, 120(90.9%), with the average age group of 23-49 years, (42.85%), and 99(66.7%) them were illiterate. The study revealed that 95(72%) of the food samples had pathogenic bacterial contaminations. Three different bacterial species were isolated: E. coli 68(51.5%), S. aureus 85(64.4%) and 26(19.7%) Salmonella species. The highest incidence of S. aureus 23/33(69%) was seen in ‘Sambusa’; the highest incidence of E. coli 24/33(73.5%) was observed in ‘Pasta’, while the highest Salmonella incidence was observed in ‘Ades’.Conclusion: This study revealed that there is a reasonable gap on food safety knowledge among street food venders. The microbial profile was also higher compared to standards set by the World Health Organization. Due attention should be given by the government to improve knowledge about food safety and the quality standard of street foods sold in the City.Keywords: Microbiological safety, Street vended foods, Isolation, Jigjiga
Published: 2016

40. The sanitary conditions of food and drink establishments in Woldia town, Northeastern Ethiopia

Author: Melese Abate Reta, Testa, Mekonnin, and Adere, Ashete
Abstract: Background: A lack of basic infrastructure and a low level of knowledge of hygiene and sanitary practices in catering establishments provide to outbreaks of food-borne diseases. The aim of this study was to assess the sanitary conditions of food and drink establishments in Woldia town, Northeastern Ethiopia.Methods: A descriptive cross-sectional study was carried out from January to June 2016. Two hundred and eight food and drink establishments were included through a systematic, simple, random selection method after a list of all the establishments was found from the town Trade and Industry Office. Trained enumerators use structured and pre-tested questionnaires to collect data. Data were analyzed using SPSS (version 20). P
Published: 2018

41. Adolescent-parent communication on sexual and reproductive health issues and associated factors among high school students in Woldia town, Northeastern Ethiopia

Author: Molla Temere, Mekonen, Hana Abebe, Dagnew, Tesfay Ambaye, Yimam, Hayat Nuradis, Yimam, and Melese Abate, Reta
Subjects: Male, associated factors, Adolescent, communication, Sexual Behavior, Research, education, Woldia town, body regions, SRH issues, Young Adult, parent, Cross-Sectional Studies, Logistic Models, Reproductive Health, Adolescent Behavior, Humans, Female, Ethiopia, Parent-Child Relations, Students
Abstract: Introduction Sexual and reproductive health (SRH) communication is most likely to promote healthy sexual practices and to reduce risky sexual behavior among adolescents. Communication is the principal means for parents to transmit sexual values and knowledge to their children. This study aimed to assess adolescent-parent communication on SRH issues among high school students in Woldia town. Methods A cross-sectional study was conducted from December 15-31, 2016. Systematic random sampling technique was used to select 693 students from Grades 9 and 10. Data were entered into Epi-info version 3.5.1 and analyzed by using SPSS version 20. Logistic regression with Odds Ratios (OR) and 95% Confidence intervals (CI) was used to identify the independent predictors of adolescent-parent communication. Results 674 students accepted to participate in this study giving a response rate of 97.3%. Only 205(30.4%) had discussed on two or more SRH topics with their parents. In logistic regression analyses, mothers who could read and write [AOR=2.0; 95% CI=1.3-3.1] and had diploma certificate [AOR=2.0; 95% CI=1.4-2.9] were more likely to discuss on SRH issues with their children. Adolescents who agreed on the importance of discussion on SRH issues [AOR=2.5; 95% CI=1.3-4.5], whoever got SRH information [AOR=2.0; 95% CI=1.4-2.9] and those whoever had sexual intercourse [AOR=1.7; 95% CI=1.1-2.6] were more likely to discuss on different SRH issues with their parents. Conclusion This study revealed that parent-adolescent communication on SRH issues was inadequate. Therefore, there is a need to equip and educate parents on different adolescents' SRH issues.
Published: 2017

42. Prevalence and Associated Risk Factors of Anemia among Pregnant Women in Rural Part of JigJiga City, Eastern Ethiopia: A Cross Sectional Study

Author: Lemessa Assefa Ayana, Adunga Negussie Gudeta, Melese Abate Reta, and Solomon Gebretsadik Bereka
Subjects: medicine.medical_specialty, Veterinary medicine, Cross-sectional study, business.industry, Anemia, Public health, Logistic regression, medicine.disease, World health, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Environmental health, Medicine, Residence, 030212 general & internal medicine, Rural area, business, Body mass index
Abstract: Background: Anemia prevalence varies by place of residence â a higher proportion of women in rural areas are anemic as compared to those in urban areas. The main objective of this study was to identify and analysis the prevalence and associated risk factors of anemia among pregnant women in rural part of Jigjiga city, eastern Ethiopia. Method: Among 417 pregnant women, a cross-sectional study was done from August to December 2015. A structured questionnaire was used to collect data related to socio-demographic characteristics, medical, obstetric and dietary practices. Haemoglobin levels of pregnant women were determined by applying HemoCue photometer. Statistical analysis was conducted with SPSS-version 21. Result: Of the total respondent 63.8% were anemic. The multiple logistics regression analysis showed that gravidity (AOR=2.07; 95% CI: 1.30-2.91); mother’s age (AOR=2.4; 95% CI: 0.01-4.06); family size (AOR=2.12; 95% CI: 1.11-3.31); third trimester (AOR=2.1; 95% CI: 1.07-5.04); iron supplementation (AOR=1.30; 95% CI=1.01-4.01); mid-upper arm circumference of less than 23 (AOR=0.57; 95% CI: 0.20-0.89) and body mass index (AOR=2.03; 95% CI: 2.00-3.81) were significant predictors associated with anemia among pregnant women. Conclusion: Based on World Health Organization (WHO) in the study area anemia was a major public health problem (prevalence greater than 40%). Hence, we recommended that nutritional education and also education about risk factors of anemia should be done.
Published: 2017

43. Neonatal bacterial meningitis in Tikur Anbessa Specialized Hospital, Ethiopia: a 10-year retrospective review

Author: Tamrat Abebe Zeleke and Melese Abate Reta
Subjects: Meningitides, Pediatrics, medicine.medical_specialty, Streptococcus pneumonia, Bacterial meningitis, Prevalence, medicine.disease_cause, Haemophilus influenzae, Neonatal meningitis, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Streptococcus pneumoniae, medicine, 030212 general & internal medicine, Multidisciplinary, biology, business.industry, Streptococcus, Mortality rate, Research, E. coli, Neonates, Acinetobacter, biology.organism_classification, medicine.disease, business
Abstract: Background Bacterial meningitis is still a major public health threat in developing countries. It is an overwhelming infection with a high morbidity and mortality rate, especially in neonates. The aim of this study was to determine the prevalence and etiological agents that cause bacterial neonatal meningitis at Tikur Anbessa Specialized Hospital (TASH). Methods This is a retrospective analysis of 1189 cerebrospinal fluid (CSF) specimens submitted to the bacteriology laboratory of TASH for culture from 2001 to 2010. All newborns younger than 29 days old that were suspected for bacterial meningitis cases were included in the study. Results Based on CSF culture, 56 newborns were identified as having bacterial meningitis from a total of 1189 suspected cases. The overall prevalence of neonatal bacterial meningitis from the total suspected cases was 4.7%. The organisms identified and their prevalence rates were Streptococcus pneumoniae 13 (23%), Escherichia coli 9 (16%), Acinetobacter 7 (13%), Neisseria meningitides 5 (9%), Klebsiella spp. 5 (9%), Staphylococcus aureus 3 (5%) and Streptococcus pyogen 3 (5%). There were two (4%) cases each that was caused by Coagulase-Negative-Staphylococcus and Non-Group-A-Streptococcus, while 1 (2%) caused by Haemophilus influenzae. S. pneumoniae was the main etiological agent identified from CSF culture. The male to female ratio was 1:0.88 (53% were male). The birth weights of 34 (61%) patients were under 2500 g, and 22 (39%) patients had normal birth weights. Twenty-seven (48%) were early onset cases, and 29 (52%) were late-onset. Conclusion Streptococcus pneumoniae and Escherichia coli were the two main etiological agents for neonatal bacterial meningitis infection in the study area.
Published: 2016

44. Bacterial contaminations of raw cow’s milk consumed at Jigjiga City of Somali Regional State, Eastern Ethiopia

Author: Tesfaye Wolde Bereda, Melese Abate Reta, and Ayalew Nigusie Alemu
Subjects: 0301 basic medicine, Salmonella, Veterinary medicine, medicine.drug_class, Health, Toxicology and Mutagenesis, 030106 microbiology, Antibiotics, Public Health, Environmental and Occupational Health, Biology, Amoxicillin, Raw milk, medicine.disease_cause, Penicillin, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Ampicillin, medicine, 030212 general & internal medicine, Food science, Rifampicin, Food Science, medicine.drug
Abstract: Milk is a compensatory part of daily diet especially for the expectant mothers as well as growing children. It is virtually a sterile fluid when secreted into alveoli of udder. However, beyond this stage of production, microbial contamination might generally occur from different sources. A cross-sectional study was carried out from March 2013-January 2014 in Jigjiga city to assess bacterial contamination of raw milk meant for human consumption and to determine antimicrobial susceptibility patterns of the isolates. A total of 120 raw milk samples were aseptically collected from different sampling points that were hypothesized to be a source of potential contaminations. Data were analyzed using SPSS version 17 computer software. P-value of
Published: 2016

45. Department of Error

Author: Maziar Moradi-Lakeh, Krishna K. Aryal, Mohamad-Hani Temsah, Ahmad Daryani, Claudio Alberto Davila, Achala Upendra Jayatilleke, David L. Smith, Chinwe Juliana Iwu, Kavumpurathu Raman Thankappan, Ibrahim Abdollahpour, Mehdi Fazlzadeh, Robert C. Reiner, Bineyam Taye, Dadi Marami, Ghulam Mustafa, Manasi Kumar, Mostafa Leili, Mehdi Sharif, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Oluchi Okpala, Shivakumar K.M. Kondlahalli, Nihal Thomas, Man Mohan Mehndiratta, Ebrahim Babaee, Tsegaye Lolaso Lenjebo, Miliva Mozaffor, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Carlos Miguel Rios González, Pallab K. Maulik, Ali H. Mokdad, Mehran Alijanzadeh, Florian Fischer, Lalit Dandona, Aso Mohammad Darwesh, Alemayehu Toma Mena, Jennifer Rickard, Benjamin K. Mayala, Seyed Mostafa Mir, Moslem Soofi, Bhaskaran Unnikrishnan, Boris Bikbov, Bereket Duko Adema, Jagdish Khubchandani, Sachin R Atre, Rafael Moreira Claro, Sandra B. Munro, Carlos Zambrana-Torrelio, Kassawmar Angaw Bogale, Soraya Siabani, Muluken Azage Yenesew, Birhan Tamene Alemnew, Anwar E. Ahmed, Morteza Shamsizadeh, Masresha Tessema Anegago, Muluken Bekele Sorrie, Vivekanand Jha, Gebrekiros Gebremichael Meles, Andre M. N. Renzaho, Muhammad Aziz Rahman, Hebat Allah Salah A. Yousof, Naohiro Yonemoto, Ahmad Ghashghaee, Kebede Embaye Gezae, Hadi Pourjafar, Junaid Khan, Farnam Mohebi, Marcel Ausloos, Manisha Dubey, Quynh Anh P. Nguyen, Assefa Desalew, Vera Marisa Costa, Mohammad Fareed, Ronny Westerman, Maciej Banach, Paul S. F. Yip, Kala M. Mehta, Mehdi Yaseri, Quique Bassat, Amir Almasi-Hashiani, Fatemeh Rajati, Irina Filip, Gelin Xu, Derrick A Bennett, Atalay Goshu Muluneh, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Fariba Ghassemi, Behzad Karami Matin, David C. Schwebel, Syed Ather Hussain, Milena Ilic, Xiu Ju Zhao, Jost B. Jonas, Dian Kusuma, Martin Amogre Ayanore, Mostafa Hosseini, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Santosh Varughese, Cuong Tat Nguyen, Chalachew Genet Akal, Chabila C Mapoma, Aubrey J. Levine, Jacqueline Elizabeth Alcalde Rabanal, Hesham M. Al-Mekhlafi, Rufus A. Adedoyin, Gudlavalleti Vs Murthy, Amir Khater, Olufemi Ajumobi, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Lorenzo Monasta, Mohammad Hossein Khosravi, Rizwan Suliankatchi Abdulkader, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Dhirendra N Sinha, Shai Linn, Fisaha Haile Tesfay, Abdullah Al Mamun, Yoshan Moodley, Amjad Mohamadi-Bolbanabad, Hajer Elkout, Mohammad Zamani, Yousef Mohammad, Yousef Veisani, Iman El Sayed, Asmamaw Bizuneh Demis, Alex Yeshaneh, Sharath Burugina Nagaraja, Segun Emmanuel Ibitoye, Charles Shey Wiysonge, Pushpendra Kumar, Engida Yisma, Maysaa El Sayed Zaki, Kebede Deribe, Ali Akbar Fazaeli, Moritz U. G. Kraemer, Ayele Geleto Bali, Platon D. Lopukhov, Paula Moraga, Giovanni Damiani, Alebachew Fasil Ashagre, Hossein Farzam, Amir Kasaeian, Taye Abuhay Zewale, Ben Lacey, Mika Shigematsu, Bryan L. Sykes, Abdur Razzaque Sarker, Ali Kabir, Lal B. Rawal, Juan Sanabria, Ehsan Khodamoradi, Saeed Amini, Hasan Yusefzadeh, Josephine W. Ngunjiri, Aberash Abay Tassew, Sezer Kisa, Biruck Desalegn Yirsaw, Hosni Salem, Ayman Grada, Jean Jacques Noubiap, Mina Anjomshoa, Gebre Teklemariam Demoz, Sharareh Eskandarieh, Maryam Adabi, Nuworza Kugbey, Rahman Shiri, Melkamu Merid Mengesha, Zemenu Tadesse Tessema, Amir Radfar, Girmay Teklay Weldesamuel, Sahel Valadan Tahbaz, Nader Jahanmehr, Yuming Guo, Roghiyeh Faridnia, Mehdi Naderi, Ziad A. Memish, Adnan Kisa, Gbenga A. Kayode, Yafeng Wang, Ehsan Sadeghi, Behnam Heidari, Apurba Shil, Kamarul Imran Musa, Jagadish Rao Padubidri, Farshad Pourmalek, Saravanan Muthupandian, Navid Rabiee, Mario Poljak, Nima Hafezi-Nejad, Hagos Degefa Hidru, Jemal Abdu Mohammed, MohammadBagher Shamsi, Mohsen Asadi-Lari, Sameh Magdeldin, Berhe Etsay Tesfay, Khanh Bao Tran, James A Platts-Mills, Jan-Walter De Neve, Maria Jesus Rios-Blancas, Hedley Quintana, Félix Carvalho, Yun Jin Kim, Eric L. Ding, Noushin Mohammadifard, Saeed Safari, Addisu Melese, Rakesh Lodha, Reza Shirkoohi, Itamar S. Santos, Alireza Khatony, Mohammad Khazaei, Mekdes Tigistu Yilma, Taweewat Wiangkham, Hamed Kalani, Mayowa O. Owolabi, Mohammad Reza Sobhiyeh, Frank B. Osei, Narayan Bahadur Mahotra, Zewdie Aderaw Alemu, Konrad Pesudovs, Kewal Krishan, Samath D Dharmaratne, Ayalew Jejaw Zeleke, Osayomwanbo Osarenotor, Tina Beyranvand, Yahya Salimi, Winfried März, Sheikh Mohammed Shariful Islam, Azmeraw T. Amare, Julio Cesar Campuzano Rincon, Maha El Tantawi, Anusha Ganapati Bhat, Susanna Dunachie, Shymaa Enany, Anelisa Jaca, Desalegn Tadese Mengistu, Salvatore Rubino, Nelson J. Alvis-Zakzuk, Indang Trihandini, Bartosz Miazgowski, Huda Basaleem, Zahid A Butt, Vijay Kumar Chattu, Navid Manafi, Si Si, Joan B. Soriano, Victor Adekanmbi, Andrea Farioli, Masoud Moradi, Joseph Frostad, Collins Chansa, Enrico Rubagotti, Edward J Mills, Senbagam Duraisamy, Foad Abd-Allah, Moses K. Muriithi, Elias Merdassa Roro, Netsanet Fentahun, Kenji Shibuya, Amira Hamed Darwish, Ai-Min Wu, Tomohide Yamada, Lauren E. Schaeffer, Sonia Lewycka, Catalina Liliana Andrei, Ali Kazemi Karyani, Beyene Meressa Adhena, Shaimaa I. El-Jaafary, Francisco Rogerlandio Martins-Melo, Faris Lami, Aziz Eftekhari, Naser Mohammad Gholi Mezerji, André Karch, Suraj Bhattarai, Mona M. Khater, Paulina A. Lindstedt, Marcos Roberto Tovani-Palone, Kedir Hussein Abegaz, Padukudru Anand Mahesh, Alexandre C. Pereira, Ammas Siraj Mohammed, Mehdi Hosseinzadeh, Reta Tsegaye Gayesa, In-Hwan Oh, Dietrich Rothenbacher, Margaret Kosek, Yunquan Zhang, Ketema Bizuwork Gebremedhin, Rahul Gupta, Claudiu Herteliu, Nicole Davis Weaver, Dawit Zewdu Wondafrash, Oliver J. Brady, Samad Azari, Ebrahim M Yimer, Andrew T Olagunju, Ana Laura Manda, Ali Rostami, Aniruddha Deshpande, Ninuk Hariyani, Gulfaraz Khan, Narinder Pal Singh, Dabere Nigatu, Jae Il Shin, Preeti Dhillon, Duduzile Ndwandwe, Michelle L. Bell, Rakhi Dandona, Mojtaba Hoseini-Ghahfarokhi, Obinna Onwujekwe, Olatunji O. Adetokunboh, Tanuj Kanchan, Suleman Atique, Rovshan Khalilov, Ai Koyanagi, Ejaz Ahmad Khan, Jalal Arabloo, Ahmed Abdelalim, Van C. Lansingh, Ali Almasi, Catherine A. Welgan, Surendra Karki, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Hamid Yimam Hassen, Mohammad Ali Sahraian, Akram Pourshams, Mowafa Househ, Dilaram Acharya, Getnet Mengistu, Arya Haj-Mirzaian, Salman Khazaei, Bahram Armoon, Emerito Jose Aquino Faraon, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, David Laith Rawaf, Ali S. Akanda, Till Bärnighausen, Veincent Christian Filipino Pepito, Ahmed Omar Bali, Norberto Perico, Sergio I. Prada, Mohammad Moradi-Joo, Helen Derara Diro, Gebremicheal Gebreslassie Kasahun, Andre Rodrigues Duraes, Ajay Patle, Simin Mouodi, Yuan-Pang Wang, Alireza Esteghamati, Paramjit Gill, Ahamarshan Jayaraman Nagarajan, Meghnath Dhimal, Hafiz Ansar Rasul Suleria, Saleh Salehi Zahabi, Nader Jafari Balalami, Lucas Earl, Haileab Fekadu Wolde, Doris D. V. Ortega-Altamirano, Beatriz Paulina Ayala Quintanilla, Franz Castro, Deborah Carvalho Malta, Desta Haftu Hayelom, Sebastian Vollmer, Getinet Ayano, Arianna Maever L. Amit, Bárbara Niegia Garcia de Goulart, John S. Ji, Raaj Kishore Biswas, Michael R.M. Abrigo, Arash Etemadi, Andrey Nikolaevich Briko, Nefsu Awoke, Anton Sokhan, Daniel Adane Endalew, Ibrahim Abdelmageed Ginawi, Jacek Jóźwiak, Mihajlo Jakovljevic, Degu Abate, Ali S. Shalash, Hamidreza Haririan, Lucas Guimarães Abreu, Davide Guido, Masoud Foroutan, Karzan Abdulmuhsin Mohammad, Niranjan Kissoon, Farkhonde Salehi, Ashish Awasthi, Hosein Shabaninejad, Trang Huyen Nguyen, Anthony Masaka, Getenet Dessie, Fakher Rahim, Aklilu Endalamaw, Kiana Ramezanzadeh, Farzad Manafi, Olayinka Stephen Ilesanmi, Vahid Alipour, Neeraj Bedi, Kimberly B. Johnson, Laurie B. Marczak, Mehran Shams-Beyranvand, Amira Shaheen, Zubair Kabir, Saleem Muhammad Rana, Marzieh Nojomi, Peter Njenga Keiyoro, Yared Asmare Aynalem, Tissa Wijeratne, Fiseha Wadilo Wada, Giuseppe Remuzzi, Carlo La Vecchia, Chuanhua Yu, Pascual R. Valdez, Senthilkumar Balakrishnan, Phetole Walter Mahasha, Liliana Preotescu, Tewodros Eshete Wonde, Keivan Ahmadi, Masood Ali Shaikh, Leticia Avila-Burgos, Ken Lee Chin, Dinh-Toi Chu, Francesco Saverio Violante, Yasir Waheed, Daniel Diaz, Rosario Cárdenas, Ibrahim A Khalil, Ernoiz Antriyandarti, Adrian Pana, Salman Rawaf, Nauman Khalid, Nejimu Biza Zepro, Turki Alanzi, Amir Jalali, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Demelash Woldeyohannes Handiso, Nuruzzaman Khan, Takeshi Fukumoto, Christiane Dolecek, Melese Abate Reta, Vinay Nangia, Soumyadeep Bhaumik, Ravi Mehrotra, Seyed-Mohammad Fereshtehnejad, Brigette F. Blacker, Savita Lasrado, Seifadin Ahmed Shallo, Arash Ziapour, Krittika Bhattacharyya, Praveen Hoogar, Nicola Luigi Bragazzi, Mahdi Safdarian, Seyed Sina Naghibi Irvani, Chi Linh Hoang, Boikhutso Tlou, Manfred Accrombessi, Christopher J L Murray, Dragos Virgil Davitoiu, Hossein Poustchi, Farid Najafi, Sathish Thirunavukkarasu, Daniel Bekele Ketema, Dharmesh Kumar Lal, Vafa Rahimi-Movaghar, Christopher Troeger, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Paul H. Lee, Genet Melak Alamene, George C Patton, Andem Effiong, André Faro, Rushdia Ahmed, Colm McAlinden, Parvaneh Mirabi, Joshua Longbottom, Hagos Tasew Atalay, Alireza Rafiei, Somayeh Bohlouli, Temesgen Yihunie Akalu, Syed Mohamed Aljunid, Javad Nazari, Ismael R. Campos-Nonato, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Arvin Haj-Mirzaian, Sanghamitra Pati, Bakhtiar Piroozi, Rafael Alves Guimarães, Khaled Khatab, Evanson Z. Sambala, Mohsen Afarideh, Nelson Alvis-Guzman, Koku Sisay Tamirat, Mustafa Z. Younis, Hamed Zandian, Aparna Lal, Tamer H. Farag, Tahereh Pashaei, Benn Sartorius, Kidane Tadesse Gebremariam, Demelash Abewa Elemineh, Marwa Rashad Salem, Davide Rasella, Hedayat Abbastabar, Manu Raj Mathur, Peng Jia, Natalie Maria Cormier, Olatunde Aremu, Mohammad Reza Salahshoor, Kirsten E. Wiens, Ghobad Moradi, Srinivas Goli, Ruth W Kimokoti, Aliasghar Ahmad Kiadaliri, Khalid A Altirkawi, Ritesh G. Menezes, Molly K. Miller-Petrie, Alaa Badawi, Beriwan Abdulqadir Ali, Ensiyeh Jenabi, Getnet Azeze Gedefaw, Ahmed I. Hasaballah, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Eleonora Dubljanin, Amir Hasanzadeh, Jasvinder A. Singh, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Feleke Mekonnen Demeke, Agus Sudaryanto, Muhammad Ali, Yilma Chisha Dea Geramo, Leonardo Roever, Gebreamlak Gebremedhn Gebremeskel, Maheswar Satpathy, Asnakew Achaw Ayele, Seyyed Meysam Mousavi, Devasahayam J. Christopher, Malede Mequanent Sisay, Yibeltal Alemu Bekele, Tamirat Tesfaye Dasa, Gessessew Bugssa Hailu, Luca Ronfani, James Albright, Nathaniel J. Henry, Ionut Negoi, Dessalegn Ajema Berbada, Brijesh Sathian, Yousef Khader, Bal Govind Chauhan, Nikolay Ivanovich Briko, Hamideh Salimzadeh, Ali Bijani, Irfan Ullah, Shirin Djalalinia, Shanshan Li, Kebreab Paulos, Mohsen Bayati, Nasir Salam, Mohammad Ali Mansournia, Rajesh Sagar, Fatemeh Heydarpour, Siamak Sabour, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Mathew M. Baumann, Mehedi Hasan, Vishnu Renjith, Nuno Taveira, Getaneh Alemu Abebe, Pranab Chatterjee, Shafiu Mohammed, Dongyu Zhang, Abbas Mosapour, Muki Shey, Rajat Das Gupta, Muktar Beshir Ahmed, Satar Rezaei, Wondimeneh Shibabaw Shiferaw, Kenean Getaneh Tlaye, Eugenio Traini, Oladimeji Adebayo, Aisha Elsharkawy, David M. Pigott, Hadi Hassankhani, Anas M. Saad, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Abdallah M. Samy, Ali Talha Khalil, Nelson G.M. Gomes, Afsaneh Arzani, Ayesha Humayun, Michael Tamene Haile, Huyen Phuc Do, Maryam Khayamzadeh, Rajeev Gupta, Davoud Adham, Farah Daoud, Jai K Das, Ana Isabel Ribeiro, Sameer Vali Gopalani, Joel M. Francis, Alyssa N. Sbarra, Brian J. Hall, Ravi Prakash Jha, David Teye Doku, Guoqing Hu, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, S. Mohammad Sajadi, Shankar M Bakkannavar, Ali Yadollahpour, Masoud Behzadifar, and G Anil Kumar
Subjects: Burden of disease, 030219 obstetrics & reproductive medicine, business.industry, Low income and middle income countries, General Medicine, Specific mortality, 030204 cardiovascular system & hematology, Article, 3. Good health, 03 medical and health sciences, Geography, 0302 clinical medicine, Environmental health, Medicine, 030212 general & internal medicine, Geographical inequalities, business, Demography
Abstract: Reiner RC Jr, Hay SI. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017. Lancet 2020; 395: 1779–801—In this Article, the author byline has been amended to Local Burden of Disease Diarrhoea Collaborators. This correction has been made to the online version as of June 4, 2020, and the printed version is correct. © 2020 Elsevier Ltd
Published: 2018

46. High enteric bacterial contamination of drinking water in Jigjiga city, Eastern Ethiopia

Author: Melese Abate Reta

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