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Atnafu Bushen,1 Eyob Tekalign,2 Mengistu Abayneh2 1Department of Medical Laboratory Sciences, Mizan-Tepi University Teaching Hospital, Mizan-Aman, SNNPR, Ethiopia; 2Department of Medical Laboratory Sciences, Mizan-Tepi Universities, Mizan-Aman, SNNPR, EthiopiaCorrespondence: Mengistu AbaynehDepartment of Medical Laboratory Sciences, Mizan-Tepi Universities, Mizan-Aman, SNNPR, EthiopiaTel +251-913256673Email menge.abay@gmail.comBackground: In Ethiopia, the precise attribution of animals and their food products as the sources of resistant strains and the consequences of it on human health have not yet been seriously evaluated. Therefore, the aim of this study was to assess the drug- and multidrug-resistance pattern of Enterobacteriaceae isolated from chicken droppings at Jimma University poultry farm, College of Agriculture and Veterinary Medicine, southwest of Ethiopia.Methods: A cross-sectional descriptive study was conducted from April, 2018 to June, 2018. A total of 140 fresh chicken dropping samples were collected and transported to Jimma University Medical Microbiology Laboratory for analysis. All samples were inoculated on MacConkey agar and xylose lysine deoxycholate agar. Gram stain and relevant biochemical tests were done for identification of isolates. Antimicrobial susceptibilities were tested by the Kirby–Bauer disk diffusion method.Results: Out of 140 chicken dropping samples, 61 (43.6%) showed bacterial growth. Of these, E. coli accounts for 39.0% followed by K. pneumoniae (22.0%), P. mirabilis (19.3%), and Salmonella species (17.7%). With regard to antibiotic resistance pattern, E. coli demonstrated a high rate of resistance against ampicillin (91.7%), tetracycline (75.0%), and trimethoprim-sulfamethoxazole (70.8%). K. pneumoniae showed a high resistance rate against ampicillin, trimethoprim-sulfamethoxazole, and tetracycline, with a resistance rate ranging from 76.9% to 85.6%. P. mirabilis and Salmonella spp. also showed high resistance against ampicillin, tetracycline, and trimethoprim-sulfamethoxazole with a resistance rate ranging from 72.7% to 83.3%. All isolates relatively showed lower resistance rates with a range of 20.8% to 41.7% against third-generation cephalosporins (ceftazidime and ceftriaxone), ciprofloxacin, and gentamicin. Totally, 32 (52.5%) of the isolates showed MDR against three or more antibiotics.Conclusion: Antibiotic resistant isolates against commonly prescribed single and multiple drugs were common. This highlights that chickens in the farm may serve as the reservoirs of antibacterial resistant bacteria that might infect humans through the food chain. Therefore, emphasis on the usage of antibiotics in chicken farms has to be considered.Keywords: drug- and multidrug-resistance, Enterobacteriaceae, chicken droppings, Ethiopia

Background Bloodstream infections (BSIs) are one of the most common infections seen in all age groups and in all locations. The current knowledge on the patterns of bacterial profile, and its antibiotic resistance are essential to design and implement appropriate interventions. This study was conducted to assess the prevalence and multi-drug resistance pattern of bacterial isolates among septicemia and/or bacteremia suspected cases in Ethiopia. Methods Searching was conducted in databases of PubMed, Research Gate, Scopus and Google Scholar. In addition, manual searching is also conducted in bibliographies of included studies and in other meta-analysis studies. Required data were extracted from articles published up to 2020 on the bacterial profile of septicemia in Ethiopia, and analyzed using comprehensive meta-analysis version 3.3.0 software. Results A total of 5,823 septicemia suspected cases were extracted from 18 included studies and the overall blood culture positive rate of 31.9% (95% CI: 0.261–0.382). Of these, the overall Gram positive and Gram negative isolates was 57.8% (95% CI: 0.534–0.584) and 42.2% (95% CI: 0.416–0.466), respectively. Among Gram positives, predominantly reported isolates was Staphylococcus aureus (47.9%: 480 of 1,003), followed by Coagulase-Negative Staphylococcus (42.7%: 428 of 1,003), whereas among Gram negatives, the most frequently reported isolates was Klebsiella species (29.8%: 218 of 731), followed by Escherichia coli (23.1%: 169 of 731). Significant levels of resistance was reported against ampicillin, amoxicillin, ceftriaxone, co-trimoxazole and tetracycline with a pooled resistance range of 40.6–55.3% in Gram positive and 52.8–85.7% in Gram negative isolates. The pooled estimates of multi-drugs resistance (MDR) was (66.8%) among Gram positives and (80.5%) among Gram negatives, with the overall MDR rate of (74.2%). Conclusions The reported blood culture positive rates among septicemia cases were relatively high. Second, the level of drug and multi-drug resistant isolates against commonly prescribed antibiotics was significant. However, the scarcity of data on culture confirmed septicemia cases as well as patterns of antimicrobial resistance may overshadow the problem.

Since the emergency of COVID-19 pandemics, many countries have been encountered a multitude of challenges. People have been facing health related and other social consequences throughout the world. It is too early to know the aggravated impact of COVID-19 on people living in resource-limited setting, like east Africa countries. In these countries, besides direct public health impact, the COVID-19 pandemic has provoked social stigma and discriminatory behaviors against people of certain ethnic backgrounds as well as anyone perceived to have been in contact with the virus. Social stigma can negatively affect those with the disease, as well as their caregivers, family, friends and communities. COVID-19 pandemics have also been provoked great impacts on daily social consumptions such as food and other food supplements. In addition, COVID-19 pandemic were overshadowed endemics diseases such as malaria, TB and HIV related care and antenatal care services as well as other non-communicable diseases prevention and control. Social stigma coupled with other consequences could result in more severe health problems, can undermine social cohesion and prompt possible social isolation of groups, which might contribute to a situation where the virus is more, not less, likely to spread and difficulties controlling a disease outbreak. Therefore, how we communicate about COVID-19 is critical in supporting people to take effective action to help combat the disease and to avoid fuelling fear and stigma. An environment needs to be created in which the disease and its impact can be discussed and addressed openly, honestly and effectively. This is a message for government, media and local organizations working on the COVID-19 infections.

Background Raw meat is one of the commonly consumed traditional diets in Ethiopia. However, unhygienic processing and distribution practices are risky for contamination of meat leading to human infection. This study was conducted to assess the presence of multi-drug resistant E. coli with special emphasis on E. coli O157:H7 from meat of cattle and swab samples at abattoir houses and butcher shops in Jimma town, Southwest district of Ethiopia. Methodology A cross-sectional descriptive study was conducted from April to July, 2018. The isolation and identification processes passed through enrichment of samples with modified tryptone soy broth (mTSB), streaked onto MacConkey agar and Cefixime-tellurite sorbitol MacConkey agar, biochemical testing (indole and TSI), followed by latex agglutination testing. Results Out of 505 samples, 102 (20.2%) and 27 (5.4%) were positive for E. coli and E. coli O157:H7, respectively. Of these, 55 (19.3%) and 47 (21.4%) of E. coli and 17 (6.0%) and 10 (4.5%) of E. coli O157:H7 were isolated from the abattoir and butcher shop samples, respectively. A significant difference in the occurrences was observed among sample sources. Antimicrobial susceptibility test results showed that, 92.2% to 96.1% of E. coli and 85.5% to 96.3% of E. coli O157:H7 were susceptible to third generation cephalosporin, ciprofloxacin, gentamycin, kanamycin, streptomycin, and chloramphenicol. About 91.2% and 97.1% of E. coli and 88.9% and 92.6% of E. coli 0157:H7 were resistant to ampicillin and erythromycin, respectively. A total of 57 (44.2%) E. coli and E. coli O157:H7 isolates were resistant to three or more classes of antibiotics. All abattoir and butcher shop workers did not have any formal education or training certificates on food safety, and unhygienic practices were also observed. Conclusion The presence of E. coli and E. coli O157:H7 including multi-drug resistant isolates in raw meat highlights how the current meat processing and distribution practice was unhygienic. Therefore, strategies in the prevention and control of food-borne infections that could be caused by multi-drug resistant strains will depend greatly on hygienic processing and distribution practices of meat.

Background. In Ethiopia, the national TB case detection rate is becoming improved; still some districts are not able to meet their case detection targets which leads to ongoing spread of TB infections to family members and communities. This study was intended to assess possible obstacles contributing to low TB case detection in Kaffa zone, Southwest Ethiopia. Methods. A cross-sectional descriptive study involving qualitative and quantitative data was conducted from Mar. to Sep. 2019. Sociodemographic characteristics and data on duration of cough, whether sputum smear microscopy was requested or not, and data on TB knowledge and health care-seeking practice were collected from outpatients. Health care delivery barrier for TB case detection was also explored by using in-depth interview and FGD of health staff. Results. From 802 outpatients with coughing for 2 or more weeks of duration, 334 (41.6%) of them were not requested to have TB microscopic diagnosis. Of these, 11/324 (3.4%) of them were positive for TB after sputum smear microscopy. Only 24.2% of the outpatients were aware as they have had health education on TB disease. Twenty-eight percent of patients perceived that TB was due to exposure to cold air, and 13.5% could not mention any sign or symptom of TB. Amazingly, 54.2% of them did not have any information as current TB diagnosis and treatment is free. Thirty-five percent of the patients were taking antibiotics before visiting the health facility. The interrupted supply of TB diagnostic reagents, frequent electricity interruption, shortage of trained TB care providers, weak health information system, and weak active case finding practice were explored as the factors contributing to low TB case detection. Conclusion. Interrupted functioning of diagnostic centers, shortage of trained care providers, limited active TB case finding practice, weak health information system, and inadequate knowledge and health care-seeking practice of the patients were identified as contributors for low TB case detection. Thus, improving functioning of diagnostic centers, active TB case finding activities, and expanding health education on TB disease will help to improve TB case detection in the districts.

Background: Intestinal parasitic infections are still very common, especially in areas where immune-compromised patients like HIV/AIDS patients are high prevalent. Therefore, the aim of this study was to assess the prevalence of intestinal parasite and risk factor among HIV/ AIDS patients attending ART clinic in Mizan-Tepi university teaching hospital, Southwest Ethiopia. Method: A cross -sectional survey was conducted from July to September, 2021. A total of 191 study subjects were participated in this study. A structured questionnaire was used for collecting socio-demographic and risk factors data. Stool sample was collected and processed using direct wet mount, formol-ether concentration technique and modified Ziehl-Neelson staining techniques. Data was analyzed using statistical package for social sciences (SPSS) Version 25 software and logistic regressions were applied to assess any association between explanatory factors and outcome variables. Result: From a total of 191 stool samples, 67 (35.1%) were positive for intestinal parasites. The prevalence of intestinal parasites among patients on-ART was 31.5% (45/143) and 45.8% (22/48) among ART naïve group. Entamoeba histolytica/dispar (7.7%) and (12.5%) and Giardia lamblia (7.0%) and (10.4%) was the most predominant parasites detected both in ART and ART naïve groups (p > 0.05). Drinking untreated water (AOR = 0.13; 95% CI: 0.016-1.012), consuming raw food (AOR = 0.23; 95% CI: 0.025-2.108), eating unwashed raw vegetables (AOR = 2.26; 95% CI: 1.052-4.843); CD4 count 3 (AOR = 0.22; 95% CI: 0.062-0.798), CD4 count 200-500cells/mm3 (AOR = 0.40; 95% CI: 0.195-0.811), WHO stage II (AOR = 0.30; 95% CI: 0.156-0.589), WHO stage III (AOR = 0.32; 95% CI: 0.108-0.917) and viral load ≥150 copies/ml (AOR = 0.44; 95% CI: 0.220-0.873) were showed significant association with prevalence of intestinal parasite.Conclusion: In this study, higher rate of intestinal parasitosis were associated with hygienic practices like drinking untreated water, consuming raw food and eating unwashed raw vegetables and with some clinical findings such as lower CD4 counts, increased viral load and being WHO stage II & III. Therefore, public health measures and adherence to ART should be strengthened to improve the immune status and to reducing vulnerability of the patients for intestinal parasites.

Mengistu Abayneh,1 Molla Asnake,2 Dassalegn Muleta,1 Asnake Simieneh1 1College of Medical and Health Science, Department of Medical Laboratory Sciences, Mizan-Tepi University, Mizan-Aman, Southwest Ethiopia; 2College of Medical and Health Science, Department of Medicine, Mizan-Tepi University, Mizan-Aman, Southwest EthiopiaCorrespondence: Mengistu Abayneh, Email menge.abay@gmail.comBackground: Although emergency health-care services, particularly clinical and surgical care, are an important part of the provision of high quality health care in Ethiopia, infections related with surgical care are still the most well-known medical services-related diseases. This study aimed to assess the bacterial profiles and antimicrobial susceptibility pattern of isolates among patients diagnosed with surgical site infections at Mizan-Tepi university teaching hospital, southwest Ethiopia.Methodology: A prospective observational cohort study was conducted from June to September 2021. Patient data were collected using a structured questionnaire. Follow-up of patients who had undergone a surgical procedure was conducted for at least 30 days. Wound swabs were collected from patients suspected to have surgical site infections (SSIs) and cultured onto appropriate culture media. The antimicrobial susceptibility testing was done using the disk diffusion technique. Data were analyzed using SPSS software version 25.0. Frequencies and cross-tabulation were used to summarize descriptive statistics.Results: In this study, the postoperative SSIs rate was 12.6%. All patients with SSIs were culture positive, and a total of 41 bacterial isolates were detected. Of these, 73.2% were Gram-negative, 26.8% were Gram-positive and 24.2% were a mixture of two bacterial growths. Escherichia coli accounted for 29.3%, followed by Staphylococcus aureus (19.5%), Proteus species (14.6%) and Pseudomonas aeruginosa (12.2%). With the exceptions of amikacin and meropenem, which exhibited very high sensitivity, ranging from 33.3– 100.0% isolates was resistant against all other tested antibiotics. The resistance rate to three or more classes of antibiotics was 100.0%.Conclusion: In this study, the most isolated bacteria causing SSIs were Gram-negative and multidrug-resistant strains. This event highlights that surveillance of the bacterial profile and antibiotic susceptibility pattern coupled with the implementation of the strict protocol for antibiotic use and operative room regulations is important to minimize the burden of SSIs.Keywords: surgical site infections, bacterial profile, antimicrobial resistance, Ethiopia

Introduction: Traditionally, men are not supposed to take part in maternal health issues in many cultures. Nevertheless, pregnancy care and childbirth are the most crucial matters of reproductive health influenced by men. Hence, the aim of this study was to identify individual, sociocultural, and health facility factors affecting men’s involvement in facility-based childbirth in Southwest, Ethiopia. Objectives: The aim of this study was to identify individual, sociocultural, and health facility factors affecting men’s involvement in facility-based childbirth in Southwest, Ethiopia. Methods: A community-based cross-sectional study accompanied with a qualitative method was carried out from 1 July to 30 August 2019. A multistage cluster sampling technique was employed to recruit study participants. Descriptive statistics, frequencies, proportions, and mean were calculated, and the results of the analysis were presented in text, tables, and graphs. A multivariate logistic regression model was fitted to investigate the independent effect of each explanatory variable on the likelihood of men’s involvement in facility-based childbirth. Qualitative data were analyzed thematically using OpenCode 4.0 software. Results: Out of 800 men, only 36.5% (95% confidence interval: 33.3%–39.6%) were found to have involved in facility-based childbirth. Several factors were associated with men’s involvement in facility-based childbirth of this, being in the age group of 40–49 (adjusted odds ratio 5.04, 95% confidence interval: 2.49–10.20), attaining secondary education and above (adjusted odds ratio 2.14, 95% confidence interval: 1.53–5.60), and having sufficient knowledge of danger signs during pregnancy (adjusted odds ratio 5.65, 95% confidence interval: 3.25–7.46) associated with men’s involvement in facility-based childbirth. Conclusion: Relevant entities had better design-specific educational programs targeting younger age groups, those with lower schooling, and had previous bad obstetrics outcomes. Involving elders and religious leaders in the reproductive health program could also help in overcoming the existing cultural barriers. Moreover, creating a men-friendly facility environment and extensively engaging medias are suggested to improve men’s involvement in the study area.

— Since the emergency of COVID-19 pandemics, many countries have been encountered a multitude of challenges. People have been facing health related and other social consequences throughout the world. It is too early to know the aggravated impact of COVID-19 on people living in resource-limited setting, like east Africa countries. In these countries, besides direct public health impact, the COVID-19 pandemic has provoked social stigma and discriminatory behaviors against people of certain ethnic backgrounds as well as anyone perceived to have been in contact with the virus. Social stigma can negatively affect those with the disease, as well as their caregivers, family, friends and communities.COVID-19 pandemics have also been provoked great impacts on daily social consumptions such as food and other food supplements. In addition, COVID-19 pandemic were overshadowed endemics diseases such as malaria, TB and HIV related care and antenatal care services as well as other non-communicable diseases prevention and control. Social stigma coupled with other consequences could result in more severe health problems, can undermine social cohesion and prompt possible social isolation of groups, which might contribute to a situation where the virus is more, not less, likely to spread and difficulties controlling a disease outbreak. Therefore, how we communicate about COVID-19 is critical in supporting people to take effective action to help combat the disease and to avoid fuelling fear and stigma. An environment needs to be created in which the disease and its impact can be discussed and addressed openly, honestly and effectively. This is a message for government, media and local organizations working on the COVID-19 infections.

Mengistu Abayneh Sebsibe, Eyob Tekalign Asfaw School of Medical Laboratory Sciences, Mizan-Tepi University, Mizan Teferi, EthiopiaCorrespondence: Mengistu Abayneh Sebsibe Email menge.abay@gmail.comBackground: Raw meat is one of the commonly consumed traditional diets in Ethiopia. However, unhygienic processing and distribution practices are risky for contamination of meat leading to human infection. This study was conducted to assess the presence of multi-drug resistant E. coli with special emphasis on E. coli O157:H7 from meat of cattle and swab samples at abattoir houses and butcher shops in Jimma town, Southwest district of Ethiopia.Methodology: A cross-sectional descriptive study was conducted from April to July, 2018. The isolation and identification processes passed through enrichment of samples with modified tryptone soy broth (mTSB), streaked onto MacConkey agar and Cefixime-tellurite sorbitol MacConkey agar, biochemical testing (indole and TSI), followed by latex agglutination testing.Results: Out of 505 samples, 102 (20.2%) and 27 (5.4%) were positive for E. coli and E. coli O157:H7, respectively. Of these, 55 (19.3%) and 47 (21.4%) of E. coli and 17 (6.0%) and 10 (4.5%) of E. coli O157:H7 were isolated from the abattoir and butcher shop samples, respectively. A significant difference in the occurrences was observed among sample sources. Antimicrobial susceptibility test results showed that, 92.2% to 96.1% of E. coli and 85.5% to 96.3% of E. coli O157:H7 were susceptible to third generation cephalosporin, ciprofloxacin, gentamycin, kanamycin, streptomycin, and chloramphenicol. About 91.2% and 97.1% of E. coli and 88.9% and 92.6% of E. coli 0157:H7 were resistant to ampicillin and erythromycin, respectively. A total of 57 (44.2%) E. coli and E. coli O157:H7 isolates were resistant to three or more classes of antibiotics. All abattoir and butcher shop workers did not have any formal education or training certificates on food safety, and unhygienic practices were also observed.Conclusion: The presence of E. coli and E. coli O157:H7 including multi-drug resistant isolates in raw meat highlights how the current meat processing and distribution practice was unhygienic. Therefore, strategies in the prevention and control of food-borne infections that could be caused by multi-drug resistant strains will depend greatly on hygienic processing and distribution practices of meat.Keywords: multi-drug resistant E. coli and E. coli O157:H7, abattoir and butcher shops, Jimma town

Background. Klebsiella pneumoniae and Escherichia coli are the major extended-spectrum β-lactamase- (ESBL-) producing organisms increasingly isolated as causes of complicated urinary tract infections and remain an important cause of failure of therapy with cephalosporins and have serious infection control consequence. Objective. To assess the prevalence and antibiotics resistance patterns of ESBL-producing Escherichia coli and Klebsiella pneumoniae from community-onset urinary tract infections in Jimma University Specialized hospital, Southwest Ethiopia, 2016. Methodology. A hospital-based cross-sectional study was conducted, and a total of 342 urine samples were cultured on MacConkey agar for the detection of etiologic agents. Double-disk synergy (DDS) methods were used for detection of ESBL-producing strains. A disc of amoxicillin + clavulanic acid (20/10 µg) was placed in the center of the Mueller–Hinton agar plate, and cefotaxime (30 µg) and ceftazidime (30 µg) were placed at a distance of 20 mm (center to center) from the amoxicillin + clavulanic acid disc. Enhanced inhibition zone of any of the cephalosporin discs on the side facing amoxicillin + clavulanic acid was considered as ESBL producer. Results. In the current study, ESBL-producing phenotypes were detected in 23% (n = 17) of urinary isolates, of which Escherichia coli accounts for 76.5% (n = 13) and K. pneumoniae for 23.5% (n = 4). ESBL-producing phenotypes showed high resistance to cefotaxime (100%), ceftriaxone (100%), and ceftazidime (70.6%), while both ESBL-producing and non-ESBL-producing isolates showed low resistance to amikacin (9.5%), and no resistance was seen with imipenem. In the risk factors analysis, previous antibiotic use more than two cycles in the previous year (odds ratio (OR), 6.238; 95% confidence interval (CI), 1.257–30.957; p = 0.025) and recurrent UTI more than two cycles in the last 6 months or more than three cycles in the last year (OR, 7.356; 95% CI, 1.429–37.867; p = 0.017) were found to be significantly associated with the ESBL-producing groups. Conclusion. Extended-spectrum β-lactamases- (ESBL-)producing strain was detected in urinary tract isolates. The occurrence of multidrug resistance to the third-generation cephalosporins, aminoglycosides, fluoroquinolones, trimethoprim-sulfamethoxazole, and tetracyclines is more common among ESBL producers. Thus, detecting and reporting of ESBL-producing organisms have paramount importance in the clinical decision-making.

Acute respiratory infections (ARIs), especially pneumonia, remain the leading cause of childhood mortality and the most common reason for adult hospitalization in low- and middle-income countries, despite advances in preventative and management strategies. This study was conducted to assess factors associated with poor clinical outcome of suspected pneumonia cases among hospitalized patients at the three public health hospitals in Southwest district of Ethiopia. A cross-sectional study was conducted from May to July, 2020. Those patients admitted with suspected pneumonia were followed up during their hospital stay, and data on outcomes were captured by study nurses. Socio-demographics, clinical features, and follow-up data were gathered, and analyzed using SPSS versions 20.0. The differences in patients’ outcome in relation to their clinical features and epidemiologically linked exposures were described and compared using chi-square tests at 95% confident intervals. In this study, 742 patients with suspected pneumonia were analyzed. Of these, 473 (62.8%) of them were male, and 264 (35.6%) were of age 1–4 years. About 533 (71.8%) patients with suspected pneumonia were presented with irregular respiratory signs/symptoms (more than one symptoms) and 132 (17.9%) had underline illnesses. About 633 (85.4%) of patients were improved after treatment, and 109 (14.7%) of them ended with poor clinical outcome after completion of their treatment. Age of the patients and presence of comorbid conditions such as HIV/AIDS infections and bronchial asthma were identified as the risk factors for poor outcome of patients with suspected pneumonia. The clinical outcome of patients with suspected pneumonia at the three hospitals in Southwest district of Ethiopia was not satisfactory. Our findings highlight that in order to reduce poor clinical outcome related to suspected pneumonia, the efforts should be focused on some factors like management and prevention of chronic comorbidities. Increasing clinicians’ awareness on early management of suspected pneumonia cases is also essential in reducing the burden of the disease .