Search

Summary Background Ethiopia reported the first case of COVID-19 on 13th March, 2020 with community transmission ensuing by mid-May. A national, population-based serosurvey against anti-SARS-CoV-2 IgG was conducted to measure the prevalence of prior COVID-19 infections and better approximate the burden across major towns in Ethiopia. Methods We conducted a cross-sectional, population-based serosurvey from June 24 to July 8, 2020 in 14 major urban areas. Two-stage cluster sampling was used to randomly select enumeration areas and households. All persons aged ≥15 years were enrolled. Serum samples were tested by Abbott™ ARCHITECT™ assay for SARS-CoV-2 IgG antibodies. National COVID-19 surveillance data on the median date of the serosurvey is analyzed for comparison. Findings Adjusted seroprevalence was 3.5% (95% CI: 3.2%-3.8%) after controlling for age, sex and test kit performance. Males (3.7%) and females (3.3%) were nearly equally infected, while middle-aged adults '40-65 years' had the highest (4.0%) prevalence. Gambella (7.5%), Dire Dawa (6.2%) and Jigjiga (6.1%) were the most affected towns. About 6.7% and 8.0% of seropositives had symptoms and chronic underlying illness, respectively. A surveillance system had identified 4,416 RT-PCR confirmed cases in Addis Ababa. Interpretation This serosurvey shows that a majority of urban Ethiopians remain uninfected with SARS-CoV-2. Most anti-SARS-CoV-2 IgG positive cases were asymptomatic with no underlying illness, keeping case detection to a minimum.

Background. Chikungunya virus is a ribonucleic acid (RNA) virus transmitted by a mosquito bite. Chikungunya virus outbreaks are characterized by rapid spread, and the disease manifests as acute fever. This study aimed at determining risk factors for chikungunya virus outbreak to apply appropriate prevention and control measures. Methods. Unmatched case-control study was performed to identify risk factors of chikungunya outbreak in Somali region of Ethiopia in 2019. Cases and controls were enrolled with 1 : 2 ratio. All cases during the study period (74 cases) and 148 controls were included in the study. Bivariate and multivariable analyses were implemented. The serum samples were tested by real-time polymerase chain reaction at Ethiopian Public Health Institute Laboratory. Results. A total of 74 chikungunya fever cases were reported starting from 19th May 2019 to 8th June 2019. Not using bed net at daytime sleeping (adjusted odds ratio (AOR): 20.8; 95% confidence interval (CI): 6.4–66.7), presence of open water holding container (AOR: 4.0; CI: 1.2–3.5), presence of larvae in water holding container (AOR: 4.8; CI: 1.4–16.8), ill person with similar signs and symptoms in the family or neighbors (AOR: 27.9; CI: 6.5–120.4), and not wearing full body cover clothes (AOR: 8.1; CI: 2.2–30.1) were significant risk factors. Conclusion. Not using bed net at daytime sleeping, presence of open water holding container, presence of larvae in water holding container, ill person with similar signs and symptoms in the family or neighbors, and not wearing full body cover clothes are risk factors for chikungunya virus outbreak.

Background Globally, the Tuberculosis treatment success rate was worse for HIV-positive TB patients compared with HIV- negative TB patients. This study aimed at determining the impact of HIV-AIDS and factors associated with TB treatment outcomes. Methods This study was a retrospective cohort study of five years of tuberculosis data from four public health facilities in Hosanna Town. A total of 604 study participants were included using a systematic random sampling technique. Descriptive analysis of ratios, rates, and proportions was done and binary logistic regression, bivariable and multivariable, analysis was also done. Result A total of 604 TB patients were enrolled in this study. 302 (50%) were HIV co-infected. The overall treatment success rate was 90.1% (544/604). Treatment success rates are 86.4% (261/302) for TB-HIV co-infected patients and 93.7% (283/302) for non-co-infected patients. TB-HIV co-infected patients had a higher risk of an unsuccessful treatment outcome (Adjusted Relative Risk [ARR]: 2.7; 95% Confidence Interval [CI]: 1.4 – 5.2). The risk of unsuccessful treatment outcome is also higher among rural residents (ARR: 3.3; CI: 1.4 – 5.0), patients on the re-treatment category (ARR: 2.7; CI: 1.4 – 5.1), and with chronic disease (ARR: 3.3; CI: 1.3 – 8.1). Conclusion TB treatment success rate is good as compared to the WHO minimum requirement. Successful treatment outcome is lower among patients with HIV infection, rural residents, patients on re-treatment, and patients with chronic disease. Therefore, due emphasis should be given to these high-risk groups.

Rapid scale-up of surveillance activities is the key to successful coronavirus disease 2019 (COVID-19) pandemic prevention and mitigation. Ethiopia did not have a sufficient number of active surveillance officers for the public health COVID-19 response. Training of surveillance officers was needed urgently to fill the gap in the workforce needed. Subject-matter experts from the United States and Ethiopia developed applicable training modules including background on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), contact investigation, and communications. The training modules were delivered live in real-time via web-based virtual presentation. Seventy-seven health surveillance officers were hired, trained, and deployed in two weeks to assist with surveillance activities in Ethiopia. Electronic capacity building is needed in order to improve Web-based training in resource-limited settings where internet access is limited or unreliable. Web-based synchronously delivered course was an effective platform for COVID-19 surveillance training. However, strengthening public and private information technology capacity, literacy, and internet availability will improve Web-based education platforms in resource-limited countries.

Introduction: Chicken pox or varicella is an acute viral infectious disease of childhood caused by varicella-zoster virus. Humans are the only known hosts for this virus. The major route of transmission is airborne, however, transmissions via aerosols or direct contact with blister fluid have also been reported. The primary infection presents as fever and exanthematous rash. Clinically apparent infection usually provides lifelong immunity. The disease is usually acute and self-limiting but occasionally can lead to secondary infections like pneumonia, encephalitis, and secondary bacterial infections. Varicella is vaccine preventable disease. An estimated 4.2 million cases and 4200 deaths occur annually worldwide. This outbreak investigation was conducted to describe chicken pox cases in terms of person, place and time from 6th to 18th August 2018. Methods: We conducted a descriptive study in the Yirga cheffe town. We line listed all reported cases which contains sociodemographic characteristics and signs and symptoms of patients. We have also visited the reporting internally displaced population (IDP) sites during investigation. The line listed data were analyzed with person, place and time. Cases were treated symptomatically in mobile clinics. Results: A total of 25 suspected cases of chicken pox were reported between 6th and 18th of August 2018 from Yirga cheffe town IDP sites. The cases were reported from two IDP sites. Out of the total reported cases 14 (56%) were males while the remaining 11 (44%) were females with regard to sex. 88% of the total reported cases were children under the age of fifteen. Conclusion: The most affected age group in this outbreak was under the age of fifteen. Males were more affected than females in this outbreak. Unavailability of chicken pox vaccine in Ethiopia might be a risk for the occurrence of this outbreak. Strengthening routine surveillance in the IDP sites is recommended. Ministry of Health of Ethiopia should consider the introduction of chicken pox vaccine in the country. Ministry of Health should prepare guidelines and manuals for response of outbreaks.

Hepatitis A virus is a non-enveloped, single-stranded, linear ribonucleic acid (RNA) virus Hepatovirus from the Picornaviridae. It is transmitted by ingestion of food contaminated by fecal matter. Gastrointestinal symptoms with Fever, fatigue, yellowing of the skin or eyes, light-colored feces and dark-colored urine are among symptoms. It is a cause of death for 15 000 annually around the globe. The objective of this study is to describe hepatitis A outbreak in in terms of person, place and time. We investigated the outbreak to describe the cases and to identify the etiology. Medical records and line list were reviewed and descriptive data analysis was performed. Serum samples were tested by Immunoglobulin M (IgM) enzyme linked Immunosorbent assay (ELISA) and real time polymerase chain reaction (PCR) methods. We included all 81 cases with acute jaundice syndrome diagnosis and analyzed the data using Microsoft Excel. A total of 81 persons were affected with the acute jaundice syndrome. Among those, 37 (46%) were females and 44 (54%) were males. The median age of patients was 7 years with range 1-40 years old. The overall attack rate of the outbreak was 27 per 100,000. The age of patients ranged from 1 to 40 years. Out of 18 tested samples, 11 (61%) were positive for Hepatitis A. From the total cases listed, 44 (45%) were from the local community and 37 (46%) were from the internally displaced people (IDP). The outbreak lasted from February to August 2017. Hepatitis A was confirmed affecting people below 40 years of ages in Dolo zone, Somali region, Ethiopia in 2017 and there will be no way that it cannot cause illness again.