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Cryptosporidium, Shigella, toxin-producing Escherichia coli, and rotavirus were reported to be the most responsible for severe and fatal diarrhea among infants. This study aimed to investigate the presence of these pathogens in infants' drinking water samples and analyzing using water quality determinants in eastern Ethiopia. A molecular (LAMP)-based cross-sectional study design was employed. A total of 410 and 37 water samples were tested from infant point-of-use at household and corresponding water source, respectively, from June 2020 to May, 2021. Cryptosporidium, Shigella, toxin-producing E. coli, and rotavirus were detected in 28.5, 30.0, 26.3, and 32.2%, of water samples tested from infant point-of-use, respectively. About 13.2% of the water samples were positive for all (four) pathogens together. Cryptosporidium, Shigella, toxin-producing E. coli, and rotavirus were detected in 27.0, 32.4, 29.7, and 37.8%, of water samples tested from water sources, respectively. Positive significant correlation was observed between infant point-of-consumption and water sources from which it is drawn toward the presence of each targeted pathogen. Unimproved water source showed a strong significant association with the presence of Cryptosporidium, Shigella and toxin-producing E. coli. Therefore, efforts should be made in development of improved water sources, source protection safety and health education to caretakers of infants. [ABSTRACT FROM AUTHOR]

Problem Lymphatic filariasis and podoconiosis are the major causes of tropical lymphoedema in Ethiopia. The diseases require a similar provision of care, but until recently the Ethiopian health system did not integrate the morbidity management. Approach To establish health-care services for integrated lymphoedema morbidity management, the health ministry and partners used existing governmental structures. Integrated disease mapping was done in 659 out of the 817 districts, to identify endemic districts. To inform resource allocation, trained health extension workers carried out integrated disease burden assessments in 56 districts with a high clinical burden. To ensure standard provision of care, the health ministry developed an integrated lymphatic filariasis and podoconiosis morbidity management guideline, containing a treatment algorithm and a defined package of care. Experienced professionals on lymphoedema management trained government-employed health workers on integrated morbidity management.To monitor the integration, an indicator on the number of lymphoedema-treated patients was included in the national health management information system. Local setting In 2014, only 24% (87) of the 363 health facilities surveyed provided lymphatic filariasis services, while 12% (44) provided podoconiosis services. Relevant changes To date, 542 health workers from 53 health centres in 24 districts have been trained on integrated morbidity management. Between July 2013 and June 2016, the national health management information system has recorded 46487 treated patients from 189 districts. Lessons learnt In Ethiopia, an integrated approach for lymphatic filariasis and podoconiosis morbidity management was feasible. The processes used could be applicable in other settings where these diseases are co-endemic. Probleme La filariose lymphatique et la podoconiose sont les principales causes du lymphcedeme tropical en Ethiopie. Ces maladies requierent une prestation de soins similaire, mais en 2012, le systeme de sante ethiopien n'a pas integre la gestion de la morbidite. Approche Le ministere de la Sante et ses partenaires ont utilise les structures gouvernementales existantes pour mettre en place des services de sante en vue de la gestion integree de la morbidite liee au lymphcedeme. Une cartographie integree de la maladie a ete realisee dans 659 des 817 districts pour reperer ceux ou elle etait endemique. Afin d'orienter l'affectation des ressources, des agents de vulgarisation sanitaire qualifies ont integre des evaluations de la charge de morbidite dans 56 districts presentant une charge clinique elevee. Pour assurer une prestation standard de soins, le ministere de la Sante a redige des directives sur la gestion integree de la morbidite liee a la filariose lymphatique et a la podoconiose. Ces directives comportent un algorithme de traitement et un programme de soins precis. Des professionnels possedant de l'experience dans la gestion du lymphoedeme ont forme des agents de sante employes par le gouvernement a la gestion integree de la morbidite. Pour suivre l'integration, un indicateur relatif au nombre de patients pris en charge pour un lymphcedeme a ete inclus dans le systeme national d'information sanitaire. Environnement local En 2014, seuls 24% (87) des 363 etablissements de sante participant a l'enquete ont fourni des services lies a la filariose lymphatique et 12% (44) ont fourni des services lies a Ia podoconiose. Changements significatifs A ce jour, 542 agents de sante provenant de 53 centres de sante repartis dans 24 districts ont ete formes a la gestion integree de la morbidite. Entre juillet 2013 et juin 2016, le systeme national d'information sanitaire a enregistre 46487 patients pris en charge dans 189 districts. Lecons tirees La mise en place d'une approche integree pour la gestion de la morbidite liee a la filariose lymphatique et a la podoconiose a ete possible en Ethiopie. Les processus utilises pourraient etre appliques dans d'autres environnements ou ces maladies sont co-endemiques. Situacion La filariasis linfatica y la podoconiosis son las mayores causas del iinfedema tropical en Etiopia. Las enfermedades requieren una atencion sanitaria similar, pero en 2012 el sistema sanitario de Etiopia no integro la gestion de la morbilidad. Enfoque Para establecer servicios sanitarios para la gestion integrada de la morbilidad por Iinfedema, el ministerio de salud y colaboradores utilizaron estructuras gubernamentales existentes. Se realizo un mapeo integrado de la enfermedad en 659 de 817 distritos para identificar los distritos endemicos. Para informar sobre la asignacion de recursos, agentes formados de extension sanitaria integraron evaluaciones sobre la carga de la enfermedad en 56 distritos con una carga clinica elevada. Para garantizar un suministro estandar de la atencion, el ministerio de salud desarrollo unas directrices para la gestion integrada de la morbilidad de la filariasis linfatica y la podoconiosis, las cuales contenian un algoritmo de tratamiento y un paquete definido de cuidados. Profesionales con experiencia en la gestion del linfedema formaron a trabajadores de la salud empleados por el gobierno sobre la gestion integrada de la morbilidad. Para controlar la integracion, se incluyo un indicador del numero de pacientes tratados de iinfedema en el sistema nacional de informacion para la gestion de la salud. Marco regional En 2014, solo el 24% (87) de los 363 centros sanitarios encuestados ofrecian servicios para la filariasis linfatica, mientras que el 12% (44) ofrecian servicios para la podoconiosis. Cambios importantes Hasta la fecha, 542 trabajadores sanitarios de 53 centros de salud en 24 distritos han sido formados acerca de la gestion integrada de la morbilidad. Entre julio de 2013 yjunio de 2016, el sistema nacional de informacion para la gestion de la salud registro 46 487 pacientes tratados de 189 distritos. Lecciones aprendidas En Etiopia, fue viable un enfoque integrado de la gestion de la morbilidad para la filariasis linfatica y la podoconiosis. Los procesos utilizados podrian ser aplicables en otros lugares donde estas enfermedades son coendemicas., Introduction Lymphatic filariasis and podoconiosis are major causes of lymphoedema in tropical areas. (1) Lymphatic filariasis is a mosquito-borne parasitic infection, while podoconiosis is an inflammatory disease caused by prolonged [...]

Background: Early case detection and prompt treatment are important malaria control and elimination strategies. However, the emergence and rapid spread of drug-resistant strains present a major challenge. This study reports the first therapeutic efficacy profile of pyronaridine-artesunate against uncomplicated Plasmodium falciparum in Northwest Ethiopia. Methods: This single-arm prospective study with 42-day follow-up period was conducted from March to May 2021 at Hamusit Health Centre using the World Health Organization (WHO) therapeutic efficacy study protocol. A total of 90 adults ages 18 and older with uncomplicated falciparum malaria consented and were enrolled in the study. A standard single-dose regimen of pyronaridine-artesunate was administered daily for 3 days, and clinical and parasitological outcomes were assessed over 42 days of follow-up. Thick and thin blood films were prepared from capillary blood and examined using light microscopy. Haemoglobin was measured and dried blood spots were collected on day 0 and on the day of failure. Results: Out of 90 patients, 86/90 (95.6%) completed the 42-day follow-up study period. The overall PCR-corrected cure rate (adequate clinical and parasitological response) was very high at 86/87 (98.9%) (95% CI: 92.2–99.8%) with no serious adverse events. The parasite clearance rate was high with fast resolution of clinical symptoms; 86/90 (95.6%) and 100% of the study participants cleared parasitaemia and fever on day 3, respectively. Conclusion: Pyronaridine-artesunate was highly efficacious and safe against uncomplicated P. falciparum in this study population. [ABSTRACT FROM AUTHOR]

Background: Declining efficacy of chloroquine for the treatment Plasmodium vivax malaria has been reported in different endemic settings in Ethiopia. This highlights the need to assess alternative options for P. vivax treatment with artemisinin-based combination therapy, such as pyronaridine-artesunate. This treatment regimen has shown high efficacy for uncomplicated malaria in both Africa and Asia. However, limited data are available from Ethiopia. This study was conducted to assess the efficacy and safety of pyronaridine-artesunate for the treatment of uncomplicated P. vivax malaria in Northwest Ethiopia. Methods: A single arm prospective efficacy study was conducted in the Hamusite area, Northwest Ethiopia. Fifty-one febrile adult patients with uncomplicated P. vivax malaria were enrolled between March and July 2021. Patients were treated with pyronaridine-artesunate once daily for three days. Clinical and parasitological parameters were monitored over a 42-day follow-up period using the standard World Health Organization protocol for therapeutic efficacy studies. Results: A total of 4372 febrile patients were screened with 51 patients enrolled and 49 completing the 42-day follow-up period. The PCR-uncorrected adequate clinical and parasitological response (ACPR) was 95.9% (47/49; 95% CI 84.9–99.0) on day 42. Two patients had recurrences [4.0% (2/49); 95% CI 0.7–12.1] on days 35 and 42. The parasite clearance rate was rapid with fast resolution of clinical symptoms; 100% of participants had cleared parasitaemia on day 1 and fever on day 2. All 16 (31.4%) patients with gametocyte carriage on day 0 had cleared by day 1. There were no serious adverse events. Conclusion: In this small study, pyronaridine-artesunate was efficacious and well-tolerated for the treatment of uncomplicated P. vivax malaria. In adults in the study setting, it would be a suitable alternative option for case management. [ABSTRACT FROM AUTHOR]

Background: Determining malaria transmission within regions of low, heterogenous prevalence is difficult. A variety of malaria tests exist and range from identification of diagnostic infection to testing for prior exposure. This study describes the concordance of multiple malaria tests using data from a 2015 household survey conducted in Ethiopia.Methods: Blood samples (n=2279) from 3 regions in northern Ethiopia were assessed for Plasmodium falciparum and Plasmodium vivax by means of microscopy, rapid diagnostic test, multiplex antigen assay, and multiplex assay for immunoglobulin G (IgG) antibodies. Geospatial analysis was conducted with spatial scan statistics and kernel density estimation to identify malaria hot spots by different test results.Results: The prevalence of malaria infection was low (1.4% by rapid diagnostic test, 1.0% by microscopy, and 1.8% by laboratory antigen assay). For P. falciparum, overlapping spatial clusters for all tests and an additional 5 unique IgG clusters were identified. For P. vivax, clusters identified with bead antigen assay, microscopy, and IgG partially overlapped.Conclusions: Assessing the spatial distribution of malaria exposure using multiple metrics can improve the understanding of malaria transmission dynamics in a region. The relative abundance of antibody clusters indicates that in areas of low transmission, IgG antibodies are a more useful marker to assess malaria exposure. [ABSTRACT FROM AUTHOR]

Background: Early case detection and prompt treatment are important malaria control and elimination strategies. However, the emergence and rapid spread of drug-resistant strains present a major challenge. This study reports the first therapeutic efficacy profile of pyronaridine-artesunate against uncomplicated Plasmodium falciparum in Northwest Ethiopia., Methods: This single-arm prospective study with 42-day follow-up period was conducted from March to May 2021 at Hamusit Health Centre using the World Health Organization (WHO) therapeutic efficacy study protocol. A total of 90 adults ages 18 and older with uncomplicated falciparum malaria consented and were enrolled in the study. A standard single-dose regimen of pyronaridine-artesunate was administered daily for 3 days, and clinical and parasitological outcomes were assessed over 42 days of follow-up. Thick and thin blood films were prepared from capillary blood and examined using light microscopy. Haemoglobin was measured and dried blood spots were collected on day 0 and on the day of failure., Results: Out of 90 patients, 86/90 (95.6%) completed the 42-day follow-up study period. The overall PCR-corrected cure rate (adequate clinical and parasitological response) was very high at 86/87 (98.9%) (95% CI: 92.2-99.8%) with no serious adverse events. The parasite clearance rate was high with fast resolution of clinical symptoms; 86/90 (95.6%) and 100% of the study participants cleared parasitaemia and fever on day 3, respectively., Conclusion: Pyronaridine-artesunate was highly efficacious and safe against uncomplicated P. falciparum in this study population., (© 2023. The Author(s).)

Lymphatic filariasis (LF) is one of the most debilitating and disfiguring diseases common in Ethiopia and is caused by Wuchereria bancrofti. Mapping for LF has shown that 70 woredas (districts) are endemic and 5.9 million people are estimated to be at risk. The national government's LF elimination programme commenced in 2009 in 5 districts integrated with the onchocerciasis programme. The programme developed gradually and has shown significant progress over the past 6 years, reaching 100% geographical coverage for mass drug administration (MDA) by 2016. To comply with the global LF elimination goals an integrated morbidity management and disability prevention (MMDP) guideline and a burden assessment programme has also been developed; MMDP protocols and a hydrocoele surgical handbook produced for country-wide use. In Ethiopia, almost all LF endemic districts are co-endemic with malaria and vector control aspects of the activities are conducted in the context of malaria programme as the vectors for both diseases are mosquitoes. In order to monitor the elimination, 11 sentinel and spot-check sites have been established and baseline information has been collected. Although significant achievements have been achieved in the scale up of the LF elimination programme, there is still a need to strengthen operational research to generate programme-relevant evidence, to increase access to morbidity management services, and to improve monitoring and evaluation of the LF programme. However, the current status of implementation of the LF national programme indicates that Ethiopia is poised to achieve the 2020 goal of elimination of LF. Nevertheless, to achieve this goal, high and sustained treatment coverage and strong monitoring and evaluation of the programme are essential.

Background: Mapping of lymphatic filariasis (LF) is essential for the delineation of endemic implementation units and determining the population at risk that will be targeted for mass drug administration (MDA). Prior to the current study, only 116 of the 832 woredas (districts) in Ethiopia had been mapped for LF. The aim of this study was to perform a nationwide mapping exercise to determine the number of people that should be targeted for MDA in 2016 when national coverage was anticipated., Methodology/principal Finding: A two-stage cluster purposive sampling was used to conduct a community-based cross-sectional survey for an integrated mapping of LF and podoconiosis, in seven regional states and two city administrations. Two communities in each woreda were purposely selected using the World Health Organization (WHO) mapping strategy for LF based on sampling 100 individuals per community and two purposely selected communities per woreda. Overall, 130 166 people were examined in 1315 communities in 658 woredas. In total, 140 people were found to be positive for circulating LF antigen by immunochromatographic card test (ICT) in 89 communities. Based on WHO guidelines, 75 of the 658 woredas surveyed in the nine regions were found to be endemic for LF with a 2016 projected population of 9 267 410 residing in areas of active disease transmission. Combining these results with other data it is estimated that 11 580 010 people in 112 woredas will be exposed to infection in 2016., Conclusions: We have conducted nationwide mapping of LF in Ethiopia and demonstrated that the number of people living in LF endemic areas is 60% lower than current estimates. We also showed that integrated mapping of multiple NTDs is feasible and cost effective and if properly planned, can be quickly achieved at national scale.