Search

Cecal perforation following blunt abdominal trauma is an uncommon and challenging injury. We report a 19-year-old HIV-positive woman who presented with abdominal pain after a high-speed motor vehicle crash. Abdominal exam revealed a seatbelt sign with evidence of peritonitis; Focused Assessment with Sonography for Trauma showed free intraperitoneal fluid. After fluid resuscitation and antibiotics, the patient was taken for urgent laparotomy. Intraoperatively, we discovered hemoperitoneum and an isolated rupture of the cecum. A right hemicolectomy with end-to-end ileo-transverse colon anastomosis was performed. Her only significant postoperative complication was a superficial wound infection. We review the epidemiology of hollow viscus injury in blunt trauma and discuss important considerations in diagnosis and treatment. Keywords: Blunt abdominal trauma, Cecal rupture, HIV positive, Hollow viscus

Hepatitis B infection (HBV) infection is a serious public health problem worldwide and its co-infection with human immune deficiency virus (HIV) is common due to shared routes of transmission. An increased mortality due to accelerated hepatic disease progression and the frequent hepatotoxicity caused by antiretroviral therapy are the challenges in the clinical management of HIV. Epidemiological studies on HBV and HBV/HIV co infection are scarce in Ethiopia, particularly at the study area. The aim of this study was to determine the magnitude of HBV, its risk factors and co-infection with HIV among clients of a voluntary counseling and testing (VCT) center in Southern Ethiopia. A facility based cross-sectional study was conducted from 1st February 2016 to 15th March among clients of Nigist Eleni Memorial Hospital VCT Center. Data were collected by face-to-face interview and specific formula sheet as well recorded results of laboratory diagnosis of blood sample from each participant. Both descriptive and inferential statistics were used for data analysis. Multivariable logistic regression modeling was done to identify predictors of HBV. Overall, 331 participants were included in the study. The prevalence of HBV was 8.8%, HBV/HIV co-infection was found in 3.6%. Individuals with a history of multiple sexual partner [AOR = 10.3; 95% CI, 3.71 - 28.83], previous history of invasive procedure [adjusted odds ratio (AOR) = 10.88; 95% CI, 3.84 - 30.86] and history of surgical procedure [AOR = 9.2; 95% CI, 3.1 - 27.88] were identified as in dependent predictors of HBV infection. High HBV infection and HBV/HIV co-infection was found in the study. Previous history of surgical procedure, invasive procedure and multiple sexual partners were identified as independent predictor of HBV infection. Key words: Hepatitis B virus (HBV), human immune deficiency virus, HBV-HIV co-infection, risk factors, Hosanna.

Chuchu Churko,1 Manaye Yihune,2 Abinet Teshome,3 Yilma Chisha,2 Birhanu Getachew,4 Markos Sleshi,4 Mekuria Asnakew Asfaw,1 Tamiru Shibiru,5 Nebiyu Negussu Ayele,6 Fikre Seife,6 Zerihun Zerdo,1 Alemayehu Bekele Kassahun1 1Collaborative Research and Training Center for Neglected Tropical Diseases, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 2Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 3Department of Biomedical Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 4Ethiopia Public Health Institute, Addis Ababa, Ethiopia; 5School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 6Neglected Tropical Diseases, Federal Ministry of Health, Addis Ababa, EthiopiaCorrespondence: Chuchu Churko Email churkochuchu2005@gmail.comBackground: Onchocerciasis is the second leading cause of blindness globally next to trachoma, thus eliminating the infection is an important health priority. It is estimated that 15.7 million people are at risk of infection in different parts of Ethiopia. Mass drug administration with ivermectin at community and school level is the basis for control and elimination of onchocerciasis. This study was aimed at validating onchocerciasis treatment coverage in the selected districts of Ethiopia.Methods: A community-based cross-sectional study was employed in Itang special and Wombera districts of Ethiopia, from April 1 to 30, 2019 G.C. We used a coverage validation survey builder tool to compute sample size. Individuals aged five years old and above were eligible population. Data were entered into Microsoft Excel and exported to STATA 14 for cleaning and analyses. A chi-square test was used to note statistical association of the outcome variables with independent variables.Main Findings: A total of 3765 individuals were interviewed. Of these, 3244 were offered onchocerciasis treatment. The overall treatment coverage of onchocerciasis in the two selected districts of Ethiopia was 85.9% of the eligible population (3235/3765) (95% CI, 84.8%, 87%). There was significant difference between the two districts in terms of ivermectin offering (X2=70.467, P< 0.001). School attendance was also significantly associated with treatment offering and swallowing status (X2=77.29, P< 0.001; and X2=30.581, P< 0.001). The main reported reasons for not being offered ivermectin were “being absent” (40.86%) and “not knowing about the mass drug administration” (MDA) (25.29%).Conclusion: In conclusion, the treatment coverage of onchocerciasis in this survey was higher than minimum national desired therapeutic coverage. Treatment coverage in Wombera was higher than Itang special district. In addition, children who attended school had a higher chance of swallowing the drug.Keywords: ivermectin, onchocerciasis, coverage survey, mass drug administration

Introduction measles is the leading vaccine preventable childhood disease designated for elimination by WHO. More than 20 million people are affected by measles each year, particularly in Africa and Asia. With annual outbreaks reported from Ethiopia´s Oromia region. We analyzed measles containing vaccine coverage (MCV), measles cases and measles deaths over a 10-year period (2007-2016). Methods we reviewed Oromia measles surveillance data and first-dose measles containing vaccine (MCV1) administrative coverage. Descriptive statistics and multivariable logistic regression were performed to assess variables associated with measles death. Additional spatial mapping was performed to visually display key areas of measles case distribution in Oromia. Results a total of 26,908 measles suspect cases were identified, of which 18,223 (68%) were confirmed. A median age of 6 years (IQ range 0.5-71 years) and 288 deaths were observed. Among the total cases, 29% were unvaccinated and 46% had unknown vaccination status. The highest IR was seen in Guji zone (IR=190/100,000 population) among 1-4 years, with a majority from rural areas. Risk factors associated with death include age

Eshetu Andarge,1 Teshale Fikadu,1 Rodas Temesgen,2 Mulugeta Shegaze,1 Tesfaye Feleke,1 Firehiwot Haile,1 Gisila Endashaw,3 Negussie Boti,1 Alemayehu Bekele,4 Mustefa Glagn1 1School of Public Health, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia; 2Department of Internal Medicine, School of Medicine, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia; 3School of Nursing, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, Ethiopia; 4Center for Neglected Tropical Diseases, Arba Minch University, Arba Minch, Southern Nations Nationalities and Peoples Regional State, EthiopiaCorrespondence: Eshetu AndargeSchool of Public Health, Arba Minch University, P.O. Box: 021, Arba Minch, Southern Nations Nationalities and Peoples Regional State, EthiopiaTel +251-9-45-89-59-37Email andeshe7@gmail.comPurpose: With prevention being the only and best available intervention, COVID-19 has recently become a global threat, having had and continuing to have enormous health, economic, and societal impacts. Evidence so far has documented a heightened risk of mortality to people with chronic conditions. There is a dearth of evidence regarding chronic disease patients’ intention and practice on the preventive measures. This study tried to fill this gap by assessing the intention to practice and practice on personal preventive measures (PPMs) among adults with chronic conditions.Materials and Methods: A facility-based cross-sectional study was conducted in Southern Ethiopia among 806 adults with chronic conditions by employing a multistage sampling technique. Data were collected using a pre-tested and structured questionnaire. Statistical analysis was done using IBM SPSS software version 25. Binary logistic regression analysis was done to identify factors associated with intention and practice. Level of statistical significance was declared at a P-value of less than 0.05.Results: The study showed that 52% (95% CI=47.61– 54.80) and 76.3% (95% CI=73.36– 79.24) of adults with chronic conditions were intending to practice and had ever practiced the personal preventive measures. Participants’ subjective norm (SN) (AOR=4.94; 95% CI=3.49– 6.96) and perceived behavioral control (PBC) (AOR=4.13; 95% CI=2.69– 6.34) were the factors associated with their intention. Good knowledge and a positive attitude were found to be significant factors associated with the participants’ actual practice of the PPMs among other independent factors.Conclusion: Around half of the participants were intending to practice PPMs, and three-quarters had good practice on the PPMs against COVID-19. Interventions targeted to improve intention and practice on the PPMs need to take into account improving knowledge and attitude, and build positive subjective norms and heighten the confidence to control the preventive behaviors.Keywords: intention, practice, theory of planned behavior, chronic conditions, South Ethiopia

BackgroundThe number of confirmed Coronavirus disease 2019 (COVID-19) cases surge substantially in resource-poor settings within the fragile health system. Since there are no proven vaccine and treatment in place against the disease, controlling strategy mainly rely on preventive measures. However, data on the extent of implementing physical distancing and other preventive measures were under estimated. This study, therefore, investigated these gaps among people in Arba Minch town, southern Ethiopia.MethodsWe conducted a community based cross-sectional study in Arba Minch town; from 15-30 June 2020. Data were collected using interviewer administered questionnaire and checklist. Then, data were cleaned, coded and entered to EpiData version 4.4.2, and exported to SPSS version 20 for analysis.ResultsOf the total participants (459), 43.6% achieved above the mean score (6±1.97) on preventive measures of COVID-19. Only 29.8% of participants kept the recommended physical distance, and surprisingly, in all public gathering places the distance was not kept totally. In addition, of the total participants, only 37.7% had face-mask use practice; 20.5% had hand sanitizer use practice, and 13.1% were measuring their body temperature every two weeks. Moreover, 42.5% of participants avoided attendance in public gatherings; 44.7% stopped touching their nose, eye and mouth; 55.6% practiced stay-at-home; and 60% had frequent hand washing practice. Majority of participants (66.7%) practiced covering their mouth and nose while coughing or sneezing; 68.2% had treatment seeking behavior if they experience flue like symptoms; 69.1% practiced isolating themselves while having flue like symptoms; and 89.3% avoided hand shaking.ConclusionsThe findings of this study suggest that physical distancing and other COVID-19 preventive measures were inadequately implemented among people in Arba Minch town. Thus, an urgent call for action is demanding to mitigate the spread of the COVID-19 as early as possible before it brings a devastating impact.

Background Soil-transmitted helminths (STH) (Ascaris lumbricoides, Trichuris trichiura and hookworm) are among the most prevalent neglected tropical diseases (NTDs) in Ethiopia. Pre-school age children (PSAC) pay high morbidity toll associated with STH infections. Site specific operational evidence is lacking on prevalence, intensity and control strategies of STH among PSAC in Ethiopia. This study is, therefore, aimed to fill that missing knowledge gap. Methods We did a community-based cross-sectional study in five districts of Gamo Gofa zone; from December 2018 to January 2019. Data were collected using pre-tested questionnaire, and the Kato-Katz technique was used to diagnose parasites egg in stool. Then data were edited, coded and entered into EpiData 4.4.2, and exported to SPSS software (IBM, version 25) for analysis. Results A total of 2462 PSAC participated in this study. Overall, the prevalence of STH was 23.5% (578/2462). Ascaris lumbricoides was the most prevalent, 18.6% (457/2462), followed by Trichuris trichiura, 9.2% (226/2462), and hookworm, 3.1% (76/2462). The prevalence of STH in Chencha, Dita, Deremalo, Bonke and Demba Gofa districts were 33.8% (210/622), 26.4% (109/413), 21.3% (88/414), 20.6% (128/621), and 11% (43/392), respectively. Of the total, 7.4% (181/2462) PSAC were infected with two STH species. Ascaris lumbricodes infections had moderate intensity (15%), and the rest had low infections intensity. It is found that 68.7% of PSAC were treated with Albendazole. This study also revealed households level data as, 39.4% used water from hand-dug well, 52.5% of need to move ≥ 30minutes to collect water, 77.5% did not treat water, and 48.9% not had hand washing facility. Conclusion This study showed that a significant proportion of pre-school age children are suffering from STH infections across districts in the study area despite preventive chemotherapy distribution for more than 10 years. Further, gaps in control strategies of STH were highlighted, which calls for action. Author summary Infections with STH pose serious public health challenge among children; it causes anemia, vitamin A deficiency, stunting, malnutrition, impaired development, and intestinal obstruction. About 4 billion people are at risk for STH infection worldwide, and with over 2 billion already infected. In Ethiopia, about 81 million people are at risk for STH infection. STH can be controlled, possibly eliminated by combined interventions such as preventive chemotherapy (PC), large scale administration of anthelmintic drugs to at-risk population, and improved water, sanitation and hygiene (WASH). Ethiopia has been working to reduce the prevalence of moderate and heavy infections with soil transmitted helminth in pre-school and school aged children to below 1%. Since 2013 remarkable progress has been made on STH control strategies in terms of mapping and distribution of PC. However, evidence is lacking to track progress towards control and elimination goal, particularly among PSAC. The findings of our study highlight that achieving STH control and elimination goal in Gamo Gofa zone by 2020 and even beyond could be challenging unless the current STH control strategies are improved.

Background Pre-school aged children (PSAC) are highly affected by soil-transmitted helminths (STH), particularly in areas where water, sanitation, and hygiene (WASH) are inadequate. Context-specific evidence on determinants of STH infections in PSAC has not been well established in the study area. This study, therefore, aimed to fill these gaps in Gamo Gofa zone, Southern Ethiopia. Methods A community-based unmatched case-control study, nested in a cross-sectional survey, was conducted in January 2019. Cases and controls were identified based on any STH infection status using the Kato-Katz technique in stool sample examination. Data on social, demographic, economic, behavioral, and WASH related variables were collected from primary caregivers of children using pre-tested questionnaire. Determinants of STH infections were identified using multivariable logistic regression model using SPSS version 25. Results A total of 1206 PSAC (402 cases and 804 controls) participated in this study. Our study showed that the odds of STH infection were lowest among PSAC living in urban areas (AOR = 0.55, 95% CI: 0.39–0.79), among those from households with safe water source (AOR = 0.67, 95% CI: 0.47–0.0.93), and in those PSAC from households with shorter distance from water source ( Conclusions Given efforts required eliminating STH by 2030; the existing preventive chemotherapy intervention should be substantially strengthened with WASH and behavioral interventions. Thus, an urgent call for action is required to integrate context-specific interventions, particularly in rural areas.

Background Soil-transmitted helminths (STH), i.e., Ascaris lumbricoides, Trichuris trichiura and hookworms are among the most prevalent Neglected Tropical Diseases (NTDs) in Ethiopia. Although pre-school aged children pay a high morbidity toll associated with STH infections, evidence on prevalence, intensity and intervention status is lacking in Ethiopia. This study, therefore, aimed to address these gaps to inform decision made on STH. Methods We did a community-based cross-sectional study in five districts of Gamo Gofa zone, Southern Ethiopia; in January 2019. Data were collected using pre-tested questionnaire, and the Kato-Katz technique was used to diagnose parasites eggs in stool. Then, collected data were edited and entered into EpiData 4.4.2, and exported to SPSS software (IBM, version 25) for analysis. Results A total of 2462 PSAC participated in this study. Overall, the prevalence of STH was 23.5% (578/2462) (95% confidence interval (CI) = 21.8%–25.2%). As caris lumbricoides was the most prevalent (18.6%), followed by Trichuris trichiura (9.2%), and hookworms (3.1%). Of the total, 7.4% PSAC were infected with two STH species. Most of the positive cases with STH showed low infection intensities, while 15.1% ascariasis cases showed moderate infection intensities. The study found that 68.7% of PSAC were treated with albendazole. Also, household’s level data showed that 39.4% used water from hand-dug well; 52.5% need to travel ≥30 minutes to collect water; 77.5% did not treat water, and 48.9% had no hand washing facility. In addition, almost 93% care givers achieved less than the mean knowledge and practice score (≤5) on STH prevention. Conclusions This study showed that significant proportions of pre-school aged children are suffering from STH infections despite preventive chemotherapy exist at the study area. Also, gaps in the interventions against STH were highlighted. Thus, a call for action is demanding to eliminate STH among PSAC in Ethiopia by 2030.

Background Measles is a highly infectious and serious respiratory viral disease which caused by a virus. It is a significant cause of illness and death worldwide. This data analysis was conducted to describe the trend and determine the reporting rate of measles cases in Addis Ababa to make recommendation for the government of the city to strengthening measles control interventions. Methods We obtained and extracted ten years (2005–2014) Addis Ababa city’s measles surveillance data from national database. We carried out retrospective descriptive data analysis by time, place and person variables. We calculated cumulative and specific reporting rates by dividing measles cases (lab confirmed, epidemiologically linked and compatible cases) to respective population and multiplying by 100,000. We divided average of ten years measles cases to midyear population and multiplied by 100,000 to calculate annualized reporting rate. We analyzed non-measles febrile rash rate by dividing laboratory negative cases to total population and multiplying by 100,000. Results A total of 4203 suspected measles cases were identified. Among them 1154 (27.5%) were laboratory confirmed, 512 (12.2%) were clinically compatible, 52 (1.2%) were epidemiologically linked cases and the rest 2485 (59.1%) were IgM negative for measles which makes total measles cases 1718 (40.9%). Median age was 5 years with 2–18 years interquartile-range. The annualized measles reporting rate was 5.9, which was 40.2 among > 1 year, 11.5 among 1–4 years, 6.0 among 5–14 years, 4.1 among 15–44 years and 0.01 among ≥ 45 years per 100,000 population. Among the total measles cases; 380 (22%) were received at least one dose of measles containing vaccine (MCV) while 415 (24%) cases were not vaccinated and the vaccination status of 923 (54%) cases were not known. Conclusion Our analysis revealed that the reporting rate was higher among young children than older age group. Among all the patients 22% were received at least one dose of measles vaccine whereas 13% were not vaccinated against measles antigen. Routine immunization should be strengthened to reach all children through well monitored vaccine cold chain management.

Background: Hypertension has become an epidemic and a global public health challenge resulting in considerable morbidity, mortality, and disability in human beings. There are reports indicating increasing magnitude of hypertension in Ethiopia. Despite this fact, less is known as for the determinants of hypertension. Objective: To assess the determinants of hypertension among adults in Tigray, Northern Ethiopia. Methods: A matched case–control study design was employed to identify the determinants of hypertension. A total of 117 cases and 235 controls were included in the study. Conditional logistic regression analysis was conducted to identify the determinants of hypertension. Results: Low-income status, moderate work-related physical activity, shorter duration of alcohol use, and normal waist circumference were found to reduce the odds of hypertension. Poor perception on body size and mental stress was found to increase the odds of hypertension. Conclusions: Multifaceted interventions including raising awareness and attitudinal changes on lifestyle modifications have to be intervened to prevent the risky behaviors by different actors.

Background: According to the monitoring results in Africa, the regional average completeness rate of birth registration has increased from around 40% to 56% from 2012 to 2015. Ethiopia is among the countries with less than 20% of births registered. Even if Ethiopia, with its 38,000 health extension workers already deployed on the ground and increasingly linked to communities through the Women’s Development Army, had a unique opportunity to rapidly accelerate the coverage of birth registration but until the recent time, the rate of birth registration in Ethiopia is very low.Objective: This study was aimed to assess the level of birth registration, status of awareness about birth registration and factors affecting birth registration status in in Gamo Gofa and Zegen area people Zone SNNPR, Ethiopia. Methods: The study was s in Gamo Gofa and Gegen area people Zone using pretest quasi experimental study design. The data (was collected in November 2018. The quantitative data was collected by structured interviewer-administered questionnaire from 498 households. Qualitative data was collected through Focal Group Discussion using interview guides from key informants. Descriptive statistics including frequencies, means and standard deviations were employed to present finding. Logistic regression analyses were used to determine association with birth registration practice. Model fitness was checked.Results: The study shows that majority of the respondents were male 300(60.2%) and females account 198(39.8%). The finding also revealed that the prevalence of birth registration among children age below 5 years old is 12.1%; whereas, prevalence of birth registration practice among age group between 5 and 18 years old is 14.9%. The level of awareness on birth registration among study participants accounts 33.7%. In the multivariate analysis sex, religion, level of education, awareness on birth registration institution, radio program and VERA office have a significant association with the birth registration.Conclusion: The overall level of practice of birth registration in this study is far lower than many studies from other countries. Thus, implementing remedial action in order to improve birth registration is essential.

We report the use of Fano resonances as compact optical switches by exploiting their sharp asymmetric lineshape together with thermo-optic effects. This enables low footprint and efficient on chip integrated systems. The device consists of a photonic crystal (PhC) membrane with a waveguide side-coupled to a nanocavity surrounded by a p-i-n junction. We demonstrate the thermal tuning of an asymmetric Fano resonances with low power requirements and a response time of 16.1μs. Their high extinction ratio and close spectral separation between maximum and minimum of transmission makes Fano resonances suitable candidates for such optical switching.

Fano resonances occur as a result of the interference between a discrete mode and a continuum of modes. We have realized a Fano structure using a planar indium phosphide photonic crystal membrane device, which consists of a point-defect nanocavity side-coupled to a line-defect waveguide. Compared to the traditional symmetric Lorentzian lineshape, the asymmetric Fano lineshape is characterized by having a transmission maximum and minimum in close spectral vicinity, leading to new opportunities for optical switching, lasing, sensing and narrow band filtering. Here, we present our recent work on optical switches exploiting the sharp asymmetric Fano lineshape in combination with strong carrier-induced nonlinear resonance shifts. This unique combination has enabled femtojoule per bit all-optical switching at tens of gigahertz operation speed. Focus is given to our experimental and theoretical investigations aiming at achieving faster recovery of the switches by using a p-i-n junction around the nanocavity to sweep out carriers.

PurposeCervical cancer remains the second most common cancer and cancer-related death among women in Ethiopia. This is the first study, to our knowledge, describing the demographic, and clinicopathologic characteristics of cervical cancer cases in a mainly rural, Southwestern Ethiopian population with a low literacy rate to provide data on the cervical cancer burden and help guide future prevention and intervention efforts.MethodsA descriptive analysis of 154 cervical cancer cases at the Jimma University Teaching Hospital in Southwestern Ethiopia from January 2008 – December 2010 was performed. Demographic and clinical characteristics were obtained from patient questionnaires and cervical punch biopsies were histologically examined.ResultsOf the 154 participants with a histopathologic diagnosis of cervical cancer, 95.36% had not heard of cervical cancer and 89.6% were locally advanced at the time of diagnosis. Moreover, 86.4% of participants were illiterate, and 62% lived in a rural area.ConclusionA majority of the 154 women with cervical cancer studied at the Jimma University Teaching Hospital in Southwestern Ethiopia were illiterate, had not heard of cervical cancer and had advanced disease at the time of diagnosis. Given the low rates of literacy and knowledge regarding cervical cancer in this population which has been shown to correlate with a decreased odds of undergoing screening, future interventions to address the cervical cancer burden here must include an effective educational component.

Nanocavity devices enabling concentration of light in a very small volume have resulted in several interesting applications over the past years. Of particular interest are the asymmetric resonance lineshapes known as Fano resonances, which result from the interference between a discrete mode of the nanocavity and a continuum of background modes. Compared to the conventional symmetric Lorentzian lineshape, asymmetric Fano lineshapes enable novel or improved device structures for use in optical switches, sensors, lasers, and narrow band filters. Herein, the use of Fano lineshapes in photonic crystal membranes for realizing various optical signal processing functionalities is reviewed. The basic theory of Fano resonances is presented, different photonic crystal Fano device geometries are discussed, the nonlinear processes empowering the devices are explained, and an overview of all-optical signal processing demonstrations based on Fano resonances is given.

Background Dengue Fever (DF) is a viral disease primarily transmitted by Aedes (Ae.) aegypti mosquitoes. Outbreaks in Eastern Ethiopia were reported during 2014–2016. In May 2017, we investigated the first suspected DF outbreak from Kabridahar Town, Somali region (Eastern Ethiopia) to describe its magnitude, assess risk factors, and implement control measures. Methods Suspected DF cases were defined as acute febrile illness plus ≥2 symptoms (headache, fever, retro-orbital pain, myalgia, arthralgia, rash, or hemorrhage) in Kabridahar District residents. All reported cases were identified through medical record review and active searches. Severe dengue was defined as DF with severe organ impairment, severe hemorrhage, or severe plasma leakage. We conducted a neighborhood-matched case-control study using a subset of suspected cases and conveniently-selected asymptomatic community controls and interviewed participants to collect demographic and risk factor data. We tested sera by RT-PCR to detect dengue virus (DENV) and identify serotypes. Entomologists conducted mosquito surveys at community households to identify species and estimate larval density using the house index (HI), container index (CI) and Breteau index (BI), with BI≥20 indicating high density. Results We identified 101 total cases from May 12–31, 2017, including five with severe dengue (one death). The attack rate (AR) was 17/10,000. Of 21 tested samples, 15 (72%) were DENV serotype 2 (DENV 2). In the case-control study with 50 cases and 100 controls, a lack of formal education (AOR [Adjusted Odds Ratio] = 4.2, 95% CI [Confidence Interval] 1.6–11.2) and open water containers near the home (AOR = 3.0, 95% CI 1.2–7.5) were risk factors, while long-lasting insecticide treated-net (LLITN) usage (AOR = 0.21, 95% CI 0.05–0.79) was protective. HI and BI were 66/136 (49%) and 147 per 100 homes (147%) respectively, with 151/167 (90%) adult mosquitoes identified as Ae. aegypti. Conclusion The epidemiologic, entomologic, and laboratory investigation confirmed a DF outbreak. Mosquito indices were far above safe thresholds, indicating inadequate vector control. We recommended improved vector surveillance and control programs, including best practices in preserving water and disposal of open containers to reduce Aedes mosquito density., Author summary In 2017 an outbreak of Dengue fever (DF) was reported in Kabridahar Town, Ethiopia. This mosquito transmitted disease was recently detected in Ethiopia only four years prior, with this being the first time it was identified in the area. In response, our team was dispatched to confirm the presence of the disease, identify potential causes, and implement mitigation and control measures. We identified and compared suspected cases and suspected non-cases to identify the potential risk factors of infection. Laboratory confirmation of infection and disease-type was also performed. Due to the entomological nature of disease transmission, additional entomological investigations were conducted at the households of both groups to understand its influence at the household level. Through these measures, we were able to establish the presence of DF in Kabridahar Town and identify risk factors leading to infection. Risk factors included a lack of formal education and open water containers near the home, while the presence of long-lasting insecticide-treated nets were found to be protective. Mitigation and control measures were implemented to combat or promote the identified risk and protective factors respectively. Cases counts began to reduce five days after the onset of these measures. Recommendations were made based on our findings to prevent future outbreaks. The last case was recorded ten days after implementation of the mitigation and control measures.

Threats to the survival of wild primate population have greatly increased. Most primate populations today face ongoing habitat disturbance, yet not all species respond to disturbance the same way, while many primate species experience declines in population density. There is no much information on the population status and density of primates in Zengmewerweria forest area. Their for study on the Population status, density, and habitat use of non-human primates and cause of human-wildlife conflict was carried out in Zengmewerweria forest area, Ankober district, north- eastern Ethiopia conducted from September 2018 to December 2020. Aim of this study was to provide information on population status, density and habitat use of non-human primate and human-wildlife conflict in the forest. Total counting method was used to collect data on the population status of non-human primates in six counting blocks. Questionnaire and group discussion were used to collect data about human-wildlife conflict as well as to assess the attitude of society about wildlife. Data were analyzed using SPSS software. Only two species of non-human primates Grivet monkey (Chlorocebus aethiops) and Black and white colobus (Colobus guereza) were identified in the forest. The total populations of Colobus guereza were 44 and 36 individuals during the dry and wet seasons respectively. There was no significant seasonal difference between seasons (χ2=1.3, df=1, P > 0.05). Similarly the total number of grivet monkey recorded during the dry season was 140 and the wet season was 117 and there was no a significant difference in the number between seasons (χ2=2.6, df=1 P > 0.05). The average density of grivet monkey and colobus was 39.67 and 12.35 individuals per kilometer square respectively. Illegal expanding for farming and illegal resource use, loss of wildlife habitat, increasing deforestation and overgrazing were the major problems encountered in the study area. Therefore, Woreda Administration should work a lot with the community to limit negative activities and protect the Forest. Furthermore, different conservation measures should be taken to increase the number of primates.

We present our recent experimental work involving nanocavities which enable efficient light-matter interaction in small optical mode volumes. To achieve this, we investigated photonic crystal membrane platforms for designing high-quality (Q) factor nanocavities and efficient planar waveguides. Particularly, we discuss waveguide-nanocavity coupled systems for realization of asymmetric Fano resonances which are characterized by having transmission maximum and minimum in close spectral separation (~1nm) suitable for optical switching applications.

Objectives: The diagnosis of extrapulmonary tuberculosis (EPTB) is often made on clinical suspicion alone, resulting in both under-and overdiagnosis and relatively poor outcomes. In this study, we evaluated the clinical utility of the Xpert MTB/RIF on routinely collected extrapulmonary specimens in Ethiopia. Methods: This study was carried out at Jimma University Specialized Hospital, Southwest Ethiopia. Extrapulmonary specimens were collected from 572 patients clinically suspected of suffering from EPTB. All specimens were tested for TB by smear microscopy, culture, and Xpert MTB/RIF. The diagnostic accuracy of Xpert MTB/RIF was calculated and compared to a composite reference standard (CRS), comprising clinical and laboratory results. Results: In total, 572 extrapulmonary specimens (279 lymph node, 159 pleural, 80 peritoneal, 45 cerebrospinal, and nine pericardial fluids) were tested. The pooled sensitivity and specificity of Xpert MTB/RIF were calculated to be 75% (95% CI 70-80) and 98% (95% CI 97-100) respectively when compared to the CRS. The highest sensitivity was documented for lymph node specimens (90%; 95% CI 86-94), moderate sensitivity for cerebrospinal fluid (53%; 95% CI 28-79), while the sensitivity was lowest for pleural (30%; 95% CI 17-44) and peritoneal (32%; 95% CI 12-51) fluids. Xpert MTB/RIF in addition detected rifampicin resistance in 13 patients, in perfect agreement with results from the line probe assay. Conclusions: Xpert MTB/RIF may be used as initial diagnostic tool for testing of lymph node specimens from patients suspected of having TB lymphadenitis. The added value of Xpert MTB/RIF to diagnose pleural or peritoneal TB is limited by its poor sensitivity. (C) 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Malignant nodular hidradenoma (MNH) is a rare invasive tumour arising from eccrine sweat glands, with significant risk for local recurrence and distant metastases. Hidradenoma papilliferum is reported in pregnancy. To our knowledge this is the first MNH in a human immunodeficiency virus (HIV) infected pregnant woman. The patient presented with a painless perianal growth. Wide local excision was performed and the wound left to heal by secondary intension. The pathology report confirmed MNH. The patient has been followed for 14 months without evidence of recurrence. MNH should be considered in the differential diagnosis of similar lesions in HIV infected patients. Treatment for such HIV infected patients with MNH may be similar to that in immune competent patients; they may benefit from a longer follow-up period.Keywords: Malignant Nodular Hidradenoma, HIV infection, Pregnancy

We experimentally demonstrate the use of a photonic crystal Fano resonance for carving-out short pulses from long-duration input pulses. This is achieved by exploiting an asymmetric Fano resonance combined with carrier-induced nonlinear effects in a photonic crystal membrane structure. The use of a nanocavity concentrates the input field to a very small volume leading to an efficient nonlinear resonance shift that carves a short pulse out of the input pulse. Here, we demonstrate shortening of ∼500 ps and ∼100 ps long pulses to ∼30 ps and ∼20 ps pulses, respectively. Furthermore, we demonstrate error-free low duty cycle return-to-zero signal generation at 2 Gbit/s with energy consumption down to ∼1 pJ/bit and power penalty of ∼2 dB. The device physics and limitations are analyzed using nonlinear coupled-mode theory.

We experimentally demonstrate the use of photonic crystal Fano resonances for reshaping optical data signals. We show that the combination of an asymmetric Fano resonance and carrier-induced nonlinear effects in a nanocavity can be used to realize a nonlinear power transfer function, which is a key functionality for optical signal regeneration, particularly for suppression of amplitude fluctuations of data signals. The experimental results are explained using simulations based on coupled-mode theory and also compared to the case of using conventional Lorentzian-shaped resonances. Using indium phosphide photonic crystal membrane structures, we demonstrate reshaping of 2 Gbit/s and 10 Gbit/s return-to-zero on-off keying (RZ-OOK) data signals at telecom wavelengths around 1550 nm. Eye diagrams of the reshaped signals show that amplitude noise fluctuations can be significantly suppressed. The reshaped signals are quantitatively analyzed using bit-error ratio (BER) measurements, which show up to 2 dB receiver sensitivity improvement at a BER of 10−9 compared to a degraded input noisy signal. Due toefficient light-matter interaction in the high-quality factor and small mode-volume photonic crystal nanocavity, low energy consumption, down to 104 fJ/bit and 41 fJ/bit for 2 Gbit/s and 10 Gbit/s, respectively, has been achieved. Device perspectives and limitations are discussed.

The prevalence of diabetes, dyslipidemias, and high blood pressure is increasing worldwide especially in low and middle income countries. World Health Organization has emphasized the importance of the assessment of the magnitude of the specific disease in each country. We determined the prevalence and determinant factors of high blood pressure, hyperglycemia, dyslipidemias and metabolic syndrome in Ethiopia. A community based survey was conducted from -April to June 2015 using WHO NCD STEPS instrument version 3.1. 2008. Multistage stratified systemic random sampling was used to select representative samples from 9 regions of the country. A total of 10,260 people aged 15–69 years participated in the study. Blood pressure (BP) was measured for 9788 individuals. A total of 9141 people underwent metabolic screening. The prevalence of raised blood pressure (SBP ≥140 and/or DBP ≥ 90 mmHg) was 15.8% (16.3% in females and 15.5% in males). The prevalence of diabetes mellitus (FBS ≥ 126 mg /dl) including those on medication was 3.2% (3.5% males and 3.0% females). The prevalence of impaired fasting glucose was 9.1% with ADA criteria and 3.8% with WHO criteria. Hypercholesterolemia was found in 5.2%, hypertriglyceridemia in 21.0%, high LDL cholesterol occurred in 14.1% and low HDL cholesterol occurred in 68.7%. The prevalence of metabolic syndrome using IDF definition was 4.8% (8.6% in females and vs. 1.8% in males). Advanced age, urban residence, lack of physical exercise, raised waist circumference, raised waist hip ratio, overweight or obesity, and total blood cholesterol were significantly associated with raised blood pressure (BP) and diabetes mellitus. Increased waist- hip ratio was an independent predictor of raised blood pressure, hyperglycemia and raised total cholesterol. Our study showed significantly high prevalence of raised blood pressure, hyperglycemia and dyslipidemia in Ethiopia. Community based interventions are recommended to control these risk factors.

We show that Fano resonances can be realized in photonic crystal membrane structures by coupling line-defect waveguides and point-defect nanocavities. The Fano resonance can be exploited to realize optical switches with very small switching energy, as well as Fano lasers, that can generate short optical pulses.

Background Opportunistic diseases cause morbidity and mortality among human immunodeficiency virus (HIV) infected persons. There is dearth of evidence on the magnitude and predictors of opportunistic diseases among PLHIV in Ethiopia. This study was conducted to determine the magnitude and predictors of opportunistic diseases among adults enrolled in the national HIV/AIDS care and treatment services and generate information for program planning and medicine quantification in the country. Methods A health facility-based cross-sectional study was conducted. Probability proportional to size and random sampling methods were employed to select health facilities and medical records of adult HIV-infected patients respectively. A total of 7826 medical records were reviewed from 60 health facilities nationwide. Socio-demographic and clinical data including diagnosis of opportunistic diseases were collected from the medical records. Period prevalence of opportunistic diseases over one year period was determined. Bivariate and multivariate logistic regression was used to measure associations between independent variables and the dependent variable, occurrence of opportunistic diseases. Results Of the total of 7826 study participants, 3748 (47.9%) were from hospitals and 4078 were from health centers. The majority (61.8%) were female. The median age was 32 years with interquartile range (IQR) of 27–40. The median duration of stay in HIV care was 56 (IQR = 28–80) months; 7429 (94.9%) were on antiretroviral treatment. A total of 1665 cases of opportunistic diseases were recorded with an overall prevalence estimated at 21.3% (95% confidence interval (CI): 20.36, 22.18%). Skin diseases (4.1%), diarrhea (4.1%), bacterial pneumonia (3.6%), recurrent upper respiratory tract infections (3.1%) and tuberculosis (2.7%) were the leading opportunistic diseases. Isoniazid preventive therapy coverage among eligible patients was 24.8%. Persons with a CD4 count

Island-type two-dimensional high-index-contrast grating mirror based on a standard silicon-on-insulator wafer have been experimentally demonstrated. The measured spectra shows a bandwidth of $\sim 192$ nm with a reflectivity over 99% as well as polarization independence. Numerical simulations show that the designed mirror has large tolerance to fabrication errors.

We discuss the realization of active photonic devices exploiting Fano resonances in photonic crystal membranes.

Background: Despite availability of antiretroviral therapy, HIV is responsible for 2.7 million new infections and 2.0 million deaths from worldwide. Anti-Retroviral treatment failure is not a commonly diagnosis in healthcare facilities in Ethiopia and there is dearth of information on the extent and predictors of treatment failure among adults receiving HIV care in the study setting. The aim of the current study is to assess the incidence and predictors of Anti-Retroviral Treatment (ART) failure among adults receiving HIV care at Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Methods: Facility based retrospective cohort study design was employed on archived data from 2011 to 2016. Data compilation checklist was developed from intake card and ART follow-up card. The collected data were coded and entered using Epi Info 7 and analysed using Statistical Packages for Social Science (SPSS) version 20 software. Results: The overall incidence rate of ART treatment failure were 4.91 cases per person months follow up with 2.1, 0.24 and 0.13 immunological, clinical and virological treatment failure cases per 100 person years of follow-up respectively. Conclusion: The incidence of Anti-Retroviral Treatment failure was considerable among the study participants. The predictors for ART failure were WHO stage 3 at start, CD4 count at base line, disclosure and opportunistic infections. Comprehensive interventions have to be in place to tackle treatment failure among adults on ART through rendering optimum care focusing on adults with advanced WHO stage, lower CD4 count at baseline, opportunistic infections and people who did not disclose their HIV status.

Background Ethiopia has an extremely high rate of extrapulmonary tuberculosis, dominated by tuberculous lymphadenitis (TBLN). However, little is known about Mycobacterium tuberculosis complex (MTBc) lineages responsible for TBLN in Southwest Ethiopia. Methods A total of 304 MTBc isolates from TBLN patients in Southwest Ethiopia were genotyped primarily by spoligotyping. Isolates of selected spoligotypes were further analyzed by 15-loci mycobacterial interspersed repetitive unit–variable number tandem repeat (MIRU-VNTR) (n = 167) and qPCR-based single nucleotide polymorphism (n = 38). Isolates were classified into main phylogenetic lineages and families by using the reference strain collections and identification tools available at MIRU - VNTRplus data base. Resistance to rifampicin was determined by Xpert MTB/RIF. Results The majority of isolates (248; 81.6%) belonged to the Euro-American lineage (Lineage 4), with the ill-defined T and Haarlem as largest families comprising 116 (38.2%) and 43 (14.1%) isolates respectively. Of the T family, 108 isolates were classified as being part of the newly described Ethiopian families, namely Ethiopia_2 (n = 44), Ethiopia_3 (n = 34) and Ethiopia_H 37 Rv-like (n = 30). Other sub-lineages included URAL (n = 18), S (n = 17), Uganda I (n = 16), LAM (n = 13), X (n = 5), TUR (n = 5), Uganda II (n = 4) and unknown (n = 19). Lineage 3 (Delhi/CAS) was the second most common lineage comprising 44 (14.5%) isolates. Interestingly, six isolates (2%) were belonged to Lineage 7, unique to Ethiopia. Lineage 1 (East-African Indian) and Lineage 2 (Beijing) were represented by 3 and 1 isolates respectively. M. bovis was identified in only two (0.7%) TBLN cases. The cluster rate was highest for Ethiopia_3 isolates showing clonal similarity with isolates from North Ethiopia. Lineage 3 was significantly associated with rifampicin resistance. Conclusions In TBLN in Southwest Ethiopia, the recently described Ethiopia specific Lineage 4 families were predominant, followed by Lineage 3 and Lineage 4-Haarlem. The contribution of M. bovis in TBLN infection is minimal.

We present our work on photonic crystal membrane devices exploiting Fano resonance between a line-defect waveguide and a side coupled nanocavity. Experimental demonstration of fast and compact all-optical switches for wavelength-conversion is reported. It is shown how the use of an asymmetric structure in combination with cavity-enhanced nonlinearity can be used to realize non-reciprocal transmission at ultra-low power and with large bandwidth. A novel type of laser structure, denoted a Fano laser, is discussed in which one of the mirrors is based on a Fano resonance. Finally, the design, fabrication and characterization of grating couplers for efficient light coupling in and out of the indium phosphide photonic crystal platform is discussed.

Globally, death of women due to HIV/AIDS related causes during pregnancy or within 42 days after pregnancy was estimated to be 37,000. In Ethiopia, 42,900 pregnant women living with HIV gave birth in the year 2011. This study was aimed to assess incidence and predictors of pregnancy among women on ART in Debre Markos Referral Hospital, Northwest Ethiopia. A retrospective cohort study was conducted using data recorded from September 2011 to August 2015. Data was extracted from February to March, 2016, from 1,239 records and analyzed using SPSS version 16. A Kaplan-Meier survival analysis was used to estimate the probabilities of being pregnant. The Cox proportional hazards model was done and results were expressed using hazard ratios with 95% CI. A total of 1,239 women on ART were included in the study. The incidence of pregnancy was 49.2 per 1,000 person-years. Living in rural, being married, being widowed, being unemployed, and having

Background A transfusion transmissible infection (TTI) is any infection that is transmissible from person to- person through parenteral administration of blood or blood products. The magnitude of transfusion-transmitted infections (TTI) varies from country to country depending on TTI’s load in that particular population. Measuring their severity, WHO (World Health Organization) has recommended pre-transfusion blood test for Human immunodeficiency virus (HIV), Hepatitis B virus (HBV), Hepatitis C Virus (HCV) and Syphilis as mandatory. The aim of the current study was to assess the trend and prevalence of TTI among blood donors in Jijiga Blood Bank between 2010 and 2013. Methods A Retrospective cross-sectional study was conducted by reviewing the records from 2010 to 2013 at Jijiga Blood Bank. All blood donors who presented to the blood bank and screened for TTI during the study period were included. The data was collected, entered and analyzed using Epi Info 3.5.1 & Microsoft Excel 2007. The descriptive statistics were determined in means of percentages. Chi-square was used for trend analysis and p-value was used to declare the statistical significance between the variable. Result There were a total of 4224 people donated blood during study period. Males formed the majority of the donor population accounting for 4171 (98.7 %). Majority 4139 (98 %) of donors were Replacement donors. The overall prevalence of transfusion-transmitted infection was 487/4224 (11.5 %). The prevalence for HBsAg, HCV, HIV, & Syphilis antibodies was 460 (10. 9 %), 17 (0.4 %), 6 (0.1 %) and 4 (0.1 %) respectively. Majority 460/487 (94.5 %) of infection was HBsAg. Statistically significant difference was observed in number of donation as well as sero-positivity from year 2010 to 2013 (Chi-square 9.24, p value = 0.02), in Trends of HBsAg from year to year (Chi-square 11.14, p value = 0.01), HIV virus was seen as the age of donors increases (Chi-square 8.37, p value = 0.01) and There was also statistically significance difference (p value = 0.01) in prevalence of HBsAg distribution by sex. Conclusion The present study clearly documents high Seroprevalence (487 out of 4,224, 11.5 %) of TTI, low percentage of voluntary donors and low participation of female donors. Promoting the culture of voluntary donors, recruitment of female blood donors and proper testing of donor’s blood by using standard methods are recommended.

Over the period 1998-2001 women attending Jimma hospital (southwest Ethiopia) with cervical dysplasia were screened for human papillomavirus (HPV), identifying a prevalence of 67.1% in this population. High-risk HPV types 16 (55.7%), 18 (8.2%), 56 (8.2%), 45 (4.1%), 39 (2.5%), 52 (1.6%), 31 (1.6%), 35 (1.6%), 58 (0.8%), 33 (0.8%), 59 (0.8%) caused severe pathology as single/multiple infection. Strategies need to be envisioned for vaccinating children, young women prior to first sexual contact and preventive screening of HPV high-risk types.