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Background: Continuous emergence of multi-drug-resistant malaria parasites and their rapid spread across the globe warrant urgent search for new anti-malarial chemotherapeutics. Traditional medicinal plants have been the main sources for screening active phytochemicals against malaria. Accordingly, this study was aimed at evaluating the anti-malarial activity of Osyris quadripartita Salzm. Ex Decne., a plant which is used for traditional malaria treatment by local people in different parts of Ethiopia., Methods: Aqueous, chloroform and methanol crude leaf extracts of the plant have been prepared and tested for acute toxicity and anti-malarial efficacy in Plasmodium berghei (ANKA strain)-infected Swiss albino mice., Results: At three oral doses of 200, 400 and 600 mg/kg the plant material was safe, chemosuppressive and thus prevented body weight loss, hematological abnormalities and increased mice mean survival time compared to the negative control. The most efficacious extract was that of chloroform which prolonged mean mouse survival past day 11 of infection with all the mice in this group having the highest parasitemia suppression rate (41.3%, at 600 mg/kg) although parasite clearance was not achieved compared to the standard drug (chloroquine) against the parasite., Conclusion: The finding supports the traditional use of the plant for the treatment of malaria. However, further confirmatory studies followed by isolation and characterization of the active anti-malarial compound (s) of the plant that is/are responsible for the observed parasite suppression is needed before it is recommended for malaria drug search and discovery.

Background: In Ethiopia malaria remains a leading cause of outpatient consultation despite massive control efforts. This study was aimed at analysing 5-year retrospective trend and current prevalence of malaria as well as community knowledge, attitude and practice (KAP) in Walga Health Centre (WHC) catchment area in Abeshge District, south-central Ethiopia., Methods: A cross-sectional, household survey was conducted to determine malaria prevalence and KAP in December 2013. Further, malaria cases reported from WHC in 2008-2012 were extracted. A multi-stage, random sampling technique was used to select study participants from four kebeles. Of 800 participants, 400 were interviewed to assess their KAP about malaria and the other half were recruited for malaria microscopy., Results: Overall, 11,523 (33.8%) slide-confirmed malaria cases were reported (no fatalities) among 34,060 outpatients diagnosed in 2008-2012. There was successively significant decline in malaria prevalence from 2009 onwards although a significant rise was noticed in 2009 compared to 2008 (p<0.0001). Male malaria suspects (17,626) were significantly higher than of females (16,434) (p=0.0127) but malaria prevalence was not significantly variable between sexes. Individuals who were ≥15 years constituted 44.9% of the patients. Although most participants (78.8%) associated mosquito bites with malaria, the remaining mentioned exposure to rain or body contact with malaria patients as causes of malaria. Mosquito nets, draining stagnant water and indoor residual spraying were the most frequently mentioned malaria preventive measures. In the parasitological survey, a single individual (0.25%) with mixed Plasmodium falciparum-Plasmodium vivax infections was found., Conclusion: Although malaria remains a primary cause of outpatient admission in WHC, the retrospective data showed a significantly declining trend. This together with the very low prevalence in the current parasitological survey suggests the effectiveness of ongoing control interventions in the locality.

Background: Evidence for decreasing chloroquine (CQ) efficacy against Plasmodium vivax has been reported from many endemic countries in the world. In Ethiopia, P. vivax accounts for 40% of all malaria cases and CQ is the first-line drug for vivax malaria. Mutations in multidrug resistance 1 (pvmdr-1) and K10 insertion in the pvcrt-o genes have been identified as possible molecular markers of CQ-resistance (CQR) in P. vivax. Despite reports of CQ treatment failures, no data are currently available on the prevalence of molecular markers of P. vivax resistance in Ethiopia. The objective of this study was to determine the prevalence of mutations in the pvmdr-1 and K10 insertion in the pvcrt-o genes., Methods: A total of 36 P. vivax clinical isolates were collected from West Arsi district in Ethiopia. Sequencing was used to analyse polymorphisms of the pvcrt-o and pvmdr-1 genes., Results: Sequencing results of the pvmdr-1 fragment showed the presence of two non-synonymous mutations at positions 976 and 1076. The Y → F change at codon 976 (TAC → TTC) was observed in 21 (75%) of 28 the isolates while the F → L change (at codon 1076), which was due to a single mutation (TTT → CTT), was observed in 100% of the isolates. Of 33 samples successfully amplified for the pvcrt-o, the majority of the isolates (93.9%) were wild type, without K10 insertion., Conclusions: High prevalence of mutations in candidate genes conferring CQR in P. vivax was identified. The fact that CQ is still the first-line treatment for vivax malaria, the significance of mutations in the pvcrt-o and pvmdr-1 genes and the clinical response of the patients' to CQ treatment and whether thus an association exists between point mutations of the candidate genes and CQR requires further research in Ethiopia.

Background: In Ethiopia, urinary schistosomiasis caused by Schistosoma haematobium has been known to be endemic in several lowland areas of the country where it causes considerable public health problems, mainly among school-age children. However, information on recent magnitude and risk factors of the disease is lacking, particularly for Gambella area. Therefore, this study aimed to assess the prevalence of urinary schistosomiasis and associated risk factors among Abobo Primary School children in Gambella, southwestern Ethiopia., Methods: A cross-sectional study involving 304 school children was conducted in Abobo Primary School, Gambella Regional State, southwestern Ethiopia, from February to June 2014. Ten ml of urine sample was collected from each study participant and processed for microscopic examination by the urine filtration method; egg load for positive individuals was determined per 10 ml of urine. Data on socio-demographic characteristics and risk factors were collected using an interview-based questionnaire. The data were entered into and analyzed with SPSS version 20. Logistic regression and odds ratio were used to measure association and strength between variables, respectively. P-value < 0.05 at 95% CI was considered as statistically significant., Results: The prevalence of urinary schistosomiasis was 35.9% (109/ 304) with a mean egg intensity of 8.76 per 10 ml of urine. Being male [AOR (95%CI) = 2.15(1.31, 3.52)], having father as a farmer [AOR (95%CI) = 1.96(1.19, 3.22)] and children living apart from parents [AOR (95% CI): 3.09 (1.14, 8.4)] were significantly associated with urinary schistosomiasis., Conclusion: The present study area in Gambella Regional State, southwestern Ethiopia, represents moderate-risk community for urinary schistosomiasis. Sex, father's occupation and living apart from parents were found to be associated with infection. Treatment of all school-age children and fishermen is required once every 2 years until the prevalence of infection falls below the level of public health importance. It is also recommended to complement praziquantel treatment with supplementary measures such as provision of sanitation facilities and health education.

Background: Compliance with annual ivermectin treatment is a major challenge in community-directed treatment with ivermectin (CDTI) implementation. There are individuals who do not comply with the annual mass treatment, which contributes to the continuity for disease transmission. Hence, ensuring high treatment coverage and sustained compliance should be given due emphasis in the control of onchocerciasis. The aim of this study was to determine CDTI compliance rate and predictors of compliance where the CDTI was in its 9(th) round in Kabo area, southwestern Ethiopia., Methods: Community-based cross-sectional study was conducted in Kabo area, three weeks after the 9th round of annual ivermectin distribution. Systematic random sampling was used to select head of households and structured, pre-tested questionnaire was used to interview the study participants. Data was analyzed using SPSS version 16. Descriptive statistics was used to compute mean and standard deviation of continuous variables and frequency for categorical variables, while bivariate and multivariate logistic regressions were used to assess the effects of independent variables on the outcome variable. Variables which showed association in multivariate analysis were considered as final predictors of compliance and strength of association was measured through adjusted odds ratio (AOR)., Results: A total of 308 respondents (age range 18-70, mean age ± SD, 32.21 ± 9.64) participated in the study. Of these, 249 (80.8%) reported that they took ivermectin during the 9th round annual treatment. Significantly higher rate of treatment compliance was reported by participants age ≥35 years (AOR = 5.48, 95% CI; 1.97 - 15.23), participants who stayed in the area for more than ten years (AOR = 3.86, 95% CI; 1.83- 8.11), participants who perceive that they are at risk of contracting the disease(AOR = 7.05, 2.70- 18.43), participants who perceive community drug distributors (CDDs) are doing their work well (AOR = 2.35 95% CI; 1.15- 4.83) and participants who know at least one CDD in their village (AOR = 2.83, 95% CI; 1.26- 6.40)., Conclusion: The majority of the study participants in the present study area complied with ivermectin treatment. Nevertheless, intervention packages should consider factors such as age, residence duration and community's perception of the disease to improve compliance and make drug distribution sustainable.

Background: Undernutrition is a major public health problem on the globe particularly in the developing regions. The objective of the current study was to assess the prevalence of undernutrition in different age groups and examine the relationship of the disease to parasitic and socioeconomic factors among communities in Harbu Town, northeastern Ethiopia., Methods: Stool samples of the study participants were examined for intestinal helminth infections using the Kato-Katz method. Blood specimens were diagnosed for Plasmodium infection using CareStartTM Malaria Pf/Pv Combo test. The blood type was determined from blood samples using antisera A and antisera B. In addition, the height and weight of the study participants was measured and information about their socioeconomic and sociodemographic characteristics was collected., Results: Out of 484 individuals examined, 31.8% were undernourished and 32.0% were infected with intestinal helminths. The odds of undernutrition significantly decreased with an increase in the age of individuals. The prevalence of undernutrition in adults was significantly higher in males than in females and in those who had latrines than in those who did not have the facility. The odds of undernutrition in the 5 to 19 years age group was significantly higher in those who did not wash their hands before eating than in those who did. The prevalence of undernutrition in children younger than five years was significantly lower in those whose families were educated and had less than 5 family size compared to those with illiterate families and family size of greater than 5, respectively. However, the prevalence of undernutrition was similar in individuals who were infected and not infected with intestinal helminths. The intensity of Schistosoma mansoni infection was significantly higher among individuals of blood type A compared to those of type O., Conclusions: Prevalence of undernutrition was higher in children than in adults and the association of sex and socioeconomic factors with undernutrition showed variation with age. However, helminth infection was not related with undernutrition in all age groups.

Background: The endemicity of human schistosomiasis has long been established in Ethiopia, and new foci have also been continuously reported.The objective of this study was to determine the transmission and magnitude of schistosomiasis in Hayk area, northeastern Ethiopia., Methods: A cross sectional parasitological survey involving 384 school children was conducted for intestinal schistosomiasis between January and March 2010 in two primary schools in Hayk area, northeastern Ethiopia. The stool samples were processed for microscopic examination using Kato-Katz technique. Malacological survey and observation on human water contact activities were also carried out. Snails were checked for schistosome infection by shedding and lab-bred mice were exposed to the cercariae shed from Biomphalaria pfeifferi en masse. Adult Schistosoma mansoni worms were harvested from the mice after 45 days of exposure to the schistosome cercariae., Results: The overall prevalence and intensity of intestinal schistosomiasis among school children in Hayk Number 1 and Hayk Number 2 Primary Schools was found to be 45% and 161 epg, respectively. The prevalence of infection had relationship with age and sex. Males were more infected than females. Children in the age group 15-19 years had the highest infection rate, followed by 10-14 and 5-9 years age group. Schistosome infection in Biomphalaria pfeifferi was 3.2%. Schistosome infection was also established in laboratory-bred mice and adult Schistosoma mansoni worms were harvested., Conclusion: The observed intestinal schistosomiasis with prevalence of 45% among young children, collection of schistosome infected Biomphalaria pfeifferi, and the establishment of lab infection in mice showed that transmission of intestinal schistosomiasis is taking place in the area. Preventive chemotherapy with praziquantel should be immediately put in place to reduce morbidity and interrupt transmission of schistosomiasis in the area.

Identifying determinants of soil transmitted helminth infection is vital to design control strategy for the disease. This study assessed the prevalence of STH infections and associated factors among schoolchildren in Durbete town, northwestern Ethiopia. Data about the sociodemographic and socioeconomic status of the children were collected using a questionnaire and stool samples were diagnosed using thick Kato-Katz smear. STH infection was more common among school-age children in Durbete town. Hookworm was the most frequent helminth species detected. The prevalence of STH infection was more in children who did not practice wearing shoes and washing hands before eating and in those who were older in age. Deworming of school-age children in the study area would be important. In addition, provision of health education about helminths and the importance of wearing shoes and washing hands before eating would be important to reduce the burden of STH infection in the study area.

Background: Glucose-6-phosphate dehydrogenase deficiency (G6PDd) is widespread across malaria endemic regions. G6PD-deficient individuals are at risk of haemolysis when exposed, among other agents, to primaquine and tafenoquine, which are capable of blocking malaria transmission by killing Plasmodium falciparum gametocytes and preventing Plasmodium vivax relapses by targeting hypnozoites. It is evident that no measures are currently in place to ensure safe delivery of these drugs within the context of G6PDd risk. Thus, determining G6PDd prevalence in malarious areas would contribute towards avoiding possible complications in malaria elimination using the drugs. This study, therefore, was aimed at determining G6PDd prevalence in Gambella hospital, southwest Ethiopia, using CareStart™ G6PDd fluorescence spot test., Methods: Venous blood samples were collected from febrile patients (n = 449) attending Gambella hospital in November-December 2013. Malaria was diagnosed using blood films and G6PDd was screened using CareStart™ G6PDd screening test (Access Bio, New Jersey, USA). Haematological parameters were also measured. The association of G6PD phenotype with sex, ethnic group and malaria smear positivity was tested., Results: Malaria prevalence was 59.2% (96.6% of the cases being P. falciparum mono infections). Totally 33 participants (7.3%) were G6PD-deficient with no significant difference between the sexes. The chance of being G6PD-deficient was significantly higher for the native ethnic groups (Anuak and Nuer) compared to the 'highlanders'/settlers (odds ratio (OD) = 3.9, 95% confidence interval (CI) 0.481-31.418 for Anuak vs 'highlanders'; OD = 4.9, 95% CI 0.635-38.00 for Nuer vs 'highlanders'). G6PDd prevalence among the Nuer (14.3%) was significantly higher than that for the Anuak (12.0%)., Conclusions: G6PDd prevalence in the area is substantial with 30 (90.9%) of the 33 deficient individuals having malaria suggesting the non-protective role of the disorder at least from clinical malaria. The indigenous Nilotic people tend to have a higher chance of being G6PD-deficient as 32 (96.9%) of the total 33 cases occurred among them.

Intestinal parasite infections are major public health problems of children in developing countries causing undernutrition, anemia, intestinal obstruction and mental and physical growth retardation. This study was conducted to assess the prevalence of intestinal helminthic infections among children under five years of age with emphasis on Schistosoma mansoni in Wonji Shoa Sugar Estate, Ethiopia. A cross-sectional parasitological survey was conducted in under-five children living in Wonji Shoa Sugar Estate Ethiopia, April, 2013. Stool samples were collected and examined for intestinal parasites using single Kato-Katz and single Sodium acetate-acetic acid-formalin (SAF) solution concentration methods. Out of 374 children examined using single Kato-Katz and single SAF-concentration methods, 24.3% were infected with at least one intestinal parasite species. About 10.4%, 8.8%, 4.6%, 2.9%, 1.6% and 0.8% of the children were infected with Hymenolepis nana, Schistosoma mansoni, Ascaris lumbricoides, Trichuris trichiura, Enterobius vermicularis and hookworm, respectively. Prevalence of double, triple and quadruple intestinal helminthic infection was 6.4%, 0.54% and 1.1%, respectively. A significant increase in prevalence of S. mansoni (8.3% versus 3.2%) and T. trichiura (2.7% versus 0.5%) infection was observed when determined via the single Kato-Katz method compared to the prevalence of the parasites determined via the single SAF-concentration method. On the other hand, the single SAF-concentration method (9.1%) revealed a significantly higher prevalence of H. nana infection than the single Kato-Katz (1.6%) does. In conclusion, intestinal helminths infections particularly S. mansoni and H. nana were prevalent in under-five children of Wonji Shoa Sugar Estate. Including praziquantel treatment in the deworming program as per the World Health Organization guidelines would be vital to reduce the burden of these diseases in areas where S. mansoni and H. nana infections are prevalent among under-fives. Kato-Katz can be used in estimating the prevalence of S. mansoni and other helminth infections.

Background: Malaria is one of the most important tropical diseases and the greatest cause of hospitalization and death. Recurring problems of drug resistance are reinforcing the need for finding new antimalarial drugs. In this respect, natural plant products are the main sources of biologically active compounds and have potential for the development of novel antimalarial drugs. A study was conducted to evaluate extracts of the leaves of Croton macrostachyus and Acokanthera schimperi for their in vivo antimalarial activity., Methods: The plants were selected based on their ethnomedicinal information. Acute and sub- acute toxicity studies of the crude extracts were carried out in Swiss albino mice. To assess the effect of extracts of the plants on the parasite, a 4-day suppressive standard test was performed using Plasmodium berghei (ANKA strain). Data were analyzed using paired t-test and ANOVA., Results: In acute toxicity study, the two plants extracts did not show any sign of toxicity up to 2000 mg/kg. In sub-acute toxicity study, both plants did not exhibit any hematological change and mortality throughout the observation period up to the highest dose of 1000 mg/kg given daily. Extracts of the leaves of both plants significantly (P < 0.05) suppressed parasitaemia in dose dependent manner at all dose levels., Conclusions: The findings may support the traditional use of the plants to treat malaria. Further pharmacological, toxicological and phytochemical studies are, however, required to evaluate the potential of the plants towards the development of new antimalarial agent.

Background: Both helminth and malaria infections result in a highly polarized immune response characterized by IgE production. This study aimed to investigate the total serum IgE profile in vivo as a measure of Th2 immune response in malaria patients with and without helminth co-infection., Methods: A cross sectional observational study composed of microscopically confirmed malaria positive (N=197) and malaria negative (N=216) apparently healthy controls with and without helminth infection was conducted at Wondo Genet Health Center, Southern Ethiopia. A pre-designed structured format was utilized to collect socio-demographic and clinical data of the subjects. Detection and quantification of helminths, malaria parasites and determination of serum IgE levels were carried out following standard procedures., Results: Irrespective of helminth infection, individuals infected by malaria showed significantly high levels of serum IgE compared with malaria free apparently healthy controls (with and without helminth infections). Moreover, malaria patients co-infected with intestinal helminths showed high level of serum IgE compared with those malaria patients without intestinal helminths (2198 IU/ml versus 1668 IU/ml). A strong statistically significant association was observed between malaria parasite density and elevated serum IgE levels (2047 IU/ml versus 1778 IU/ml; P=0.001) with high and low parasitaemia (parasite density >50,000 parasite/μl of blood), respectively. Likewise, helminth egg loads were significantly associated with elevated serum IgE levels (P=0.003)., Conclusions: The elevated serum IgE response in malaria patients irrespective of helminth infection and its correlation with malaria parasite density and helminth egg intensity support that malaria infection is also a strong driver of IgE production as compared to helminths.

Objective: To assess the knowledge of Abaye Deneba community members regarding intestinal parasites and prevalence of intestinal parasitic infections., Methods: Knowledge about intestinal parasites was assessed by administering a questionnaire to 345 randomly selected household heads. Parasitological stool examination of 491 randomly selected individuals was done using the formol ether concentration technique., Results: Knowledge of the Abaye Deneba community about parasitic diseases such as schistosomiasis, amoebiasis, ascariasis and taeniasis was very low. However, 204 (59.3%) members correctly responded that the cause of giardiasis is related to contaminated water and 176 (51.2%) knew how to prevent it. In some cases, respondents did correctly identify causes, symptoms of intestinal parasite infection and ways to prevent it, but they did not accurately link it to the appropriate disease caused by the different intestinal parasite species. Among the 491 stool samples examined, 50.2% of study participants showed infection with at least one intestinal parasite. Schistosoma mansoni was the most prevalent (41.3%) followed by Trichuris trichiura(9.4%), Ascaris lumbricoides (8.4%), Taenia saginata (2.4%), Enterobius vermicularis (2.0%) and hookworm (0.4%). Prevalence of schistosomiasis was highest in men aged 15-24 years., Conclusions: Intestinal parasitic infection is highly prevalent in communities of the Abaye Deneba area. Nevertheless, the knowledge of the community members about the parasite is less. Implementation of preventive chemotherapy, supplemented with health education, provision and use of sanitary facilities would be recommended to reduce morbidity and control transmission of intestinal parasites in this area.

Background: Determining the variation of circulating cathodic antigen (CCA) in urine and egg counts variation in stool between days in Schistosoma mansoni (S. mansoni) infected individuals is vital to decide whether or not to rely on a single-sample test for diagnosis of Schistosomiasis. In this study, the magnitude of day-to-day variation in urine-CCA test scores and in faecal egg counts was evaluated in school children in Ethiopia., Methods: A total of 620 school children (age 8 to 12 years) were examined for S. mansoni infection using double Kato-Katz and single urine-CCA cassette methods (batch 32727) on three consecutive days., Results: The prevalence of S. mansoni infection was 81.1% based on triple urine-CCA-cassette test and 53.1% based on six Kato-Katz thick smears. Among the study participants, 26.3% showed fluctuation in urine CCA and 32.4% showed fluctuation in egg output. Mean egg count as well as number of cases in each class of intensity and intensity of cassette band color varied over the three days of examination. Over 85% of the children that showed day-to-day variations in status of S. mansoni infection from negative to positive or vice versa by the Kato-Katz and the CCA methods had light intensity of infection. The fluctuation in both the CCA test scores and faecal egg count was not associated with age and sex., Conclusions: The current study showed day-to-day variation in CCA and Kato-Katz test results of children infected with S. mansoni. This indicates the necessity of more than one urine or stool samples to be collected on different days for more reliable diagnosis of S. mansoni infection in low endemic areas.

Background: The negative impact of synthetic molluscicides on the environment and their high cost necessitated search for an alternative approach of using plant extracts for the control of schistosomiasis. The objective of this study was, therefore, to evaluate aqueous and ethyl acetate crude extracts of Glinus lotoides fruits for their cercariacidal activity and molluscicidal effect against schistosome snail intermediate hosts., Methods: Assessment of the molluscicidal activity against Biomphalaria pfeifferi was made by immersion method in accordance with WHO guideline. The results of mortality were statistically analyzed using probit analysis. The attenuating effect of the plant on Schistosoma mansoni cercariae was determined using establishment of adult worms as a parasitological parameter post exposure., Results: The 24 and 48 hour-LC50 values for the aqueous extract of G. lotoides fruits were 47.1 and 44.1 mg/L, respectively, whereas that of ethyl acetate were 66.1 and 59.6 mg/L, respectively. The 24 and 48 hour LC90 values for the aqueous extract of G. lotoides fruits were 56.96 and 51.0 mg/L, respectively, while that of ethyl acetate were 77.2 and 70.0 mg/L, respectively. The in vitro cercariacidal activity was determined after 2 hrs of exposure to the aqueous plant extract. It was found out that the LC50 and LC90 values were 18.7 and 41.7 mg/L, respectively. Besides, infectivity of Schistosoma mansoni cercariae to mice was determined by exposing mice to cercariae pre-treated with the sub-lethal concentrations (3.7, 11.6 and 18.7 mg/L) of the aqueous extract. A significant reduction in worm burden in mice was obtained at 11.6 mg/L (p < 0.05). Moreover, the reduction in number of worms recovered was highly significant at 18.7 mg/L (p < 0.001)., Conclusions: The results showed that G. lotoides has molluscicidal activity against B. pfeifferi snails and cercariacidal activity against S. mansoni. Yet, further comprehensive evaluation is recommended for the possible use of G. lotoides against B. pfeifferi and the schistosome parasite.

Background: Intestinal schistosomiasis, caused by digenetic trematodes of the genus Schistosoma, is the most prevalent water related disease that causes considerable morbidity and mortality. Although prevalence of Schistosoma mansoni infection has been reported for the present study area, earlier studies have not estimated intensity of infections in relation to periportal fibrosis, which would have been crucial for epidemiological and clinical evaluations. Hence, a community based cross sectional study was conducted from December 2011 to March 2012 to assess prevalence of infection and schistosomal periportal fibrosis in Waja-Timuga, northern Ethiopia., Methods: In a cross sectional study involving 371 randomly selected individuals, fresh stool samples were collected and processed by the Kato-Katz method and examined microscopically. Ultrasonography was used to determine status of schistosomal periportal fibrosis and to detect hepatomegaly and/or splenomegaly. Serum was collected for assay of hepatic activity. Statistical analysis was performed using STATA 11 statistical soft ware. P-value <0.05 was reported as statistically significant., Results: The prevalence of S.mansoni infection was 73.9%, while the prevalence of schistosomal periportal fibrosis was 12.3% and mean intensity of infection was 234 eggs per gram of stool. Peak prevalence and intensity of S.mansoni infection was documented in the age range of 10-20 years. Among the study individuals, hepatomegaly was recorded in 3.7% and splenomegaly was recorded in 7.4% of the study individuals. Similarly, among the study individuals who had definite periportal fibrosis, 5.9% had elevated liver enzyme levels., Conclusion: The high prevalence of Schistosoma mansoni infection and schistosomal periportal fibrosis observed in the study area calls for a periodic deworming program to reduce disease, morbidity and transmission. Preventive chemotherapy complemented with other control measures is highly required for sustainable control of schistosomiasis in the study area.

Monitoring the efficacy of anthelminthic drugs is essential. The objective of this study was to assess the efficacy of a single oral dose of 400mg albendazole (ABZ) against the major soil-transmitted helminth (STH) infection in school children, Wondo Genet, southern Ethiopia. A single fresh stool sample was collected from 298 school children and examined using a duplicate smear of the Kato-Katz method. Children positive for STH infections were treated with single oral dose of 400mg ABZ and re-examined for intestinal helminth infections 21days post-treatment. The participants were interviewed for symptoms related with the drug uptake 24h after ABZ treatment. Children positive for Schistosoma mansoni infections were treated with Praziquantel (40mg/kg of body weight) after an ABZ treatment follow up survey. 51.3%, 49.7%, 44.6% and 88.3% had hookworm, Ascaris lumbricoides, Trichuris trichiura and any intestinal helminth infection, respectively. Cure rates were 97.4% for hookworm, 96.6% for A. lumbricoides and 30.8% for T. trichiura infections. Egg reduction rates (ERRs) were 99.8% for hookworm, 99.9% for A. lumbricoides and 83.1% for T. trichiura infections. Mild and transient symptoms were observed among the participants which were quite frequent. In conclusion, a 400mg single oral dose of ABZ was effective against hookworm and A. lumbricoides but less efficacious against T. trichiura infection. The drug resulted in high ERRs for hookworm, A. lumbricoides and T. trichiura. Administration of the drug in repeated doses or in combination with other drugs might be necessary., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Background: As a result of extensive chloroquine resistance (CQR) in Plasmodium falciparum in late 1990s, Ethiopia replaced CQ with sulphadoxine-pyrimethamine (SP) as first-line drug, which in turn was replaced by artemisinin combination therapy in 2004. Plasmodium falciparum resistance to CQ is determined by the mutation at K76T of the P. falciparum chloroquine resistance transporter (pfcrt) gene. Understanding diversity in the P. falciparum genome is crucial since it has the potential to influence important phenotypes of the parasite such as drug resistance. Limited data is available regarding the type of pfcrt mutant allelic type, the effect of CQ withdrawal and diversity of the parasite population in south-central Oromia, Ethiopia., Methods: Finger-pricked blood spotted on Whatman 3MM filter papers were collected from falciparum malaria patients. Parasite DNA was extracted from individual blood spots on the filter papers. The presence of K76T mutations was determined using nested PCR for all isolates. Complete sequencing of mutations in pfcrt 72-76 was done for a set of randomly selected resistant isolates. Four microsatellite (MS) markers were analysed to determine the heterozygosity., Results: Although CQ was withdrawn for more than a decade, 100% of the parasites still carried the pfcrt K76T mutation. All isolates were mutant at the K76T polymorphism. Based on combinations of MS markers, seven different Ethiopian CQR variants (E1-E7) were identified. Heterozygosity (H(e)) for MS flanking the pfcrt chloroquine resistance allele ranged from 0.00 (mscrt -29, -29.268 kb) to 0.21 (mscrt -2, -2.814 kb). H(e) ranged from 0.00 (msint 3, 0 kb) to 0.19 (msint 2, 0 kb) for MS within the pfcrt gene. Both intronic and MS flanking the pfcrt gene showed low levels of diversity., Conclusion: pfcrt CQR allele seems to be fixed in the study area. Of the different haplotypes associated with CQR, only the CVIET genotype was identified. No reversal to the wild-type has occurred in Ethiopia unlike in many Africa countries where CQR parasites declined after cessation of CQ use. Decreased diversity in CQR isolates surrounding pfcrt suggests CQ selection and homogenization among CQR parasite population. While mutation in msint 3 and mscrt -29 of the mutant pfcrt allele is being fixed, it seems that mutations in msint 2 and mscrt -2 are still evolving and may indicate the start of re-diversification of the population from a fixed 76 T population.

Background: Because the mechanisms by which Plasmodium and helminth parasites affect nutritional status are different, these parasites likely have additive effects when they co-exist in a host. This study aimed to compare the prevalence of undernutrition in patients infected with either Plasmodium or helminths and those co-infected with the two types of parasites., Methods: Acute febrile patients suspected of having malaria who attended the outpatient clinic at Dore Bafeno Health Center between December 2010 and February 2011 were examined for Plasmodium parasites using Giemsa-stained thick and thin blood smears and for helminths using the thick Kato-Katz method. Nutritional status was determined using anthropometric indices generated from height and weight measurements., Results: Of the 702 patients examined, 34.5% were infected with helminths alone, 12.3% were infected with Plasmodium alone, and 19.4% co-infected with Plasmodium and intestinal helminths. Out of the patients examined, 44.9% were undernourished. The prevalence of undernutrition was not significantly different between those patients not infected with Plasmodium or helminth species and those infected with Plasmodium or helminth species. The differences in the odds of undernutrition were also not significant between patients who were co-infected with different Plasmodium and helminth species and those with single infections with Plasmodium or helminth species in our multivariable logistic regression model adjusted for the confounding effects of age and sex., Conclusion: The prevalence of undernutrition was comparable in patients infected with Plasmodium or helminths alone and those co-infected with Plasmodium and helminths in Dore Bafeno Health Center, Southern Ethiopia. However, further studies are needed in areas of intense transmission where both parasites are endemic to elucidate whether the impact of Plasmodium and helminth co-infection on undernutrition is additive or multiplicative., (Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.)

Background: The epidemiology of schistosomiasis is well documented and its geographic distribution has been mapped and there is an ongoing mapping in Ethiopia. Nevertheless, new transmission foci have been discovered in different parts of the country. The objective of this study was to assess the establishment of transmission and determine the prevalence of Schistosoma mansoni infection in school children from Sanja Town, northwest Ethiopia., Methods: A cross-sectional parasitological survey involving 384 school children in two primary schools of Sanja Town was conducted between February and April 2013. Stool specimens were collected and microscopically examined using Kato-Katz and Sodium acetate-acetic acid-formalin (SAF) concentration methods. Malacological survey was also carried out to identify snail intermediate hosts and larval infection rate in the snail. The snails collected were checked for trematode infection by shedding. Observation was also made on water contact habits of the study population., Results: The prevalence of Schistosoma mansoni infection using Kato-Katz method was high among male (79.5%) children in Sanja Primary school while it was high among female (75%) children in Ewket Amba Primary school. The prevalence of Schistosoma mansoni infection among Sanja Primary school children in the age groups 5-9 and 10-14 years were 84.6% and 75.2%, respectively while in Ewket Amba Primary school, the prevalence was 66% and 77.9% in the age groups 5-9 and 10-14 years respectively. The prevalence of schistosome infection in Biomphalaria pfeifferi was 16.9% and 0.027% during February and April, respectively. S. mansoni infection was successfully established in laboratory mice and adult worms were harvested after six weeks of laboratory maintenance. Observations made on water contact activities showed swimming, bathing and washing in the river and the stream as the high risk activities for Schistosoma mansoni infection., Conclusion: The study has shown establishment of transmission of schistosomiasis mansoni in Sanja Town. Therefore, appropriate integrated control measures need to be introduced to reduce morbidity in the population and also to control the transmission of schistosomiasis in the study area.

Objective: To assess the efficacy and side effects of praziquantel in the treatment for Schistosoma mansoni infection in school children in Senbete Town, northeastern Ethiopia., Methods: A single stool specimen was collected from 342 school children and examined for S. mansoni ova using Kato-Katz technique (single slide) and formol-ether concentration technique. Positive individuals were treated with a single oral dose of praziquantel at 40 mg/kg body weight. Egg reduction and cure rates were assessed 4 weeks post-treatment. Structured questionnaires were also used to collect pre-treatment and 24-h post-treatment signs and symptoms to assess side effects of the drug., Results: Praziquantel reduced the egg rate by 79.46% and achieved a cure rate of 82.89% 4 weeks post-treatment. 86.67% of the children presented at least one transient drug-related sign and symptom 24-h post-treatment., Conclusion: Praziquantel demonstrated sufficient efficacy against S. mansoni in Senbete Town, northeastern Ethiopia. Mild and transient signs and symptoms associated with therapy disappeared within 24 h without specific treatment., (© 2013 John Wiley & Sons Ltd.)

Background: Prompt and effective malaria diagnosis not only alleviates individual suffering, but also decreases malaria transmission at the community level. The commonly used diagnostic methods, microscopy and rapid diagnostic tests, are usually insensitive at very low-density parasitaemia. Molecular techniques, on the other hand, allow the detection of low-level, sub-microscopic parasitaemia. This study aimed to explore the presence of sub-microscopic Plasmodium falciparum infections using polymerase chain reaction (PCR). The PCR-based parasite prevalence was compared against microscopy and rapid diagnostic test (RDT)., Methods: This study used 1,453 blood samples collected from clinical patients and sub-clinical subjects to determine the prevalence of sub-microscopic P. falciparum carriages. Subsets of RDT and microscopy negative blood samples were tested by PCR while all RDT and microscopically confirmed P. falciparum-infected samples were subjected to PCR. Finger-prick blood samples spotted on filter paper were used for parasite genomic DNA extraction., Results: The prevalence of sub-microscopic P. falciparum carriage was 19.2% (77/400) (95% CI = 15. 4-23.1). Microscopy-based prevalence of P. falciparum infection was 3.7% (54/1,453) while the prevalence was 6.9% (100/1,453) using RDT alone. Using microscopy and PCR, the estimated parasite prevalence was 20.6% if PCR were performed in 1,453 blood samples. The prevalence was estimated to be 22.7% if RDT and PCR were used. Of 54 microscopically confirmed P. falciparum-infected subjects, PCR detected 90.7% (49/54). Out of 100 RDT-confirmed P. falciparum infections; PCR detected 80.0% (80/100). The sensitivity of PCR relative to microscopy and RDT was, therefore, 90.7% and 80%, respectively. The sensitivity of microscopy and RDT relative to PCR was 16.5 (49/299) and 24.2% (80/330), respectively. The overall PCR-based prevalence of P. falciparum infection was 5.6- and 3.3 fold higher than that determined by microscopy and RDT, respectively. None of the sub-microscopic subjects had severe anaemia, though 29.4% had mild anaemia (10-11.9 g/dl)., Conclusions: Asymptomatic, low-density malaria infection was common in the study area and PCR may be a better tool for measuring Plasmodium prevalence than microscopy and RDT. The inadequate sensitivity of the diagnostic methods to detect substantial number of sub-microscopic parasitaemia would undoubtedly affect malaria control efforts, making reduction of transmission more difficult. RDT and microscopy-based prevalence studies and subsequent reports of reduction in malaria incidence underestimate the true pictures of P. falciparum infections in the community. PCR, on the other hand, seems to have reasonable sensitivity to detect a higher number of infected subjects with low and sub-microscopic parasite densities than RDTs or microscopy.

Background: Praziquantel (PZQ) is the drug of choice for treatment of all human schistosomes. It is used in population based targeted or mass deworming strategies in several countries. The effect of PZQ on S. hematobium has not been studied in Ethiopia. The objective of this study was to determine the efficacy of PZQ against S. haematobium in Dulshatalo village, western Ethiopia., Methods: A prospective study was conducted from October to December, 2007. Urine samples from 341 residents were collected and screened for haematuria and proteinuria using urinalysis dipstick. S. haematobium eggs were detected and quantified using filtration techniques. The participants who were positive for haematuria were treated with a standard dose of PZQ (40 mg/kg). Data on pre and 24 hours post treatment symptoms were collected via questionnaire. Urine samples were also collected 7 weeks after treatment and examined to assess the cure and the egg reduction rates., Results: The prevalence of S. haematobium among the study participants was 57.8% (197/341). Haematuria was detected in 234 (68.6%) of the study participants. For PZQ efficacy asessment, 152 of the treated participants were considered. The presence of S. haemetaobium eggs showed statistically significant association (p < 0.05) with haematuria and proteinuria. Seven weeks post treatment, the extent of haematuria and proteinuria decreased from 100% to 40.8% and 94.07% to 48.7%, respectively. The cure and the parasitological egg reduction rates seven weeks post treatment were 86% and 85%, respectively. Post treatment symptoms revealed a wide range of side effects including straining, abdominal pain, nausea and headache., Conclusions: There were marked cure and egg reduction rates, together with mild and short lived side effects of PZQ for treatment of S. haematobium, in this study.

Objective: To evaluate the diagnostic performance of antigen detecting urine-CCA cassette test for the detection of Schistosoma mansoni infection in areas of moderate prevalence in Ethiopia., Methods: Stool specimens were collected from 620 schoolchildren on three consecutive days. The samples were microscopically examined using double Kato slides; midstream urine specimens were also collected for three consecutive days and tested for S. mansoni. The sensitivity of the urine-CCA cassette test was determined using combined results of six Kato-Katz thick smears and three urine-CCA cassette tests as gold standard. The specificity of the urine-CCA cassette test was evaluated in an area where schistosomiasis is not endemic., Results: Prevalence of S. mansoni infection as determined by single urine-CCA cassette test was 65.9%, by single Kato-Katz smear 37.3% and by six Kato-Katz thick smears 53.1% (P < 0.001). A single urine-CCA cassette test was significantly (P < 0.001) more sensitive (89.1%), had a lower negative predictive value (78.2%), was more accurate (92.6%) and agreed better with the gold standard (k = 0.83) than one or six Kato-Katz thick smears. However, both the Kato-Katz and urine-CCA cassette test showed 100% specificity in endemic settings., Conclusions: In moderate and high prevalence areas, urine-CCA cassette test is more sensitive than the Kato-Katz method and can be used for screening and mapping of S. mansoni infection., (© 2013 Blackwell Publishing Ltd.)

Objective: To assess the molluscicidal and cercariacidal activities of aqueous extracts of Balanites aegyptiaca (B. aegyptiaca) against Ethiopian Biomphalaria pfeifferi (B. pfeifferi), Lymnaea natalensis (L. natalensis) and Schistosoma mansoni (S. mansoni) cercariae., Methods: Extracts of seeds, endocarp, mesocarp, and fruit of B. aegyptiaca were tested for their activities against adult B. pfeifferi and L. natalensis. The cercariacidal activity of the seeds of the plant was also evaluated against S. mansoni. Bioassays were carried out following the methods recommended by WHO. Snail mortalities were compared between each plant part and snail species, and LC50 and LC90 values for the plant parts tested were computed. The cercariacidal activity of the plant was assessed by exposing the mice to the cercariae pre-exposed to aqueous extract of B. aegyptiaca seeds., Results: For the molluscicidal activities of seeds, endocarp, mesocarp and whole fruit, the LC50 values against B. pfeifferi were 56.32, 77.53, 65.51 and 66.63 mg/L, respectively, while the respective LC90 values were 77.70, 120.04, 89.50 and 97.55 mg/L. Similarly, the LC50 values for the seeds, endocarp, mesocarp and whole fruit against L. natalensis were 80.33, 92.61, 83.52 and 87.84 mg/L, respectively, while the respective LC90 values were 102.30, 138.21, 115.42 and 127.69 mg/L. B. pfeifferi were found to be more susceptible to B. aegyptiaca than L. natalensis. S. mansoni cercariae exposed to 15 mg/L of extract of seeds were incapable of infecting mice. The mean egg load of tissue was reduced in mice infected with the cercariae exposed to 5 and 10 mg/L of the extract., Conclusions: The aqueous extracts of different parts of B. aegyptiaca exhibited reasonable molluscicidal activity against B. pfeifferi and L. natalensis, as well as cercariacidal activity against S. mansoni cercariae. However, comprehensive laboratory evaluation is recommended prior to field tests of the plant parts since their impact on other aquatic biota is not known.

Background: In many areas of the world, including Ethiopia, malaria and helminths are co-endemic, therefore, co-infections are common. However, little is known how concurrent infections affect the epidemiology and/or pathogenesis of each other. Therefore, this study was conducted to assess the effects of intestinal helminth infections on the epidemiology and clinical patterns of malaria in southern Ethiopia where both infections are prevalent., Methods: A cross-sectional study was conducted in 2006 at Wondo Genet Health Center and Bussa Clinic, southern Ethiopia. Consecutive blood film positive malaria patients (N=230) and malaria negative asymptomatic individuals (N=233) were recruited. Malaria parasite detection and quantification was diagnosed using Giemsa-stained thick and thin blood films, respectively. Helminths were detected using direct microscopy and formol-ether concentration techniques. Coarse quantification of helminths ova was made using Kato Katz method., Results: The over all magnitude of intestinal parasitic infection was high irrespective of malaria infection (67% among malaria positive patients versus 53.1% among malaria non-infected asymptomatic individuals). Trichuris trichiura infection was associated with increased malaria prevalence while increased worm burden of helminths as expressed by egg intensity was associated with increased malaria parasitaemia which could be a potential factor for development of severe malarial infection with the course of the disease. Majority (77%) of the subjects had multiple helminths infection. T. trichiura, Ascaris lumbricoides, Schistosoma mansoni, and hookworm infestation accounted for 64.5, 57.7 %, 28.4%, and 12.2% of the infections, respectively., Conclusions: Populations in malaria-endemic areas of southern Ethiopia are multi-parasitized with up to four helminths. Mass deworming may be a simple practical approach in endemic areas in reducing the risk of severe malarial attack particularly for those at high risk of both infections.

Background: Since malaria is one of the foremost public health problems in Ethiopia, assessment of situation of the disease, and communities' knowledge and perceptions about malaria is necesary to institute appropriate preventive and control measures. Thus, the aim of this study was to assess malaria prevalence and knowledge, attitude and practice (KAP) about the disease among ShewaRobit Town community, northeastern Ethiopia., Methods: A community-based cross-sectional study was conducted in Shewa Robit Town from October to November 2011. A multi-stage random sampling technique was used to select the study participants. A total of 425 individuals were examined for malaria using thin and thick Giemsa stained blood film, and 284 of the participants were interviewed to assess their KAP about malaria. Logistic regression analysis was used to assess predictor factors for malaria prevalence., Results: All respondents had ever heard of malaria. Most of the respondents (85.2%) attributed the cause of malaria to mosquito bite. However, some of the respondents (>20%) mentioned lack of personal hygiene, exposure to cold weather, hunger, chewing maize stalk, body contact with malaria patient and flies as the causes of malaria. Sleeping under mosquito nets, draining stagnant water and indoor residual spraying were the most frequently mentioned malaria preventive measures perceived and practiced by the respondents. Among 425 individuals examined for malaria, only 2.8% were positive for Plasmodium parasites. Living in houses made of wall without hole, sprayed with insecticide within the last 12 hours and located at a distance of greater than 500 meters from potential mosquito breeding sites as well as knowing and using of mosquito net were significant predictors of low malaria prevalence among the study participants., Conclusions: A high level of knowledge about the cause, transmission and preventive methods of malaria was detected among the community in Shewa Robit Town. However, a considerable proportion had misconception about the cause and transmission of malaria suggesting the necessity of health education to raise the community's awareness about the disease.

Background: The association of intestinal helminths with undernutrition varies by locality. The objective of this study was to investigate the nature of the association of helminth infection with the nutritional status of school children in Tikur Wuha Elementary School, northwestern Ethiopia., Methods: A total of 403 school children were examined for intestinal helminth infection (stool samples) and nutritional status, thick Kato-Katz and anthropometric techniques, respectively during a baseline survey. Among these children, 235 were treated for helminth infection and re-examined for weight changes four weeks after treatment., Results: Among the 403 study participants, 29.3%, 28.3% and 58.3% were stunted, underweight and infected with intestinal helminths, respectively. In the multivariate regression model, the probability of being underweight was significantly higher in children who were infected with intestinal helminths, aged 5-10 years and male compared with children who were without helminth infection, aged 11-15 years and female, respectively. The association of helminths with low body mass was strong in the case of hookworm infection, and the probability of being underweight significantly decreased with every one-year increase in the age of the children. The means for weight, weight-for-age z-scores and body mass index-for-age z-scores of the children significantly increased four weeks after treatment for helminth infection, with a single dose of albendazole and/or praziquantel., Conclusions: Helminth-infected male children in the 5- to 10-year-old age group were more vulnerable to undernutrition, which decreased four weeks after treatment. Thus, deworming of children living in the area might be important for improving their nutritional status., (Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.)

We evaluated a commercial point-of-care circulating cathodic antigen (POC-CCA) test for assessing Schistosoma mansoni infection prevalence in areas at risk. Overall, 4,405 school-age children in Cameroon, Côte d'Ivoire, Ethiopia, Kenya, and Uganda provided urine for POC-CCA testing and stool for Kato-Katz assays. By latent class analysis, one POC-CCA test was more sensitive (86% versus 62%) but less specific (72% versus ~100%) than multiple Kato-Katz smears from one stool. However, only 1% of POC-CCA tests in a non-endemic area were false positives, suggesting the latent class analysis underestimated the POC-CCA specificity. Multivariable modeling estimated POC-CCA as significantly more sensitive than Kato-Katz at low infection intensities (< 100 eggs/gram stool). By linear regression, 72% prevalence among 9-12 year olds by POC-CCA corresponded to 50% prevalence by Kato-Katz, whereas 46% POC-CCA prevalence corresponded to 10% Kato-Katz prevalence. We conclude that one urine POC-CCA test can replace Kato-Katz testing for community-level S. mansoni prevalence mapping.

Background: Intestinal schistosomiasis due to Schistosoma mansoni is prevalent and widely distributed in Ethiopia. The disease continues to spread to previously non-endemic areas mainly in connection with water resource development and population movement., Objectives: To assess the transmission and magnitude of Schistosoma mansoni infection among school children in Addisalem and Lachi Primary Schools in Mekele City, northern Ethiopia., Methods: A cross-sectional study was carried out in two primary schools in Mekele City in March 2011. Stool specimens were collected and processed for quantitative microscopic examination using Kato-Katz technique and ova were quantified Search for intermediate snail hosts was carried out in Elala stream and collected snails were examined for trematode infection by shedding after they were individually exposed to electric light for about one to two hours., Result: The overall prevalence of S. mansoni infection was 26.3% and for those infected with S. mansoni the mean intensity of infection was 50 egg per gram of stool (epg). About 1.9%, 20.8% and 77.4% of the positive children for S. mansoni had heavy, moderate and light infection, respectively. All collected snails were identified to be Biomphalaria pfeifferi, intermediate host for S. mansoni, and 2 of them shed cercariae, accounting for 2.5% (2/80) infection rate of the snails., Conclusion: The present study showed that transmission of intestinal schistosomiasis is taking place in Ellala stream. The finding of infected children with S. mansoni, the presence of infected snails in the stream as well as the prevalence of S. mansoni being above 5% all confirm the endemicity of the area for S. mansoni infection. Preventive and control measures should be instituted to reduce on-going transmission and morbidity of the disease in the area.

Studies elucidate conflicting results about the relationships between ABO blood groups and Plasmodium infection outcomes in humans. This study examined association between ABO blood group and Plasmodium falciparum (P. falciparum) malaria related outcomes among 1065 malaria suspected febrile patients who attended Dore Baafano Health Center, southern Ethiopia, between December, 2010 and February, 2011. Blood specimens were collected and examined for malaria using Giemsa-staining, while stool specimens were examined for helminth infections using Kato-Katz method. Haemoglobin level and blood group were determined using hemocue machine and antisera hemagglutination test, respectively. Clinical data were also collected for the patients. Among the study participants, the proportion of O, A, B and AB blood groups were 40.1%, 30.1%, 29.0% and 14.3%, respectively, and P. falciparum malaria cases in the corresponding blood groups were 14.8%, 14.0%, 13.4% and 15.7%. The odds of non-severe P. falciparum malaria were not significantly different between individuals of blood group A versus O or B versus O or AB versus O. Mean haemoglobin concentration was significantly lower in P. falciparum infected blood type A individuals compared to P. falciparum infected blood type O (β=-1.25, 95% CI=-2.31 to -0.19) or non-A (β=-1.27, 95% CI=-2.23 to -0.32) individuals. The odds of P. falciparum malaria related anaemia was about three times higher in individuals with blood type A compared to those with blood type O (adjusted OR=2.82, 95% CI=1.05-7.56) or non-A individuals (adjusted OR=2.84, 95% CI=1.15-7.01). However, mean P. falciparum density did not significantly differ among patients according to their blood groups. In conclusion, individuals with blood group A had higher risk of anaemia compared to those with O and non-A phenotypes among P. falciparum malaria patients. However, there is a need to investigate the mechanism., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Objective: To evaluate the efficacy and side effects of praziquantel (PZQ) in the treatment of schistosomiasis in Ethiopia., Methods: In a cross-sectional study, stool specimens were collected from randomly selected 299 school children in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia, in April 2010. Stool specimens were examined using a single Kato-Katz thick smear for Schistosoma mansoni (S. mansoni) ova. Children who were found positive for S. mansoni were treated with a single oral dose of PZQ at 40 mg/kg bw and interviewed for treatment-related symptoms 24 hours after drug administration. Four weeks post-treatment, stool specimens were collected from the same children and examined following the same procedure as in the pre-treatment. Drug efficacy was determined based on cure and egg reduction rates., Results: Pre-treatment prevalence of S. mansoni infection was 74.9% with geometric mean egg count of 268. The evaluated generic PZQ produced an overall cure rate of 73.6% (P<0.000 1, OR: 8.33, CI: 5.3-13.1) and egg reduction rate of 68.2% (P=0.03, F=0.64). The cure rate showed significant association with age (χ(2)=11, P=0.004), the highest rate being observed in the 15-22 age group. 83% of S. mansoni infected children showed various treatment-related symptoms, the most frequent being headache, nausea, and abdominal pain. These symptoms were associated with age (P<0.001) and pre-treatment intensity of infection (P<0.05)., Conclusions: The present observations revealed relatively lower cure and egg reduction rates of the PZQ evaluated as compared to previous reports for other PZQ brands in Ethiopia. Hence, in depth studies are recommended to clarify whether the present relatively lower cure rate is the actual cure rate of the praziquantel evaluated, treatment failure, or reduced susceptibility of the parasite. Treatment-related side effects observed were transient and tolerable.

Decisions on individual or community treatment and evaluation of chemotherapy based control programs depend on parasitological diagnostic techniques. The aim of this study was to compare the accuracy of a single Kato-Katz thick smear and a single FLOTAC for the determination of the prevalence and intensity of soil-transmitted helminth infections. A total of 271 faecal specimens were collected from schoolchildren in Ethiopia, and microscopically examined using the Kato-Katz method (41.7 mg stool per slide) and the FLOTAC technique. The combined results from the Kato-Katz and FLOTAC methods were used as diagnostic 'gold' standard for reference in the analysis. Agreement between the two methods showed kappa values of 0.74, 0.73 and 0.28 for Ascaris lumbricoides, Trichuris trichiura and hookworm, respectively. A single FLOTAC revealed significantly more infections than a single Kato-Katz for each of the three soil-transmitted helminths (p<0.01). The sensitivities of a single Kato-Katz for diagnosis of T. trichiura, A. lumbricoides and hookworm infections were 76.6%, 67.8% and 19.6%, respectively, while the sensitivity of FLOTAC was 100% for all the three soil-transmitted helminth species. A single Kato-Katz yielded considerably higher mean faecal egg counts (FECs) (729.1, 145.2 and 60.7 eggs per gram of stool (EPG) for A. lumbricoides, T. trichiura and hookworm, respectively) compared with a single FLOTAC (142.5, 54.5 and 14.6 EPG, respectively) (p<0.05). Our study confirms that a single FLOTAC is more sensitive than a single Kato-Katz for the diagnosis of soil-transmitted helminth infections, but results in lower FECs. Further standardization and validation are still required in different epidemiological settings with varying levels of intensity of infections before recommending FLOTAC for large-scale community diagnosis., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Objective: To assess the distribution of ABO blood group and their relationship with Plasmodium falciparum (P. falciparum) malaria among febrile outpatients who sought medical attention at Dore Bafeno Health Center, Southern Ethiopia., Methods: A total of 269 febrile outpatients who visited Dore Bafeno Health Center, Southern Ethiopia, were examined for malaria and also tested for ABO blood groups in January 2010. The blood specimens were collected by finger pricking, stained with Geimsa, and examined microscopically. Positive cases of the parasitemia were counted. CareStart™ Malaria Pf/Pv Combo was also used to test the blood specimens for malaria. ABO blood groups were determined by agglutination test using ERYCLONE(®) antisera. Data on socio-demographic characteristics and treatment status of the participants were also collected. Chi-square and ANOVA tests were used to assess the difference between frequencies and means, respectively., Results: Out of a total of 269 participants, 178 (66.2%) febrile patients were found to be infected with Plasmodium parasites, among which 146 (54.3%), 28 (10.4%), and 4 (1.5%) belonged to P. falciparum, P. vivax, and mixed infections, respectively. All febrile patients were also tested for ABO blood groups and 51.3%, 23.5%, 21.9% and 3.3% were found to be blood types of O, A, B and AB, respectively. Both total malaria infection and P. falciparum infection showed significant association with blood types (P<0.05). The proportion of A or B but not O phenotypes was higher (P<0.05) in individuals with P. falciparum as compared with non-infected individuals. The chance of having P. falciparum infection in patients with blood groups A, B and AB was 2.5, 2.5 and 3.3 times more than individuals showing blood O phenotypes, respectively. The mean P. falciparum malaria parasitaemia for blood groups A, B, AB, and O were 3 744/µL, 1 805/µL, 5 331/µL, and 1 515/µL, respectively (P<0.01)., Conclusions: The present findings indicate that individuals of blood groups A, B and AB are more susceptible to P. falciparum infection as compared with individuals of blood group O. Nevertheless, further in depth studies are required to clearly establish the role that ABO blood group plays in P. falciparum malaria.

Background: Distribution of malaria and intestinal helminths is known to overlap in developing tropical countries of the world. Co-infections with helminth and malaria parasites cause a significant and additive problem against the host. The aim of this study was to asses the prevalence of malaria/helminth co-infection and the associated problems among febrile outpatients that attended Alaba Kulito Health Center, southern Ethiopia November and December 2007. A total of 1802 acute febrile patients were diagnosed for malaria. 458 Giemsa-stained thick and thin blood films were used for identification of Plasmodium species and Stool samples prepared using Kato-Katz technique were used to examine for intestinal helminths. Haemoglobin concentration was measured using a portable spectrophotometer (Hemocue HB 201). Anthropometry-based nutritional assessment of the study participants was done by measuring body weight to the nearest 0.1 kg and height to the nearest 0.1 cm., Findings: 458 of the total febrile patients were positive for malaria. Co infection with Plasmodium and helminth parasites is associated with significantly (p < 0.001) higher anaemia prevalence than single infection with Plasmodium parasites. And this difference was also significant for haemoglobin concentration (F = 10.18, p = 0.002), in which patients co infected with Plasmodium and helminth parasites showed lower mean haemoglobin concentration. More than one-third of the infected cases in both malaria infections and malaria/helminth co infections are undernourished. However the statistics for the difference is not significant., Conclusion: Malaria and soil-transmitted helminthiasis obviously contribute to anaemia and low weight status and these conditions are more pronounced in individuals concurrently infected with malaria and soil-transmitted helminths. Hence, simultaneous combat against the two parasitic infections is very crucial to improve health of the affected communities.

Background: Soil-transmitted helminths (STHs) are widespread in underdeveloped countries. In Ethiopia, the prevalence and distribution of helminth infection varies by place and with age. We therefore investigated the prevalence of and risk factors for STH infection in mothers and their one year-old children living in Butajira town and surrounding rural areas in southern Ethiopia., Methods: In 2005-2006, 1065 pregnant women were recruited in their third trimester of pregnancy. In 2006-2007, when children reached their first birthdays, data on the infants and their mothers were collected, including stool samples for qualitative STH analysis. Questionnaire data on various demographic, housing and lifestyle variables were available. Logistic regression analysis was employed to determine the independent risk factors for STH infection in the mothers and children., Results: 908 mothers and 905 infants provided complete data for analysis. Prevalence of any STH infection was 43.5% (95% confidence interval (CI) 40.2-46.8%) in mothers and 4.9% (95%CI 3.6-6.5%) in children. In the fully adjusted regression model, infrequent use of soap by the mother was associated with increased risk (odds ratio (OR) 1.40, 95% CI 1.04-1.88, and 1.66, 95% CI 0.92-2.99, for use at least once a week and less frequent than once a week respectively, relative to daily use; p for trend = 0.018), and urban place of residence (OR 0.45, 95% CI 0.28-0.73, p = 0.001) was associated with reduced risk of maternal STH infection. The only factor associated with STH infection in infants was household source of water, with the greatest risk in those using piped water inside the compound (OR 0.09, 95% CI 0.02-0.38 for river water, 0.20, 95% CI 0.56-0.69 for either well or stream water and 0.21, 95% CI 0.09-0.51 for piped water outside compared with piped water inside the compound, overall p = 0.002), Conclusion: In this rural Ethiopian community with a relatively high prevalence of STH infection, we found a reduced risk of infection in relation to maternal hygiene and urban living. Daily use of soap and a safe supply of water are likely to reduce the risk of STH infection.

Objective: To investigate the possible impact of soil-transmitted helminth (STH) infection on malaria severity, level of parasitaemia and clearance/reduction of Plasmodium parasites following treatment with anti-malarial drugs., Methods: 458 voluntary malaria patients who visited the Alaba Kulito Health Center, southern Ethiopia, for medical treatment in November and December 2007 were included in this study. Giemsa-stained thick and thin blood films were used for the determination of parasitaemia and identification of Plasmodium species, respectively. Stool sample was collected from these patients and diagnosed for intestinal helminths using Kato-Katz technique. Haemoglobin concentration was measured using a portable spectrophotometer (HemoCue HB 201). Malaria parasite clearance was checked on day 3 post-treatment., Findings: The prevalence of co-infection of malaria with the major soil-transmitted helminths (STHs), i.e., with hookworm species, Ascaris lumbricoides and Trichuris trichiura was 9.6%, 6.3% and 2.1%, respectively. About 8.1% of the study subjects had severe malaria. Intensity of hookworm infection showed positive association with malaria parasite densities (F=3.510, P=0.033). STHs infection in general was negatively correlated with the symptoms of severe malaria (OR=0.317, 95% CI=0.315-0.86, P=0.01), but a small proportion (4.5%) of malaria patients who were concurrently harboring one or more intestinal helminths had severe malaria. Only few malaria patients (2.3%) co-infected with STHs were found positive for Plasmodium parasites on day 3 post-treatment., Conclusion: The present findings indicate that soil-transmitted helminths have very little contribution to malaria severity in co-infected individuals. The findings also indicate that STHs do not have significant impact on clearance rate of Plasmodium falciparum and Plasmodium vivax when treated with anti-malarial drugs.

Objective: To evaluate the diagnostic performance of CareStart Malaria Pf/Pv Combo test relative to microscopy for the diagnosis of falciparum and vivax malaria in Ethiopia., Methods: 668 febrile patients visiting two health centers in Wondo Genet, southern Ethiopia, involved in this study in 2008. Giemsa-stained thin and thick blood smears were prepared and microscopically examined under a 100x oil immersion microscope objective for Plasmodium species identification and determination of parasitaemia, respectively. CareStart Malaria Pf/Pv Combo test and Paracheck Pf test were performed as per the manufacturers' instruction., Findings: The diagnostic validity of CareStart Malaria Pf/Pv Combo test for the diagnosis of Plasmodium falciparum were very good with sensitivity of 99.4%, specificity of 98%, positive predictive value of 94.4% and negative predictive value of 99.8%. Sensitivity, specificity, positive predictive value and negative predictive value of the test for the diagnosis of P. vivax were 99.4%, 98.2%, 94.5% and 99.8%, respectively. The diagnostic performance of CareStart Malaria Pf/Pv Combo test is comparable to that of Paracheck Pf test for the diagnosis of P. falciparum (sensitivity 99.4%, specificity 98.2%)., Conclusion: Although CareStart Malaria Pf/Pv Combo test and Paracheck Pf test have comparable diagnostic performance for the diagnosis of P. falciparum, CareStart Malaria Pf/Pv Combo test has the added advantage of diagnosing P. vivax. Hence, it is preferable to use CareStart Malaria Pf/Pv Combo test for the diagnosis of malaria in areas where microscopy is not accessible and where malaria due to P. falciparum and P. vivax are co-endemic as in Ethiopia.

Background: In developing countries, malnutrition is a considerable health problem with prevalence ranges of 4-46%, with 1-10% severely malnourished., Objectives: This study aimed to determine the prevalence of malnutrition and intestinal parasitoses and identify risk factors of malnutrition in schoolchildren., Subjects and Methods: A cross-sectional study was carried out on 322 schoolchildren, of age 6 to 14 years, attending private and government primary schools, in Gonder town, North West Ethiopia. The study was conducted from December 2006 to February 2007. Nutritional status of these children was determined using anthropometric parameters (weight-for-age, height-for-age and weight-for-height). Epi Info 2000 software was used to evaluate anthropometric results of each individual and formol-ether concentration technique was employed to identify parasites., Results: The prevalence of underweight, stunting, wasting and intestinal parasitoses was 34.8%, 27%, 50% and 55.6%, respectively. Parasites encountered during the study were Ascaris lumbricoides (17.8%), Trichuiris trichiura (3.4%), hookworm (4.3%), Giardia lamblia (9%), Entamoeba histolytica (2.1%), Schistosoma mansoni (2.4%), Hymenolepis nana (4.7%) and Enterobius vermicularis (0.31%), respectively, in single infections. Only two cases of Strongyloides stercoralis was found in multiple infections and none in single infections. The prevalence of multiple parasitoses was 10.9%. Maternal literacy status, sex and age of the child were significantly associated with malnutrition (p < 0.05)., Conclusion: Even though chronic type of malnutrition (stunting) was decreasing, indicators of acute type of malnutrition were increasing at a higher rate in the area. Implementation of maternal education and school feeding programs, avoidance of students from getting in contact with waste and river water were recommended to avoid malnutrition and intestinal parasitoses in children of the study area.

A study was undertaken to assess the role of cockroaches as potential carriers of human intestinal parasites in Addis Ababa and Ziway, Ethiopia. A total of 6480 cockroaches were trapped from the two localities from October 2006 to March 2007. All the cockroaches trapped in Addis Ababa (n=2240) and almost 50% (2100/4240) of those trapped in Ziway were identified as Blattella germanica. The rest of the cockroaches trapped in Ziway were identified as Periplaneta brunnea (24.52%), Pycnoscelus surinamensis (16.03%) and Supella longipalpa (9.90%). Microscopic examination of the external body washes of pooled cockroaches and individual gut contents revealed that cockroaches are carriers of Entamoeba coli and Entamoeba histolytica/dispar cysts as well as Enterobius vermicularis, Trichuris trichiura, Taenia spp. and Ascaris lumbricoides ova. Besides their role as a nuisance, the present study further confirms that cockroaches serve as carriers of human intestinal parasites. The possible association of cockroaches with allergic conditions such as asthma is also discussed. Hence, appropriate control measures should be taken particularly to make hotels and residential areas free of cockroaches as they represent a health risk.

The objective of this study was to assess the potential of the snails Physa acuta and Melanoides tuberculata and the African catfish Clarias gariepinus as biological control agents against the Schistosoma mansoni intermediate host Biomphalaria pfeifferi under laboratory conditions. Groups of five target and five competitor snails were raised together in experimental aquaria and same number in separate aquaria as controls. Shell size, number of eggs and mortality rate were recorded for twelve consecutive weeks. The stocking density for C. gariepinus was one fish per aquarium. Fish were provided with adequate or inadequate supplementary food and fifteen B. pfeifferi were added to each aquarium. The snails and their eggs were counted daily. Significant differences in shell growth and fecundity were noted between B. pfeifferi and M. tuberculata. Physa acuta was noted to be voracious in food consumption. Snail consumption was faster by fish provided with inadequate supplementary food. Based on the present findings, it is suggested that the two competitor snails and African catfish could be used as biological control agents against B. pfeifferi. Nevertheless, the susceptibility of the competitor snails to other trematodes in Ethiopia must first be ruled out before introducing these snails into new habitats. Follow-up field observation and rigorous laboratory studies remain areas for further research.

A study was conducted to determine the role of non-biting cyclorrhaphan flies as carriers of intestinal parasites in slum areas of Addis Ababa from January 2004 to June 2004. A total of 9550 flies, comprising of at least seven species were collected from four selected sites and examined for human intestinal parasites using the formol-ether concentration method. The dominant fly species was Chrysomya rufifacies (34.9%) followed by Musca domestica (31%), Musca sorbens (20.5.%), Lucina cuprina (6.8%), Sarcophaga sp. (2.8%), Calliphora vicina (2.2%) and Wohlfahrtia sp. (1.8%). Six intestinal helminths (Ascaris lumbricoides, Trichuris trichiura, hookworms, Hymenolepis nana, Taenia spp. and Strongyloides stercoralis) and at least four protozoan parasites (Entamoeba histolytica/dispar, Entamoeba coli, Giardia lamblia and Cryptosporidium sp.) were isolated from both the external and gut contents of the flies. A. lumbricoides and T. trichiura among the helminths and E. histolytica/dispar and E. coli among the protozoans were the dominant parasites detected both on the external and in the gut contents of the flies, but occurring more in the latter. Among the flies, C. rufifacies and M. sorbens were the highest carriers of the helminth and protozoan parasites, respectively. The public health significance of these findings is highlighted.

The sensitivity of a reagent strip test for the diagnosis of schistosomiasis by detecting circulating cathodic antigen (CCA) in urine was evaluated under field conditions using 251 stool and urine samples collected from a Schistosoma mansoni-endemic area of Ethiopia. The specificity of the test was evaluated in an area where schistosomiasis is not endemic. Stool samples were examined microscopically using duplicate Kato slides and formol-ether concentration methods. The effectiveness of the test in monitoring efficacy was also evaluated following chemotherapy. The results revealed that detection of CCA in urine using the one-step reagent strip test was superior to the stool examination methods (P<0.05) in indicating the prevalence of the disease. Assuming the combination of parasitological test results as the gold standard, the sensitivity and specificity of the test were 82.1% and 75.9%, respectively. The results of egg counts suggested the potential use of urine CCA in indicating the intensity of infection as an alternative to parasitological methods. The sensitivity and specificity of the test were 75% and 73.7%, respectively, following chemotherapy. Diagnosis of S. mansoni infection in urine using reagent strips would provide information on the prevalence of the disease, although further study is needed to improve its sensitivity and specificity.

Members of the genus Echinops in the family of Asteraceae are widely used in Ethiopian herbal medicine for the treatment of various diseases and illness such as migraine, diarrhea, heart pain, different forms of infections, intestinal worm infestation and hemorrhoid. Hydroalcoholic extracts of the root, flower head, leaf and stem of Echinops ellenbeckii O. Hoffm. and Echinops longisetus A. Rich were investigated for their chemical constituents and biological activities. The presence of alkaloids, saponins, phytosterols, polyphenols and carotenoids in the different parts of the plants was observed whilst anthraquinones were not detected. The leaf extracts of both plants and stem extract of E. longisetus showed strong inhibitory activity against cultures of Staphylococcus aureus. None of the extracts were found to be active against Gram-positive organisms. The flower extract of E. ellenbeckii showed strong inhibitory activity against Candida albicans. Root and flower extracts of the plants investigated showed lethal activity against earthworms. Moreover, the extracts of the roots of both plants showed molluscicidal activity against schistosome-transmitting snail hosts. The biological activities observed were dose dependent.

Examination of stool specimens by Kato-Katz (K-K) thick smears is the standard method recommended by the WHO for field diagnosis of intestinal schistosomiasis. However, there is increasing concern that this technique has low diagnostic sensitivity. In 326 study subjects, we compared the diagnostic yield of examining one, three or five Kato-Katz thick smears prepared from one stool specimen using 41.7 mg templates. In a subset of 169 subjects who had no demonstrable Schistosoma mansoni eggs in their first three Kato-Katz thick smears, we assessed the comparative advantage of examining an additional three Kato-Katz thick smears from another stool specimen, taken four weeks later, to that of cumulative yield obtained by examining all five Kato-Katz thick smears derived from the first stool specimen. For all helminth infections, single Kato-Katz thick smear-based prevalence estimates were significantly lower than those obtained from triplet or quintet Kato-Katz thick smears. Prevalence of S. mansoni infection based on single, triplet and quintet Kato-Katz thick smears from one stool specimen were 31.3%, 45.7% and 52.1%, respectively. Prevalence estimate of S. mansoni based on quintet Kato-Katz thick smears from the first day stool specimens was not different from cumulative estimate obtained with two triplet Kato-Katz thick smears from two stool specimens, 52.1% and 52.8%, respectively. In conclusion, either examination of quintet Kato-Katz thick smears from one stool specimen using 41.7 mg template or initial triplet Kato-Katz thick smears from one stool specimen, and if these are negative, followed by examination of additional triplet Kato-Katz thick smears from subsequent day stool specimen can adequately assess individuals for infection status with S. mansoni.

Identifying factors that contribute to malaria susceptibility, severity and treatment failure remains one of the major research areas in malaria control strategies. In the present study, we superinfected Schistosoma mansoni infected mice with a lethal strain Plasmodium berghei ANKA to assess whether or not infection with S. mansoni affects parasite development, parasitaemia and parasite reduction or clearance following antimalarial treatment. Mice infected with P. berghei alone were used as control. The mice were followed for parasite development and parasitaemia between days 4 and 9 post-infection. On day 9, after taking blood samples, the mice were orally treated with 100mg/kg of chloroquine and then with 10mg/kg for three consecutive days. Parasite reduction/clearance and mortality were followed between days 10 and 13 post-treatment. The results showed, that superinfection with S. mansoni enhanced P. berghei parasite development, increased parasitaemia and mortality, and delayed reduction/clearance in parasitaemia. Hence, the results postulate that co-infections with schistosome and malaria parasites would aggravate malarial severity and prolong parasite reduction or clearance after chemotherapy in humans. This would necessitate the need for considering schistosome infection in clinical as well as therapeutic management of malaria patients in areas where the two diseases are co-endemic.

A total of 59 faecal samples from ranging Papio anubis (baboons) and another 41 from Cercopithecus aethiops (vervet) from the Rift Valley areas of Ethiopia were microscopically examined to determine the prevalence and species of major gastro-intestinal parasites of zoonotic importance. Faecal smears were prepared from fresh faecal samples, stained using modified Ziehl-Neelsen method and microscopically examined. About 3 gm of the dropping was also preserved separately in clean and properly labelled containers containing 10% formalin. The specimens were microscopically examined after formalin-ether concentration for ova, larvae, cysts and oocyst of intestinal parasites. The results of microscopic examination of faecal samples of baboons demonstrated the presence of Trichuris sp. (27.1%), Strongyloides sp. (37.3%), Trichostrongylus sp. (8.5%), Oesophagostomum sp. (10.2%), Schistosoma mansoni (20.3%), Entamoeba coli (83.1%), Entamoeba histolytica/dispar (16.9%), Blastocystis hominis (3.3%), Cyclospora sp. (13.3%) and Cryptosporidium sp. (11.9%). Likewise, the results of microscopic examination of faecal samples of vervets demonstrated the presence of Trichuris sp. (36.6%), Oesophagostomum sp. (4.9%), E. coli (61.0%), E. histolytica/dispar (24.4%), B. hominis (34.2%), Cyclospora sp. (22.0%) and Cryptosporidium sp. (29.3%). The presence of parasitic protozoa and helminths in baboons and vervets in the study areas is a high risk to human welfare because these non-human primates use the same water sources as humans and range freely in human habitats. An implication of such parasitic infection for the control programme is discussed.

A parasitological survey was made in 1999 and 2002 to determine the magnitude of geohelminthiasis (soil-transmitted helminthiasis) and generate reference baseline helminthological data for Wondo Genet area, southern Ethiopia. Stool specimens were collected using Kato technique from 3167 schoolchildren, 92 schoolteachers, and 1160 residents of two Peasant Associations (PAs) and microscopically examined. The prevalence of infection for Ascaris lumbricoides and Trichuris trichiura among schoolchildren was 83.4% and 86.4%, respectively, and the respective intensity of infection was 7343 eggs per gram of stool (EPG) and 461 EPG. The prevalence of infection for Ascaris lumbricoides, Trichuris trichiura, and Schistosoma mansoni among schoolteachers was 33.7%, 35.9% and 17.4%, respectively, with the respective intensity of 1089 EPG, 194 EPG and 89 EPG. Similarly, the prevalence of infection among the residents of Shesha Kekele and Wondo Wosha Peasant Associations for Ascaris lumbricoides, Trichuris trichiura, and Schistosoma mansoni was 77%, 88% and 30%, respectively, with the respective intensity of 4673 EPG, 452 EPG and 125 EPG. Both the prevalence and intensity of infection were low among the schoolteachers possibly due to a better personal hygiene. The most prevalent soil-transmitted helminth in the area was Trichuris trichiura. Other rare helminths encountered were Taenia species, hookworms, Enterobius vermicularis and Hymenolepis nana, all occurring in less than 4% prevalence of infection. The heavy helminth burden among the schoolchildren calls for immediate intervention to reduce morbidity and transmission of helminthiasis in Wondo Genet.

Intestinal schistosomiasis is undergoing a rapid increase in magnitude in Finchaa Sugar Estate in Ethiopia. A pilot control trial of intestinal schistosomiasis was instituted in 1995 to reduce the magnitude of the disease and introduce sustainable schistosomiasis control approaches in the Sugar Estate. Following initial parasitological survey of all the camps in the Sugar Project area in 1995 using Kato method, mass chemotherapy of the heavily infected residents of Camp 7 and selective treatment of lightly infected residents of other camps were made using praziquantel. Endod (type 44) was applied to transmission sites along Fekerie stream in Camp 7 on quarterly basis whenever Biomphalaria pfeifferi was detected. Other inputs to the project as parts of capacity building included transplantation of Endod cuttings (type 44), training and health education. Cross sectional parasitological surveys were made in 1998 to assess the impact of the pilot control trial. The results of stool examination showed that the prevalence of schistosomiasis was reduced from 30% in 1995 to 26% in 1998 among residents of Camp 7 and the intensity of infection from 198 eggs per gram of feces (EPG) in 1995 to 85 EPG in 1998. Similarly, the prevalence of infection among children in Finchaa Valley Elementary School was reduced from 78% in 1994 to 56% in 1998 and the reduction in respective intensity of infection was from 283 EPG to 114 EPG. Although significant reduction in the magnitude of the disease was not achieved, the control activities were taken over by the Sugar Project Polyclinic to ensure sustainability. In addition to chemotherapy and snail control using Endod, other disease non-specific methods such as health education should be used to get maximum benefit from such facilities as latrines, and ensure participation of the community in order to sustain the control activities.

This study was conducted to evaluate the efficacy of 100 mg mebendazole administered twice a day for three consecutive days and a single dose of 400 mg albendazole for the treatment of single or mixed Ascaris lumbricoides and Trichuris trichiura infections. Both drugs were found to be highly effective against Ascaris lumbricoides infection, with cure rate of over 96% and egg reduction of over 99.8%. However, the efficacy of the two drugs against Trichuris trichiura infection was low. Mebendazole appeared to be more effective against Trichuris trichiura in that it exhibited a cure rate of 34.7% and egg reduction of 92.3% as opposed to albendazole, which exhibited a cure rate and egg reduction rate of 13.9% and 63.4%, respectively. The two drugs appeared to have little effect on Schistosoma mansoni infection. More complaints were reported by individuals treated with albendazole than with mebendazole. In conclusion, mebendazole appears to be safer and more effective for the treatment of single or mixed infections with Trichuris trichiura and Ascaris lumbricoides as compared to albendazole.