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Sirak Biset,1 Ayantu Benti,2 Lidya Molla,2 Sitot Yimer,2 Tena Cherkos,2 Yalewayker Eyayu,2 Ashenafi Ebabu,3 Desie Kasew,1 Aklilu Ambachew1 1Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia; 2School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia; 3University of Gondar Comprehensive Specialized Hospital, Gondar, EthiopiaCorrespondence: Sirak Biset Postal Address: 196 Tel +251-911-598-568Email serbis33@gmail.comBackground: Meningitis, which is mostly caused by infectious agents, occurs more commonly during the first month of life. Bacterial meningitis is an important source of mortality and morbidity, especially in neonates of resource-limited countries. We aimed to determine the prevalence and etiological agents of bacterial meningitis and their antibiotic susceptibility pattern in neonates at the University of Gondar Comprehensive Specialized Hospital.Methods: We collected retrospective data from bacteriological results of cerebrospinal fluid of meningitis suspected neonates from 2013 to 2019. Sample collection, culture preparation, bacterial identification, and susceptibility testing were performed using standard microbiological techniques. We extracted data on socio-demographic characteristics and culture and antibiotic susceptibility testing results. We inputted the data using Epi-info version 7 and exported it to SPSS version 20 for analysis.Results: In this study, 1101 cerebrospinal fluid samples, 595 (54%) male and 506 (46%) female neonates, were cultured to look for meningitis-causing bacteria. Of 1101 cerebrospinal fluid, 19 (1.73%) were culture positive for meningitis-causing bacteria. The common etiological agents were Klebsiella pneumoniae 36.8% (7), non-lactose-fermenter Gram-negative rods 21% (4), and Group B streptococcus 15.8% (3). The overall resistance rate among cephalosporin, cotrimoxazole, penicillin, and aminoglycosides classes were 90%, 88.9%, 77.3%, and 54.54%, respectively. Of all isolates, 58% (11) were multidrug-resistant, including all the non-lactose-fermenter Gram-negative rods and 71.4% of the Klebsiella pneumonia isolates.Conclusion: The prevalence of neonatal bacterial meningitis was 1.73%. Klebsiella pneumonia and other Gram-negative rods, with a high multidrug-resistant rate, were the leading cause of neonatal bacterial meningitis. Further studies are needed to explore the source of infection, incidence, and risk factors of neonatal bacterial meningitis.Keywords: bacterial meningitis, etiology, antibiotic susceptibility, Ethiopia

Background: Malaria poses a significant public health threat globally, particularly in African regions, where asymptomatic malaria is a considerable logistic problem. Individuals with asymptomatic malaria do not seek treatment, and thus they are invisible to health facilities and represent a substantial hidden reservoir of Plasmodium species. This study aimed to determine the prevalence of asymptomatic malaria and its associated factors in Gorgora, western Dembia district, Northwest Ethiopia., Methods: A community-based cross-sectional study was conducted from May to June 2023 in the Gorgora area, Western Dembia district, Northwest Ethiopia. Data were collected using a semi-structured questionnaire. Giemsa-stained blood smear microscopy was employed for the diagnosis of Plasmodium species. The data were entered into Epi Data version 4.6 and exported to SPSS version 25 for analysis. Bivariate and multivariable binary logistic regression analyses were conducted to identify associated factors., Results: Among the 357 individuals who participated in this study, 9.2% (33/357) [95% CI 6.40-12.70: p = 0.000] were confirmed to be infected with Plasmodium species. Plasmodium falciparum and Plasmodium vivax accounted for 66.7% and 33.3%, respectively. Not using bed nets [AOR = 7.3, 95% CI 2.08-23.46, p = 0.006)], previous malaria history [AOR = 2.6, 95% CI 1.01-6.45, p = 0.041], outdoor activities at night [AOR = 8.3, 95% CI 3.21-21.30, p = 0.000], and family size [AOR = 3.3, 95% CI 1.18-9.22, p = 0.023] were significantly associated with asymptomatic malaria (p < 0.05)., Conclusions: A considerable proportion of asymptomatic Plasmodium infections was found which likely act as a reservoir of transmission. This has implications for ongoing malaria control programmes that are based on the treatment of symptomatic patients and highlight the need for intervention strategies targeting asymptomatic carriers. Not using bed nets, engaging in outdoor activities at night, and having a family size of more than five increased the odds of developing asymptomatic malaria. The district health office and health extension workers should collaborate to promote the regular use of mosquito bed nets among community residents., Competing Interests: Declarations. Ethics approval and consent to participate: Prior to commencing the study, ethical clearance was obtained from the ethical review committee of the School of Biomedical and Laboratory Sciences, University of Gondar, with reference number SBMLS/516. Additionally, permission was obtained from the Western Dembia district health office and Kebele administrators, where the data were collected. Written informed consent was obtained from eligible study participants who willingly agreed to be part of the study after being informed about the purpose, procedures, benefits, and risks involved. For eligible children, verbal assent was sought before obtaining written informed consent from their parents/legal guardians. The study participants were informed that participation in the study was voluntary, and the confidentiality of their information was ensured by using codes instead of names and identification in the data collection form. Finally, malaria-positive asymptomatic study participants were referred to nearby health centers for appropriate treatment. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Gram-negative bacteria in the nasopharynx can eventually invade bacteria-limited sites and cause serious illnesses such as meningitis, otitis media, and pneumonia. However, data related to the carriage of these bacteria in children attending outpatient departments in the study area are limited. To assess nasopharyngeal carriage, antibiotic susceptibility patterns, and associated factors of gram-negative bacteria among children attending the outpatient department at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. A hospital-based cross-sectional study was conducted from September 1, 2023, to December 30, 2023. A total of 385 children aged 3 to 14 years were enrolled using a systematic random sampling technique. Sociodemographic and clinical data were collected using a semistructured questionnaire. A total of 385 nasopharyngeal samples were collected using a sterile specimen collection nasopharyngeal swab, transported using Amie's transport medium, and subsequently inoculated on chocolate agar, blood agar, modified thayer martin agar, and MacConkey agar plates. Bacterial species were identified by colony morphology, Gram staining, and biochemical tests such as oxidase tests, satellitism tests, and carbohydrate utilization tests. An antibiotic susceptibility test was performed using the Kirby-Bauer and modified Kirby-Bauer methods on Mueller-Hinton agar plates. The data were entered into Epi-Data version 4.6.0.6 and exported to SPSS version 25 for analysis. The adjusted odds ratio at a 95% confidence interval with a P value of < 0.05 in the binary logistic regression model was considered to indicate statistical significance. The overall nasopharyngeal carriage of gram-negative bacteria was 146 (37.9%) (95% CI: 33.2-42.9). Among these, nonfastidious gram-negative bacteria represented 45 (11.7%), followed by M. catarrhalis 41 (10.6%), N. meningitidis 34 (8.8%), and H. influenzae 26 (6.8%). The isolates exhibited high resistance to tetracycline (85; 75.9%), trimethoprim-sulfamethoxazole (105; 71.9%), ampicillin (76; 67.9%), and amoxicillin/clavulanic acid (60; 69.8%) but high susceptibility to meropenem (122; 83.6%), gentamicin (73; 84.9%), and minocycline (87; 72.5%). There were 99 total multidrug-resistant strains (67.8%, 95% CI: 59.7-75.0). Male sex (AOR = 1.785, 95% CI: 1.102-2.892, P = 0.019), smoking (AOR = 2.675, 95% CI: 1.149-6.230, P = 0.022), and large family size (≥ 5) (AOR = 1.857, 95% CI: 1.140-3.023, P = 0.013) were risk factors for nasopharyngeal colonization. Increased nasopharyngeal colonization of multidrug-resistant gram-negative isolates was observed in this study. Gentamicin, minocycline, and meropenem were the most effective antibiotics for the tested isolates. Bacterial colonization increased with increasing family size, smoking status, and male sex. Therefore, a definitive diagnosis in the outpatient pediatric department should be based on culture and susceptibility test results., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Gram-positive bacteria residing in the nasopharynx can lead to severe illnesses in children, such as otitis media, pneumonia, and meningitis. Despite the potential threat, there is a lack of comprehensive data regarding the carriage rates of these bacteria among children in outpatient departments in the study area., Objective: This study aimed to assess the nasopharyngeal carriage, antimicrobial resistance patterns, and associated factors of Gram-positive bacteria among children attending the outpatient department at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia., Methods: A hospital-based cross-sectional study was conducted from May 1, 2023, to August 30, 2023. A total of 424 nasopharyngeal swab samples were collected using sterile nasopharyngeal swabs, inoculated on Blood Agar and Mannitol Salt Agar plates, and identified through colony morphology, Gram stain, and biochemical tests. Antimicrobial susceptibility of the identified bacterial isolates was determined employing both the Kirby-Bauer and modified Kirby-Bauer methods. D-tests were conducted using clindamycin and erythromycin discs to detect inducible clindamycin resistance, while cefoxitin disc tests were utilized to ascertain methicillin resistance. Data entry was executed using Epi-Data version 4.6, and subsequent analysis was performed utilizing SPSS version 25. Bivariable and multivariable logistic regression analyses were employed to identify associated factors. An adjusted odds ratio at a 95% confidence interval with a P-value of < 0.05 was considered statistically significant., Results: The overall nasopharyngeal carriage rate of Gram-positive bacteria was 296/424 (69.8%, 95% CI: 65.3-74.0). Staphylococcus aureus was the most prevalent 122/424 (28.8%), followed by Streptococcus pneumoniae 92/424 (21.7%). Methicillin resistance was observed in 19/122 (15.6%) of S. aureus and 3/60 (5%) of coagulase-negative staphylococcus (CoNS) species. Inducible clindamycin resistance was 10/122 (8.2%) in S. aureus and 4/53 (7.5%) in coagulase-negative staphylococcus species. Multidrug resistance was found in 146/296 (49.3%, 95% CI: 43.6-55.0) of the isolates. Associated factors with a bacterial carriage were large family size (AOR = 3.061, 95% CI: 1.595-5.874, P = 0.001), having siblings under five years old (AOR = 1.991, 95% CI: 1.196-3.313, P = 0.008), indoor cooking (AOR = 2.195, 95% CI: 1.275-3.778, P = 0.005), an illiterate mother (AOR = 3.639, 95% CI: 1.691-7.829, P = 0.001), and hospital visits (AOR = 2.690, 95% CI: 1.405-5.151, P = 0.003)., Conclusion: The study found a high nasopharyngeal carriage of Gram-positive bacteria in outpatient children, including notable levels of methicillin-resistant S. aureus and multi-drug-resistant isolates. Clindamycin, rifampin, and erythromycin were the most effective antimicrobials for the tested isolates. Factors contributing to bacterial carriage include visits to healthcare facilities, larger family sizes, having younger siblings, maternal illiteracy, and indoor cooking. This emphasizes the need for methicillin-resistant S. aureus surveillance in pediatric outpatient settings and community health education, especially for children's guardians. Additionally, improving household ventilation by separating kitchens from sleeping areas and regular screening of younger siblings in healthcare environments were recommended to reduce bacterial transmission within family members. The study also called for studies with advanced procedures like minimum inhibitory concentration testing and molecular characterization to better comprehend the resistance patterns and genes in circulating bacteria., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Birhanu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: In the sub-Saharan countries, many of the children including found in health facilities are not having sufficient care of diarrhea. Diarrheal disease in these countries is one of the main causes of deaths for under-five children., Methods: A community-based cross-sectional study design was used to collect data from May-June, 2016 to determine environmental factors of diarrhea prevalence among under five children in North Gondar Zone. Structured interview questionnaire and observational checklist were used to collect data. Using probability proportion to size, number of households was determined in each district. The multivariable binary logistic regression analysis with a 95% confidence interval and p < 0.05.was used to identify environmental factors associated with childhood diarrheal disease., Results: Of the total 736 individuals surveyed from 736 households, a total of 163 (22.1%) with [95% CI (19.1-25.1)] under -five children had 2 week period diarrhea prevalence. Roof material [AOR: 1.99, 95% CI (1.1-3.82)], hand washing facility [AOR: 0.52, 95%CI (0.33-0.82)], presence of Latrine facility [AOR: 1.65, 95% CI (1.01-2.72)], presence of feces around the pit hole [AOR: 1.65, 95% CI (1.01-2.72)], presence of feces around the house compound [AOR: 1.65, 95% CI (1.01-2.72)] and risk of contamination of household storage had significant associations with diarrheal morbidity., Conclusion: The prevalence of childhood diarrheal disease among under - five children in rural settings of northwest Ethiopia was high. Type of roof material, hand washing facility, presence of Latrine facility, presence of feces around the pit hole, presence of feces around the house compound and risk of contamination of household storage had significant associations with diarrheal morbidity.