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Gebreselassie Demeke, Abebe Fenta, Tebelay Dilnessa Department of Medical Laboratory Science, Health Science College, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Gebreselassie Demeke Tel +251924338828Email gebredemeke@yahoo.comBackground: Intestinal parasitic infection has serious medical and public health impacts in developing countries. Intestinal parasites were under reported via direct wet mount method due to its poor sensitivity. So, the selection of a more sensitive and reliable diagnostic method is essential.Objective: The aim of the study was to evaluate the diagnostic performance of wet mount and concentration techniques of stool examination for intestinal parasites identification.Methods: A cross-sectional study among 797 pregnant women was conducted from October 2018 to February 2019 at Debre Markos Comprehensive Specialized Hospital. The study participants were selected by using a systematic random sampling technique. Stool sample was processed by using Wet Mount (WM) and Formol-Ether Concentration (FEC) techniques. Data was entered into Epi-data version 3.1 and analysis using SPSS version 20.0. The sensitivity, specificity, positive predictive value, and negative predictive value were determined against the combined result as “Gold” standard. Kappa value was determined to estimate the agreement of the diagnostic methods.Results: The overall prevalence of intestinal parasites (IP) was 35.2% with a combined method. By using WM and FEC the prevalence of IP was 13.1% and 25.7%, respectively. The sensitivity and negative predictive value of WM method were 37.1% and 74.6%, and for FEC method 73.5% and 87.5%, respectively. Test efficiency of direct WM and FEC were 77.9% and 90.7%, respectively. The agreement of WM and FEC techniques with combined technique were moderate (κ=0.434) and perfect (κ=0.783), respectively.Conclusion: The prevalence of intestinal parasites was under-reported by wet mount technique. The diagnostic performance of FEC technique for the diagnosis of intestinal parasites in pregnant women was notably high as compared to WM technique in the present study. Therefore, the WM and FEC combined method should be used as a routine diagnostic technique for the diagnosis of intestinal parasites identification.Keywords: diagnostic method comparison, intestinal parasites, pregnant women, Ethiopia

Adugnaw Alemu,1 Moges Wubie Aycheh,2 Tebelay Dilnessa3 1School of Medicine, Debre Markos University, Debre Markos, Ethiopia; 2Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 3Department of Medical Laboratory Sciences, College of Health Sciences, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Tebelay DilnessaDepartment of Medical Laboratory Sciences, College of Health Sciences, Debre Markos University, PO Box 269, Debre Markos, EthiopiaTel +251 912198715Email tebelay@gmail.comBackground: Human immunodeficiency virus (HIV) and tuberculosis (TB) are the principal global causes of death among patients with communicable diseases. Because of shared immune defense mechanisms, they are the primary cause of morbidity worldwide. However, little information was found regarding the magnitude of TB/HIV co-infection in the study area, in Northwest Ethiopia.Objective: The main aim of this study was to assess the prevalence of TB and HIV co-infection and associated factors among TB patients.Methods: All TB patients at Debre Markos Comprehensive Specialized Hospital were included from September 11, 2012 to September 10, 2016. Data were analyzed using SPSS version 22. Logistic regression was used to determine the associations between independent and outcome variables.Results: A total of 180 TB patients were enrolled. Pulmonary tuberculosis (PTB) accounted for 97/180 (53.9%), followed by extrapulmonary tuberculosis (EPTB) in 83/180 (46.1%). There were 164/180 (91.1%) new TB cases and 16/180 (8.9%) treatment failures, but no relapsing or defaulting cases were observed. Forty percent (72/180) of patients were co-infected with TB and HIV. The likelihoods of having TB/HIV co-infection were 3.2 and 2.1 times higher in PTB smear-positive and PTB smear-negative patients (AOR=3.2, 95% CI 1.4– 8.1, p=0.006; and AOR=2.1, 95% CI 1.0– 4.3, respectively, p=0.05), in comparison to EPTB. The rate of TB/HIV co-infection was 28/66 (42.4%) in 2013, 18/38 (47.4%) in 2014, 13/32 (40.6%) in 2015, and 13/44 (29.5%) in 2016.Conclusion: TB/HIV co-infection showed a decreasing trend in the past 2 years in the study area. TB/HIV co-infection is one of the most serious community health concerns in the study area. Therefore, TB/HIV collaborative activities should be implemented to reduce co-infection and its impact on the community.Keywords: TB/HIV co-infection, tuberculosis, HIV, multidrug resistant TB

Background: Healthcare-associated infections occur in patients under medical care, which is a major public health issue in hospitals worldwide. The prevalence is two to three folds higher in developing countries compared to developed countries. Inanimate objects used by healthcare professionals such as gowns, mobile phones, and stethoscopes are highly prone to bacterial contamination from the healthcare setting. In Ethiopia, there is a paucity of published data on the bacterial profile and susceptibility patterns of an isolates., Objective: To determine the bacterial profile and antimicrobial susceptibility patterns from inanimate objects used by healthcare professionals and associated factors at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia., Methods: A cross-sectional study was conducted at Debre Markos Comprehensive Specialized Hospital from inanimate objects from April 10, 2023 to June 30, 2023 using simple random sampling technique with lottery method. Socio-demographic data was collected using a structured questionnaire. A swab sample from healthcare professionals' gowns, mobile phones, and stethoscopes were collected and inoculated onto blood agar, chocolate and MacConkey agar. Isolates were identified and characterized by colony morphology, Gram staining and biochemical tests. Antimicrobial susceptibility testing was performed in all isolates by the disk diffusion technique on Muller Hinton agar according to CLSI, 2022 guidelines. Data was entered into EPI-Data and analyzed using SPSS version 25. Logistic regression model was used. Variables with p-value ≤ 0.25 in bivariable logistic regression was fitted to multivariate logistic regression analysis. A p-value of ≤ 0.05 with 95%CI was considered statistically significant., Result: A total of 376 healthcare professionals' inanimate objects were included from 191 study participants. Overall, 60.1% (226/376) (95%CI: 55.1-65) inanimate objects were contaminated. The proportion of bacterial contamination was (65.1%; 82/126), (60.3%; 76/126) and (54.8%; 68/124) for mobile phones, gowns and stethoscopes, respectively. Staphylococcus aureus was the most frequent isolate accounting (22.1%; 83/376) followed by Staphylococcus epidermidis (17.0%; 64/376), Escherichia coli (8.8%; 33/376) and Pseudomonas aeruginosa (4.9%; 18/376). Working in gynecology/ obstetrics wards (AOR: 8.69; 95%CI: 1.09-69.41, P = 0.041), did not disinfect mobile phones (AOR: 2.69; 95%CI: 1.15-6.25; P = 0.021) and stethoscopes regularly (AOR: 3.06, 95%CI: 1.23-7.59; P = 0.016), carry mobile phones with patient care materials (AOR: 2.72; 95%CI: 1.18-6.29, P = 0.019) and not taken infection prevention training (AOR:3.91; 95%CI:1.71-8.93; P = 0.001) were significantly associated with bacterial contamination.Most Gram-negative bacteria were resistant to ampicillin, trimethoprim-sulfamethoxazole and amoxacilline-clavunic acid, while Gram-positive isolates showed high level of resistant to penicillin. On the other hand, meropenem, for Gram-negative and clindamycin for Gram-positive bacteria showed lower level of resistance. Multidrug resistance among Gram-positive and Gram-negative bacteria were (62.6%; 92/147) and (75.3%; 64/85), respectively with over all MDR (67.2%, 156/232)., Conclusion: Inanimate objects commonly used by healthcare professionals are important sources of bacterial contamination. S. aureus, S. epidermidis and E. coli were the predominant isolates. Most Gram-negative bacteria were resistant to ampicillin while Gram-positive isolates showed high level of resistant to penicillin. All healthcare professionals should regularly disinfect their inanimate objects to prevent bacterial colonization and potential spread of infection., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kindie 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: Septicemia is potentially fatal infection caused by pathogenic bacteria infiltrating the bloodstream, resulting in morbidity and mortality among Ethiopian hospital patients. Multidrug resistance is a therapeutic challenge in this patient population. There is an insufficiency data among hospitals in Ethiopia. Hence, this study aimed to assess the phenotypic bacterial isolates, antimicrobial susceptibility pattern, and associated factors among septicemia suspected patients., Methods: Prospective cross-sectional study was conducted among 214 septicemia suspected patients from February to June 2021 at Debre Markos Comprehensive Specialized hospital in northwest, Ethiopia. Blood samples were collected aseptically and processed to identify bacterial isolates by using different standard microbiological procedures. Antimicrobial susceptibility pattern was performed using the modified Kirby Bauer disc diffusion on Mueller Hinton agar. Epi-data V4.2 was used to enter data and SPSS V25 for analysis. The variables were assessed using a bivariate logistic regression model with a 95% confidence interval, and declared statistically significant; P-value was < 0.05., Results: The overall bacterial isolates was found 45/214 (21%) in this study. Gram-negative and positive bacteria were 25/45(55.6%), 20/45(44.4%) respectively. The most common bacterial isolates were Staphylococcus aureus12/45 (26.7%), Klebsiella pneumoniae 8/45(17.8%), Escherichia coli 6/45 (13.3%). Gram-negative bacteria showed susceptibility to amikacin (88%), meropenem, imipenem (76%) but, (92%) resistance to ampicillin, (85.7%) amoxicillin-clavulanic acid. S.aureus (91.7%) was resistance to Penicillin, (58.3%) cefoxitin and (75%) susceptible to ciprofloxacillin. S.pyogenes and S.agalactia were (100%) susceptible to Vancomacin. Multidrug resistance was found in 27/45(60%) of the bacterial isolates. The main predictors related to patients suspected of septicemia were prolonged hospitalization (AOR = 2.29, 95% CI: 1.18, 7.22), fever (AOR = 0.39, 95%CI: 0.18, 0.85) and length of hospital stay (AOR = 0.13, 95%CI: 0.02, 0.82)., Conclusions: Incidence of bacterial isolates among septicemia suspected patients were high. The majority of the bacterial isolates were multidrug-resistant. To prevent antimicrobial resistance, specific antibiotic utilization strategy should be applied., (© 2023. The Author(s).)

Background: External eye infection caused by bacteria can lead to reduced vision and blindness. Therefore, pathogen isolation and antimicrobial susceptibility testing are vital for the prevention and control of ocular diseases., Objective: The main aim of this study was to assess bacterial isolates, their antimicrobial susceptibility pattern, and associated factors of external ocular infection (EOI) among patients attended eye clinic at Debre Markos Comprehensive Specialized Hospital (DMCSH), Northwest Ethiopia., Methods: We conducted a cross-sectional study in patients with external ocular infections from January 1, 2021, to June 30, 2021, at DMCSH. Socio-demographic and clinical data were collected using semi-structured questionnaires. Following standard protocols, external ocular swabs were collected and inoculated onto blood agar, chocolate agar, MacConkey agar and mannitol salt agar (MSA). Finally, bacterial isolates were identified by Gram stain, colony morphology, and biochemical tests. Antimicrobial susceptibility testing was done by using the modified Kirby-Bauer disk diffusion technique according to Clinical and Laboratory Standards Institute (CLSI) guideline. Cleaned and coded data were entered into EpiData version 4.2 software and exported to Statistical Packages for Social Sciences (SPSS) version 22 for analysis. Bivariate logistic regression was applied to investigate the association between predictors and outcome variables. P-values ≤ 0.05 with 95% confidence interval were considered statistically significant., Results: Two hundred seven study participants were enrolled in this study. More than half of them (57.5%, 119/207) were males, and 37.7% (78/207) of them were ≥ 65 years old. A total of 130 (62.8%) bacterial isolates were identified, with Gram-positive bacteria accounting for 78.5% (102/130) of the isolates. Staphylococcus aureus was the most common isolate with a 46.2% (60/130) prevalence. Ciprofloxacin was comparatively effective against Gram-positive and Gram-negative bacteria. The prevalence of culture-confirmed bacteria was significantly associated with age groups 15-24 (AOR: 9.18, 95%CI: 1.01-82.80; P = 0.049) and 25-64 (AOR: 7.47, 95%CI: 1.06-52.31; P = 0.043). Being farmer (AOR: 5.33, 95% CI: 1.04-37.33; P = 0.045), previous history of eye surgery (AOR: 5.39, 95% CI: 1.66-17.48; P = 0.005), less frequency of face washing (AOR: 5.32, 95% CI: 1.31-7.23; P = 0.010) and face washing once a day (AOR: 3.07, 95% CI: 1.13-25.13; P = 0.035) were also significantly associated with the prevalence of culture-confirmed bacteria., Conclusion: The prevalence of culture-confirmed bacteria among patients with EOI was high in the study area. A considerable proportion of bacterial isolates exhibited mono and/or multi-drug resistance. Age (15-64 years), being farmer, previous history of eye surgery and less frequency of face washing were significantly associated with the prevalence of culture-confirmed bacteria. Bacterial isolation and antibiotic susceptibility testing should be routinely performed in the study area to combat the emergence of antibiotic resistance., Competing Interests: The authors have declared that no competing interests exist.

Objective: The aim of this study was to assess knowledge and factors associated with obstetrics danger signs among married men in Dessie town, North-East Ethiopia in 2020., Design: Community-based cross-sectional study., Setting: Dessie town, North-East Ethiopia., Participants: The study was conducted on selected 824 men. The data were collected through face-to-face interviews using pretested questionnaires and then the data were entered into Epi-Data V.3.1 software, and analysis was carried out using Statistical Package for the Social Sciences V.20. Bivariable and multivariable logistic regression analyses were used to determine the association between each independent variable with the dependent variable, and those variables with a value of p≤0.25 in bivariable analysis were candidates for multivariable analysis. Finally those variables with a value of p<0.05 with 95% CI in multivariable analysis were reported as statistically significant., Result: This study revealed that the overall knowledge of obstetric danger signs was 53.8% (95% CI 50.2 % to 57.2%). Respondents aged 35-40 years (AOR=4.92, 95% CI 2.6 to 9.0), exposure to media (AOR=10.4, 95% CI 4.19 to 25.9), wife's age ≤35 years (AOR=4.16, 95% CI 2.25 to 7.69), wife who attended secondary education (AOR=1.59, 95% CI 1.06 to 2.39), participation in the Health Development Army (AOR=4.74, 95% CI 1.8 to 12.5), previous obstetric complication (AOR=4.27, 95% CI 2.0 to 9.14) and number of pregnancy ≤2 (AOR=0.42, 95% CI 0.05 to 3.38) and 3-4 (AOR=0.22 95% CI 0.06 to 0.83) were significantly associated with knowledge of obstetric danger signs., Conclusion: Men's knowledge about obstetric danger signs was low. Age of respondents, wives' age, and respondents' media exposure, participation in the Health Development Army, wives' educational status, previous obstetrics complication and gravidity were significantly associated knowledge of obstetrics danger sign., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Urinary tract infection is a major public health problem in developing countries among immunocompromized populations where there are limited health-care services. People living with human immunodeficiency virus (HIV) are more likely to develop urinary tract infections (UTI) due to the suppression of their immunity. There is no single representative figure as well as the presence of significant heterogeneity among studies conducted on people living with HIV in Ethiopia. Hence, this study tried to pool the magnitude of UTI among people living with HIV in Ethiopia., Method: To find relevant studies, researchers looked through Web of Science, Science Direct, PubMed, EMBASE, the Cochrane Library, Google Scholar, and Worldwide Science. The I2 statistic was used to examine for heterogeneity among the studies that were included. To evaluate the pooled effect size across studies, a random-effects model was used. The presence of publication bias was determined using a funnel plot and Egger's regression test. STATATM version 14.0 software was used for all statistical analyses., Results: A total of 7 studies with 2257 participants were included in this meta-analysis. UTI was shown to be prevalent in 12.8% (95% CI: 10.8-14.79, I2 = 50.7%) of HIV patients. Being male (0.35, 95% CI:0.14, 1.02), rural residents(OR:1.41,95% CI: 0.85, 2.34), no history of catheterization (OR: 0.35, 95% CI: 0.06, 1.85), had no history of DM (OR:0.84, 95% CI:0.12, 0.597) and having CD4 count greater than 200 (OR:0.36 95% CI: 0.06, 2.35) were the factors which were the associated factors assessed and having association with UTI among people living with HIV but not statistically significant., Conclusions: In Ethiopia, one in every eight HIV-positive people is at risk of acquiring UTI. Regardless, we looked for a link between sex, residency, CD4, catheterization history, and DM and UTI, but there was none. To avoid this phenomina, every HIV patient should have a UTI examination in every follow-up., Competing Interests: The authors have declared that no competing interests exist.

Background: Clostridium difficile is the leading cause of infectious diarrhea that develops in patients after hospitalization during antibiotic administration. It has also become a big issue in community-acquired diarrhea. The emergence of hypervirulent strains of C. difficile poses a major problem in hospital-associated diarrhea outbreaks and it is difficult to treat. The antimicrobial resistance in C. difficile has worsened due to the inappropriate use of broad-spectrum antibiotics including cephalosporins, clindamycin, tetracycline, and fluoroquinolones together with the emergence of hypervirulent strains., Objective: To estimate the pooled prevalence and antimicrobial resistance pattern of C. difficile derived from hospitalized diarrheal patients, a systematic review and meta-analysis was performed., Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review published studies conducted. We searched bibliographic databases from PubMed, Scopus, Google Scholar, and Cochrane Library for studies on the prevalence and antimicrobial susceptibility testing on C. difficile. The weighted pooled prevalence and resistance for each antimicrobial agent was calculated using a random-effects model. A funnel plot and Egger's regression test were used to see publication bias., Results: A total of 15 studies were included. Ten articles for prevalence study and 5 additional studies for antimicrobial susceptibility testing of C. difficile were included. A total of 1967/7852 (25%) C. difficile were isolated from 10 included studies for prevalence study. The overall weighted pooled proportion (WPP) of C. difficile was 30% (95% CI: 10.0-49.0; p<0.001). The analysis showed substantial heterogeneity among studies (Cochran's test = 7038.73, I2 = 99.87%; p<0.001). The weighed pooled antimicrobial resistance (WPR) were: vancomycin 3%(95% CI: 1.0-4.0, p<0.001); metronidazole 5%(95% CI: 3.0-7.0, p<0.001); clindamycin 61%(95% CI: 52.0-69.0, p<0.001); moxifloxacin 42%(95% CI: 29-54, p<0.001); tetracycline 35%(95% CI: 22-49, p<0.001); erythromycin 61%(95% CI: 48-75, p<0.001) and ciprofloxacin 64%(95% CI: 48-80; p< 0.001) using the random effect model., Conclusions: A higher weighted pooled prevalence of C. difficile was observed. It needs a great deal of attention to decrease the prevailing prevalence. The resistance of C. difficile to metronidazole and vancomycin was low compared to other drugs used to treat C. difficile infection. Periodic antimicrobial resistance monitoring is vital for appropriate therapy of C. difficile infection., Competing Interests: The authors have declared that no competing interests exist.

Background: Hepatitis B virus is a public health problem in the world. It is a major cause of chronic hepatitis, cirrhosis, and hepatic cellular carcinoma. The presence of a confirmed HBsAg result is indicative of ongoing HBV infection. This study aims to assess the sero-prevalence and associated factors of the hepatitis B virus among pregnant women in North West Ethiopia., Methods and Materials: An institution-based cross-sectional study was conducted at Debre Markos Referral Hospital from January to July 2017. A consecutive 338 pregnant women attending the antenatal clinic were included. A structured questionnaire was used to assess hepatitis B virus infection associated factors and some socio-demographic characteristics. A 5 mL of venous blood was collected from each study participant and plasma was separated and analyzed using a rapid HBsAg kit and further confirmed by double sandwich ELISA. The data were analyzed using SPSS software version 24., Results: The mean age of the study participants was 27 (SD ± 4.75) years. The sero-prevalence of hepatitis B virus in pregnant women was 28 (8.3%). Body tattooing practice (AOR = 4.94 95% CI, 1.87-13.0), multi-partner sexual intercourse (AOR = 4.48 95% CI, 1.89-10.5) and family hepatitis B history (AOR = 7.40 95% CI, 2.23-24.5) were statistically significantly associated with HBV infection (p = 0.001)., Conclusion: The prevalence of hepatitis B infection is very high among pregnant women in the study area. Awareness creation on modes of transmission and early screening of all pregnant women attending antenatal care must be strengthened to minimize and control infection., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Demeke et al.)

Background: Intestinal parasitosis is a common disease that causes misery and disability in poor populations. The number of individuals affected is staggering. From two billion peoples who harbor parasites worldwide, 300 million suffer severe morbidity and more than 25% of pregnant women are infected with hookworm, which causes intestinal bleeding and blood loss, and has been most commonly associated with anemia. Intestinal parasite infection during pregnancy has been associated with iron deficiency, maternal anemia, and impaired nutritional status, as well as decreased infant birth weight., Objective: This study aimed to assess the effects of intestinal parasite infection on hematological profiles of pregnant women attending antenatal care in Debre Markos Referral Hospital from December 2017 to February 2019., Method: A prospective cohort study design was conducted among 94 intestinal parasite-infected pregnant women as an exposed group and 187 pregnant women free from intestinal parasite were used as a control group. The effect of intestinal parasites on hematological profiles of pregnant women was assessed at Debre Markos Referral Hospital antenatal care ward. Socio-demographic data and nutrition status were assessed by using structured questionnaires and mid-upper arm circumference (MUAC), respectively. Two ml of venous blood and 2 gm of stool samples were collected to analyze the hematological profiles and detect intestinal parasites, respectively. Wet mount and formol-ether concentration (FEC) techniques were used to detect intestinal parasites. Hematological profile was analyzed using Mind ray BC-3000 plus instrument. Data were double entered into EpiData version 3.1 software and exported to SPSS version 24 software for analysis. Results were presented using tables and graphs. Associations of hemoglobin levels with intestinal parasitic infections were determined using binary logistic regression models. P≤0.05 was considered statistically significant. The mean hematological profile difference between parasite-infected and parasite-free pregnant women was computed using independent t-test., Results: In the present study, the predominant parasites identified were Entamoeba histolytica, hookworm, Giardia lamblia, Schistosoma mansoni, and Ascaris lumbricoides. About 8.2% of intestinal parasite-infected pregnant women had mild anemia while 4% had moderate anemia. Only 1.2% of intestinal parasite-free pregnant women developed moderate anemia. The mean HGB, HCT, MCV, MCH, and MCHC values of intestinal parasite-infected pregnant women were 12.8g/dl, 38.2%, 94.7fl, 33.1pg and 34.7g/dl, respectively. But the mean HGB, HCT, MCV, MCH and MCHC values of pregnant women who were free from intestinal parasites were 14.4 g/dl, 39.8%, 94.9fl, 33.9pg and 35.5g/dl, respectively. Anemia was strongly associated with hookworm (AOR = 21.29, 95%CI: 8.28-54.75, P<0.001), S.mansoni (AOR = 63.73, 95% CI: 19.15-212, P<0.001) and A.lumbricoide (AOR = 14.12, 95% CI 3.28-60.65, P<0.001)., Conclusion: Intestinal parasitic infection in pregnant women caused adverse impact on hematological profiles and was an independent predictor of anemia. Intestinal parasitic infection significantly decreased pregnant the level of HGB, HCT, MCV, MCH, and MCHC values. To minimize maternal anemia deworming could be good before pregnancy., Competing Interests: The authors have declared that no competing interests exist.

The Coronavirus disease-19 (COVID-19) pandemic is still devastating the world causing significant social, economic, and political chaos. Corresponding to the absence of globally approved antiviral drugs for treatment and vaccines for controlling the pandemic, the number of cases and/or mortalities are still rising. Current patient management relies on supportive treatment and the use of repurposed drugs as an indispensable option. Of a crucial role in the viral life cycle, ongoing studies are looking for potential inhibitors to the main protease (M pro ) of severe acute respiratory syndrome Coronavirus -2 (SARS-CoV-2) to tackle the pandemic. Although promising results have been achieved in searching for drugs inhibiting the M pro , work remains to be done on designing structure-based improved drugs. This review discusses the structural basis of potential inhibitors targeting SARS-CoV-2 M pro , identifies gaps, and provides future directions. Further, compounds with potential M pro based antiviral activity are highlighted., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Mengist, Dilnessa and Jin.)

Background: Ethiopia still suffers high levels of neonatal and maternal mortality, so the maternity continuum of care is a continuous framework for the delivery of maternal care from pregnancy to the postnatal period. Skilled care during pregnancy, childbirth, and the postpartum period is an important intervention in reducing maternal and neonatal morbidity and mortality. But in Ethiopia, there are limited studies on the completion of the maternity continuum of care, so this study will help to suggest interventions in order to reduce the dropout of the maternity continuum of care., Objective: To assess the completion of the maternity continuum of care and factors associated with it among mothers who gave birth in the last one year in Enemay District, Northwest Ethiopia. Method and Materials . A community-based cross-sectional study was conducted from February 25 to March 10, 2019, on 651 women who gave birth in the last one year. The data were collected by a face-to-face interview through pretested and structured questionnaires. Binary logistic regression was used to identify predictors of the completion of the maternity continuum of care. Variables with a P value < 0.05 in multivariable analysis were declared as statistically significant associated factors., Results: This study revealed that about 45% (95% CI: 40.9%, 48.8%) of respondents completed the continuum of care. Women with secondary education (AOR = 6, 95% CI: 2.26, 16.6), women whose occupation is farming (AOR = 0.18, 95%, CI: 0.1, 0.32), women who have autonomy in health care decision (AOR = 4, 95% CI: 2.26, 7.2), women who have exposure to media (AOR = 1.97, 95% CI: 1.2, 3.27), women with wanted pregnancies (AOR = 3.33, 95% CI: 1.87, 5.9), para five and above women (AOR = 2.85, 95% CI: 1.28, 6.3), and women whose husbands are employed (AOR = 4.97, 95% CI: 1.16, 21.2) were significantly associated with the completion of the maternity continuum of care. Conclusions and Recommendation . This study showed that less than half of the participants had achieved the continuum of care and education level, and both respondents and their husband's occupation, parity, autonomy in health care decision, exposure to the mass media, and wantedness of pregnancy were associated with the completion of the maternity continuum of care; therefore, working on enhancing the capacity of women's autonomy in health care and decision-making and preventing unintended pregnancy helps to improve the completion of the maternity continuum of care., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2020 Anguach Shitie et al.)

Background: Staphylococcus aureus particularly MRSA strains are one of the major causes of community and hospital acquired bacterial infections. They are also becoming increasingly multi-drug resistant and have recently developed resistance to vancomycin, which has been used successfully to treat MRSA for many years. In-vitro determination of drug resistance patterns of S. aureus is critical for the selection of effective drugs for the treatment of staphylococci infections. The main aim of this study was to determine the prevalence of methicillin resistant S. aureus strains from different clinical specimens from patients referred for routine culture and sensitivity testing., Method: A cross sectional study was conducted among 1360 participants at Yekatit 12 Hospital Medical College in Ethiopia from September 2013 to April 2014. Clinical samples from various anatomical sites of study participants were cultured on blood agar and mannitol salt agar and identified to be S. aureus by using catalase, coagulase and DNAse tests. S. aureus isolates then were screened for MRSA using 30 μg cefoxitin disc and other 11 antimicrobial drugs by disc diffusion procedure, and agar dilution and E tests for vancomycin. All S. aureus isolates examined for beta-lactamase production by employing nitrocefin. Data were analyzed using SPSS version 20 software and logistic regressions were applied to assess any association between dependent and independent variables., Results: Of 1360 clinical specimens analyzed S. aureus was recovered from (194, 14.3 %). Rate of isolation of S. aureus with regard to clinical specimens was the highest in pus (118, 55.4 %).No S. aureus was isolated from CSF and urethral discharge. Out of 194 S. aureus isolates, (34, 17.5 %) were found out to be MRSA and the remaining (160, 82.5 %) were MSSA. Ninety eight (50.5 %) S. aureus were multi drug resistant and the highest isolates were resistant to penicillin (187, 96.4 %) and least resistant for clindamycin (23, 11.9 %) and vancomycin (10, 5.1 %). MRSA strains were 100 % resistant to penicillin G, erythromycin, trimethoprim-sulfamethoxazole and least resistant to vancomycin (10, 29.4 %). Out of 194 S. aureus isolates (153, 79.0 %) were beta-lactamase producers., Conclusion: In this study S. aureus isolates exhibited very high degree of resistance to different antibiotics. The isolates were also multidrug resistant to several combinations of the tested antibiotics. The emergence of vancomycin resistant S. aureus highlights the value of prudent prescribing of antibiotics and avoiding their irrational use.