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Gemechu Ameya,1 Gelila Biresaw,2 Hayat Mohammed,3 Abebayehu Chebud,4 Melese Meskele,5 Mohammed Hussein,6 Muktar Endris7 1Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Kotebe Metropolitan University, Addis Ababa, Ethiopia; 2Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 3Department of Medical Laboratory Science, College of Medicine and Health Science, Jimma University, Jimma, Ethiopia; 4Melka Oda Primary Hospital, West Guji, Melka Sodo, Ethiopia; 5Worabe Comprehensive Specialized Hospital, Worabe, Ethiopia; 6Dessie Selam General Hospital, Dessie, Ethiopia; 7Galikoma Health Center, Afar Region, Galikoma, EthiopiaCorrespondence: Gemechu AmeyaDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Kotebe Metropolitan University, P.O. Box: 3268, Addis Ababa, EthiopiaTel +251-91-783-7681Email gemechuameya@gmail.comBackground: Epistaxis is one of the most common otorhinolaryngological emergencies affecting the majority of the population in their lifetime, with some of them requiring serious medical attention. This study aimed to assess the prevalence and associated factors of epistaxis among pre-college students in Wolaita Sodo, Ethiopia.Methods: An institution-based cross-sectional study was conducted. Data were collected using a pre-tested interviewer administered questionnaire. The study participants were selected by systematic random sampling technique. A logistic regression analysis was employed to assess the presence and strength of association factors with epistaxis. An adjusted odds ratio with 95% confidence interval was used to determine the presence and strength of the association at 0.05 level of significance.Results: Of 387 participants, 57.1% of them were male, and the mean age of all participant was 18.05± 1.401 SD years. The overall epistaxis prevalence was 108 (27.9%). Blood group O, which accounted for about 43.4% was more prevalent. Blood group O (AOR=3.96, 95% CI=1.5– 10.4), participants who drink coffee daily (AOR=2.75, 95% CI=1.0– 7.4), and participants who took a bath frequently with both hot and cold-water (AOR=4.55, 95% CI=1.1– 18.6) were significantly associated with epistaxis.Conclusion: The type of blood group, interval of coffee drinking, and type of bathing were significantly associated with epistaxis. Working on the identified associated factor and increased awareness about epistaxis for the students with effective first aid training is mandatory.Keywords: epistaxis, blood group, southern Ethiopia, pre-college students

Abstract Background Misconceptions and myths are still the bottlenecks for the prevention of HIV/AIDS transmission in developing countries. This study aimed to assess the prevalence and associated factors of misconception about HIV transmission among reproductive age groups using the most recently available Ethiopian Demographic and Health Surveydata. Methods A cross-sectional study design was done using the Ethiopian Demographic and Health Survey 2016 data set. The data analysis was conducted using Statistical Package for Social Sciences version 25. Multivariable logistic regression analysis was done to identify associated factors of misconception about HIV/AIDS transmission. A p-value of

The usage of virtual platforms for reforming teachers' continuous professional development (CPD) is becoming more and more necessary in contemporary higher education (HE) settings. For a comprehensive understanding of the implications of this strategy for CPD, research studies from various contexts are required. This study evaluated the effectiveness and implementation of a pilot online professional development (PD) package called the ‘higher diploma program (HDP)’ for health professional educators (HPEs) in the Ethiopian HE context. We used mixed methods in a Hybrid II design. Additionally, a comprehensive e-learning quality framework guided the overall research and integration of the qualitative and quantitative data. The qualitative component includes a key-informant interview (KII) with facilitators, a program coordinator, and a single focus group discussion with HPEs. Additionally, the quantitative component includes a cross-sectional survey of the (HPEs’) responses to a self-report questionnaire. The findings show that this pilot project was feasible and well accepted by the HPEs, facilitators, and coordinators of the project. These participants also perceived several implementation challenges as weaknesses of the pilot project. Mitigating the prevailing challenges requires sustained and collaborative efforts by universities, the education and health sector, and other partner institutions. Our interpretations imply that customizing online PD in HE is, ultimately, a local phenomenon that results from individual motivation and interest, institutional capacity, and contextual factors like access to technology, the quality of online PD resources, and program management.

Abstract Background Plants are able to deliver a huge number of differing bioactive compounds which may supplement the requirements of the human body by acting as natural antioxidants. Antioxidants are mindful for the defense component of the life form against the pathologies related to the assault of free radicals. The main purpose of this study was to investigate the qualitative phytochemical composition of Vernonia amygdalina leaf extract and its antioxidant activity. Method The powdered plant sample was successively extracted with aqueous, methanol and ethanol solvents using Soxhlet apparatus. The antioxidant activities of the crude leaf extract were determined using 1, 1- diphenyl-2-picryl hydrazyl (DPPH) radical, 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid (ABTS) radical, phosphomolybdate (PM) and hydrogen peroxide (H2O2) scavenging assay. All the examinations were drained triplicates and average values of each test were taken. Results Phytochemical investigation of the plant revealed that the three solvent extracts contained numerous bioactive compounds namely alkaloids, tannins, saponins, phenols, terpenoids, steroids, glycosides and sugars. The result showed that, the leaf extracts of V. amygdalina obtained from methanol extract exhibit the maximum antioxidant activity compared ethanol and aqueous extracts. The IC50 values of DPPH assay for the H2O, MeOH and EtOH extracts were 111.4, 94.92 and 94.83 μg/ml; of ABTS assay were 334.3, 179.8 and 256.9 μg/ml; of H2O2 assay were 141.6, 156 and 180.6 μg/ml, respectively. The maximum radical scavenging activity was obtained in DPPH assay while the lowest scavenging activity was obtained in ABTS assay method. The data obtained in the in vitro models clearly suggest that methanol extract has higher antioxidant activity due to a higher presence of phenolic constituents in the extract. Conclusion This study revealed that V. amygdalina leaf has a noteworthy antioxidant and free radical scavenging activity mitigating the traditional use of the plant for different aliments.

The post-ionization dynamics of chemo-treated and untreated 4T1 breast cancer cells ionized by laser trapping techniques are studied. We have determined each cell’s charge and refractive index by developing a theoretical model for the forces determining the post-ionization dynamics. The shift in a cell’s refractive index due to an intense oscillating electric field was studied, and the results are reported here. We observed that a trapped cell, as it becomes charged, will eventually exit the trap perpendicular to the beam’s direction; this means that the electric force of the cell overcomes the trapping force. As a result, the cell’s conductivity changes due to the oscillating field, causing a decrease in the cell’s refractive index.

The Muslim scholars of Wällo are known for composing panegyrics that are usually chanted on special occasions or gatherings like ḥaḍra and Mawlid (festival to solemnize the birthday of the Prophet). The Ramsa is a very famous collection of poems made up of three Arabic litanies: the first two of them were composed by šayḫ Aḥmad Ādam (d. 1903) the founder of Dana, centre of Islamic learning and mysticism located in Yäǧǧu province, northeastern Wällo. The third one is by šayḫ Ibrāhīm Č̣ale (d. 1958). This paper is a preliminary attempt to introduce the first of the three invocational poems composing the Ramsa to the academic world, to give a first impression of the level of Arabic proficiency of local Ethiopian scholars and to discuss the message the text contains as part of a spiritual culture practiced and cherished for at least a century by both the Muslim intelligentsia and the laity. Some codicological information about one of the manuscripts which preserve these texts is also given.

Abstract Background Parasitic infections have been shown to have deleterious effects on host nutritional status. In addition, although helmintic infection can modulate the host inflammatory response directed against the parasite, a causal association between helminths and allergy remains uncertain. The present study was therefore designed to evaluate the relationship between nutritional status, parasite infection and prevalence of allergy among school children. Methods A cross sectional study was performed involving school children in two elementary schools in Gondar, Ethiopia. Nutritional status of these children was determined using anthropometric parameters (weight-for-age, height-for-age and BMI-for-age). Epi-Info software was used to calculate z-scores. Stool samples were examined using standard parasitological procedures. The serum IgE levels were quantified by total IgE ELISA kit following the manufacturer’s instruction. Result A total of 405 children (with mean age of 12.09.1 ± 2.54 years) completed a self-administered allergy questionnaire and provided stool samples for analysis. Overall prevalence of underweight, stunting and thinness/wasting was 15.1%, 25.2%, 8.9%, respectively. Of the total, 22.7% were found to be positive for intestinal parasites. The most prevalent intestinal parasite detected was Ascaris lumbricoides (31/405, 7.6%). There was no statistically significant association between prevalence of malnutrition and the prevalence of parasitic infections. Median total serum IgE level was 344 IU/ml (IQR 117–2076, n = 80) and 610 IU/ml (143–1833, n = 20), respectively, in children without and with intestinal parasite infection (Z = −0.198, P > 0.8). The prevalence of self reported allergy among the subset was 8%. IgE concentration was not associated either with the presence of parasitic infection or history of allergy. Conclusion The prevalence of malnutrition, intestinal parasitism and allergy was not negligible in this population. In addition, there was no significant association between the prevalence of allergy and their nutritional status, and parasite infection. Further research prospective observational and intervention studies are required to address the question of causality between nutritional factors, parasites, and allergy.

Background: The prevalence of migraine headaches varied from 2.4 to 48.5% worldwide among university students. As per the knowledge of the investigators, the study of migraine headaches is not done in this study area. Hence, this study aimed to assess determinates of migraine headaches among regular undergraduate students, of Wollo University, Dessie, Ethiopia, 2020., Method: Institution-based cross-sectional study design was conducted from November 15-30 /2020 by using a self-administered questionnaire among 371 regular undergraduate students at Wollo University. A multistage sampling technique was employed to represent our study population. Identity migraine test, Migraine Disability Assessment Questionnaire, perceived stress scale, and Oslo social support scale was used. Descriptive statistics, binary and multiple logistic regression were employed. The adjusted odds ratio at a 95% confidence interval and level of significance (p-value < 0.05) was used to interpret the findings., Results: From 371 participants, the prevalence of migraine headache in this study was 34% (95% CI: 29.2, 38.5). Variables statistically associated with migraine headache, were a family history of headache (AOR = 3.83, CI: 2.313, 6.366), suicidal thoughts in the past 3 months (AOR = 10.76, CI: 2.117, 54.74), and had low perceived stress 62.6% (AOR = 0.374, CI: 0.205, 0.683)., Conclusion: In this study, the prevalence of migraine headaches was very high. Family history of headache, suicidal thoughts, and low perceived stress were determinates for migraine headache. So special emphasis shall be given to those participants who had high perceived stress, a family history of migraine headache, and suicidal thoughts., (© 2021. The Author(s).)

Background: Severe mental illness is strongly associated with an impaired quality of life. This intern can affect the treatment adherence and outcomes of the illness. However, there are insufficient studies in the literature pertaining to the quality of life of patients with severe mental illness in Ethiopia. Therefore, assessing the quality of life of patients with severe mental illness and its correlates is a yardstick measure of the effectiveness of the mental health service., Methods: An institutional based cross-sectional study was conducted from May 1 to 16, 2019 at Amanuel Mental Specialized Hospital. A systematic random sampling technique was used to get a total number of 387 samples. Data were collected using interview-administered questionnaires; World Health Organization Quality of Life Brief Version, Morisky Medication Adherence Screening Tool, Oslo Social Support Scale, and Jacoby Stigma Scale. Simple and multiple linear regression analysis were used to assess the contributing factors of quality of life in the participants and B coefficient with 95% CI confidence interval was used. The statistical significance was accepted at p value < 0.05., Results: The result showed that the Mean quality of life score of patients with severe mental illness for each domain (mean ± SD) was 41.3 ± 7.5, 42.8 ± 8.2, 38.9 ± 8.9, and 41.8 ± 6.5 for physical, psychological, social and environmental, respectively. Multiple regression analysis showed that age of participants was strongly positively correlated with all domains of quality of life. It predicts above 45% of the variability in each domain. Social support is also another strong predictor which was negatively correlated with all domains of quality of life, except physical., Conclusion: This study revealed that the mean score quality of life of patients with severe mental illness in each domain was low. This demonstrates a need for improving the quality of life of people with severe mental illness by integration of a positive mental health approach and bio-psychosocial view with biological treatment of severe mental illness. Moreover, in Collaboration with medical professionals, people with severe mental illness should screen and managed for any comorbid medical conditions., (© 2021. The Author(s).)

Objectives: As the hospital environment favors the circulation of drug resistant bacteria, continuous surveillance of antibiotic resistant patterns is an important approach for a better patient management. This study is therefore, aimed to assess multidrug resistant bacterial isolates from patients suspected of nosocomial infections at the University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia., Results: Of the 260 patients, 173 (66.5%) of them were culture positive. Among culture positive patients a total of 216 bacterial isolates were recovered, of which the most common species were S. aureus 77 (35.6%), followed by E. coli 33 (15.3%) and Klebsiella spp 29 (13.4%). Of the S. aureus isolates, 67.5% were cefoxitin (methicillin) resistant. Citrobacter spp (100%), Klebsiella spp (79.3%) and E. coli (75.3%) were the leading MDR Gram-negative isolates. The overall MDR resistant rate was 152 (70.4%).

Objectives: Empirical selections of antimicrobial therapy based on clinical observations are common clinical practices in Ethiopia. This study identified common external ocular infections and determined antibiotic susceptibility testing in northwest Ethiopia., Results: Among 210 patients studied, conjunctivitis 32.9%(69), blepharitis 26.7%(56), dacryocystitis 14.8%(51), blepharoconjunctivitis 11.9%(25), and trauma 10.0%(21) were the most common external ocular infections. Pathogenic bacteria were isolated among 62.4%(131) cases. The distributions of bacteria detected in conjunctivitis, dacryocystitis, and blepharitis patients were 32.8%(43), 23.7%(31), and 16.0%(21), respectively. The most prevalent isolates were coagulase negative Staphylococci; 27.5%(36), S. aureus; 26.7%(35), Pseudomonas species; 10.7%(14), and E. coli; 7.6%(10). Tetracycline, amoxicillin, chloramphenicol, ampicillin, and nalidic acid showed resistance to bacterial isolates with a respective prevalence of 35.9%(47), 32.1%(42), 26.2%(34), 25.2%(33), and 23.7%(31). Multi-drug resistance patterns to the commonly prescribed antibiotics tested was 20.6%(27), 18.3%(24), 17.6%(23), 5.3%(7), and 4.6%(6) to two, three, four, five, and six antibiotics, respectively. Overall, the multi-drug resistance prevalence rate was 66.4%(87). This study confirmed diverse types of external ocular manifestations associated with bacterial infections with wide ranges of antibiotic resistant phenotypes. Thus, combining clinical information, bacteriological analysis, and antimicrobial susceptibility tests are useful for making an evidence-based selection of antibiotics therapy.

The approach to treatment of visceral leishmaniasis (VL)-HIV co-infection in East Africa has not been systematically examined. Although antiretroviral treatment (ART) should be initiated for all co-infected persons, the extent of ART prescription is not known. We conducted a retrospective cohort study including all VL-HIV co-infected adults at selected referral and district hospitals in northwest Ethiopia from 2010 to 2015. Purposes of the study were to compare the proportion of VL diagnoses made in previously diagnosed HIV-patients versus diagnosis concurrent with HIV diagnosis and to quantify utilization of ART. We included 112 patients and 58 patients at the referral and district hospital, respectively (median age: 30 years, 98% males). Of all VL cases, 56% (63/112) and 19% (11/58) occurred in known HIV patients at the referral and district hospital, respectively, with a median CD4 count at VL diagnosis of 45 cells/µL and 248 cells/µL at the referral and district hospital, respectively. Seventy-six percent (56/44) were on ART at VL diagnosis and nine (12%) started ART after VL diagnosis. The remaining 96 (56%) patients had both infections diagnosed concurrently, with a median CD4 count of 56 and 143 cells/µL at the referral and district hospital, respectively. Among cured patients, ART initiation was 67% and 36% at the referral and district hospital, respectively. A substantial proportion of VL-HIV cases occur while in HIV care, requiring further evaluation of preventive strategies. Among newly diagnosed VL-HIV co-infected patients, ART initiation was low. The reasons, including poor documentation and information exchange, should be assessed.

Background: Enterococci become clinically important especially in immune compromised patients and important causes of nosocomial infections. Data on the prevalence, antimicrobial susceptibility patterns and associated factors of enterococci are scarce in Ethiopia., Methods: A hospital based cross-sectional study was conducted at the University of Gondar Teaching Hospital from February 28, 2014 to May 1, 2014. Pretested structured questionnaire was used to collect socio-demographic data and possible associated factors of enterococci infections. Clinical samples including urine, blood, wound swabs and other body fluids from patients requested by physician for culture and antimicrobial susceptibility test during the study period were included. A total of 385 patients were included in the study. Data were entered and analyzed using SPSS Version 20. P values <0.05 were considered as statistically significant., Result: The overall prevalence of enterococci infection was 6.2% (24/385). The commonest sites of infections were urinary tract followed by wound and blood. Among the 24 isolates, 33.3% (8/24) were resistant to all tested antimicrobial agents. Forty one point 7 % (10/24) of the enterococci isolates were vancomycin resistant enterococci (VRE). Moreover, two third of the isolates were multidrug resistant (MDR) enterococci. In multivariate analysis, duration of hospital stay for two days and more than two days with infection rate 17/32 (53.1%), previous history of any antibiotics (AOR = 9.13; [95% CI; 2.01-41.51] P = 0.00) and history of urinary catheterization (AOR = 8.80; [95% CI; 1.70-45.64] P = 0.01) were associated with presence of higher enterococci infections than their respective groups., Conclusion: The prevalence of enterococci infections among patients with UTIs, wound infections and sepsis were higher than the other infections. Multi drug resistant enterococci including VRE were isolated from clinical samples in the study area. Being hospitalized for ≥48 h, having history of any antibiotic administration and catheterization were associated factors for enterococci infections. Presence of VRE indicates decreased antibiotic treatment options of multidrug resistant enterococci. Therefore, efforts should be made to prevent enterococci infections and emergency of multidrug resistant enterococci. Moreover, species identification and antibiotic resistant in advanced and at large scale is demanding.

Background: Ethiopia is one of the countries that are highly affected by dual epidemics of human immunodeficiency virus (HIV) and tuberculosis (TB). HIV infection is a known risk factor for the development of active TB and it challenges in diagnosis and treatment of TB. Thus, it is essential to determine the epidemiology of HIV infection among TB patients to guide clinical actions and inform the policy makers. This study was aimed to assess the prevalence of HIV infection among TB patients and to describe the associated risk factors for HIV seropositivity., Methods: A retrospective study was conducted on TB registries at Metema Hospital directly observed therapy short-course (DOTS) clinic. Binary and multivariate logistic regression analysis was used to determine the association of HIV seropositivity among TB patients. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. P value less than 0.05 was considered as statistically significant., Results: Of the total 2096 patients, 2005 (95.7%) were tested for HIV. The overall HIV-TB co-infection rate was 20.1% (404), 12.3% (246) in males and 7.9% (158) in females. The highest proportion of co-infection rate was observed among the patients in the age group of 25-34 years (32.4%) and smear negative pulmonary TB patients (59.7%). A declining trend of HIV-TB co-infection was observed during the study period, from 22.1% (185) in 2009/10 to 12.8% (52) in 2011/12 (X(2) = 17.07, P < 0.001)., Conclusions: This study found that HIV-TB co-infection is still high in the Metema area; and occurs more frequently in males than females, and among patients in age group of 25-34 years. Thus, concerted efforts and interventions methods that target these at risk groups are recommended.

Background. Bacterial sepsis is a major cause of illness in human immunodeficiency virus infected patients. There is scarce evidence about sepsis among HIV patients in Ethiopia. This study aimed to determine the etiologic agents of bacterial sepsis and their antibiotic susceptibility patterns among HIV infected patients. Methods. A cross-sectional study was carried out from March 1 to May 2, 2013. One hundred patients infected with HIV and suspected of having sepsis were included. Sociodemographic data were collected by interview and blood sample was aseptically collected from study participants. All blood cultures were incubated aerobically at 35°C and inspected daily for 7 days. The positive blood cultures were identified following the standard procedures and antimicrobial susceptibility testing was performed using disk diffusion technique. Data was entered by Epi-info version 3.5.1 and analysis was done using SPSS version 20. Results. Of the study participants, 31 (31%) confirmed bacterial sepsis. The major isolates were 13 (13%) Staphylococcus aureus, 8 (8%) coagulates negative staphylococci, and 3 (3%) viridans streptococci. Majority of the isolates, 25 (80.6%), were multidrug resistant to two or more antimicrobial agents. Conclusions. Bacterial sepsis was a major cause of admission for HIV infected patients predominated by Staphylococcus aureus and coagulase negative staphylococci species and most of the isolates were multidrug resistant.

Background. Cockroaches are source of bacterial infections and this study was aimed to assess bacterial isolates and their antimicrobial profiles from cockroaches in Gondar town, Ethiopia. Methods. A total of 60 cockroaches were collected from March 1 to May 30, 2014, in Gondar town. Bacterial species were isolated from external and internal parts of cockroaches. Disk diffusion method was used to determine antibiotic susceptibility patterns. Data were entered and analyzed by using SPSS version 20; P values <0.005 were considered as statistically significant. Results. Of 181 identified bacteria species, 110 (60.8%) and 71 (39.2%) were identified from external and internal parts of cockroaches, respectively. Klebsiella pneumoniae 32 (17.7%), Escherichia coli 29 (16%), and Citrobacter spp. 27 (15%) were the predominant isolates. High resistance rate was observed to cotrimoxazole, 60 (33.1%), and least resistance rate was noted to ciprofloxacin, 2 (1.1%). Additionally, 116 (64.1%) of the isolates were MDR strains; Salmonella spp. were the leading MDR isolates (100%) followed by Enterobacter (90.5%) and Shigella spp. (76.9%). Conclusion. Cockroaches are the potential source of bacteria pathogens with multidrug resistant strains and hence effective preventive and control measures are required to minimize cockroach related infections.

Background: Updates on the epidemiology of antibiotic resistance bacterial pathogens is important. This is because the spread of multidrug resistant enterobacteriaceae (MDRE) and recently carbapenemase producing enterobacteriaceae (CPE) have emerged as a major public health concern in patients with urinary tract infections (UTIs). This study is therefore, aimed to assess the prevalence and associated risk factors of MDR and CPE among patients with UTIs., Methods: A cross sectional study was conducted among 442 symptomatic UTI suspected patients. Data on socio-demographic characteristics, clinical information and possible risk factors were collected using structured questionnaire. Early morning mid-stream urine samples were collected and processed to characterize bacterial isolates. Disk diffusion method was used to determine the antibiotic susceptibility patterns of isolates. Carbapenemase producing strains were detected using CHROMagar KPC medium. Data were entered and analyzed using SPSS version 20. P-value <0.05 was considered as statistical significant., Results: Among 442 patients enrolled a total of 183 Enterobacteriaceae were recovered. Of these isolates; 160 (87.4%) were MDRE; the most common isolates were K. pneumoniae and E.coli. Five (2.73%) of the isolates were found to be carbapenemase producers and all of CPE strains were 100% ESBL producers. Significant drug resistances were observed among CPE compared to other MDRE, low resistance rates were noted to ciprofloxacin (20%). Being female (OR 4.46; P = 0.018), age (OR 1.08; P = 0.001), hospitalization (OR 5.23; P = 0.006), and prior antibiotic use (OR 3.98; P = 0.04) were associated risk factors for MDRE., Conclusion and Recommendation: High rates of MDR (87.4%) were observed among enterobacteriaceae uropathogens; K. pneumoniae and E.coli were the principal MDR isolates. Overall prevalence of CPE was 2.73% and all of these strains were 100% ESBL producer. Attributing risk factors for MDR UTIs were found to be sex (female), age, hospitalization, and history of antibiotic therapy. Therefore, efforts should be made to reduce patient hospital stay and maximize rational use of drugs. Additional and vigorous investigation especially on CPE should be encouraged.

Background: Bacterial pathogens isolated from dacryocystitis patients are diverse and complex in terms of their distribution, prevalence, and antimicrobial susceptibility pattern. The clinical importance of microbial causes of dacryocystitis and pattern of drug resistance has not been reported in northwest Ethiopia. Moreover, the management of dacryocystitis is based on only clinical observation Therefore, this study attempted to identify and define clinical and microbiological characteristics of microbial agents of dacryocystitis and its antibiotic susceptibility patterns., Methods: A cross sectional study was conducted from January 2011-January 2012 among dacryocystitis patients attending ophthalmology outpatient department of Gondar University teaching Hospital. Sociodemographic and clinical data collection, microbiological analysis and antibiotic susceptibility test patterns were done following standard procedures., Results: From the total of 51 dacryocystitis cases, bacterial origins were isolated among 31(60.8%) cases. The dominant isolates were Coagulase negative Staphylococci (CNS) 9(29.0%), Staphylococcus aureus (S. aureus) 6(19.4%), and Pseudomonas species 3(9.7%). S. pneumoniae, Entrobacter species, K. pnemoniae and H. influenzae were each accounted 6.5% isolation rate. Among the commonly prescribed antimicrobials tested for susceptibility pattern; amoxicillin 38.7%, ciprofloxacin 25.8%, chloramphinicol 25.8%, co-trimoxazole 25.8%, and ampicillin 19.4% were resistant to the overall bacterial isolates identified. Only Citrobacter species were sensitive to all antibiotics tested but the rest bacterial isolates were resistant for at least to one, two, three, four and more antibiotics tested. Overall, 9(29.0%) of the bacterial isolates were resistant to only one antibiotics and resistance to two, three and four antibiotics each accounted 5(16.1%) rate., Conclusions: Though the information derived from this study was very meaningful, further studies encompassing viral, fungal, parasitic and anaerobic bacterial origin are important to better define the spectrum and relative incidence of pathogens causing dacryocystitis. Microbiological analysis and antimicrobial susceptibility pattern is mandatory for the selection of a specific antimicrobial therapy and to the control of further resistance development of bacterial strains.

Background: Syphilis and HIV infections in pregnancy result in a number of adverse outcomes including neonatal death and vertical transmission. Ethiopia is a country where these infections are highly prevalent. However, data on co-morbidities of syphilis and HIV among pregnant women in Gondar are scarce. Thus, the aim of this study was to determine the seroprevalence of these infections and associated factors among pregnant women attending antenatal care at the University of Gondar teaching hospital, Northwest Ethiopia., Methods: A cross sectional study was conducted from February to June 2011. Structured interviews were used to collect socio-demographic and obstetric data. Sera against syphilis were screened by rapid plasma reagin test; and confirmed by Treponema pallidum hemagglutination assay. HIV infection was detected by rapid HIV test kits following the national algorithms for HIV testing. Data were summarized by descriptive statistics and binary logistic regression. Odds ratio (OR) and 95% confidence intervals (CI) were calculated., Results: Of 385 pregnant women, reactive syphilis was noted in 11/385 (2.9%) and seroprevalence of HIV was 43/385 (11.2%). The prevalence of syphilis and HIV co-infection was 2/385(0.5%). High rate of syphilis was observed among the women with above 30 years of age (OR 3.69, 95% CI 0.83 - 16.82). Women with a history of miscarriage and stillbirth were more likely to be infected by syphilis (OR 2.22, 95% CI 0.54-9.60) and (OR 3.24, 95% CI 0.00-17.54), respectively., Conclusion: Our data indicated that syphilis and HIV infections are still important public health concerns among pregnant women in the Gondar area. Hence, we recommend strenuous screening of all pregnant women for these infections during antenatal care. Further, strengthening health education on the mode of transmission and prevention of HIV and syphilis is essential for effective control of these infections.

Infectious diseases of bacterial origin are a major cause of morbidity and mortality in developing countries such as Ethiopia. To minimise such burdens, proper use of antibiotics has played a vital role and saved countless lives. However, use of antimicrobials as therapeutic agents is compromised by the potential development of drug-resistant micro-organisms. Currently, antimicrobial drug resistance has become a public health concern both in developing and developed countries. Antimicrobial drug resistance is dramatically accelerated when antimicrobials are misused. This is critical, especially in developing countries where they are not only misused but are often underused due to financial constraints. Although large-scale studies on antimicrobial resistance in Ethiopia have not yet been conducted, the available reports indicate a trend towards increasing resistance rates among pathogens such as Escherichia coli, Shigella spp., Salmonella spp. and Staphylococcus aureus to commonly prescribed antibiotics, including ampicillin, amoxicillin, penicillin, tetracycline and trimethoprim/sulfamethoxazole. This review summarises the existing data on antibacterial drug resistance in this country., (Copyright © 2014 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.)

Background: Toxoplasmosis is a major public health problem among immuno-compromised individuals. This study aimed to determine the seroprevalence and associated risk factors of Toxoplasma gondii infection among pregnant women with and out HIV infections., Methods: This cross sectional study was conducted among consecutive 385 pregnant women attended Antenatal Clinic from May 2010 to October 2011 at the Gondar University Teaching Hospital, Northwest Ethiopia. Venous blood was collected from each pregnant woman for testing HIV-1/2 and anti- Toxoplasma antibodies using rapid test kits. Data were entered and analyzed using SPSS version 20 statistical package., Results: The overall magnitude of T. gondii and HIV was 88.6% (341/385) and 11.2% (43/385), respectively. The seroprevalence of T. gondii was not different among HIV infected and non-infected pregnant women (88.4%, 38/ 43 vs 88.6%, 303/342). Keeping cats in house showed statistically significant association with seropositivity of toxoplasmosis (P<0.05)., Conclusion: Irrespective of HIV infection, high rate of T. gondii was detected among pregnant women. These high prevalences indicate the need for an intensified public health awareness to reduce both infections.

Introduction. Asymptomatic malaria is prevalent in highly endemic areas of Africa and is new challenge for malaria prevention and control strategies. Objective. To determine the prevalence of asymptomatic malaria and associated risk factors among school children in Sanja Town, northwest Ethiopia. Methods. A cross-sectional study was conducted from February to March 2013, on 385 school children selected using stratified proportionate systematic sampling technique. Pretested questionnaire was used to collect sociodemographic data and associated risk factors. Giemsa-stained thin and thick blood films were examined for detection, identification, and quantification of malaria parasites. Data were entered and analyzed using SPSS 20.0 statistical software. Multivariate logistic regression was done for assessing associated risk factors and proportions for categorical variables were compared using chi-square test. P values less than 0.05 were taken as statistically significant. Results. The prevalence of asymptomatic malaria was 6.8% (n = 26). The majority of parasitemic study participants had low parasite density 65.5% (17/26). Level of grade, age, bed net usage, and frequent exposure to malaria infection were associated with risk of asymptomatic malaria. Conclusion. Asymptomatic malaria was low in this study area and is associated with level of grade, age, bed net usage, and frequent exposure to malaria infection.

Background: The importance of bacterial isolates from waste water environment as a reservoir of antibiotic resistance and a potential source of novel resistance genes to clinical pathogens is underestimated. This study is aimed at to isolate and characterize public health important bacteria from waste water in hospital and non- hospital environments and evaluate the distribution of multiple drug resistance bacteria in the study area., Methods: A cross-sectional study was conducted at Gondar from January-June 2012. The hospital waste water was taken from different sections of the Gondar University Teaching Hospital. Non- hospital environment samples were taken at different sites of the university campuses, Gondar College of Teachers education, and soft drink factory in Gondar. Samples were aseptically collected, transported and processed with in two hours following standard procedure. Identified organisms were assessed for different antibiotics following Kirby-Bauer disk diffusion method. All data was registered and entered in to SPSS version 16 computer program. P-values less than 0.05 were taken as statistically significant., Result: A total of 60 waste water samples were processed for the presence of drug resistance pathogens. Among the total samples 113 bacterial isolates were recovered and of these 65 (57.5%) were from hospital environment and 48 (42.5%) were from non-hospital environment. The most frequently identified bacterium was Klebsiella spp. 30 (26.6%) followed by Pseudomonas spp. 19(16.8%), E. coli (11.5%) and Citrobacter spp (11.5%), and Staphylococcus aureus (8.2%). The over all prevalence of multiple drug resistance (MDR) in this study was 79/113 (69.9%). MDR in hospital environment was found to be 53/68 (81.5%) while in non hospital environment was found to be 26/48 (54.2%)., Conclusions: Multiple drug resistance to the commonly used antibiotics is high in the study area. The contamination of waste water by antibiotics or other pollutants lead to the rise of resistance due to selection pressure. The presence of antibiotic resistance organisms in this waste water should not be overlooked. Since this organisms may be vital to the safety and well-being of patients who are hospitalized and individual susceptible to infection. Therefore, proper waste water treatment plant should be established and improved sanitary measure should be practice.

Background: Enterococci are the most important multidrug resistant organisms associated with immunocompromised patients. Data are lacking about the epidemiology of vancomycin resistant Enterococci (VRE) in Ethiopia. This study aimed to assess the prevalence of VRE, their susceptibility patterns to different antibiotics and associated risk factors in fecal samples of Human Immunodeficiency Virus (HIV) positive and HIV negative clients., Methods: A cross sectional study was carried out in a total of 226 (113 HIV positive and 113 HIV negative) clients, from July 1/2013 to September 30/2013 at the University of Gondar Teaching Hospital. Data on socio-demographic characteristics and risk factors were collected with a short interview guided by pre-tested structured questionnaire. The enterococci were isolated and identified from stool sample using standard bacteriological procedures. Kary Bauer disk diffusion method was used to determine the susceptibility patterns of Enterococci isolates. Data were entered and analyzed using SPSS version 20 statistical package., Results: The overall colonization of Enterococci was 88.9% (201/226) of which 11 (5.5%) were VRE. The prevalence of VRE among clients with and without HIV infections were 8(7.8%) and 3(3.1%), respectively. Ninety percent of the Enterococci isolates (181/201) were resistant to two or more antibiotics tested. Isolates of Enterococci recovered from stool samples of HIV infected patients were more resistant to amoxicillin and amoxicillin-calvulinic acid than HIV negative clients (P < 0.05). Antibiotic treatment for the last 2 weeks was found to be the risk factor that showed statistically significant association with the presence of high VRE colonization. However, the socio-demographic variables and factors such as malnutrition, leucopenia, thromobocytopenia, anaemia, duration of Highly Active Antiretroviral Therapy, CD4 cell count, stage of WHO and drinking alcohol were not associated with VRE (P > 0.05)., Conclusion: The high prevalence of VRE in this study signals the emergence of VRE in the study area. Prior antibiotic treatment was associated with VRE colonization. Therefore, rational use of antibiotics and more detailed study using phenotypic and genotypic methods are needed.

Background: Visceral leishmaniasis (VL) causes considerable morbidity and mortality in Ethiopia. Data on the prevalence and associated risk factors on malnutrition among VL patients in Ethiopia are scarce. This study aimed to assess the prevalence of malnutrition and its associated risk factor among VL patients in Northwest Ethiopia., Methods: An institution-based cross-sectional study was conducted from June to September 2012 at four leishmaniasis treatment sites in Northwest Ethiopia. Four hundred and three adult VL patients were enrolled in the study. Malnutrition was defined as a body mass index (BMI) ≤ 18.5 kg/m2. The data collected from the VL patients included sex, age, residence, occupation, weight, height, laboratory results (HIV, hemoglobin, intestinal parasites). Multivariate logistic regression model was used to determine the strength of association between malnutrition and associated risk factors., Results: Among 403 adult VL patients 385 (95.5%) were malnourished. Twenty eight percent (n = 113), 30.3% (n = 122), and 37.2% (n = 150) were mildly, moderately and severely malnourished, respectively. The prevalence of intestinal parasitic infection was 47.6% (n = 192) and it was associated with malnutrition (P = 0.01). The prevalence of VL-HIV co-infection was 10.4% (n = 42). Hook worm, Giardia intestinalis and Ascaris lumbircoides were the leading prevalent intestinal parasites. Factors such as age, sex, residence, occupation, HIV status and anemia were not associated with severe malnutrition., Conclusions: The prevalence of malnutrition in VL patients was very high and it was associated with intestinal parasitic infections. Therefore, screening of severely malnourished VL patients for intestinal parasitic infections during admission is recommended.

Background. In most hospitals of developing countries, urinary tract infections are treated empirically because of lack of culture facilities. This leads to emergence of multiresistant uropathogens. Culturing and drug susceptibility testing are essential to guide therapy. Objectives. To assess changing prevalence and resistance pattern of uropathogens to commonly used antibiotics in a two-year study period. Methods. Urine specimens were collected and cultured. Uropathogens were identified by standard methods and tested for antibiotics resistance. Data were analyzed using SPSS version 16 statistical sofware. P value < 0.05 was considered statistically significant. Results. The commonest isolates in both the previous and present studies were E. coli, Klebsiella, CoNS, S. aureus, Proteus, and Citrobacter species. Previous isolates of Enterobacteriaceae were 100% sensitive to ciprofloxacin, whereas present isolates developed 31% to 60% resistance to it. Previous isolates were less resistant to gentamycin than the present ones. Multiresistance isolates were predominant in present study than previous ones. Conclusion. E. coli was predominant in the two study periods. Present isolates were more resistant than previous ones. Some previous isolates were 100% sensitive to ciprofloxacin, whereas present isolates were increasingly resistant. Ciprofloxacin and gentamicin have been recommended for empiric treatment of urinary tract infections.

Background. Intestinal schistosomiasis is one of the most widespread parasitic infections in tropical and subtropical countries. Objective. To determine the prevalence of S. mansoni infection and associated determinant factors among school children in Sanja Town, northwest Ethiopia. Methods. A cross-sectional study was conducted from February to March, 2013. 385 school children were selected using stratified proportionate systematic sampling technique. Pretested questionnaire was used to collect sociodemographic data and associated determinant factors. Stool samples were examinedusing formol-ether concentration and Kato-Katz technique. Data were entered and analyzed using SPSS 20.0 statistical software. Multivariate logistic regression was done for assessing associated risk factors and proportions for categorical variables were compared using chi-square test. P values less than 0.05 were taken as statistically significant. Results. The prevalence of S. mansoni infection was 89.9% (n = 346). The overall helminthic infection in this study was 96.6% (n = 372). Swimming in the river, washing clothes and utensil using river water, crossing the river with bare foot, and fishing activities showed significant association with the occurrence of S. mansoni infection. Conclusion. Schistosoma mansoni infection was high in the study area. Therefore, mass deworming at least twice a year and health education for community are needed.

Background and Objectives: Visceral leishmaniasis (VL) is one of the neglected diseases affecting the poorest segment of world populations. Sepsis is one of the predictors for death of patients with VL. This study aimed to assess the prevalence and factors associated with bacterial sepsis, causative agents, and their antimicrobial susceptibility patterns among patients with VL., Methods: A cross-sectional study was conducted among parasitologically confirmed VL patients suspected of sepsis admitted to the University of Gondar Hospital, Northwest Ethiopia, from February 2012 to May 2012. Blood cultures and other clinical samples were collected and cultured following the standard procedures., Results: Among 83 sepsis suspected VL patients 16 (19.3%) had culture confirmed bacterial sepsis. The most frequently isolated organism was Staphylococcus aureus (68.8%; 11/16), including two methicillin-resistant isolates (MRSA). Patients with focal bacterial infection were more likely to have bacterial sepsis (P < 0.001)., Conclusions: The prevalence of culture confirmed bacterial sepsis was high, predominantly due to S. aureus. Concurrent focal bacterial infection was associated with bacterial sepsis, suggesting that focal infections could serve as sources for bacterial sepsis among VL patients. Careful clinical evaluation for focal infections and prompt initiation of empiric antibiotic treatment appears warranted in VL patients.

Objectives. The aim of this study was to assess treatment outcome and associated risk factors among TB patients registered for anti-TB treatment at Enfraz health center, northwest Ethiopia. Methods. A five-year retrospective data (2007-2011) of tuberculosis patients (n = 417) registered for anti-TB treatment at Enfraz health center, northwest Ethiopia, were reviewed. Tuberculosis outcomes were following the WHO guidelines. Data were entered and analyzed using SPSS version 20. Results. Among 417 study participants, 95 (22.8%), 141 (33.8%), and 181 (43.4%) were smear-positive, smear-negative, and extrapulmonary tuberculosis patients, respectively. Of the 417 study participants, 206 (49.4%) were tested for HIV. The TB-HIV coinfection was 24/206 (11.7%). Seventeen study participants (4.2%) were transferred to other health facilities. Among the 400 study participants, 379 (94.8%) had successful treatment outcome (302 treatment completed and 77 cured). The overall death, default, and failure rates were 3.4%, 0.5%, and 1.2%, respectively. There was no significant association between sex, age, residence, type of TB, HIV status, and successful TB treatment outcome. Conclusion. Treatment outcome of patients who attended their anti-TB treatment at Enfraz health center was successful. Therefore, this treatment success rate should be maintained and strengthened to achieve the millennium development goal.

Background. Malaria and typhoid fever are major public health problems in tropical and subtropical countries. People in endemic areas are at risk of contracting both infections concurrently. Objectives. The study was aimed at determining the prevalence and associated risk factors of malaria, typhoid, and their coinfection among febrile patients. Methods. A cross-sectional study was conducted on 200 febrile patients suspected for malaria and/or typhoid fever from April to May, 2013, at Ayinba Health Center, Northwest Ethiopia. Blood samples were collected for blood culture, Widal test, and blood film preparation. Data were analyzed using SPSS version 20 statistical software. Results. The prevalence of malaria was 36.5% (n = 73). Among these 32 (43.8%), 30 (41.1%) and 11 (15.1%) were positive for P. falciparum, P. vivax, and mixed infections, respectively. The seroprevalence of typhoid fever was 38 (19%), but 1 (0.5%) with blood culture. Malaria typhoid fever coinfection was 13 (6.5%). 2-5-year-old children and poor hand washing habit were significantly associated with malaria and typhoid infection, respectively (P < 0.05). Conclusions. The prevalence of malaria and typhoid fever was found high. Further studies should be done on the other determinants of malaria and typhoid fever coinfection in different seasons and different study areas.

Objective. To assess the magnitude of intestinal parasitic infection and associated risk factors in Teda Health Centre, Northwest Ethiopia. Method. A cross-sectional study was conducted in Teda Health Centre from February to April, 2011. Stool samples were collected from 410 study participants and analysed by direct wet mount and formal ether concentration techniques. Furthermore, sociodemographic data were collected by using standardized questionnaire. Result. The overall prevalence of intestinal parasitic infection in this study was 62.3%. Ascaris lumbricoides was the most predominant parasite (23.2%) followed by Giardia intestinalis (12.4%), Entamoeba histolytica/dispar (4.6%), Schistosoma mansoni (8.9%), hookworm (6.6%), Hymenolepis nana (1.5%), Enterobius vermicularis (0.4%), and Strongyloides stercoralis (0.2%). Absence of toilet and hand washing after toilet was shown to be associated with intestinal parasitic infection (P < 0.05 for both). Furthermore, swimming and less shoe wearing habits showed a significant prevalence of S. mansoni and hookworm infections, respectively. Conclusion. The present study showed high prevalence of intestinal parasitic infection in the study area. Absence of toilet and hand washing after toilet was found to be associated with intestinal parasitic infection. Therefore, there is a need for integrated control programme to have a lasting impact on transmission of intestinal parasitic infection.

Objective: To assess the magnitude and antimicrobial susceptibility patterns of Streptococcus pneumoniae isolates from various clinical specimens., Methods: A record based on retrospective study was conducted at Gondar University Teaching Hospital from September 2007 to January 2012. All patients who visited Gondar University Hospital and provided clinical specimens (body fluids, discharge, swab and blood) for routine bacteriological culturing and antimicrobial susceptibility testing were taken for analysis. Clinical specimens were processed for bacterial culture according to the standard procedures. Antimicrobial susceptibility test for isolated organisms was done using agar disk diffusion method. The data were entered and analyzed using SPSS software version 16 package., Results: One hundred and fifty three Streptococcus pneumoniae were isolated from patients who visited Gondar University Teaching Hospital bacteriology laboratory for culture. Majority of the pneumococcal isolates were from inpatients [111(72.5%)], and 74(48.4%) were from body fluids. Out of the total isolates, 93(61%) were found to be resistant to at least one antibiotic used for susceptibility testing. Forty eight (43.2%) of the isolates were multi-drug resistant (resistant to two or more drugs). The resistance rate noted for both ciprofloxacin 17(11.1%) and ceftriaxone 15(9.8%) were alarming., Conclusions: High proportions of the isolates tend to be increasingly resistant to the commonly prescribed drugs. The recommended drug of choice like ciprofloxacin and ceftriaxone were found to be less susceptible in the study area. Based on the findings, we therefore recommend that antimicrobial agents should be inspected for acceptable activity before they are prescribed and administered empirically. Further study with a better design and survey of antimicrobial susceptibility at large scale shoule be performed to draw advanced information.

Background: Intestinal parasitic infections are among the major public health problems in Sub-Saharan Africa. Their distribution is mainly associated with poor personal hygiene, environmental sanitation and limited access to clean water. Indeed, epidemiological information on the prevalence of various intestinal parasitic infections in different localities is a prerequisite to develop appropriate control measures. Therefore, the aim of this study was to assess the prevalence of intestinal parasitic infections and associated risk factors among schoolchildren., Method: This school-based cross-sectional study was undertaken at the University of Gondar Community School from April 2012 to June 2012. Study subjects were selected using a systematic random sampling method. Data were gathered through direct interview by using a pretested questionnaire. The collected stool specimens were examined microscopically for the presence of eggs, cysts and trophozoites of intestinal parasites using direct saline smear and formol-ether concentration methods. Data entry and analysis were done using SPSS version 16 software., Result: Out of 304 study subjects, 104 (34.2%) were infected with one or more intestinal parasites. The prevalence rate was 43 (32.1%) for male and 61 (35.9%) for female. The prevalence of intestinal parasites was high in age group of 10-12 years compared to other age groups. The predominant intestinal parasite was Hymenolepis nana, followed by Entamoeba histolytica/dispar and Ascaris lumbricoides with 42 (13.8%), 28 (9.2%), 18 (5.9%), respectively. Hand washing practice and ways of transportation were statistically associated with intestinal parasitic infections. Children in grades 1 to 3 had a higher prevalence of intestinal helminthic infection than those in grades 4 to 8 (p = 0.031)., Conclusions: Intestinal parasites were prevalent in varying magnitude among the schoolchildren. The prevalence of infections were higher for helminths compared to protozoa. Measures including education on personal hygiene, environmental sanitation, water supply and treatment should be taken into account to reduce the prevalence of intestinal parasites.

Bacteremia due to Shigella is rare. A 26-year-old HIV-negative male presented with a persistent high-grade fever of two months duration to the Leishmaniasis Research and Treatment Center of University of Gondar Hospital. He was anorexic and had lost significant weight (from 76 to 57 kg in 4 months, BMI = 17.2 kg/m(2)). He also complained of headache, chills, and rigor. In the last one year, he was experiencing a few episodes of acute bloody diarrhea, the last episode being two months ago. Microscopy from splenic aspiration showed Leishman-Donovan bodies with parasite load of +3. The blood culture showed Shigella species, but the stool was culture negative. The isolate was sensitive to most tested antibiotic discs, sulfamethoxazole, ceftriaxone, gentamicin, tetracycline, and norfloxacilin, except ampicillin. Therefore, requesting blood culture for identifying unexpected type of organisms causing infections in patients with underlying diseases like visceral leishmaniasis should be encouraged.

Objective. The aim of this study was to evaluate the operational characteristics (sensitivity and negative predictive value (NPV)) of wet mount, formol-ether concentration (FEC), and Kato-Katz techniques for the determination of intestinal parasitic infections. Method. A total of 354 faecal specimens were collected from students in Northwest Ethiopia and screened with Kato-Katz, wet mount, and FEC for the presence of intestinal parasitic infection. Since a gold standard test is not available for detection of intestinal parasites, the combined results from the three methods were used as diagnostic gold standard. Result. The prevalences of intestinal parasites using the single wet mount, FEC, and Kato-Katz thick smear techniques were 38.4%, 57.1%, and 59%, respectively. Taking the combined results of three techniques as a standard test for intestinal parasitic infection, the sensitivity and negative predictive value of Kato-Katz is 81.0% (confidence interval (CI) = 0.793-0.810) and 66.2% (CI = 0.63-0.622), respectively. The FEC detected 56 negative samples that were positive by the gold standard, indicating 78.3% (CI = 0.766-0.783) and 63.2% (CI = 0.603-63) sensitivity and NPV, respectively. Furthermore, Kato-Katz detects 113 cases that were negative by a single wet mount. The κ agreement between the wet mount and Kato-Katz methods for the diagnosis of Ascaris lumbricoides and hookworm was substantial (κ = 0.61 for Ascaris lumbricoides, κ = 0.65 for hookworm).