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OBJECTIVE: This study examined the prevalence, severity and risk factors of anaemia among adult people living with HIV attending an antiretroviral therapy centre in Woreta Primary Hospital, Woreta town, Ethiopia. DESIGN: Hospital-based retrospective cross-sectional study. SETTING: Public health facility that provides HIV care in Woreta town. PARTICIPANTS: A total of 289 medical records of adults living with HIV/AIDS on highly active antiretroviral therapy from February 2019 to September 2023 at government hospital were reviewed using a systematic sampling method. The data were entered using Epi-info V.7 and exported to SPSS V.23 for data analysis. The data were analysed using bivariate and then multivariate logistic regression models in order to identify variables associated with anaemia. At the 95% CI level, variables having a p value of <0.05 were deemed to be statistically significant predictors. PRIMARY OUTCOME: Prevalence and severity of anaemia and its predictors among adult patients living with HIV on antiretroviral therapy in Woreta Primary Hospital. RESULTS: The total prevalence of anaemia was 31.5% (95% CI 28.9 to 33.8). The prevalence of mild, moderate and severe anaemia was 20.42%, 10.38% and 0.70%, respectively. Predictors independently linked with anaemia were female sex (adjusted OR (AOR) 1.08), age ≥40 years (AOR 1.21), lived with HIV >10 years (AOR 2.31), CD4 counts <200 cells/µL (AOR 3.81), non-suppressed viral load (AOR 1.28), history of opportunistic infections (AOR 1.54), WHO clinical stages III and IV (AOR 1.37 and 2.23, respectively) and history of parasitic infestation (AOR 2.81). CONCLUSIONS: A sizeable proportion of participants were found anaemic. Female sex, older age, longer periods lived with the virus, lower CD4 count, non-suppressed viral load, history of opportunistic infections, WHO clinical stages III and IV and history of parasitic infestation were the contributing factors. Therefore, to improve the anaemic status and living circumstances of patients living with HIV, immediate action on the linked factors is needed, such as monitoring for maintenance of CD4 counts >200 cells/µL and avoiding progression of HIV to the advanced WHO clinical stages, suppressed viral load, preventing opportunistic infections and parasitic infestation.
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Anemia , Terapia Antirretroviral Altamente Activa , Infecciones por VIH , Compuestos Heterocíclicos con 3 Anillos , Oxazinas , Piridonas , Humanos , Femenino , Masculino , Adulto , Estudios Transversales , Estudios Retrospectivos , Anemia/epidemiología , Etiopía/epidemiología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Prevalencia , Persona de Mediana Edad , Factores de Riesgo , Piridonas/uso terapéutico , Compuestos Heterocíclicos con 3 Anillos/uso terapéutico , Recuento de Linfocito CD4 , Adulto Joven , Inhibidores de Integrasa VIH/uso terapéutico , Índice de Severidad de la Enfermedad , PiperazinasRESUMEN
Introduction: sexual violence is currently a serious public health problem affecting women´s health. Globally, 1 in 3 women faces sexual violence in their lifetime. Female industry workers are at an increased risk of sexual violence. Assessing the magnitude and factors associated with sexual violence among female industrial workers is important for interventions. The objective was to assess the prevalence and factors associated with sexual violence among female large-scale industries workers in Bahir Dar, Ethiopia, 2021. Methods: institution-based cross-sectional study was conducted on 807 female industry workers from September to October 2021. Participants were selected by systematic random sampling. The data were collected by a structured questionnaire. Data entry and analysis were done by Epi data v.3.1 and SPSS v.23, respectively. Multivariable logistic regression analysis was done to identify factors. Adjusted odds ratios were computed at 95%CI. A P-value below 0.05 was used to declare association. Results: the prevalence of sexual violence were 59.4% (95% CI; 56.0%-62.6%). The significantly associated factors include; age less than twenty-five (AOR=4.01, 95%CI; 2.81, 10.83), never-married women (AOR=3.07, 95%CI; 1.11, 8.46), being secondary education (AOR=2.65, 95%CI; 1.51, 4.66), being contract employee (AOR=4.65, 95%CI; 1.92, 11.22), drinking alcohol (AOR=3.01, 95%CI; 1.49, 6.09), and night work shift (AOR=9.01, 95%CI; 4.53, 17.93). Conclusion: high rate (59.4%) of sexual violence was reported. Age, marital status, educational status, contract type of work agreement, drinking alcohol, and working night work shift were risk factors. Hence, emphasis on creating safe working environment & transportation, education on reproductive rights and reporting of sexual violence.
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Delitos Sexuales , Humanos , Etiopía/epidemiología , Femenino , Estudios Transversales , Adulto , Prevalencia , Adulto Joven , Encuestas y Cuestionarios , Factores de Riesgo , Delitos Sexuales/estadística & datos numéricos , Persona de Mediana Edad , Adolescente , Industrias/estadística & datos numéricos , Factores de EdadRESUMEN
BACKGROUND: Teenage pregnancy remains one of the major reproductive health problems, especially in sub-Saharan African countries. It can lead to maternal and neonatal complications and social consequences. The proportion of teenage pregnancy differs across regions of Ethiopia. Thus, this study aimed to determine the spatial variation in determinants of teenage pregnancy among adolescents aged 15-19 years in Ethiopia using the 2019 Demographic and Health Survey (DHS). METHODS: This study included a total weighted sample of 2165 teenage girls aged 15 to 19 years. A mixed-effect binary logistic regression model was employed to consider the hierarchical nature of the DHS data using STATA version 17. Adjusted odds ratios with 95% confidence intervals are reported, and a p-value less than 0.05 was used to identify significant predictors. The spatial analysis was conducted with ArcGIS version 10.7 and Python 3. To identify factors associated with the hotspots of teenage pregnancy, a multiscale geographically weighted regression (MGWR) was performed. Spatial regression models were compared using adjusted R2, the corrected Akaike information criterion (AICc), and the residual sum of squares (RSS). RESULTS: The prevalence of teenage pregnancy among adolescents aged 15 to 19 years was 12.98% (95% CI: 11.6%, 14.5%). It was spatially clustered throughout the country with a significant Moran's I value. Significant hotspot areas were detected in central and southern Afar; northern, central, and western Gambela; northeastern and southern central Oromia; and the eastern Somali region. The MGWR analysis revealed that the significant predictors of spatial variations in teenage pregnancy were being illiterate and being married. Based on the multivariable multilevel analysis, age 17 (AOR = 3.54; 95% CI: 1.60, 7.81), 18 (AOR = 8.21; 95% CI: 3.96, 17.0), 19 (AOR = 15.0; 95% CI: 6.84, 32.9), being literate (AOR = 0.57; 95% CI: 0.35, 0.92), being married (AOR = 22.8; 95% CI: 14.1, 37.0), age of household head (AOR = 0.98; 95% CI: 0.98, 0.99) and residing in the Gambela region (AOR = 3.27; 95% CI: 1.21, 8.86) were significantly associated with teenage pregnancy among adolescents aged 15 to 19. CONCLUSION: Teenage pregnancy is a public health problem in Ethiopia. Policymakers should prioritize addressing early marriage and improving teenage literacy rates, with a focus on the Gambela region and other hotspot areas. It is crucial to implement policies aimed at transforming the traditional practice of early marriage and to take measures to enhance literacy levels and promote awareness about sexual and reproductive health at the family and school levels. This will help ensure that young people have the opportunity to pursue education and make informed decisions about their reproductive health.
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Encuestas Epidemiológicas , Embarazo en Adolescencia , Adolescente , Humanos , Embarazo en Adolescencia/estadística & datos numéricos , Etiopía/epidemiología , Femenino , Embarazo , Adulto Joven , Regresión Espacial , Factores Socioeconómicos , PrevalenciaRESUMEN
INTRODUCTION: Pneumococcal disease is a serious global public health concern. The primary causative agent of severe illnesses such as pneumonia, meningitis, acute otitis media, and bacteremia is the pneumococcus bacterium. The pneumococcal conjugate vaccine is a key strategy to reduce the burden of pneumococcal disease. Understanding the spatial distribution of complete childhood pneumococcal conjugate vaccine utilization and its associated factors is crucial for designing strategies to improve vaccination implementation. Therefore, this study aimed to determine the spatial distribution of complete childhood pneumococcal conjugate vaccination coverage and identify its determinants in Ethiopia. METHOD: A spatial and multilevel analysis was conducted using data from the 2019 Ethiopian Mini Demographic and Health Survey. The analysis included a total of 2,055 weighted children. The association between the outcome variable and the explanatory variables was determined by calculating adjusted odds ratios at a 95% confidence interval. Explanatory variables were considered significantly associated with the outcome if the p-value was less than 0.05. RESULT: The prevalence of complete childhood pneumococcal conjugate vaccination in Ethiopia was 53.94% (95% CI: 51.77, 56.08). Higher complete childhood pneumococcal vaccination coverage was observed in the Addis Ababa, Tigray, Amhara, Benishangul-Gumuz, and Oromia regions, while lower coverage was seen in the Afar, Somali, and SNNPR regions of Ethiopia. Factors significantly associated with complete childhood pneumococcal conjugate vaccination included maternal age, antenatal care visits, place of delivery, region, community women's literacy level, community poverty level, and community antenatal care utilization. CONCLUSION: The distribution of complete childhood pneumococcal conjugate vaccination exhibited spatial variability across Ethiopia. Approximately half of children aged twelve to thirty-five months received the full dose of the childhood pneumococcal conjugate vaccine in the country. Several factors were identified as statistically significant determinants of complete childhood pneumococcal conjugate vaccination, including maternal age, antenatal care visits, place of delivery, region, community women's literacy level, community poverty level, and community ANC utilization. Therefore, policies and strategies aimed at combating pneumococcal disease should consider these determinants and address areas with low vaccination coverage.
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Análisis Multinivel , Infecciones Neumocócicas , Vacunas Neumococicas , Análisis Espacial , Cobertura de Vacunación , Vacunas Conjugadas , Humanos , Etiopía/epidemiología , Femenino , Vacunas Neumococicas/administración & dosificación , Preescolar , Masculino , Lactante , Cobertura de Vacunación/estadística & datos numéricos , Vacunas Conjugadas/administración & dosificación , Infecciones Neumocócicas/prevención & control , Infecciones Neumocócicas/epidemiología , Prevalencia , Adolescente , Adulto , Adulto JovenRESUMEN
BACKGROUND: Self-medication practices involve the use of medications without healthcare professional requests. The threat of coronavirus disease 2019 (COVID-19) caused the practice of a fittest to survive action, with the assumption that something is better than nothing. Moreover, owing to the lack of effective treatment for COVID-19, the general public has shifted toward self-medication and symptomatic treatment, with approximately 80% of people stockpiling medication for use during the pandemic. Thus, this study aimed to assess the factors associated with self-medication practices during the COVID-19 pandemic crisis in southwestern Ethiopia. METHODS: A community-based cross-sectional study design was employed at selected drug retail outlets in southwestern Ethiopia for 415 community pharmacy clients from July 1, 2021, to September 1, 2021. Purposive sampling techniques were employed to select five drug retail outlets on the basis of high patient flows, and we took the study participants until the required quota allotted to each selected drug retail outlet had been filled. Bivariable and multivariable logistic regression analyses were employed to identify factors associated with self-medication. AORs with 95% CIs were used to report associations, and the level of significance was set at P < 0.05. RESULTS: Self-medication was significantly associated with being female (AOR 3.51, 95% CI 1.04-12.41), having a college education or above (AOR 47, 95% CI 4.32-55.21), time wastage at public health facilities (AOR 2.71, 95% CI 3.47-5.21), being afraid of contracting COVID-19 (AOR 0.006, 95% CI 0.004-0.185), and having high fees at public health facility (AOR 0.006, 95% CI 0.004-0.185). The most frequently used medications to treat or prevent the COVID-19 pandemic were analgesics (42.4%) and cold medicines (29.5%). Headache (22.2%), fever (13.2%), respiratory infection (14.3%), and cold (21.4%) were the most frequently reported symptoms of the COVID-19 pandemic. CONCLUSION: This study revealed high self-medication practices among study area residents during the COVID-19 pandemic. The primary reasons for self-medication in the context of COVID-19 are fear of the pandemic and time wastage at public health facilities. Therefore, special attention should be given to educating public and health care providers on the types of illnesses that can be self-diagnosed and self-treated and the types of drugs to be used for self-medication.
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COVID-19 , Automedicación , Humanos , Automedicación/estadística & datos numéricos , Etiopía/epidemiología , Estudios Transversales , Femenino , Masculino , Adulto , COVID-19/epidemiología , Persona de Mediana Edad , Adulto Joven , SARS-CoV-2 , Adolescente , Encuestas y Cuestionarios , Tratamiento Farmacológico de COVID-19 , PandemiasRESUMEN
BACKGROUND: In sub-Saharan African countries, preventable and manageable diseases such as diarrhea and acute respiratory infections still claim the lives of children. Hence, this study aims to estimate the rate of change in the log expected number of days a child suffers from Diarrhea (NOD) and flu/common cold (NOF) among children aged 6 to 11 months at the baseline of the study. METHODOLOGY: This study used secondary data which exhibit a longitudinal and multilevel structure. Based on the results of exploratory analysis, a multilevel zero-inflated Poisson regression model with a rate of change in the log expected NOD and NOF described by a quadratic trend was proposed to efficiently analyze both outcomes accounting for correlation between observations and individuals through random effects. Furthermore, residual plots were used to assess the goodness of fit of the model. RESULTS: Considering subject and cluster-specific random effects, the results revealed a quadratic trend in the rate of change of the log expected NOD. Initially, low dose iron Micronutrient Powder (MNP) users exhibited a higher rate of change compared to non-users, but this trend reversed over time. Similarly, the log expected NOF decreased for children who used MNP and exclusively breastfed for six months, in comparison to their counterparts. In addition, the odds of not having flu decreased with each two-week increment for MNP users, as compared to non-MNP users. Furthermore, an increase in NOD resulted in an increase in the log expected NOF. Region and exclusive breastfeeding also have a significant relationships with both NOD and NOF. CONCLUSION: The findings of this study underscore the importance of commencing analysis of data generated from a study with exploratory analysis. The study highlights the critical role of promoting EBF for the first six months and supporting children with additional food after six months to reduce the burden of infectious diseases.
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Diarrea , Humanos , Etiopía/epidemiología , Lactante , Estudios Longitudinales , Masculino , Femenino , Diarrea/epidemiología , Distribución de Poisson , Resfriado Común/epidemiología , Gripe Humana/epidemiología , Modelos Estadísticos , Enfermedades Transmisibles/epidemiologíaRESUMEN
BACKGROUND: Surra is a parasitic disease caused by Trypanosoma evansi that threatens the health and productivity of camels. Despite its significant impact on camels in Ethiopia, surra has not received as much attention as diseases in cattle and other domestic animals. The objective of the study was to estimate the prevalence of surra, identify the potential risk factors and assess the traditional knowledge, attitude and practices of camel herders towards the disease. METHODS: The study used a parasitological and participatory epidemiological (PE) approach. Between February and July 2022, a total of 335 blood samples were collected from camels across three districts and tested using the buffy coat technique. The PE investigation involved six key informant groups consisting of 8 to 12 key persons, and used a semi-structured interview and various PE tools and principles. RESULT: The study found that the prevalence of surra among examined camels was 3.9% (95% CI: 2.1-6.5). The prevalence was significantly higher in camels with a poor body condition score (BCS) (OR = 9.3; 95% CI: 1.8-47.5; p = 0.008) compared with camels with a good BCS. However, district, age, sex, and ethnicity had no effect on the prevalence of surra (p > 0.05). The study also found that the packed cell volume (PCV) was significantly lower (p < 0.0001) in parasitaemic animals (18.92 ± 2.63) than in aparasitaemic animals (25.13 ± 4.56). Camels with poor BCS (22.7 ± 3.5) had a significantly (p < 0.001) lower mean PCV than camels with good BCS (26.2 ± 5.0). The PE investigation showed that all the camel herders were well aware of surra, known locally as Dhukana. The clinical symptoms, the season of high incidence, routes of transmission, impact on production, and control methods were accurately described. Moreover, this study emphasized that surra is the primary disease affecting camel health and productivity. CONCLUSION: The study identified a moderate prevalence of surra in the research area. To reduce surra incidence and associated losses, enhancing veterinary services and providing support for proper camel husbandry practices in the region is recommended. Additionally, future studies should consider using more sensitive and specific techniques like serological and molecular assays, as this study relied on microscopy only.
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Camelus , Conocimientos, Actitudes y Práctica en Salud , Trypanosoma , Tripanosomiasis , Animales , Etiopía/epidemiología , Prevalencia , Femenino , Masculino , Tripanosomiasis/veterinaria , Tripanosomiasis/epidemiología , Trypanosoma/aislamiento & purificación , Humanos , Factores de Riesgo , Crianza de Animales Domésticos/métodosRESUMEN
BACKGROUND: Asthma is a leading cause of emergency hospital visits and a significant factor in lost productive hours. The lack of a synthesized body of knowledge on bronchial asthma has notable public health implications. OBJECTIVE: This systematic review and meta-analysis aim to investigate the prevalence of asthma and its predictors among patients presenting in Ethiopian public hospitals. DESIGN: Duplicate studies were removed using EndNote version X9. The Newcastle-Ottawa Scale guided the quality assessment, and data extraction followed the Joanna Briggs Institute format. DATA SOURCE AND METHODS: The authors used advanced search methods, including databases such as PubMed, Scopus, Embase, Africa Index Medicus, Science Direct, HINARI, Google Scholar, and manual searches. Data presentation adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Publication bias was assessed using Egger's regression test and a funnel plot. Sensitivity analysis was also conducted. RESULTS: The search yielded 352 original articles, with 22 meeting the criteria for inclusion. Using the random-effects DerSimonian-Laird model, the prevalence of bronchial asthma was found to be 9.02% (95% CI: 7.50, 10.53). Several factors were associated with the prevalence of bronchial asthma, including the spring season (AOR 3.7; 95% CI: 2.11, 6.49), childhood age (AOR 4.2; 95% CI: 1.84, 9.55), and urban residence (AOR 1.7; 95% CI: 1.29, 2.31). Other significant factors include family history of asthma (AOR 2.89; 95% CI: 2.22, 3.75), insecticide exposure (AOR 3.3; 95% CI: 2.23, 4.91), and the presence of household insects like cockroaches (AOR 3.33; 95% CI: 2.15, 5.15). Smoking (AOR 3.64; 95% CI: 2.66, 4.98), obstructive sleep apnea (AOR 4.29; 95% CI: 2.37, 7.76), and recurrent upper respiratory tract infections (AOR 4.31; 95% CI: 2.24, 8.32) were also significant. CONCLUSION: The pooled prevalence of bronchial asthma is notably high in Ethiopia. Key predictors include childhood age, spring season, urban living, family history of asthma, exposure to insecticides, presence of cockroaches, smoking, obstructive sleep apnea, and recurrent upper respiratory infections. Targeted interventions are crucial and should focus on lifestyle improvements, allergen identification, cockroach control, smoking cessation, reducing insecticide exposure, and promoting a safe environment. TRIAL REGISTRATION: This review's protocol was pre-registered with the International Prospective Register of Systematic Reviews (PROSPERO registration number CRD42023491222).
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Asma , Hospitales Públicos , Asma/epidemiología , Asma/diagnóstico , Asma/fisiopatología , Prevalencia , Humanos , Etiopía/epidemiología , Factores de Riesgo , Adulto , Masculino , Femenino , Niño , Adolescente , Persona de Mediana Edad , Adulto Joven , Estaciones del Año , Medición de Riesgo , Preescolar , AncianoRESUMEN
The early stages of childhood are a crucial period of life for health, with inadequate nutrition impacting physical growth, cognitive development, and the immune system. A considerable proportion of children are affected by micronutrient intake inadequacy and deficiency across the globe. Evidence on micronutrient intake among children aged 6-23 months is limited in Northwest Ethiopia, where there is a divergence between production and dietary consumption practices compared to other regions of the country. This study aimed to determine micronutrient inadequacy and associated factors among children aged 6-23 months. From February 1 to February 18, 2023, 435 children aged 6-23 months participated in a community-based cross-sectional study in the North Mecha District of the Amhara Region, Northwest Ethiopia. The study participants were selected using a multistage sampling technique. A multiphasic interactive 24-h dietary recall was used to collect dietary intake data via an interviewer-administered questionnaire. The interviews were conducted with the mothers of the selected children. Nutrient values for the selected 12 micronutrients were calculated using the NutriSurvey 2007 software and food composition tables from Ethiopia, Tanzania, and Kenya. SPSS version 25 was used for the remaining parts of the analysis. The Nutrient Adequacy Ratio and Mean Adequacy Ratio were calculated to evaluate the nutrient intakes. To identify the factors associated with overall micronutrient intake inadequacy, a binary logistic regression analysis was performed, with statistical significance determined at a p-value < 0.05. The overall prevalence of micronutrient intake inadequacy was 64.7% (95% CI 59.9, 69.2). The odds of inadequacy of micronutrient intake were 2.8 times higher among children aged 6-8 months than children aged 9-23 months (AOR = 2.80, 95% CI 1.71, 4.59). Children with paternal education unable to read and write and primary school incomplete were 3.1 (AOR = 3.12, 95% CI 1.26, 7.70) and 2.4 (AOR = 2.40, 95% CI 1.01, 5.73) times more likely to have micronutrient intake inadequacy, respectively, compared to children with paternal education of primary school completed and above. The likelihood of micronutrient intake inadequacy was 1.8 times higher among children from mothers who had an unfavorable nutrition-related attitude than those from mothers who had a favorable attitude (AOR = 1.76, 95% CI 1.02, 3.05). Inadequate intake of micronutrients was shown to be highly prevalent among children aged 6-23 months. Child age, paternal education, and maternal nutrition-related attitude were significantly associated with micronutrient intake inadequacy. Integrating community-guided nutrition interventions targeting nutrition-related knowledge and attitudes of parents is critical in addressing the inadequate micronutrient intake of children in the study community, where production is not a major problem.
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Micronutrientes , Estado Nutricional , Humanos , Etiopía/epidemiología , Lactante , Femenino , Masculino , Estudios Transversales , DietaRESUMEN
BACKGROUND: Thyroid disease is a global health problem and the most common type of endocrine disorder next to diabetic mellitus, accounting for around 30-40% burden of the endocrine disorders. OBJECTIVE: The objective of the study was to assess patterns, treatment outcome and associated factors of surgically treated thyroid disease at Public Hospitals in Eastern Ethiopia. METHODS: The study was conducted among surgically treated patients for thyroid disorders using a retrospective cross-sectional study design by reviewing all patients' charts. A data abstraction sheet was used to collect relevant data, and the collected data was analyzed using SPSS version 26 software. Bi-variable and multivariable binary logistic regression was employed to assess the association between dependent and independent variables. RESULTS: The study was conducted on 200 patients' medical records who had complete information. Out of this, 84.5% were female and 66.5% of patients' age was between 20 and 40 years. Toxic goiter was the most common thyroid disease which accounted for 49.5%. Hemorrhage and Hypocalcemia were the most common complications after surgery. Anterior neck swelling of greater than 15 years [(AOR: 52.892 CI = 95% (6.087-459.5.68) (P-0.000)], Total/ near total thyroidectomy [(AOR: 20.139 CI = 95% (4.059-99.931) P-00.000] were significantly associated with complicated post-operative course, while female sex [(AOR: 0.124 CI = 95% (0.34-0.494) P- 0.003)] was associated with lower risk of developing post-operative complications. CONCLUSION: This study showed that 9.5% of operated patients with thyroid disease had complicated post-operative course. Long standing goiter and total/ near total thyroidectomy were significantly associated with complicated post-operative course.
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Hospitales Públicos , Enfermedades de la Tiroides , Tiroidectomía , Humanos , Estudios Transversales , Femenino , Etiopía/epidemiología , Estudios Retrospectivos , Masculino , Adulto , Hospitales Públicos/estadística & datos numéricos , Enfermedades de la Tiroides/cirugía , Tiroidectomía/métodos , Tiroidectomía/efectos adversos , Persona de Mediana Edad , Resultado del Tratamiento , Adulto Joven , Adolescente , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , AncianoRESUMEN
BACKGROUND: In Ethiopia, ticks are the major threat to cattle productivity and production, leading to considerable economic losses. The current study was designed to estimate the prevalence of ixodid tick infestation, identify species, assess major risk factors associated with tick infestation and assess public awareness. METHODS: A cross-sectional and questionnaire-based study was conducted from January 2022 to June 2022 in the Aleltu district. The study animals were selected using a simple random sampling method. RESULTS: Of the 400 cattle examined, 303 (75.8%) were found to be infested by one or more tick species. Six species of ticks were identified that belonged to three genera: Amblyomma, Hyalomma and Rhipicephalus, and the subgenus Rhipicephalus (Boophilus). The most common tick species identified in terms of their prevalence and dominance were Rh. (Bo) decoloratus, Rh. evertsi, Am. variegatum, Hy. rufipes, Rh. bergeoni and Rh. praetextatus. In the present study, Rh. (Bo) decoloratus was the most prevalent (56.8%) in the study area. Among the risk factors considered, the prevalence of tick species had a statistically significant (p < 0.05) association with the age, production systems and body condition of animals. Out of 110 people interviewed, 107 (97.3%) believed there was a tick infestation in their village, and almost all farmers 103(93.6%) in the study area were unaware that ticks serve as vectors. CONCLUSIONS: The present study provides preliminary information on the prevalence of tick infestation and the composition of ticks in the Aleltu district. Ticks are a major problem for the cattle in the study area. Therefore, the problem observed in the study area alarms the district and calls for a comprehensive control strategy.
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Enfermedades de los Bovinos , Ixodidae , Infestaciones por Garrapatas , Animales , Etiopía/epidemiología , Bovinos , Infestaciones por Garrapatas/veterinaria , Infestaciones por Garrapatas/epidemiología , Infestaciones por Garrapatas/parasitología , Ixodidae/fisiología , Prevalencia , Enfermedades de los Bovinos/epidemiología , Enfermedades de los Bovinos/parasitología , Estudios Transversales , Femenino , Masculino , Factores de RiesgoRESUMEN
Animals play a central role in human livelihoods and welfare. Animal diseases have a great impact on the benefits humans derive from animals and can also pose a risk to human health. Better control of animal diseases generates wider societal benefits, including reducing the climate and ecological impacts of livestock and improving animal welfare. To better understand the scale of investment justified for the control and prevention of animal disease, the wide-ranging impacts of disease on animal production and health must be measured. The Global Burden of Animal Diseases (GBADs) programme is quantifying animal disease burden from the local to global levels. The GBADs programme includes country case studies for national- and local-level analysis. Ethiopia is the first case study country in which GBADs methods have been applied. GBADs'Ethiopia case study consists of three activity areas: i) stakeholder engagement; ii) livestock disease burden estimation, including data collection, analytics, evidence generation and communication; and iii) capacity building in animal health economics. At the start of the case study, various stakeholder communication platforms were used to familiarise stakeholders with GBADs and engage their support in various ways, including data access, and, through this engagement, to ensure the programme tools and outputs were relevant and useful to their needs. Existing data were retrieved from multiple sources and used to estimate disease burden. This process involved multiple steps, including estimation of biomass and economic value, the Animal Health Loss Envelope (farm-level disease burden), wider economic impacts and attribution of the disease burden to different levels of causes. This was carried out for major livestock species (cattle, sheep, goats and poultry) in Ethiopia. Capacity building on animal health economics was carried out for GBADs end users to increase competence in utilising animal health economic evidence, including GBADs outputs. This article documents experiences of the implementation of these activities in the GBADs Ethiopia case study.
Les animaux représentent une part substantielle des moyens de subsistance et contribuent de manière essentielle au bien-être humain. Les bénéfices que l'humanité peut retirer des animaux sont toutefois compromis par les maladies animales, qui font aussi peser un risque sur la santé publique. Les avantages sociétaux d'un meilleur contrôle des maladies animales dépassent la portée strictement sanitaire et recouvrent notamment l'atténuation de l'impact climatique et environnemental des animaux d'élevage et l'amélioration du bien-être animal. Pour mieux appréhender l'échelle des investissements requis pour contrôler et prévenir les maladies animales, il convient de mesurer les impacts très divers de ces maladies sur la production et la santé animales. Le programme " Impact mondial des maladies animales " (GBADs) procède actuellement à la quantification de la charge des maladies animales, du niveau local au niveau mondial. Il comprend aussi des études de cas conduites dans des pays choisis pour une analyse à l'échelle nationale, voire locale. L'Ethiopie est le premier pays à avoir fait l'objet d'une étude de cas nationale reprenant les méthodes du GBADs. L'étude comportait trois volets d'activités : i) la mobilisation des parties prenantes ; ii) l'estimation de la charge des maladies chez les animaux d'élevage, notamment la collecte de données, leur analyse, l'apport d'éléments probants et la communication ; et iii) le renforcement des capacités en économie de la santé animale. Au lancement de l'étude, plusieurs plateformes de communication professionnelles ont été utilisées pour mieux faire connaître le GBADs aux différents acteurs et solliciter leur soutien de diverses manières, en particulier en termes d'accès aux données, et pour s'assurer, grâce à cette mobilisation, que les outils et les résultats du programme étaient pertinents pour eux et répondaient à leurs besoins. Les données existantes ont été recueillies auprès de multiples sources et ont permis d'estimer la charge sanitaire. Ce processus comportait plusieurs étapes, dont l'estimation de la biomasse et de la valeur économique, la définition de l'enveloppe des pertes sanitaires animales (charge sanitaire à l'échelle des exploitations), l'appréciation des effets économiques au sens large et la répartition de la charge sanitaire en fonction des niveaux des causes attribuées. Les analyses portaient sur les principales espèces d'animaux d'élevage (bovins, ovins, caprins et volailles) en Ethiopie. Des activités de renforcement des capacités en économie de la santé animale ont été proposées aux utilisateurs finaux du GBADs afin de les former à l'utilisation des preuves économiques en santé animale. Les auteurs expliquent comment s'est déroulée la mise en oeuvre de ces activités lors de l'étude du GBADs conduite en Ethiopie.
Los animales desempeñan un papel fundamental en los medios de subsistencia y el bienestar humanos. En este sentido, las enfermedades animales tienen un gran impacto en los beneficios que los humanos obtienen de los animales y también pueden suponer un riesgo para la salud humana. Un mejor control de las enfermedades animales genera beneficios sociales más amplios, como la reducción del impacto climático y ecológico de la ganadería y la mejora del bienestar animal. Para comprender mejor la magnitud de la inversión justificada para el control y la prevención de las enfermedades animales, es preciso medir las amplias repercusiones de las enfermedades en la producción y la sanidad animal. El programa sobre el impacto global de las enfermedades animales (GBADs) cuantifica el impacto de las enfermedades animales desde el nivel local hasta el mundial. El programa GBADs incluye estudios de casos por países a fin de realizar un análisis a escala nacional y local. Etiopía es el primer país en el que se han aplicado los métodos del GBADs. El estudio de caso del GBADs en dicho país se divide en tres áreas de actividad: i) la participación de las partes interesadas; ii) la estimación del impacto de las enfermedades del ganado, incluida la recopilación de datos, el análisis, la generación de pruebas y la comunicación; y iii) el desarrollo de capacidades en el ámbito de la economía de la sanidad animal. Al inicio del estudio de caso, se utilizaron diversas plataformas de comunicación con las partes interesadas para familiarizarlas con el GBADs y recabar su apoyo a través de diversas vías, entre las que se incluía el acceso a los datos, y, mediante esta colaboración, garantizar que las herramientas y los resultados del programa fueran pertinentes y útiles para sus necesidades. Se obtuvieron datos de diversas fuentes que se utilizaron para estimar el impacto de las enfermedades. Este proceso implicó múltiples pasos, incluida la estimación de la biomasa y el valor económico, la cartera de pérdidas en sanidad animal (impacto de las enfermedades a nivel de explotación), los impactos económicos más amplios y la atribución del impacto de las enfermedades a diferentes categorías de causas. Esto se llevó a cabo para las principales especies ganaderas (bovinos, ovinos, caprinos y aves de corral) en Etiopía. Se realizaron actividades de capacitación en economía de la sanidad animal para los usuarios finales con el fin de aumentar su competencia en la utilización de los datos económicos sobre sanidad animal, incluidos los resultados del GBADs. Este artículo documenta las experiencias de la puesta en práctica de estas actividades en el estudio de caso del GBADs en Etiopía.
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Enfermedades de los Animales , Ganado , Etiopía/epidemiología , Animales , Enfermedades de los Animales/epidemiología , Enfermedades de los Animales/prevención & control , Enfermedades de los Animales/economía , Humanos , Carga Global de Enfermedades , Crianza de Animales Domésticos/métodos , Crianza de Animales Domésticos/economíaRESUMEN
BACKGROUND: Frailty is a multidimensional geriatric syndrome associated with physical, psychological and social changes. There is a paucity of research on frailty in Sub-Saharan African (SSA) countries, especially Ethiopia. OBJECTIVES: To assess the initial correlations among frailty, nutritional status, depression and QOL (quality of life) in a group of older people in Ethiopia who are later enrolled in a study examining the effects of a nurse-led community intervention on frailty and related health outcomes. METHODS: Data from 68 community-dwelling individuals 60 years of age, or over, were collected. Frailty was measured using the Amharic version of the Tilburg Frailty Indicator. The statistical analysis included Spearman's rank correlation coefficient for degrees of association, Mann-Whitney U-test for variables with two categories and Kruskal-Wallis for variables with three or more categories. RESULTS: The mean frailty score for participants was 7.3 (±1.9). Participants with higher frailty scores had lower nutritional status (rs = -0.46, p < 0.01). There was a statistically significant relationship (positive) between frailty scores and depression (rs = 0.39, p < 0.01). Depressed (Md = 9, n = 23) and non-depressed frail older people (Md = 7, n = 45) showed a significant difference in their overall frailty score, U = 330.50, z = -2.49, p = 0.01, r = 0.30. There was an inverse significant association between the level of frailty across different domains in the QOL: physical (rs = -0.44, p < 0.01), psychological (rs = -0.45, p < 0.01), social relations (rs = -0.29, p < 0.05) and environmental (rs = -0.47, p < 0.01). CONCLUSION: The findings from this study were consistent with those from across middle-income and high-income countries. IMPLICATIONS FOR PRACTICE: This research indicates that older people living in communities who are identified as frail often suffer from a poor nutritional status, depression and reduced QOL. It suggests that healthcare professionals in Sub-Saharan countries would benefit from recognising the frailty in this population, and developing interventions aimed at enhancing nutrition, mental health and overall well-being.
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Depresión , Anciano Frágil , Fragilidad , Evaluación Geriátrica , Estado Nutricional , Calidad de Vida , Humanos , Anciano , Masculino , Femenino , Etiopía/epidemiología , Depresión/epidemiología , Depresión/psicología , Anciano de 80 o más Años , Persona de Mediana Edad , Fragilidad/epidemiología , Anciano Frágil/psicología , Vida IndependienteRESUMEN
BACKGROUND: Epidemiological profiles and the rundown crisis of antimicrobial resistance from bacterial isolates in neonatal sepsis compel regular surveillance to enhance data-driven decision-making. Accordingly, this study aimed to assess the phenotypic epidemiology and antimicrobial resistance profiles of bacteria isolated from clinically suspected neonatal sepsis in Ethiopia. METHODS: A total of 342 neonates suspected of clinical sepsis were randomly included in a prospective observational study conducted at the neonatal intensive care unit (NICU) of Jimma medical center (JMC) from May 2022 to July 2023. Blood samples were collected from each neonate and subjected to a culture test for identification of bacterial isolates and their antibiotic resistance profiles following the standardized guidelines. The laboratory results, along with relevant clinical data, were recorded using WHONET and analyzed using STATA software. RESULTS: Out of the 342 blood samples that were analyzed, 138 samples (40.4%, 95% CI: 35.1-45.6, P<0.01) exhibited proven bacterial infection. The infection rates were notably higher in males with 85/138 (61.6%, 95% CI: 53.4-69.8, P<0.01) and neonates aged 0-3 days with 81/138 (58.7%, 95% CI: 50.5-66.9, P<0.01). The majority of the infections were attributed to Gram-negative bacteria, accounting for 101/138(73.2%, 95% CI: 65.6-80.7) cases, with 69/101(68.3%, 95% CI: 63.8-72.8) cases involving ESBL-producing strains, while Gram-positive bacteria were responsible for 26.8% (95% CI: 19.3-34.4) of the infections. The predominant isolates included Klebsiella pneumoniae (37.7%, 95% CI: 29.6-45.8), Coagulase-negative Staphylococci (CoNs) (20.3%, 95% CI: 13.6-27.0), and Acinetobacter species (11.6%, 95% CI: 6.0-17.1). Of the total cases, 43/72 (59.7%, 95% CI: 48.4-71.1, P<0.01) resulted in mortality, with 28/72 (38.9%, 95% CI: 27.70-50.1, P<0.03) deaths linked to Extended-Spectrum Beta-Lactamase (ESBL)-producing strains. Klebsiella pneumoniae displayed high resistance rates to trimethoprim-sulfamethoxazole (100%), ceftriaxone (100%), cefotaxime (98.1%), ceftazidime (90.4%), and gentamicin (84.6%). Acinetobacter species showed resistance to ampicillin (100%), cefotaxime (100%), trimethoprim-sulfamethoxazole (75%), ceftazidime (68.8%), chloramphenicol (68.8%), and ceftriaxone (68.8%). Likewise, CoNs displayed resistance to ampicillin (100%), penicillin (100%), cefotaxime (86.0%), gentamicin (57.2%), and oxacillin (32.2%). Multidrug resistance was observed in 88.4% (95% CI: 81.8-93.0) of isolates, with ESBL-producers significantly contributing (49.3%, 95% CI: 45.1-53.5). Furthermore, 23.0% (95% CI: 15.8-31.6) exhibited a prevalent resistance pattern to seven distinct antibiotic classes. CONCLUSION: The prevalence and mortality rates of neonatal sepsis were significantly high at JMC, with a notable surge in antibiotic and multidrug resistance among bacterial strains isolated from infected neonates, specifically ESBL-producers. These resistant strains have a significant impact on infection rates and resistance profiles, highlighting the requisite for enhanced diagnostic and antimicrobial stewardship, stringent infection control, and further molecular characterization of isolates to enhance neonatal survival.
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Antibacterianos , Sepsis Neonatal , Humanos , Etiopía/epidemiología , Recién Nacido , Masculino , Sepsis Neonatal/microbiología , Sepsis Neonatal/epidemiología , Sepsis Neonatal/tratamiento farmacológico , Femenino , Estudios Prospectivos , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Unidades de Cuidado Intensivo Neonatal , Pruebas de Sensibilidad Microbiana , Farmacorresistencia Bacteriana , Bacterias/efectos de los fármacos , Bacterias/aislamiento & purificación , FenotipoRESUMEN
BACKGROUND: Antimicrobial resistance is a major global public health issue. Infections caused by resistant species are associated with higher mortality rates, longer hospital stays, medication failure, and rising medical costs. The World Health Organisation has declared multidrug resistance-associated infections as an epidemic of public health concern. OBJECTIVE: This study aimed to evaluate the antimicrobial resistance profile and associated factors of hospital-acquired Gram-negative bacterial pathogens among hospitalized patients in Northeast Ethiopia. MATERIALS AND METHODS: A health facility-based cross-sectional study was conducted among hospitalized patients from March 2021 to February 2022. About 810 clinical specimens were collected, transported, and processed from admitted patients following the standard bacteriological procedures. The clinical samples were inoculated onto blood agar, MacConkey agar, and chocolate agar. Furthermore, the species identification was done using gram reactions, colony morphology, and color and biochemical tests. Antimicrobial susceptibility tests, extended-spectrum beta-lactamase, and carbapenemase production were performed as per the clinical laboratory standard institute guidelines. For analysis, the information was entered into Epi-data and exported to SPSS. A P value of < 0.05 with a 95% confidence interval was considered as a statistically significant association. RESULTS: Out of 810 clinical specimens, 285/810 (35.2%) developed bacterial infections. From the isolated bacteria, E. coli was the predominant bacteria accounting for 78/285 (27.4%) followed by K. pneumoniae, 69/285(24.42%), whereas P. vulgaris accounted for the least, 7/285 (2.5%). Overall, 132/285 (46.3%) and 99/285 (34.7%) of culture-positive patients were infected by extended-spectrum beta-lactamase and carbapenemase-producing bacteria. The overall multidrug resistance rate of the isolated bacteria was 89.4%. The highest antibiotic resistance rates were detected for doxycycline (92.9%), amoxicillin-clavulanic acid (83.9%), and ampicillin (93%). The least antibiotic resistance rate was observed for meropenem at 41.1% and amikacin at 1.7%, respectively. CONCLUSIONS AND RECOMMENDATIONS: In the study area, significant health concerns include a range of hospital-acquired bacterial infections associated with elevated rates of multidrug resistance, Extended-spectrum beta-lactamase (ESBL), and carbapenemase-producing bacterial pathogens. Consequently, it is recommended to conduct drug-susceptibility testing of isolates and molecular detection at a national level to optimize antibiotic usage for treating prevalent bacterial infections in this area.
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Antibacterianos , Infección Hospitalaria , Farmacorresistencia Bacteriana Múltiple , Bacterias Gramnegativas , Infecciones por Bacterias Gramnegativas , Pruebas de Sensibilidad Microbiana , Humanos , Etiopía/epidemiología , Estudios Transversales , Masculino , Femenino , Adulto , Persona de Mediana Edad , Antibacterianos/farmacología , Infección Hospitalaria/microbiología , Infección Hospitalaria/epidemiología , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Gramnegativas/clasificación , Bacterias Gramnegativas/genética , Adulto Joven , Adolescente , Infecciones por Bacterias Gramnegativas/microbiología , Infecciones por Bacterias Gramnegativas/epidemiología , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Farmacorresistencia Bacteriana Múltiple/genética , beta-Lactamasas/genética , beta-Lactamasas/metabolismo , Anciano , Niño , Preescolar , Lactante , Hospitalización/estadística & datos numéricos , Proteínas Bacterianas/genética , Anciano de 80 o más AñosRESUMEN
BACKGROUND: In patients with heart failure (HF), multiple electrolyte disorders are common, and recent studies have shown that chloride disorders play a significant role in the prognosis of HF. Data about the prevalence and prognostic role of hypochloremia in patients with acute HF (AHF) are scarce in African nations, including Ethiopia. Hence, this study aimed to assess the prevalence, associated factors, and prognostic role of hypochloremia in patients with AHF in Ethiopia. METHODS: This was a single-center retrospective analysis of AHF patients, aged ≥15 years, with chloride determination upon admission to the medical wards and medical ICU of Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, from July 1, 2022, to July 1, 2023. Statistical Package for Social Sciences, version 26, was used to enter and analyze the data. Descriptive analysis was used to summarize clinical profiles, laboratory data, and outcomes of AHF patients stratified by the presence and absence of hypochloremia. Logistic regression analysis was used to determine the factors associated with hypochloremia and to assess the association of hypochloremia and other factors with in-hospital mortality in patients with AHF. A two-tailed P value <0.05 was regarded as statistically significant. RESULTS: A total of 267 AHF patients who had chloride determination on admission were included in this study; the mean age was 56.7 years (standard deviation: 18.6), and the gender-based distribution of the patients was nearly equal. The prevalence of hypochloremia was 36.7%. Diastolic blood pressure <60 mm Hg [adjusted odds ratio (AOR) = 3.63, 95% confidence interval (CI), 1.04, 12.72] and hyponatremia (AOR = 29.20, 95% CI, 13.21, 64.56) were significantly associated with hypochloremia. The in-hospital mortality rate was higher in AHF patients with hypochloremia (16.3%) compared to those without hypochloremia (4.7%). The odds of in-hospital mortality among AHF patients with hypochloremia were 2.8 times higher compared to patients without hypochloremia (AOR = 2.82, 95% CI: 1.08, 7.04) after adjusting for ICU admission, systolic blood pressure < 120 mm Hg and diastolic blood pressure < 60 mm Hg. CONCLUSIONS: This study revealed a high prevalence of hypochloremia among patients with AHF. Low diastolic blood pressure and hyponatremia were significantly associated with the development of hypochloremia. Most importantly, AHF patients with hypochloremia had a higher in-hospital mortality rate compared to those without hypochloremia. Hence, hypochloremia on admission should be considered a potential prognostic factor in patients with AHF, and further research with a larger sample size is needed to support the findings of this study.
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Cloruros , Insuficiencia Cardíaca , Mortalidad Hospitalaria , Humanos , Etiopía/epidemiología , Femenino , Masculino , Estudios Retrospectivos , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/sangre , Insuficiencia Cardíaca/mortalidad , Persona de Mediana Edad , Prevalencia , Pronóstico , Anciano , Cloruros/sangre , Adulto , Enfermedad AgudaRESUMEN
BACKGROUND: Anemia in pregnancy has been associated with a number of adverse birth outcomes, such as low birth weight (LBW) or preterm birth (PTB). However, the evidence from primary studies on anemia in pregnancy with LBW and PTB is contentious. Moreover, a systematic review and meta-analysis to summarize these findings have not been conducted for Ethiopia. This study aimed to synthesize the best available evidence and quantify the strength and direction of the association of anemia in Ethiopia. METHODS: This review examined women with singleton pregnancies with low birth weight (LBW) and preterm birth (PTB). We retrieved studies from PubMed, Wiley, Cochrane databases, and Google Scholar from inception to February 2, 2024. The World Health Organization (WHO) defines anemia in pregnancy as a low blood haemoglobin (Hgb) concentration below 11 g/dl or a hematocrit level of < 33%. When the newborn's weight was below 2500 g, LBW was considered. Preterm birth refers to the birth of a baby before 37 completed weeks of gestation. Meta-analysis was conducted using fixed and random effects models. The degree of heterogeneity, publication bias, and quality of the evidence of studies was assessed. RESULTS: There were 35 and 8 studies, with 14,319 and 3,265 respondents included in the meta-analysis for LBW and PTB, respectively. Neonates born to women who had normal Hgb levels were less likely to be LBW [pooled odds ratio (POR) = 0.22, 95% CI: (0.17, 0.28); I2 = 80%] (low-quality evidence). Neonates born to women with normal Hgb levels had a lower risk of PTB [POR = 0.22, 95% CI: 0.18, 0.28; I2 = 19%] (very low-quality evidence). The effect size estimate remained significant after sub-group analysis based on study design and province, except in two retrospective cohort studies for LBW. CONCLUSION: The findings suggest major implications for strengthening the implementation of nutrition policies to prevent anemia during pregnancy in Ethiopia. Further research is warranted to assess interventions that are effective in combating maternal anemia to reduce rates of LBW and PTB.
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Anemia , Recién Nacido de Bajo Peso , Nacimiento Prematuro , Humanos , Femenino , Embarazo , Etiopía/epidemiología , Nacimiento Prematuro/epidemiología , Anemia/epidemiología , Anemia/sangre , Recién Nacido , Complicaciones Hematológicas del Embarazo/epidemiología , Complicaciones Hematológicas del Embarazo/sangreRESUMEN
Background: Diarrhea is a major cause of mortality and morbidity in under-5 children globally, especially in developing countries like Ethiopia. Limited research has used machine learning to predict childhood diarrhea. This study aimed to compare the predictive performance of ML algorithms for diarrhea in under-5 children in Ethiopia. Methods: The study utilized a dataset of 9501 under-5 children from the Ethiopia Demographic and Health Survey 2016. Five ML algorithms were used to build and compare predictive models. The model performance was evaluated using various metrics in Python. Boruta feature selection was employed, and data balancing techniques such as under-sampling, over-sampling, adaptive synthetic sampling, and synthetic minority oversampling as well as hyper parameter tuning methods were explored. Association rule mining was conducted using the Apriori algorithm in R to determine relationships between independent and target variables. Results: 10.2% of children had diarrhea. The Random Forest model had the best performance with 93.2% accuracy, 98.4% sensitivity, 85.5% specificity, and 0.916 AUC. The top predictors were residence, wealth index, and child age, number of living children, deworming, wasting, mother's occupation, and education. Association rule mining identified the top 7 rules most associated with under-5 diarrhea in Ethiopia. Conclusion: The RF achieved the highest performance for predicting childhood diarrhea. Policymakers and healthcare providers can use these findings to develop targeted interventions to reduce diarrhea. Customizing strategies based on the identified association rules has the potential to improve child health and decrease the impact of diarrhea in Ethiopia.
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Algoritmos , Diarrea , Aprendizaje Automático , Humanos , Etiopía/epidemiología , Diarrea/epidemiología , Diarrea/diagnóstico , Preescolar , Lactante , Femenino , Masculino , Recién Nacido , Encuestas Epidemiológicas/métodosRESUMEN
Streptococcus pneumoniae, a medically important opportunistic bacterial pathogen of the upper respiratory tract, is a major public health concern, causing a wide range of pneumococcal illnesses, both invasive and noninvasive. It is associated with significant global morbidity and mortality, including pneumonia, meningitis, sepsis, and acute otitis media. The major purpose of this study was to determine the molecular epidemiology of Streptococcus pneumoniae strains that cause invasive and noninvasive infections in Ethiopia. A prospective study was undertaken in two regional hospitals between January 2018 and December 2019. Whole-genome sequencing was used to analyze all isolates. Serotypes and multilocus sequence types (MLST) were derived from genomic data. The E-test was used for antimicrobial susceptibility testing. Patient samples obtained 54 Streptococcus pneumoniae isolates, 33 from invasive and 21 from noninvasive specimens. Our findings identified 32 serotypes expressed by 25 Global Pneumococcal Sequence Clusters (GPSCs) and 42 sequence types (STs), including 21 new STs. The most common sequence types among the invasive isolates were ST3500, ST5368, ST11162, ST15425, ST15555, ST15559, and ST15561 (2/33, 6% each). These sequence types were linked to serotypes 8, 7 C, 15B/C, 16 F, 10 A, 15B, and 6 A, respectively. Among the noninvasive isolates, only ST15432, associated with serotype 23 A, had numerous isolates (4/21, 19%). Serotype 14 was revealed as the most resistant strain to penicillin G, whereas isolates from serotypes 3, 8, 7 C, and 10 A were resistant to erythromycin. Notably, all serotype 6 A isolates were resistant to both erythromycin and penicillin G. Our findings revealed an abnormally significant number of novel STs, as well as extremely diversified serotypes and sequence types, implying that Ethiopia may serve as a breeding ground for novel STs. Recombination can produce novel STs that cause capsular switching. This has the potential to influence how immunization campaigns affect the burden of invasive pneumococcal illness. The findings highlight the importance of continuous genetic surveillance of the pneumococcal population as a vital step toward enhancing future vaccine design.
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Antibacterianos , Pruebas de Sensibilidad Microbiana , Epidemiología Molecular , Tipificación de Secuencias Multilocus , Infecciones Neumocócicas , Serogrupo , Streptococcus pneumoniae , Secuenciación Completa del Genoma , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/aislamiento & purificación , Streptococcus pneumoniae/efectos de los fármacos , Streptococcus pneumoniae/clasificación , Humanos , Etiopía/epidemiología , Infecciones Neumocócicas/microbiología , Infecciones Neumocócicas/epidemiología , Masculino , Niño , Femenino , Preescolar , Adolescente , Adulto , Persona de Mediana Edad , Estudios Prospectivos , Lactante , Adulto Joven , Antibacterianos/farmacología , AncianoRESUMEN
Bacterial vaginosis is a polymicrobial syndrome characterized by the decrease of Lactobacilli and an overgrowth of facultative and anaerobic bacteria in vaginal fluid. Though it has received little attention, it has been associated with poor pregnancy outcomes, such as pre-term labor and delivery, premature rupture of membranes, low birth weight, spontaneous abortion, and postpartum infections. This study aimed to determine the prevalence of bacterial vaginosis and its associated factors among pregnant women attending antenatal care clinics from September 15 to December 14, 2021, at public hospitals in West Shoa Zone, Oromia, Ethiopia. An institutional-based cross-sectional study was conducted on 260 pregnant women, and systematic random sampling was employed to recruit the study participants. Data were collected through a structured questionnaire and the vaginal swab was collected using a sterile cotton swab. The gram staining result was interpreted using the Nugent scoring system. Data was entered into an Excel spreadsheet and exported to STATA-14 for analysis. Data were presented using tables and graphs. Binary and multivariable logistic regressions were performed. Variables with a P value ≤ 0.25 at the binary logistic regression were entered into the multivariable logistic regression. Finally, variables with a P value ≤ 0.05 were considered predictors of bacterial vaginosis and interpreted using adjusted Odds Ratios (AOR) with a 95% confidence interval (CI). A total of 260 pregnant women attending antenatal care were included in the study. The prevalence of bacterial vaginosis according to the Nugent scoring system was 22.3% (95% CI 17.4 to 27.9%). Pregnant women with other marital status were at reduced risk of bacterial vaginosis as compared with married pregnant women (AOR = 0.260, 95% CI 0.068 to 0.9995; P = 0.05). Rural residence (AOR = 2.1, 95% CI 1.05 to 4.24; P = 0.036), use of one pant per week (AOR = 2.7, 95% CI 1.04 to 7.2; P = 0.041), and use of two or more pants per week (AOR = 4.96, 95% CI 1.49 to 16.57; P = 0.009) were significantly associated with bacterial vaginosis. In the current study, a high magnitude of bacterial vaginosis was reported. Residence, marital status, and number of pants used per week were found significantly associated among pregnant women. Hence, screening for the disease should be integrated into the recommended basic laboratory investigations during antenatal visits.