Browsing by Author "Ali, Ibrahim (PhD)"

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    Bacterial Uropathogens and their Drug Resistance Pattern in Diabetic Patients Attending Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
    (Addis Ababa University, 2015-07) Lega, Tebarek; Ali, Ibrahim (PhD)
    Background: Urinary tract infection (UTI) is one of the most common infections encountered and treated worldwide. UTI has been reported to be around four times higher in diabetics compared to non-diabetic patients. Since diabetic patients are at a high risk of development of UTIs, it is recommended that special attention is paid to them, especially for the management of bacterial UTIs. Objective: The aim of this study was to determine prevalence of significant bacteriuria and assess drug susceptibility pattern of the bacterial isolates in diabetic patients. Materials and Methods: A cross sectional study was conducted in Yekatit 12 Hospital Medical College from April to July 2015. . In this study, 246 patients diagnosed with diabetes mellitus were recruited consecutively. A standard questionnaire was used to collect information regarding the socio-demographic status and clinical history of the study participants. Mid-stream urine was used for chemical analysis, microscopy and microbiological isolation and identification of bacteria. Standardized disc diffusion method was used for the determination of antibiotic sensitivity testing. Data were entered into and analyzed by SPSS version 20. Results: Among the 246 study participants, 150 (60%) of them were females and 96 (40%) were males. The mean age of the study population was 51.5 years. Pyuria was detected in 27 (11%) of the urine specimens examined microscopically. Of the 246 urine specimens cultured on CLED and blood agar plate, 17(6.9%) of them showed significant bacteriuria. Among the 17 bacterial isolates, E. coli was the most frequently isolated one, accounting 10 (53%), followed by Klebsiella species 4 (21%). All the isolates showed 100% sensitivity to nitrofurantoin, except Proteus species, which exhibited resistance to the antibiotic. The multidrug resistant rate of the isolates in our study was 31.6% Conclusion and Recommendation: The overall prevalence of significant bacteriuria in our study was 6.9%. Even though Proteus species showed resistance to nitrofurantoin, all the remaining isolates were 100% sensitive to the antimicrobial. Use of antibiotics for treating UTI in DM patients should be supported with periodic culture and drug susceptibility test studies in a given geographical location.
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    Diagnostic Performance of Commercially Available Widal Test Kits for the Diagnosis of Typhoid Fever: the Case of One Public Hospital and a Health Center in Addis Ababa, Ethiopia
    (Addis Ababa University, 2015-11) Temtem, Mastawesha; Ali, Ibrahim (PhD)
    Background: The causative agent of typhoid fever was first isolated in the late 19th century. The Widal agglutination test, utilizes a suspension of killed Salmonella Typhi as an antigen, to detect anti-H and anti-O agglutinins in serum from suspected Salmonella Typhi-infected patients. Information concerning the utility of Widal test in Ethiopia is limited and studies using multiple Widal test kits are even far less common. Objective: The objective of this study was to investigate the diagnostic performance of commercially available Widal test kits for the diagnosis of typhoid fever in Ethiopia. Methods: A cross-sectional study was conducted in two governmental health facilities in Addis Ababa, from October 2014 to February 2015 and a total of 192 typhoid fever suspected patients participated. Descriptive statistical analysis was conducted on the collected dataset for the purpose of data exploratory analysis. Different measures of agreements, between the Widal test kit brands as well as between slide agglutinations and tube titrations were carried out. Results: Results of the four commercially available Widal test kits under investigation showed plausibly strong test agreement with each other for slide agglutination methods (kappa statistics was k= 0.967 for anti-H and k= 0.786 for anti-O antibodies). Also in tube titration method, the four brands showed strong agreement (k= 0 .875 for anti-H and k= 0.850 for anti-O antibodies). In contrast, slide agglutination and tube titration agreement results of each brands showed a relatively lower agreement in anti-H (k <0.40) and a slightly better agreement in anti-O agglutinins, (k: 0.40–0.68). Among the 190 patient blood samples collected, 4 bacterial isolates were obtained in which, two of them were S. Typhi. Conclusion: In this study, the slide agglutination results of the four brands were generally good and comparable but the tube titration result agreements were lower than the agglutination agreement results. Also, a significance difference between slide agglutination and tube titration results of the four brands was found. The current study indicates that although the Widal test can be used as a good screening method treatment decisions should not be made solely based on results of slide agglutination. Key words: Typhoid fever, Salmonella, Widal test kits
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    Immunological and Lipid Profile Among Leprosy Patientsat Alert Centre, Addis Ababa Ethiopia
    (Addis Ababa University, 2016-02) Nega, Tihitna; Ali, Ibrahim (PhD)
    Background: Leprosy is an old chronic infectious disease that continues to be an important public health problem in several developing countries.Host immunologic factors contribute to the clinical outcome in leprosy. This infection is also accompanied by several alterations in lipid metabolism and changes inthesynthesis of a number of acute phase proteins. Objective: To assess the immunological and lipid profile of leprosy patients across the disease spectrum Material and Methods: A crossectional study was conducted at ALERT center which included 30 leprosy patients and 21 healthy controls. An 8 ml of blood sample was collected from30 patients and 21 healthy controls and used for immunological and lipid profile assays. About 200μl of whole blood was stained with antibody conjugated flourochromes and data acquisition was done on FACSCanto II flowcytometer. Lipid profile and C reactive protein tests have been done using chemistry analyzer and qualitative test respectively. Mann-Whitney U test were used to analyze Memory T cells and lipid profile analysis. Result:The percentage of memory T cells (CD45RO+) expressed on CD3+ was significantly higher in PB patients than MB patients. Activated T cells (CD62L-) expressed on CD4+ were significantly higher in PB patients than in MB patients. MB patient’s CD3+ effector T cells were significantly higher than the healthy controls. PB patients showed significantly higher CD3+, CD4+ and CD8+ effector memory cells than MB patients. Regarding the lipid profile it showed that, healthy control serum total cholesterol level was significantly higher than MB patients. On the contrary serum HDL level was significantly higher in healthy control than MB patients. Conclusion: This study provides further evidence that there is a significant difference in lipid profile among leprosy spectrum. The percentage of both activated and memory T cells in MB patients are significantly lower than in PB patients and this confirms the unresponsiveness of T cells in MB patients regardless of the high bacterial load in these patients. Recommendation:We recommend that monitoring and regulate the lipid homeostasis of leprosy patients may be useful. We also recommend further study on host immune responses in leprosy diseases in which lipid metabolism and inflammation intersect
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    Prevalence and Drug Susceptibility Pattern of Bacteria Associated with Urinary Tract Infection Among Hiv Positive Patients Attending Alert Center, Addis Abeba Ethiopia
    (Addis Ababa University, 2015-06) Getu, Yemisrach; Ali, Ibrahim (PhD)
    Background: Urinary tract infections (UTI) are one of the most common types of bacterial infections in humans occurring both in the community and the health care settings. UTI rank high amongst the most common causes that compel an individual to seek medical attention. HIV/AIDS is one of the greatest public health crisis faced by the global community without a complete cure. UTI represents a considerable health problem amongst HIV infected patients. Objective; to determine the prevalence and drug susceptibility pattern of bacteria associated with UTI among HIV positive patients. Methods: A cross sectional study was conducted in ALERT Center Addis Ababa Ethiopia from September to January 2015 among 165 adult HIV patients. Midstream urine (MSU) was collected from the study participants with sterile wide mouthed urine cups. Urine samples were inoculated in to Blood agar, MacConkey and Cysteine lactose electrolyte deficient and biochemical tests were performed to identify isolates. Drug susceptibility pattern of isolates was determined using the disc diffusion techniques. Data were analyzed using SPSS version-20 software package. Chi – square (X2) test was used to compare categorical data and to compare associations between proportions. Differences were considered significant when the p-values were < 0.05 at 95% confidences limit. Result: Among the total 165 study participants 114 were females and the remaining 51 were males and the mean of age was 37.9. The overall prevalence of UTI was 15.7. High bacterial isolates were found in asymptomatic study participants than symptomatic HIV positive patients. Among Gram negative isolates Escherichia coli were the leading cause of UTI followed by Gram positive isolates Staphylococci aureus. Most bacterial isolates were resistant to Amp, TE, P and SXT and Gentamicin were susceptible for all isolates. Conclusion: the prevalence of UTI was high, and both Gram-negative and Gram positive organisms were causes of UTIs. In this study the chance of acquiring UTI was higher among females than males. UTI prevalence was also high among study participants those have previous history of catheterization and UTI. E. coli were the most predominant organisms followed by Staphylococci aureus and most of the bacterial isolates were sensitive to Gentamicin, Ceftriaxone, Ciprofloxacin, Norfloxacine, Oxacilin and Nitrofurantion. Multi-drug resistance bacteria were common Key words: Asymptomatic UTI, Symptomatic UTI, urinary tract infection, HIV/AIDS, Ethiopia
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    Prevalence of Diabetes mellitus among active pulmonary tuberculosis patients at St. Peter specialized hospital, Addis Ababa Ethiopia
    (Addis Ababa University, 2014-06) Damtew, Emeshaw; Ali, Ibrahim (PhD)
    Background: The merging epidemics of pulmonary tuberculosis (PTB) and diabetes mellitus (DM) have been raised concerns by many experts but no large scale screening and intervention have been launched yet, especially in low-income countries like Ethiopia. The thought that tuberculosis could cause diabetes seems farfetched, but is not. The peculiar relationship and frequent association of diabetes mellitus and tuberculosis has been observed for more than 2000 years, yet the reason for this correlation is, to this day, not known. Objective: the aim of this study was to determine the prevalence of diabetes mellitus among active PTB patients at St.Peter hospital. Methods/design: A cross-sectional Hospital based study was carried out and the study included all active pulmonary tuberculosis patients visiting St. Peter specialized hospital until the required sample size was obtained. We included 120 active PTB patients: 67 of these were male and 84 of them were urban dwellers. Analysis of fasting blod glucose was carried out using venous blood samples by enzymatic colorimetric test for glucose (GOD-PAP Method). For testing significance, the categorical data were compared using a chi-square test and expressed as proportion with a 95% confidence interval. Result: The prevalence of DM was found to be 15.8% (95% CI:9.20-22.45), which was higher (25.4%) among male than female TB patients(3.8%).Likewise 70% of the patients were from urban and 30% of them were from rural areas. The prevalence of newly diagnosed diabetic cases was 84.2% of all patients tested positive for DM. And all of the patients diagnosed as diabetic were in the age group greater than 25 years of age. The prevalence of IFG was (26.7%) and that of HIV co-infection in the study population was (52.5%). The occurrence of DM in HIV co-infection was a little bit higher (15.9%) than HIV negative TB patients (15.8%). Of all patients with active tuberculosis, 60 (50%) were sputum smear negative. The proportion of DM was (25%) among smear positive and (6.7%) among smear negative patients. Conclusion: The prevalence of diabetes mellitus and pre-diabetes (IFG) among active pulmonary tuberculosis cases was higher compared to the published prevalence of DM in Ethiopia. Therefore, it is important to implement a screening program of each TB patient for diabetes and Vis versa. Key words: TB/DM, IFG, HIV co-infection
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    Prevalence of Hepatitis B, Hepatitis C and Hiv Among Chronic Liver Disease Patients in Selected Hospitals, Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-05) Mohammed, Yacob; Ali, Ibrahim (PhD)
    Introduction; Hepatitis B virus (HBV) and hepatitis C (HCV) virus is hepatotropic virus spread mainly through contaminated blood and blood products, sexual contact and contaminated needles. Chronic infection by these viruses leads to slow progressive liver disease that over a period of up to 30 years may result in cirrhosis, chronic liver failure and hepatocellular carcinoma (HCC). HIV, HBV, and HCV infection share similar transmission routes and therefore co-infection is common. These viruses are prevalent in different parts of the world including Ethiopia there for this study shows the burden of these viruses in Ethiopia. Objective: To determine the prevalence of HBV, HCV and HIV infection among clinically diagnosed chronic liver disease patients visited at Black Lion, St. Paul and Armed force hospital Addis Ababa, Ethiopia. Method: Hospital based cross-sectional study was conducted in three selected hospitals of Addis Ababa over a period of 3 months (March2014- May 2014) on clinically diagnosed chronic liver disease patients. By using questionnaire brief history and risk factors was taken from each volunteering patient. Serum samples from each volunteering patients was screened for the presence of HBsAg and anti-HCV by ELISIA test kit and HIV by national test algorism. Result: A total of 117 participants who have chronic liver disease participated in the study, where 82 of them were males and the remaining 35 were females. The age distribution range form 18-78 years and the median age was 39 years. The overall prevalence of HBsAg, HCV and HIV was 34.2%, 18.8% and 9.4 respectively. The study participants had combined HBV/HIV, HCV/HIV and HBV/HCV infection which is possible because of their common modes of transmission. History of multiple sexual partner and blood transfusion also found statically significance with HBV and HCV virus infection respectively. Conclusion: The prevalence of HBV and HCV is high where as HIV is moderate among chronic liver disease patients and history of blood transfusion and multiple sexual partners was statistically associated with HCV and HBV infection respectively
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    Sero - Prevalence And Associated Risk Factors of Hepatitis B Virus Amoung Preganat Women in Hawassa University Teaching and Referral Hospital
    (Addis Ababa University, 2015-06) Metaferia, Yeshi; Ali, Ibrahim (PhD)
    Background: Hepatitis B virus (HBV) is a public health problem worldwide. It is highly endemic in Asia and Sub-Saharan Africa. Even though there was an introduction of universal infants HBV immunization in 2007,distribution of HBV remains a public health problem in Ethiopia. Objective: To determine the sero-prevalence of HBsAg among pregnant women and to identify potential risk factors associated with the infection. Methods: A cross-sectional study was conducted from April-May, 2015 among pregnant women attending the antenatal clinic (ANC) of Hawassa University Teaching and Referral Hospital. After obtaining written and informed consent, blood sample was collected from 269 pregnant women using consecutive non- duplicative sampling method. Serum was separated from whole blood and tested for HBsAg using Bioline strip test and enzyme-linked immunosorbent assay (ELISA) method for further testing. Data was collected using pre-structured questionnaire and analyzed using SPSS version 21. Chi-square and bivariate logistic regression analysis was used to determine the association between explanatory variables and the outcome variables. The result was considered statistically significant at p < 0.05. Result: In this study, 269 pregnant women were participated. The mean age was 26.0 years (standard deviation (SD), 4.5; range, 16 –39 years) and the majority of study participants live in urban 226(84%). The overall prevalence of sero-positive HBsAg among pregnant women was 21(7.8%). The HBV/HIV co-infection rate was 2/14(14.2%). Of the studied risk factors only educational status [(χ2= 8.1; p- value=0.044)] had significant association with HBV infection. There was no statistically significant association between history of blood transfusion, multiple sexual practices, hospital admission, genital mutilation, surgical procedure, body tattooing history of abortion and HBV infection. Conclusion: The highest prevalence of HBV infection was detected as compared to the previous studies in different region of Ethiopia. Hence, screening of pregnant women for HBV irrespective of basis of risk factor may reduce exposure to HBV infection Key words: Hepatitis B virus, Risk factors, Pregnant women, Hawassa
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    Seroprevalence and Risk Factors of Hbv, Hiv And Syphilis Infections Among Pregnant Women Attending at Gandhi Memorial Hospital, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2014-06) Fissehatsion, Kinfe; Ali, Ibrahim (PhD)
    Background Sexually transmitted infections (HIV, HBV and Syphilis) are major public health problems worldwide with a highly prevalent in developing countries like Asia and Sub-Saharan Africa. All of these common sexually transmitted infections share similar mode of transmission which is these includes: receiving of blood through donation, ear piercing and history of abortion for HBV infection and sharing different sharp materials and contact history with infected person for HIV infection alone. Conclusion This study showed that HIV infection was similar with Addis Ababa HIV prevalence whereas; HBV infection was intermediate according to WHO classification. Syphilis was non-existing and HBV-HIV co-infection was very low. Therefore; not only for HIV but also for HBV infection needs to be screened for all pregnant women during pregnancy. Key terms: HIV, HBsAg, Syphilis, Seroprevalence, risk factors, pregnant women horizontal and perinatal (vertical) transmission. Their complication isn’t only restricted to the pregnant women but also to their newborn infants; rather they affects concurrently. Objective This study has undertaken to determine sero-prevalence and risk factors of HBV, HIV and syphilis infections among pregnant women attending at Gandhi Memorial Hospital, Addis Ababa, Ethiopia from January to April 2014. Method A descriptive-correlational study design conducted among 403 pregnant women attending at Gandhi Memorial Hospital, Addis Ababa, Ethiopia between January and April 2014. Participants enrolled consecutively after consenting and an interview have conducted to obtain information regarding risk factors. Blood have collected and screened for hepatitis B surface antigen using rapid screening test strip and cassette device. After all; the final positive sample for HBsAg confirmed by enzyme linked immunosorbent assay (ELISA). Moreover; Antibodies to HIV-1/2 tested based on the national testing algorism but Trepollema pallidum antibodies were by Syphilis Rapid Test Strip (Quick TestTM Syphilis Serum/ Plasma/Whole Blood Strip). Finally the data entered using Epi Info version 3.5.1 and exported to SPSS version 16 so as to recode, clean, validate and analyze. Results A total of 403 pregnant women with the mean age of 24.8 (SD+5.99) years old enrolled in the study. Overall, 21/403 (5.2%) and 20 /403 (5%) of the pregnant women were positive for HIV and HBsAg, respectively. The co-infection of HIV-HBV was 0.5% (2/403). However; no cases of Syphilis detected positive. In relation to the risk factors; history of sex with multiple sexual partners, pre-exposure to STI and low level of monthly income were significantly associated with both HBV and HIV, while each infection found to have additional different risk factors;
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    Seroprevalence and Risk Factors of Hepatitis E Virus Infection among Pregnant Women in Selected Health Facilities of Addis Ababa, Ethiopia
    (Addis Ababa University, 2015-05) Abebe, Meseret; Ali, Ibrahim (PhD)
    Background: Hepatitis E virus (HEV) is highly endemic in several African countries with high mortality rate among pregnant women. The prevalence of antibodies to HEV in Ethiopian pregnant women is not known. This study aimed to assess the prevalence of anti-HEV IgG and anti-HEV IgM among pregnant women seen between April 2014 to January 2015 in Gandhi Memorial Hospital and four selected Health centers in Addis Ababa, Ethiopia. Material and methods: A total of 386 serum samples were collected from pregnant women. All pregnant women socio demographic characteristics were collected using a structured questionnaire form. Serum samples were examined for anti-HEV IgG and anti- HEV IgM using ELISA. The association of anti-HEV status with risk factors was assessed. Factors demonstrating significant association in bivariate analysis were included in multivariate logistic regression models. Analyses were performed using SPSS version 21. Results: From 386 women, 122 (31.6%) cases were positive for anti- HEV IgG and two women (0.5%) were anti-HEV IgM positive. Age and educational had statistically significant association with HEV infection. There was no significant association between anti-HEV antibody seroprevalence rate with trimester, parity, HIV status and other risk factors. Conclusion: Conclusion: This study found a high seroprevalence rate of anti-HEV IgG among pregnant women in Addis Ababa Ethiopia. Preventive measures like improvement of education in personal and public hygiene may reduce the risk in pregnant women. Moreover nationwide surveillance of HEV especially in rural setting should be conducted to establish a national estimate and validate our findings. Keywords: Seroprevalence, Hepatitis E virus, pregnant women, Addis Ababa Ethiopia