Browsing by Author "Kebede Amha (PhD)"

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    Assesment of Public Health Implication of Malaria-Hookworm Co-Infection in Asendabo South West Ethiopia
    (Addis Ababa University, 2007-08) Demissie Fekadu; Petros Beyene (Professor); Kebede Amha (PhD)
    Malaria and geo-helminth infections are causes of severe illness and poor economic growth. The present study aimed at investigating the public health importance of Malaria-hookworm co-infection with emphasis on anemia the leading co-morbid disease condition in Asendabo, south west Ethiopia during the months of October and November 2006. A total of 370 suspected malaria cases and additional 100 school children participated in the study. Modified Kato-Katz and formal-ether concentration techniques were used for stool examination. Harada Mori hookworm culture was established for identification of hookworm species. Thick and thin blood films and Paramax-3TM rapid antigen capture assay were used for detection of malaria parasites. A total of 61.6% individuals were positive for at least one intestinal helminth and/or protozoan infection. Hookworm was the most prevalent (38%) followed by Ascaris (19.2%) and Trichuris trichiura (10.3%). The majority (92.0%) of hookworm infections were N. americanus and the rest (8.0%) were A. duodenale. Furthermore, 32.4% of the study participants were positive for either of the two Plasmodium species of which 64.3% were P. falciparum and the rest 35.7% were P. vivax. Compared with Geimsa stained microscopy, Paramax-3TM was sensitive (90.1%) and specific (93.3%) for identification of total malaria with positive and negative predictive values of 86.4% and 95.0%, respectively. Hemoglobin measurement detected 27.6% anemic cases and both hookworm and malaria infections were significantly associated with anemia (P<0.05). 20.8% of study participants were co-infected with malaria and any helminth. Hookworm and malaria positive individuals had low mean hemoglobin concentration than their respective negative counter parts and the difference was significant (P<0.05). Furthermore, mean hemoglobin concentration was significantly lowered in malaria-hookworm co-infected individuals than in individuals infected with either hookworm or malaria infection alone (F=69.39, P=0.000). The study has revealed that malaria co-infections with hookworm as well as other intestinal helminths worsens hemoglobin loss and that individuals co-infected must receive prompt health care to control anemia morbidity / mortality. Furthermore, deworming of the population must be considered concurrently with malaria control. Keywords:-Hookworm, Malaria, Co-infection, Paramax-3 TM, Anemia, Helminth, Asendabo, Ethiopia.
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    Entamoeba Species Commonly Diagnosed as Entamoeba Histolytica and Enteric Bacteria in the Pathogenesis of Diarrhea in Addis Ababa.
    (Addis Ababa University, 2007-08-05) Worku Asnakew; Petros Beyene (Professor); Kebede Amha (PhD)
    Clinical reports relying on microscopic diagnosis give an impression that intestinal amoebiasis is very common in Ethiopia. However, recent species specific PCR-based method had shown little or no true infection with Entamoeba histolytica. The present study was conducted to assess the association of diarrheagenic bacteria vis-à-vis the Entamoeba trophozoites commonly diagnosed as E. histolytica in diarrheal patients. One hundred and fifty diarrheal patients from Selam Health Center in Gulelie Sub-city and Addis Ketema Propride Clinic in Addis Ababa were recruited in a study conducted between December 2005 and April 2006. Single stool samples were collected from the study participants, and inspected macroscopically for consistency, appearance, and the presence of gross blood. Wet mount of the stool samples was made to detect the presence of fecal leukocytes and red blood cells (RBCs), E. histolytica/E. dispar trophozoites and other intestinal parasites. The specimens were further tested for the presence of E. histolytica/E. dispar DNA by PCR; for stool antigens of E. histolytica by antigen ELISA; and by stool culture for dirrheagenic bacteria. Microscopic observations revealed E. histolytica/E. dispar to be the most common parasite diagnosed (40.7% of the diarrheic patients) followed by Blastocytis hominis (24.7%) and Giardia lamblia (12.7%). However, the PCR based method which amplifies short tandem repeating gene sequence on the tRNA confirmed only 10 cases (16.4%) of E. histolytica/E. dispar. Out of these only two (3.3%) were the pathogenic E. histolytica .The Entamoeba specific stool antigen ELISA detected 30 cases (20%) to be E. histolytica /E. dispar. However, only two of the ELISA positive cases were confirmed by the PCR based method. Of the 150 diarrheal patients, 57(38%) were Shigellae and 1(0.4%) Escherichia coli B. Infection with trophozoites of Entamoeba species showed no clear association with clinical symptoms such as history of bloody-mucoid stools, history of low-grade fever, and microscopic finding of pus cells and RBCs(P>0.05). On the other hand, the isolation of Shigellae in patients with these clinical symptoms was significantly higher (P<0.05). High rate of co-infection in patients with trophozoites of Entamoeba spp. were observed most commonly with Shigella spp. (41.3%), Blastocystis hominis (32.8%), Giardia lamblia (14.8%). Consistent with the previous reports, the present study indicated the rare occurrence of E. histolytica in Ethiopia and the inadequacy of microscopy for diagnosis of amoebiasis. The finding in this study reinforces the suggestion that patients with enteric bacterial pathogens may be wrongly diagnosed as suffering from amoebiasis simply due to the presence of non-pathogenic amoeba trophozoites in their stools. However, the contribution of enteric coccidians, like Cryptosporidium parvum, Isospora belli, and Microsporidia must also be assessed to more correctly establish the etiologyof diarrhea in Ethiopia.