Browsing by Author "Lakew, Mekuria (PhD)"

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    The Aetiological Causes of Tuberculous Lymphadenitis in Butajira, Ethiopia
    (Addis Ababa University, 2001-06) Habte, Abebe; Olobo, Josph (PhD); Harboe, Morten (Professor); Lakew, Mekuria (PhD)
    The utility of MPB70 antigen in serodiagnosis of Mtuberculosis complex infection and the polymerase chain reaction (PCR) for rapid identification of the causative agent if cervical lymphadenitis were investigated. The PCR assay was based on detecting a 506-bp DNA segment belonging to the alpha 32 kDa antigen (85B) common in the genus Mycobacterium, a 984-bp DNA segment belonging to the insertion sequence IS 6110 specific for the M tuberculosis complex, and a 185-bp pncA gene segment at position 169 allele-specific for genetic differentiation of Mtuberculosis from M bovis. For the ELISA purpose, sera from 25 tuberculous lymphadenitis (TBLN), 14 non-tuberculous lymphadenitis (NTBLN), 11 pulmonary tuberculosis (PTB) patients and 10 healthy control (HC) subjects were tested. For PCR, in 39 clinically diagnosed tuberculous lymphadenitis patients, fine needle aspirates (FNA) were processed and tested. Of these, which 14 were considered as non-tuberculous lymphadenitis by fine needle aspirate cytology (FNAC). Of the 39 clinically diagnosed TBLN, 27 (69%) were positive by ELISA. When this was compared with the assumed gold standard (FNAC), it showed 64% sensitivity, 21% specificity, 49% efficiency, 59% positive predictive value and 25% negative predictive value. With PCR, 29 (74%) of 39 were positive, showing 72% sensitivity, 21 % specificity, 54% efficiency, 62% positive predictive value and 30% negative predictive value. When it was compared with FNAC.Of the 29 PCR positive for genus Mycobacterium and Mtuberculosis complex, 18(62%) of them were identified as M tuberculosis, 3 (10%) of them were M. bovis and 8 8%)of them were found co-amplifying M.tuberculosis and M. bovis. These data indicated that both serodiagnosis with MPB70 antigen of the M.tuberculosis complex and peR assay are useful for rapid identification of tuberculous lymphadenitis and better management of patients.
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    Anti inflammatory and bacterial effect of Arthrospira plathensis (Spirulina) on Schistosomiasis mansoni and Selected Human Bacterial Pathogens
    (Addis Ababa University, 2011-02) Sileshi, Abraham; Lakew, Mekuria (PhD)
    Arthroscopic platen sis (spirulina) is multi cellular filamentous blue green alga that is abundantly found in lakes of high salinity in Ethiopia. Several studies have shown that it has importance in human health and nutrition. The health benefits of spirulina relies mainly on tits anti-inflammatory, anti- oxidant and antimicrobial properties. In the current study spirulina wasstudied for its anti-inflammatory and antimicrobial effects using change in size and number of S.mansoni induced granular in infected mice and inhibitions of known human bacterialpathogens (S. typhi, S. dysenteriae, E. coli, S. aureus, S. epidermidis, C. freundii, and P.aeruginosa) as parameters. S. mansoni is a parasitic helmintic infection with high public healthimportance next to malaria, HIV-AIDS and TB especially in sub Saharan countries. Chronicinflammatory response in response to S. mansoni egg trapped in liver tissue is the mainpathology responsible for the morbidity and mortality associated with the disease.Methodologies used in the study involve S. mansoni infection of Swiss albino mice, treatment ofexperimental animals with spirulina at two doses 100 and 400 mg/kg through oral, rectal, andoral/rectal. Animal dissection and histological staining of the liver to measure granulomadiameter, and finally antibiotic sensitivity test using disk diffusion method was done.Independent T. test comparison of the measurements form the anti-inflammatory test showed that the size of granular around an egg from spiritual treated compared to controls was significantly reduced. In association with this, comparison between different treated groups showed that treatment through oral route at a dose of 400 mg/ kg scores the highest percentage reduction both in granular size (59.53%) and granular number (72%). Result from the antimicrobial study showed that all test organisms except S. typhi were susceptible for the water suspension and extracts of spiritual unlike that of the Methanol extract. The possible explanations are discussed. In conclusion and recommendation the anti-inflammatory and antimicrobial effect of spiritual are summarized and future direction of research indicated Key words: - Spirulina, S. mansoni, Granuloma, Anti-inflammatory, Antimicrobia
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    Female Genital Tuberculosis in Ethiopia: Occurrence and Immunodiagnosis
    (Addis Ababa University, 2001-06) Abebe, Markos; Lakew, Mekuria (PhD)
    Female genital tuberculosis (FGTB) causes severe and irreversible damage to the reproductive organs, most commonly the fallopian tubes and the uterus, ultimately resulting in infertility. Diagnosis of FGTB is often difficult because of the inaccessibility of the affected organs, requiring invasive procedures including surgery. There is a strong need for a simplified and reliable diagnostic technique. This is even more urgent today than in the past because of the spread of HIV / AIDS and the unknown magnitude of FGTB under the current epidemic situation. We studied twenty-five gynecological patients diagnosed clinically as FGTB at the Black Lion Hospital for laboratory evidence of etiology and for possible associated immunodiagnostic indicators. Biopsy and curettage samples were taken from each patient and investigated with histopathology, smear microscopy, culture and polymerase chain reaction (PCR) for Mycobacteria. Culture positive samples were examined for the type of species. Peripheral blood mononuclear cells were stimulated in vitro with mycobacterial antigens for recall responses with lymphocyte stimulation Test (LST). Cytokines: IL-IO, TNF-a and INF-y were measured from the supernatant of cultured PBMC. CD4:CD8 ratio in blood was evaluated by flow cytometry. Serum IgG, IgA and IgM levels to Mycobacterial antigen (MPT59) were also measured by ELISA. The study subjects were all in child bearing age (18-39). Of the 17 patients whose infertility status was known, 6 (35.3) had primary while II (64.7) had secondary infertility... Among the 25 gynecological patients investigated, only I was AFB smear positive, 3 were culture positive, 7 were histology positive and 12 were positive by PCR (a total of 16 positives). CD4:CD8 ratio was not helpful indicator for FGTB. The serum antibody level did not distinguish between laboratory 'positive' and 'negative' cases. However, all 'patients' had detectable level of one or more of serum IgG, IgA and IgM to MPT59. 'Patients' and 'controls' showed remarkable difference in their proliferative response to PPD suggesting its diagnostic value. The result clearly showed that FGTB is a rather common clinical problem among Ethiopian gynecological patients and its causative agent is mainly MTB. As far as this work goes, the only diagnostic method to support the clinical suspicion is the LST to PPD.
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    Impact of Hepatitis C (HCV) Co-infection on HIV patients before and after HAART: An Immuno-haematological and Clinical Chemistry observation
    (Addis Ababa University, 2006) Taye, Solomon; Lakew, Mekuria (PhD)
    Hepatitis C virus (HCV) is an enveloped single stranded RNA virus belonging to the genus Hepacivirus within the family Flaviviridiae. It causes an acute or chronic necroinflamatory disease of liver. Due to shared risk factors of transmission, co-infection with HIV is common. The aim of this study was to assess the impact of HCV co-infection on immunohaematological and clinical chemistry parameters in HIV patients before and after HAART. 387 HIV infected patients at Yekatit-12 and Zenbaba General Hospitals were screened for HCV infection and 25 of them were found HCV/HIV co-infected. From those 25 co-infected patients, 9 of them were pre-ART and the rest 16 were under HAART patients. All those 25 HCV/HIV co-infected patients were observed for 4 years for their annual and quarterly changes in immunohaematological and clinical chemistry parameters. For this study, leftover blood samples collected for immunohaematological and clinical chemistry tests were used. Flavicheck-HCV two-site sandwich, 4th generation EIA was used for the detection of total antibodies specific to HCV in serum or plasma. CD4+ and CD8+ T-cells were counted using FACS counter (Becton Dickinson), haematological tests were done using Celldyn-1800 haemoanalyzer and liver enzymes were measured using Humastar80 chemistry analyzer. From the result, HCV/HIV coinfection prevalence was 6.5% (7.3% for males and 5.5% for females) and from the 25 coinfected, more males were co-infected than females (60% Vs 40%). The percentage increments in CD4+ and CD8+ T-cells of co-infected patients were lower than HIV mono-infected patients (131% Vs 432%) and (14% Vs 31%) respectively. It is highly associated with increased liver enzymes in both pre-ART and under HAART co-infected patients. In conclusion, if confirmed in large studies, it is advisable for HIV patients to screen HCV before initiation of HAART in order to minimize HAART associated liver damage and for better management of HIV in HIV/HCV coinfected individuals. Key words/phrases: Immunohaematological, Pre-ART, HCV/HIV co-infection, HAART, CD4+, CD8+, GOT, GPT, ALP
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    The Impact of Mass Chemotherapy on the Status of Intestinal Schistosomiais Among Schoolchildren in Kemissie, North East Ethiopia
    (Addis Ababa University, 2017-08-05) Mohammed, Ahmed; Lakew, Mekuria (PhD)
    Schistosomiasis caused by Schistosoma mansoni is a major public health concern in the tropics and yet is a neglected disease. Globally, more than 207 million people are infected Today 120 million people are symptomatic for Schistosomiasis In Ethiopia, the condition is worsened due to very low latrine coverage and overall poor personal and environmental hygiene.This study, therefore, aimed to assess the prevalence of Schistosoma mansoni infection and associated risk factors in children of less than 15 year of age in Kemissie Town. A cross sectional school based study was carried out on sample of 300 students. A pre-tested structured questionnaire was used to collect data on socio demographic characteristics, water contact habit and toilet utilization. Fecal samples were collected and processed using the direct-smear method. Univariate and multivariate logistic regression models were used for data analysis. The overall prevalence of S. mansoni in the schoolchildren was 8 % (95% confidence interval (CI):1.96). Higher prevalence was detected in male children (8.5%) than in females (7.5%) . Sex, swimming habit & previous treatment for the parasite were significantly associated with the risk of Schistosomiasis (p-value ˂0.05). Specifically, Male sex is 3 times at increased risk of having Schistosomiasis than females (AOR: 3.255, 95% CI: 0.555-0.987, p: 000). Study subjects with frequently swimming habit were found to be 4 times at risk of Schistosomiasis than those have no swimming habit regularly or not at all (AOR: 4.487 95% CI: 0.278-0.854, p: 0.022). Study participants who have previous treatment history for Schistosomiasis were have 2 times at risk of developing Schistosomiasis than their counter parts(AOR: 2.760, 95% CI: 1.014-5.731, p: 0.031). The result showed that school age children are the vulnerable segment of the population. Therefore, prompt intervention strategies should be designed and implemented including provision of adequate safe water supply and health education on personal as well as environmental hygiene.
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    Impacts of Hiv Co-Infection and Mdr-Tb on the Treatment Outcome of Tuberculosis in Patients who Attended the two Shambu Health Centers In 2010- 2015.
    (Addis Ababa University, 2017-08) Worku, Feyera; Lakew, Mekuria (PhD)
    Tuberculosis (TB) is one of the major public health problems worldwide and typically attacks the lung. The disease has been later compounded with Multi-Drug Resistance TB (MDR-TB) and with a complex relationship between Human immunodeficiency virus (HIV) (TB/HIV co-infection. The problem is worse in Africa region, where our country is situated and the country is ranked 10th of the world’s 22 high burden countries. In Oromia Regional State the Case Detection Rate and Treatment Success Rate was 37% and 83% respectively. However, there is little information about TB in ShambuWereda (Western Oromia). To this end a retrospective study was made using secondary data collected from TB patients attending DOTs Clinic Service at Shambu Health Centers between2010-2015. The result showed that out 1364 TB patients, 54.84% were males and 45.16% were females with male to female ratio of 1.2:1; with a case detection of 30% smear positive (SPTB), followed by 49% smear negative Pulmonary TB (SNTB), 21 % extra-pulmonary TB (EPTB), and 0.36% MDR-TB cases. Although TB affects all age groups, the highest prevalence of 33.65% of TB occurred in the age group of 11-30; followed by 30% infection of the age group of 31-50 indicating that TB affected more than 6o% of the most active age groups. The prevalence of total TB patients slightly varied from year to year ranging from 15% -17.8% over the years with an average prevalence of 16.8% a steady prevalence of total TB in all the years without showing a trend of decrease along the years in spite of DOTS interventions in the area as a function of time. The prevalence of TB/HIV co-infection amongst all TB patients registered and screened for the same at the DOTs clinic was 18.8% with similar pattern of male to female infection of 1.3:1and similar pattern of 11% infection of the active age groups. The average treatment success rate (TSR) of TB cases was 72% and did not meet the WHO international updated targets of 85% for the period 2011 to 2015. It is yet a formidable task to achieve the same in the area, under the circumstances, with a new post-2015 Global TB Strategy called-End TB Strategy between 2015 and 2035 unless a serious DOTS intervention plan is introduced. Key words: Case detection rate(CDR),Extra Pulmonary Tuberculosis(EPTB),Smear Positive TB( SPTB),Smear Negative TB(SNTB), Treatment success rate(TSR), TB/HIV co-infection, MultidrugResistanceTB(MDR-TB)
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    In vitro T-Cell Responses as Surrogate Markers for HIV -lInfection Progression in Ethiopia
    (Addis Ababa University, 2000-06) Legesse, Mengistu; Lakew, Mekuria (PhD)
    In an effort to use immunological abnormalities as markers of HI V -I infection progression in Ethiopian individuals, this work assessed the changes in in vitro and in vivo T-cell responses to recall M. tuberculosis antigen, purified protein derivative (PPO). This was further evaluated against C04+ and C08+ T-cells count and viral load in the same subjects. Peripheral blood mononuclear cells (PBMCs) isolated from 36 HIV -I seropositive and 105 seronegative individuals were subjected to 6 days in vitro PPO stimulation and cytokine production. The T-cell proliferative response was then evaluated using 5-bromo-2-deoxyuridine (BrdU) instead of thymidine incorporation as a method of assay. Cytokines (IFN-y and IL-4) production was measured in the PBMC culture supernatants using sandwich ELISA. Three days phytoheamagglutinin (PHA) stimulation responses were used as positive controls. In vivo tuberculin PPO responses were measured for 18 HIV -I seropositive and 74 seronegative individuals by standard Mantoux reaction. Results show that T-cell responses to PPO both in vitro and in vivo were affected by HIV -I infection, in contrast to HIV -I seronegatives. Significant reduction in IFN-y production was also observed between the two groups following PPO stimulation (p = 0.000), but not with IL-4. Thus, a shift from Thl to Th2 cytokines production was not observed. Analysis of T --;;ell responses to PPO showed a positive correlation with C04+ T cell counts, and negative with plasma viral load. This confirmed that HIV -I infection progression is followed by a depletion of C04+ T cells count and high viral load. Change in proliferation and cytokine production was specific to PPO. It suggests that Alycobacteriulll tuberculosis specific immune responses are affected in HIV -I infected sUbjects. Taken together our results indicated that evaluating T-cell responses to recall antigen, PPO can be used as an early marker for HIV -I infection progression.of unemployment, sexual promiscuity and the presence of a wide diversity of HIV-I subtypes in Africa have also been indicated as powerful components in HIV -I spread and transmission. The virus has profound economic and social implications for both developed and developing countries. No country in the world is free of the disease and can claim that it has stopped its spread. The most effective and efficient method to prevent HIV -infection and disease manifestation would be through vaccination and effective treatment, which currently are not available. The generally accepted method of implementing preventive strategies for HIV infection is education that will inform and increase awareness of the society
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    Intestinal Parasitic Infections among Patients of Aykel Health Center, Northwest Ethiopia.
    (Addis Ababa University, 2017-09-04) Dessie, Shashe; Lakew, Mekuria (PhD)
    Prevalence of Human Intestinal parasitic Infection among Patients who attended At Aykel Health Center from 2014-2016 North West Ethiopia. In developing countries like Ethiopia, intestinal parasites are the next causes of outpatient morbidity and mortality to malaria. Prevalence information on intestinal parasitic infection is important to develop appropriate control strategy. There was no study on prevalence of intestinal parasites in Aykel town and health center, North West Ethiopia. Thus the purpose of this study was to determine the status of intestinal parasitic infections among patient who attended Aykel Health Centre for diagnosis of intestinal parasite infection between 2014-2016.All subjects were considered as the sample/ representative population for Aykel town and the surrounding areas. The data for this retrospective study was collected from Aykel Health Centre record books for the three consecutive years using data collecting forms and analyzed using descriptive statistical method and presented by tables and graphs. Based on the data prevalence of the major protozoa and helminths infections were identified. Accordingly a total of 36,735 patients visited the laboratory for stool examination, 4377(11.9%) were found to have one or more parasitic infections. Males(13.9%) were more infected than females(10.3%).and Prevalence of intestinal parasites in the study area was started with 13.7%, in the first year and dropped the next year to 11.3% and got on to 10.1% on the third year .It was generally on decrease at a noticeable rate. However, the most dominant infections were protozoa parasites (6.9%) followed by helminths (5%). Infection with Giardia was found to be the commonest protozoan infection (5.2%) followed by hook worm (2.5%) and Enamoeba species (1.7%). From the total positive cases (11.9%), 6.7% and 0.3% showed dual and triple parasitic infection respectively. Age group analysis showed that > 15-20 and > 35 age groups were more, 0-5 and 30-35 were les infected than the other age groups. The rural populations (61.9%)) have doubled infection that of the urban (38.1%). Most intestinal parasitic infections are among the ten top diseases to cause death. But it is simply transmitted through fecal oral route. To minimize its prevalence the government must give attention to provide education on the area of transmission and prevention before infection especially for rural populations.
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    Modified Diagnostic Approach and Molecular Epidemiology of Childhood Tuberculosis in Hawassa, Ethiopia ity Testing, Treatment Outcome
    (Addis Ababa University, 2018-06-04) Desta, Moges; Feleke, Adey (PhD); Lakew, Mekuria (PhD); Gemechu, Daniel (PhD)
    Childhood TB accounts to 1 million (10%) of the estimated 10.4 million new cases of TB globally. It is known to be the major contributor of childhood morbidity and mortality. The prevalence of childhood TB/HIV co-infection and multidrug resistance (MDR) presumed to have grown up with the advent of HIV. Unfortunately it has been given less attention as a challenge at international level; there are no sufficient epidemiological data even in high burden countries and the effects are not included with the national policies and strategies i.e. is neglected. Due to this scarcity of epidemiological data the attempts that have been made to develop tools for childhood TB diagnosis, treatment, control and to understand how the immunological and pathological responses differ from that of the adult is very little. It is in recognition of these gaps of knowledge and attention that the present work was set with the following objectives: to use modified approach for diagnosis and determine the prevalence of childhood active TB cases, identify the strains of Mycobacterium tuberculosis, determine their drug susceptibility pattern and assess the treatment outcome. A prospective cross sectional study was done on 700 children clinically suspected for TB and 350 of them were used to determine the prevalence, molecular characterization and drug susceptibility pattern of TB isolates and the remaining 350 were used to evaluate modified childhood TB diagnostic approach. A five year retrospective cross sectional study was also done to evaluate the treatment outcome of children with TB in the study area. The results showed an overall prevalence of smear positive (7.4%) and Culture confirmed TB cases (9.7%). Drug susceptibility testing showed one (2.9%) MDR case from the isolates and Spoligotyping of 34 isolates revealed 15 different patterns, 11 of which corresponded to Shared International Types (SITs) and 4 to orphan strains. The dominantly identified strains IV were SIT 53, SIT 149, and SIT 442. The isolates belonged to Euro-American lineage (94.1%) and East-African-Indian lineage (5.9%). A 13.2% incremental yield was obtained due to testing of pooled samples compared to either of the first or second sample using GeneXpert MTB/RIF assay in diagnostic evaluation study. The overall treatment success rate among all children with TB at the study facilities was 39.7%. The lower prevalence of pediatric pulmonary TB could be due to the less sensitive nature of culture and microscopy diagnostic tools thus the modified diagnostic approach may show the real magnitude by increasing case detection. Clustering of strains in spoligotyping suggested an on-going and active transmission of M. tuberculosis in the study area. The identified MDR case showed DST is warranted to optimize the management of childhood TB. The Overall treatment success rate among all children with TB was unsatisfactory compared to WHO target of 85% and 54.7% of children with TB in the study facilities were transferred out. There should be a system to track transfer out cases are on treatment.
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    Modified Diagnostic Approach and Molecular Epidemiology of Childhood Tuberculosis in Hawassa, Ethiopia ity Testing, Treatment Outcome
    (Addis Ababa University, 6/4/2018) Desta, Moges; Feleke, Adey (PhD); Lakew, Mekuria (PhD); Gemechu, Daniel (PhD)
    Childhood TB accounts to 1 million (10%) of the estimated 10.4 million new cases of TB globally. It is known to be the major contributor of childhood morbidity and mortality. The prevalence of childhood TB/HIV co-infection and multidrug resistance (MDR) presumed to have grown up with the advent of HIV. Unfortunately it has been given less attention as a challenge at international level; there are no sufficient epidemiological data even in high burden countries and the effects are not included with the national policies and strategies i.e. is neglected. Due to this scarcity of epidemiological data the attempts that have been made to develop tools for childhood TB diagnosis, treatment, control and to understand how the immunological and pathological responses differ from that of the adult is very little. It is in recognition of these gaps of knowledge and attention that the present work was set with the following objectives: to use modified approach for diagnosis and determine the prevalence of childhood active TB cases, identify the strains of Mycobacterium tuberculosis, determine their drug susceptibility pattern and assess the treatment outcome. A prospective cross sectional study was done on 700 children clinically suspected for TB and 350 of them were used to determine the prevalence, molecular characterization and drug susceptibility pattern of TB isolates and the remaining 350 were used to evaluate modified childhood TB diagnostic approach. A five year retrospective cross sectional study was also done to evaluate the treatment outcome of children with TB in the study area. The results showed an overall prevalence of smear positive (7.4%) and Culture confirmed TB cases (9.7%). Drug susceptibility testing showed one (2.9%) MDR case from the isolates and Spoligotyping of 34 isolates revealed 15 different patterns, 11 of which corresponded to Shared International Types (SITs) and 4 to orphan strains. The dominantly identified strains IV were SIT 53, SIT 149, and SIT 442. The isolates belonged to Euro-American lineage (94.1%) and East-African-Indian lineage (5.9%). A 13.2% incremental yield was obtained due to testing of pooled samples compared to either of the first or second sample using GeneXpert MTB/RIF assay in diagnostic evaluation study. The overall treatment success rate among all children with TB at the study facilities was 39.7%. The lower prevalence of pediatric pulmonary TB could be due to the less sensitive nature of culture and microscopy diagnostic tools thus the modified diagnostic approach may show the real magnitude by increasing case detection. Clustering of strains in spoligotyping suggested an on-going and active transmission of M. tuberculosis in the study area. The identified MDR case showed DST is warranted to optimize the management of childhood TB. The Overall treatment success rate among all children with TB was unsatisfactory compared to WHO target of 85% and 54.7% of children with TB in the study facilities were transferred out. There should be a system to track transfer out cases are on treatment.
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    The present status of Schistosoma mansoni infection and associated risk factors in Harbu Town, South Wollo Zone of the Amhara Region, Ethiopia
    (Addis Ababa University, 2017-08) Seid, Yimer; Lakew, Mekuria (PhD)
    Schistosomiasis is a disease caused by a parasitic worm belonging to the genus schistosoma. It is a debilitating disease that over a long course infection could also kill some of the infected subjects. S. mansoni is one of the source that is transmitted by Bimophalaria pfeiffer and widely distributed all over Ethiopia. The prevalence of S. mansoni has been studied in Harbu and integrated intervention program were implemented in2002, since that no study has been made. It is to fill this gap the present study was designed to study the present status of S. mansoni infection and associated risk factors among neglected communities of Harbu town northeast Ethiopia. To that effect a semi structured questionnaire was administered to capture the socio-demographic and environmental factors that could influence the transmission of S. mansoni in Harbu and using data of Harbu health center diagnostic laboratory record that surveyed for six months (December2016 to May 2017), present status of S. mansoni infection was determined. Univariate and multivariate logistic regression models were used for data analysis. The result of socio-demographic study, for aware about transmission426,(71%) participant say no and only 174(29%) say yes, which showed that the public is still ignorant of the disease, whereas laboratory stool examination of Harbu health center showed that out of 600 subjects that were tested in the laboratory 131 (21.8%) were positive for S. mansoni . When categorized by age, relatively higher frequency of infection was found in age group 12-18 99(30.46%) followed by age group 5-11 years with 29(15.1%) and the rest 3(3.61%) were above 18 years old. Age Adjusted odd ratio (AOR) 1.767, 95% confidence interval (CI) 0.098-0.564, p= 0.004), other factor including lack of toilet and its improper use with (AOR 2.251, 95% CI 1.351-3.752, p=0.002),Swimming habit (AOR 2.496, 95% CI 0.778-8.003, p=0.049)and residence with AOR 2.251,95%CI 1.355-3.752,p=0.002) were found to be significantly associated with S. mansoni positivity. Over all the result showed that S. mansoni infection is a major health problem of people of Harbu and transmission is still in progress as infection of the new generation (12-18) followed by (5-11) is rating the highest frequency. This mean the earlier S. mansoni control program in Harbu Town were not sufficient to stop the spread of S. mansoni in Harbu. Therefore, it is the writer’s opinion that prompt intervention strategies should be designed and implemented including provision of adequate safe water supply, regular deworming and health education on personal and environmental hygiene must be employed if the problem is to be tackled. Keywords: Schistosomiasis, Harbu and S. mansoni.
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    Prevalence and Phylogenetic Variant of Gbv-C on Disease Progression of Hcv, Hbv and Hiv Under Haart
    (Addis Ababa University, 2019-04-03) Farouk, Mohamed; Lakew, Mekuria (PhD)
    Despite the advancements in health system management and technology, Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) remain a serious global public health challenge. GB virus (GBV-C) is a virus in the Flaviviridae family with HCV that was isolated from patients with liver disease. It has the same mode of transmission with HIV, HBV and HCV. Several studies from different countries have reported the positive role of GBV-C in improving the clinical infection and treatment outcomes of HIV patients, while its impact among HBV and HCV patients is controversy. Although the virus has been isolated from patients with fulminant hepatitis, but other studies failed to prove any association. Co-infection of GBV-C with one or more hepatotropic viruses like HBV or HCV may have negative or positive effect on the disease evolution. In Ethiopia, there has not been any study made on the prevalence or the clinical impact of GBV-C in circulation. Therefore, the aim of this study was to determine the prevalence, predominant genotype and the association between GBV-C and the clinical outcome among viral hepatitis and HIV patients under HAART. Serum samples were collected from different population living in Addis Ababa from March 2014 to February 2016. The subjects of this study comprised a total of 252 participants of all ages, and were divided into distinct groups according to their health status. The first group comprised a total of 81 HIV samples that were sent to the health research laboratory in Addis Ababa for follow-up studies, the second group comprised a total of 101 serum frozen samples collected from Adera Internal Medical Specialty Center for patients with viral hepatitis, and 70 frozen serum samples of healthy individuals collected from the Ethiopian Public Health and Research Institutes and adult volunteers. To determine the prevalence of GBV-C, RNA was extracted, reversed transcribed, and amplified by Real Time polymerase chain reaction (PCR), using primers for 5- untranslated region (5-UTR) of the HGV/GBV-C. Among the HIV patients the CD4+ cells count and plasma viral load were performed. Liver function test and abdominal ultra sound were investigated in all viral hepatitis patients. The prevalence of GBV-C RNA were detected in 20 (11.27%) of the patients with viral hepatitis and HIV, while all the healthy subjects were negatives. Among HIV patient’s comparison of the mean CD4+ count was found to be significantly different between HGV/GBV-C positive and negative patients at (P < 0.05). GBV-C and HIV coinfected patients were categorized in the first and second WHO clinical staging system. Furthermore, positive and negative GBV-C patients were sub divided into small groups based on age, sex and date of starting HAART. The number of CD4+ cells over time increased more rapidly in GBV-C positive patients compared to GBV-C negative patients. Among viral hepatitis patients the prevalence of GBV-C were slightly higher among HBV patients, however, there was no significant difference (P > 0.05) in the liver enzymes level among GBV-C negative and positive individuals. Our study found that GBV-C infection had no influence on the severity of chronic liver disease among HBV and HCV coinfection. While among HIV patients the vi coinfection reduces the viral load, increases the number of CD4+ cells and improves response to treatment. To determine the predominant genotype, serum samples were recollected on 2017, from the same patients who were GBV-C positive in 2014. After performing various molecular techniques on the samples, the virus was detected but at a low level in the patient’s serum, which indicates the clearance of the virus. Therefore it was not possible to sequence the virus. To the best of our knowledge, this is the first report of GBV-C in Ethiopia. Understanding the mechanisms between GBV-C and HIV could lead to develop novel treatment/vaccine.
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    Prevalence of Malaria Among Patients Attending Assosa General Hospital, Western Ethiopia
    (Addis Ababa University, 2017-09) Meku, Tesfaye; Lakew, Mekuria (PhD)
    Malaria is a disease caused by Plasmodium parasite and is transmitted by females Anopheles mosquitoes. It is one of the leading causes of illness and death in the world. It is a leading public health problem in Ethiopia. The aim of this study was to assess the prevalence of malaria among patients who attended in Assosa General Hospital for the last five years, Western Ethiopia. A retrospective study was conducted to assess the prevalence of malaria infection from records of peripheral blood smear positive patients in Assosa General Hospital. All malaria cases reported between 2012 and 2016 were reviewed and analyzed. During the study period of five years a total of 13697 thick and thin with Giemsa stained blood films were examined for malaria diagnosis in Assosa General Hospital and 7353 (53.68%) microscopically confirmed malaria cases were reported with a fluctuating trend. Plasmodium vivax and Plasmodium falciparum accounted for 55.02 and 44.98% of the cases respectively. All cases were monoinfections. Malaria was reported in all age groups and both sexes. But the ≥15 year age group and males were more affected. The prevalence of malaria infection between males and females was not statistically significant (P>0.05) and also the prevalence of malaria among age groups was not statistically significant (P>0.05). Despite the apparent fluctuation of malaria trends in the area, the highest peak of malaria cases was reported during September to November within the last five years. Control interventions must be maintained and scaled-up to sustainably control the prevalence of malaria infection and eventually eliminate it in the study area, considering both Plasmodium vivax and Plasmodium falciparum. Keywords/Phrases: Malaria, Plasmodium, Assosa General Hospital, Prevalence, Retrospective study
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    Status of Malaria in Wau Town, Western Bahr El Ghazal, South Sudan
    (Addis Ababa Universty, 2017-03) Ngor, Chan; Lakew, Mekuria (PhD)
    South Sudan, like all other East African Countries through Global Fund had implemented several control programs as per recommendation of WHO and succeeded to reduce malaria transmission from intense to interrupted transmission contributing to the implementation of the elimination/eradication program in the years to come. Investigation of the transmission pattern of the hotspot foci and understanding the dynamics of malaria transmission was essential. Therefore, this study planned Hotspot study on urban epidemiological setting of Wau town/city. Cross sectional studies of the town at 2 months intervals in the dry season and two others in wet season were planned. Sample size was determined, peripheral blood Smear and RDT serological methods were adopted as standard methods of prevalence study, positive in both were considered for determination of the prevalence. Accordingly, four (4) study sites were selected and data collection was completed in Hai Nazareth, just before the unpredicted war between the rebel and the government forces broke in the town. Hence, relying on one time cross sectional study for prevalence study and the retrospective data of the preceding year, 2015, taken from Health clinics and hospitals to establish the parasite prevalence. There was transmission throughout the year and an increase in all age groups in the rainy seasons between June and October with peak August-October. Infected individuals who visited the hospital and were found positive are larger in number in the age groups 6-15 and above 15. The result showed that 35% of infection in those under 5 years is greater than 23% of those between 6-10 years indicating that the under 5 are the high risk groups. The 16.1% in those under 1 year are most vulnerable for at that age they do not have protective immunity ready yet. P. falciparum was the only species diagnosed, accounting for 47.51% of all subjects who visited for any other infections (52.49%), suggesting the health significance of Malaria in the population. Primary data done in May and June showed 32.6% infection rate in the sample population of which 5.2% were children under 5 while the age groups 6-15 and above 15 years had 13 and 14.4% respectively. All were asymptomatic cases. Given the retrospective study that showed a year round transmission with a peak between June and October and then a decline to lowest level in December, the Frequency of infection in Children and age group below 15 is a high level of infection and above 15 had relatively higher infection. The demographic distribution of the study population, Metrological data of the town, age distribution of the parasite prevalence, identification of major and minor vectors were also reflected and their implications in breaking transmission were discussed. Keywords: Hotspot foci, elimination, epidemiological setting, asymptomatic cases, parasite prevalence.
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    Status of Malaria in Wau Town, Western Bahr El Ghazal, South Sudan
    (Addis Ababa University, 2017-03-03) Ngor, Chan; Lakew, Mekuria (PhD); Tekie, Habte (PhD)
    South Sudan, like all other East African Countries through Global Fund had implemented several control programs as per recommendation of WHO and succeeded to reduce malaria transmission from intense to interrupted transmission contributing to the implementation of the elimination/eradication program in the years to come. Investigation of the transmission pattern of the hotspot foci and understanding the dynamics of malaria transmission was essential. Therefore, this study planned Hotspot study on urban epidemiological setting of Wau town/city. Cross sectional studies of the town at 2 months intervals in the dry season and two others in wet season were planned. Sample size was determined, peripheral blood Smear and RDT serological methods were adopted as standard methods of prevalence study, positive in both were considered for determination of the prevalence. Accordingly, four (4) study sites were selected and data collection was completed in Hai Nazareth, just before the unpredicted war between the rebel and the government forces broke in the town. Hence, relying on one time cross sectional study for prevalence study and the retrospective data of the preceding year, 2015, taken from Health clinics and hospitals to establish the parasite prevalence. There was transmission throughout the year and an increase in all age groups in the rainy seasons between June and October with peak August-October. Infected individuals who visited the hospital and were found positive are larger in number in the age groups 6-15 and above 15. The result showed that 35% of infection in those under 5 years is greater than 23% of those between 6-10 years indicating that the under 5 are the high risk groups. The 16.1% in those under 1 year are most vulnerable for at that age they do not have protective immunity ready yet. P. falciparum was the only species diagnosed, accounting for 47.51% of all subjects who visited for any other infections (52.49%), suggesting the health significance of Malaria in the population. Primary data done in May and June showed 32.6% infection rate in the sample population of which 5.2% were children under 5 while the age groups 6-15 and above 15 years had 13 and 14.4% respectively. All were asymptomatic cases. Given the retrospective study that showed a year round transmission with a peak between June and October and then a decline to lowest level in December, the Frequency of infection in Children and age group below 15 is a high level of infection and above 15 had relatively higher infection. The demographic distribution of the study population, Metrological data of the town, age distribution of the parasite prevalence, identification of major and minor vectors were also reflected and their implications in breaking transmission were discussed.