Browsing by Author "Mohammed, Jemal"

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    Bacterial etiology, antimicrobial susceptibility patterns and the prevalence of nosocomial infection in different clinical sample from patients attending intensive care unit in Tikur Anbessa Hospital,Addis Ababa,Ethiopia
    (Addis Ababa University, 2019-06) Mohammed, Jemal; Bitew, Adane(Msc, PhD); Teklebrahan, Gebreab(Msc, PhD Fellow)
    Background: Nosocomial infections are widespread health problems in the world including in developed and developing countries which are the most important aggravating agents of mortality, morbidity, length of hospital stay and cost in the world. Nosocomial infections are becoming difficult to treat due to the increasing trend of antibiotics resistance, especially the critically ill patients in the intensive care unit (ICU). Relatively, few data are available from Ethiopia to indicate present health care associated infections (HAIs) status of situation. Objective: To determine bacterial etiology, antimicrobial susceptibility patterns and the prevalence of nosocomial infection in different clinical sample from intensive care unit patients in Tikur anbessa hospital Methods: A cross-sectional study was conducted from January to December 2018 in intensive care unit of Tikur Anbessa Specialized Hospital. Among 612 patients admitted to intensive care unit, 192 study participants (patients) who were suspected of bacterial nosocomial infections were included based on WHO guidelines for nosocomial infections using convenient sampling technique. Bacteria were isolated using culture and biochemical tests. Antimicrobial susceptibility testing was performed using Kirby-Bauer disc diffusion method as per CLSI. ESBLs confirmation was done by double disk synergy diffusion method. Data was analyzed with SPSS version 23.0. Results: During a 12 months period from January to December 2018, 612 patients admitted to intensive care unit to Tikur Anbessa Hospital were studied for prevalence of nosocomial infection. A total of 192 patients were selected based on their clinical ground as per WHO 2002 guidelines. Total 14 % (87/612) patients were confirmed by culture to have nosocomial infection. Of the 77 patients were 70.1 %( 61) male and 29.9% (26) females. The distribution of nosocomial infection among positive cases was blood stream infection (38.5%). Respiratory tract infection(20.2%),urinary tract infection(17.4%) and surgical site infection(11.0%).A total of 109 bacterial strains were isolated ,K.pneumoniae accounted for (26.6%) of total isolates, followed by Acinitobacter spps (17.4%), E.coli (16.5%) and CoNS (9.2%). A large majority of bacteria isolates (82.6%) were gram negative. High multi drug resistances (MDRs) bacteria were observed in ICU and Overall, multi drug resistance was observed in 71.6 %( 78/109) of isolates. Gram positive and Gram negative isolates showed 52.6% and 75.6% MDR respectively. Both Gram-positive and-negative isolates expressed resistance to most of the penicillin and cephalosporins tested. Amikacin and Meropenem were the most effective antibiotics against gram negative bacteria isolates (except Acinitobacter spps). Acinitobacter Spps showed highly resistance for most drugs including amikacin and meropenem.High rates of the extended spectrum beta lactamases (ESBLs) of K. pneumonia and E. coli were observed (31.9% and 21.3% respectively). Low rates (1.8%) of methicillin resistant staphyloccus aures (MRSA) was observed, whereas no vancomycin resistance Enterococcus spps were detected.
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    Challenges In Implementing Integrated Pharmaceutical Logistics System At Alert Hospital –Addis Ababa
    (Addis Ababa University, 2019-05) Mohammed, Jemal; Ensermu, Matiwos (PhD)
    Access and availability of essential pharmaceutical services play significant role in ensuring better health for the population. Implementation of integrated pharmaceutical logistics systems (IPLS) requires use of LMIS forms and records. The study aims at assessing challenges in IPLS implementation at ALERT hospital. The study used eight research questions that are answered as a result the study. In this study descriptive type of research was used with mixed method approaches where qualitative and quantitative data were collected in relation with challenges of implementing IPLS at hospital level using structured questionnaires and different secondary records and documents. The collected data were analyzed using descriptive statistics and secondary documents and records were also reviewed and analyzed. Detailed results presented in this paper on key IPLS implementation indicators. This study assessed challenges about the availability and use of quality LMIS formats and records. The study explored barriers in human resources management including improving staff capacity, on how to complete the forms and records and use technology. This study assessed the challenges related with infrastructure, finance, and application of regulatory policies and procedures in IPLS implementation. The study looked in to challenges associated with stock availability and storage conditions of pharmaceutical commodities and supplies at ALERT hospital. Human resources found to be one of the critical challenge in the IPLS implementation that include shortage of staff, lack of training on pharmaceutical logistics, and there is no mechanism in place to address attrition and enhance motivation. More efforts and resources should be geared towards addressing financial, infrastructural and technology related challenges that affect IPLS implementation. ALERT hospital still using paper based LMIS and pharmaceutical logistics efforts are not yet linked with health information management system that captures and reports services data. More attention should be given to improve LIMS data use and its quality. It was also found that the management of the hospital should address infrastructural issues around the store rooms including renovations and expansion
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    K-Trees and Catalan Identities
    (Addis Ababa University, 2011-01) Mohammed, Jemal; Zeleke, Melkamu (Professor)
    Ordered trees are trees with a distinguished vertex called the root where the children of each internal vertex are linearly ordered. K-trees generalize ordered trees in the sense that ordered trees are 2-trees in which edges between nodes are drawn as double edges. A class of numbers are introduced which unify many well-known counting coefficients, such as the Catalan numbers, the Fine numbers and the Central Binomial numbers and also their generating functions are computed. The Generalized Catalan numbers count the number of homogeneous ordered k-trees consisting of n k-cycles. We can prove the 17 most useful Catalan generating function identities by simple algebraic manipulations. In this project also we use ordered trees and k-trees to obtain generating function identities involving generalizations of Catalan numbers, Central Binomial numbers, and Fine numbers. We give some examples to show possible applications of these identities, like the Fibonacci polynomials, which is the generalization of Fibonacci numbers, the higher derivative of Central Binomial numbers, enumerating edges of odd degree and odd out degree and also show that the ratio of generalized Fine numbers to Catalan numbers is asymptotic
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    Sequential Adaptation of Vero Cell Lines in Serum Free Medium for Fixed Rabies Virus Propagation
    (Addis Ababa University, 2020-03-03) Mohammed, Jemal; Desalegn, Asnake (PhD)
    Culturing cell is a process of growing cells under physically controlled and aseptic environment in artificial medium. There are several cell lines including vero cell lines propagated using this method. Vero cell lines are derived from kidney of the African green monkey (Cercopithecus aethiops). They are continuous and anchorage based cells that need sufficient surface to proliferate in growth medium. Vero cells are most commonly used to detect bacterial toxins and production of different vaccines. It has also used to grow different strains of rabies viruses to produce cell culture based vaccine for human and animal use; however vero cells propagated in serum supplemented medium that is very expensive and source of different contaminant agents. The aim of this research was therefore to adapt Vero cell lines in serum free medium sequentially for propagation of Pasteur virus (PV) and Evelyn Rokitnicki Abelseth (ERA) rabies virus strains. Vero cells were adapted sequentially in serum supplemented media by gradually reducing from 10% to 0% of serum concentration. Viable cells were counted until passage seven in each serum concentrations. The maximum viable cell density of Vero cells at each serum supplemented medium (0%, 1%, 2.5%, 5%, 7.5% and 10%) was 2.86x106 cells/ml, 2.75x106 cells/ml, 2.75x106 cells/ml, 2.70x106 cells/ml, 2.92x106 cells/ml and 2.75x106 cells/ml, respectively. The preferable incubation times to obtain those maximum viable cells were 96 hours and 144 hours for vero cells proliferated in 2.5% - 10% and 0% - 1% supplemented medium respectively. The incubation time increased as serum concentration in growth medium decreased to reach the confluence stage. The yield of viable cells grown in serum free medium were similar to cells proliferated in a serum supplemented medium. The virus titration was carried out at each serum concentration proliferated cells to determine the virus titer of both viruses. The maximum recorded virus titers for PV was 105.36TCID50/ml with 0.01 Multiplicity of infection after 96 hours incubation on serum free grown cells propagated virus and the maximum virus titer for ERA was 105.61TCID50/ml with 0.001 Multiplicity of infection on serum free media propagated viruses after 120 hours incubation. The incubation times were also increased as serum concentration was decreased to obtain the higher titer in both virus strains. From the results of this study, it can be concluded that cells that were adapted to serum free conditions is suitable for use in the rabies vaccine production.