School of Medicine

Permanent URI for this college

http://etd.aau.edu.et/handle/123456789/62

Browse

Browsing School of Medicine by Issue Date

Filter results by year or month
Now showing 1 - 20 of 1123
  • No Thumbnail Available
    Item
    Studies on Enteric Campylobacteriosis in Tikur Anbessa Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 1993-08) Asrat, Daniel; Ekwall, Erik(PhD); Hathaway, Audrey (PhD)
    Between February 1992 and January 1993 Campylabaeter species were isolated from 86 (13.6%) of 630 patients with diarrhoea at Tikur Anbassa Hospital, Addis Ababa, Ethiopia. In the same study population, shigellae were found in 11.7% and salmonellae in 3.8%. Of the 345 paediatric patients, 72 (20.8%) and 13 (17.1 %) of the 76 controls less than 2 years of age had EPEC in their stools. No Yersinia enteroeolitiea was isolated. Campylobaeter species were found in all age groups, but the majority were isolated from children less than five years of age (68.6%). Only 2 (0.9%) of 220 controls had eampylobaeter in their stools. Of the campylobaeters that were differentiated at species level, C. j ejuni accounted for 82.4% and C. coli for 17.6% of the isolates. Serotyping of each strain was done, according to the methods of Lior, using 16 antisera against heat labile antigens; 89.3% of the C. jejuni and 75% of the C. coli were typeable. Lior serotypes 1, 2, 4. 5. 6 and 7 were the most common among the C. jejuni, while Lior serotypes I and 2 were dominant among the C.eoli isolates. These serotypes accounted for 63.2% of all isolates. More patients (53.1 %) presented for investigation of diarrhoea during the months of April through July but there was no significant difference in the isolation frequency of the enteric pathogens studied throughout the year. Concomitant isolation of Shigella or Salmonella species was achieved in 12 of the Campylobaeter infected patients. In general, eampylobaeter diaIThoea is not a severe disease . The most common symptoms and signs were watery diarrhoea in 82.4%, low grade fever in 78.4% and frequent vomiting in 45.9%. Dehydration ranging from mild to severe was observed in 25.4% of the 55 children with campylobaeter infections. VitI Of the 55 children 67.2% had signs of malnutrition and most of them (47.2%) were underweight. The antibiogram for 85 strains of the campylobacters isolated showed that all strains were sensitive to chloramphenicol, erythromycin, gentamicin, nalidixic acid, norfloxacin, sulphonamide and tetracycline. All of the strains were resistant to cephalothin, while 51 (60.0%) and 50 (58.8%) strains were resistant to ampicillin and trimethoprimsulphamethoxazole, respectively. This study indicates that campylobacters are an important cause of diarrhoea both in adults and children in Addis Ababa, and should be considered routinely in the diagnosis of patients with diarrhoea.
  • No Thumbnail Available
    Item
    Community Participation and the Effect of Participatory Research in South-Western Ethiopia
    (Addis Ababa University, 1995-05) Kebede, Adugna; Stansfield, Sally (PhD)
    A descriptive study was conducted from October 1994 to March 1995 to document the patterns and determinants o f community p a rticipation (CP) in 25 peasant associ at ion s in Seka Chekorsa Wo r e da. An experimen tal componen t o f the study tested the e ffect o f participatory r e search (PR ) on t he measurement and promot ion o f CPo The study address the barri ers to fuller communities participation in health development activities despite the high demand from the health sector. Ov e r half (52 . 5%) o f communi t y members rep o r ted partic ipatio n i n h ealth activ i t i e s wi t hin the preceding month . Most common forms of participation reported were contribution of labor (31.2%) or materials (11 . 9%) and attending meetings regarding health development (29 . 9%). Communities were most likely to identify more passive forms of CP, including s ervice utilization (60 . 9%), attending meetings (44.8%), and contri bution o f materi a l o r l abo r (33 . 9%) Few (11.2%) indi c a ted that CP implied involvement in dec ision making and planning. Key barriers to promotion of CP in health inc luded poor c ommuni t y aware ness of roles and responsibilities, lack of technical and f inancial res ources , and lack o f strategies and orga nizational structures to promote CPo PR was ef f ective in increas~ng community awareness of CP, and in increas i ng r ates of part i c ipa t ion , including through attending mee t ~ngs and through decision making the development and planning . S:rengthening CP through of clear strateg~es and policies and decentral ization of financial and technicial resources togethe r with utilization of existing mutual self help soc ieties such a s funeral soc ieties (Edi r ) were recomended in order to improve health development programs .
  • No Thumbnail Available
    Item
    Aerobic Bacteria in Post-Surgical Wound Infection and Pattern of Their Antibiotic Susceptibility in Hawassa Teaching and Referral Hospital, Southern Ethiopia
    (Addis Ababa University, 2001-05) Dessalegn, Lopiso; Gebre-Selassie, Solomon(PhD); Shemeles, Techalew
    Background: Post-operative wound infections have been found to pose a major problem in the field of surgery for a long time. Advances in control of infections have not completely eradicated this problem because of development of drug resistance. This condition is serious in developing countries where irrational prescription of antimicrobial agents is common. Objective: To determine the distribution of common aerobic bacteria in post-surgical wound infected patients and their antimicrobial susceptibility patterns. Materials and Methods: This cross sectional study was carried out in a total of 194 patients with post surgical wound infections at Hawassa Teaching and Referral Hospital, from November 2010 to March 2011. Physicians collected data on socio-demography and clinical profiles using designed formats. Moreover, pus swabs were collected, processed and cultured using the standard bacteriological methods. Isolated organisms were tested for pattern of antimicrobial susceptibility using the standard disk diffusion method. The data were entered in to a computer and analyzed using SPSS Version-16 software. Results: The prevalence of aerobic bacteria was 71.1%, and majority of the isolates (59.3 %) were Gram-negative organisms. The most frequently isolated aerobic bacteria was S. aureus (37.3%), followed by E .coli (25.4%) and Klebsiella species (13.6%). All bacterial isolates were resistant to at least one antibiotic, and 86.4 % were resistant to more than one antibiotic (multiple drug resistance). Conclusion: Single and multiple drug resistance to the commonly used antibiotics in the study area was found to be very high leaving clinicians with a very few choices of drugs for the treatment of post surgical wound infected patients. Therefore, it is critical that use of antimicrobial agents with in hospitals, public healthcare providers as well as private ones should be reviewed and further studies to find out the overall resistance patterns and their possible causes and associated factors in the region at large need to be carried out. Key words: Aerobic bacteria, post-surgical wound, antimicrobial, susceptibility
  • No Thumbnail Available
    Item
    Diagnostic Accuracy of Ultra Sound Reports of Intussusception and Factorsaffecting Treatment out Come Among Pediatricpatients in Tikur Anbassa Hospital, Tah, Addis Ababa, Ethiopia
    (Addis Ababa University, 2002) Birhanu, Addisalem(PhD); Gorfu, Yokabel(PhD); Zewdneh, Daniel(PhD)
    BACKGROUND: Intussusception is one of the main abdominal emergencies in children. Ultrasonography, is widely available, easily performed, does not produce radiation and can be used to screen suspected cases and diagnosis of intussusceptions. OBJECTIVE: To retrospectively evaluate the accuracy of ultrasound investigation reports in the diagnosis of intussusceptions and factors which affect treatment outcome of intussusceptions among pediatric patients in TikurAnbassaHospital, TAH, Addis Ababa, Ethiopia MATERIALS AND METHODS: Between September 2002 and Aug 2004 EC, 47 children were managed for intussusception at TAH and 42 patients underwent screening US for suspected intussusception. The mean age of the patients was 8 months. RESULT: Out of forty seven patients, Forty two underwent screening US and surgery. Thirty eight patients had a positive US result; 34 (89.5%) were true positive and 4(10.5%) were false positive. Four patients had a negative US result; all were false negative. The sensitivity of the ultrasound examination was 89.5%. CONCLUSIONS: It is a concern in our environment causing considerable morbidity and mortality due to late presentation. We conclude that ultrasonography can be used as a rapid, sensitive screening procedure in the diagnosis or exclusion of childhood intussusceptions. The sensitivity of ultrasound examination is shown to decrease in our situation when compared to others, For this to be effective, effort may have to be intensified toward training more specialized personnel. ii
  • No Thumbnail Available
    Item
    Prevalence, Incidence and Risk Factors for Herpes Simplex Virus Type 2 Infection in Cohorts of Factory Workers, Akaki and Wonji, Ethiopia, 1997-2002
    (Addis Ababa University, 2003-05) Kebede, Yenew; Dorigo, Wendelien(PhD); Mengistu, Yohannes(PhD)
    Retrospective cohort study (1997-2002) was conducted to determine the prevalence, incidence and risk factors for Herpes simplex virus type 2 (HSV-2) infections among factory workers at two sites in Ethiopia. Among enrolled participants in a cohort study of HIV incidence and disease progression, 1222 (71.3%) were males and 491 (28.7%) were females. The median age was 35 years for males (range, 19-62) and 33 years (range, 19-46) for females. The serologic status of each stored plasma sample for HIV and syphilis has been routinely determined. Antibody to HSV-2 was detected by using the HerpeSelect TM 2 ELISA IgG, Focus Technologies, USA. The HSV-2 prevalence at enrollment was 41.1%, 57.2% among females and 34.6% among males (p<0.001). Seventeen-percent of females and 9.7% of males younger than 25 years had evidence of HSV-2 infection. Independent risk factors for HSV-2 seropositivity were HIV seropositivity, positive TPPA serology, older age, female sex, and ever being married. The incidence of HSV-2 during follow-up was 1.2/100 person-years (95%CI, 1.0-1.4), 2/100 person-years (95% CI, 1.2-3.2) among females and 0.9/100 personyears (95%CI, 0.7-1.3) among males (p=0.02, assuming Poisson distribution). Positive HIV serology at enrollment was an independent risk factor for HSV-2 seroconversion (adjusted hazard ratio [HR], 2.5; 95% CI, 1.1-5.6). Most of HSV-2 infections were asymptomatic or had minor symptoms, which were not recognized. The study showed high prevalence and incidence of HSV-2 infection. This large number of herpes infected individuals may continue to engage in unprotected sexual activity despite their infection facilitating the sexual transmission of HSV-2 and HIV making the vicious cycle. In the absence of protective vaccine or effective antiviral therapy, prevention of HSV-2 infection will rely on the widespread use of condoms and reduction in the number of sexual partners with emphasis to prevention of HSV-2 infection at early ages. Key words: HSV-2, incidence, prevalence, seroconversion, Ethiopia
  • No Thumbnail Available
    Item
    The Size of Anterior Fontanel in Neonates and Infants in Addis Ababa
    (2004-07) G/Meskel, Tarekegn; Kinfu, Yamrot (PhD)
    The size and the time of closure of anterior fontanel (AF) is often used in the diagnosis of disorders like altered skeletal morphogenesis, increased intracranial pressure, hormonal disorders and others. In order to properly utilize AF size in the diagnosis of different disorders, it is necessary to establish a normal range of AF sizes related to age. Racial differences in the size of AF and its time of closure has been reported and there are many countries with their own national standard. To my knowledge, there is no study done to determine the AF size and its time of closure in Ethiopian neonates and infants. The present study aims to establish mean AF size for Addis Ababa (A.A.) neonates and infants at the ages of 3, 46, 76, 106 and 270 days. The study is a cross sectional design carried out from January 2003 to December 2003 in A.A. and the study sites chosen were Tikur Anebessa Specialized Hospital, Zewditu Memorial Hospital, Tekele Haymanot and Wereda 23 Health Centers. The subjects were 687 neonates and infants, of which 363 were males and 324 were females. All cases fulfilling the inclusion criteria were included in a row until the targeted sample size was attained. The AF size, body weight, body length and head circumference were measured. When measuring AF size, first the four vertices were identified. After marking the vertices with washable ink, the marks were transferred on a sheet of paper. From the marks transferred on the sheet of paper, the anterior-posterior and the lateral dimensions were measured. The mean of the anterior-posterior and the lateral dimensions was taken as AF size. The mean AF size progressively decreased with age except at 106 days measurement which showed increase over the 76 days measurement. In all ages considered, no significant difference (p>0.05) was found in neonates and infants of different gender, birth order, gestational age and economic status. AF closure was observed beginning at the age of 76 days (0.8%) and the percent of closure increased with age. In Infants at the age of 270 days, 39.6% of them had closed AF. There were no significant (p>0.05) correlations between AF size and body weight, body length and head circumference while there was negative significant (p<0.05) correlation between AF size and age. The result of the present study shows congruence with the study on Nigerian and Indian neonates but disagrees with the study done on Arab, Israeli, China and white neonates and infants. Further study in different parts of Ethiopia is recommended to establish a national age- related standard for AF size and its time of closure. Key words: Anterior fontanel, Anterior-posterior dimension, lateral dimension, Neonate and infant
  • No Thumbnail Available
    Item
    Effect of Ethanol and Khat (Catha Edulis Forsk)on Cerebellar Cortex of the Rat
    (Addis Abeba University, 2004-12) Muche, Abebe; Makonnen, Eyasu (Professor)
    This experimental study included three age groups of rats: post natal day (PND) 6, 13 and 30. Each group contained control, ethanol treated (ET), khat treated (KT) and combination of khat and ethanol treated (CT) categories. They were treated with vehicle, ethanol and khat, respectively for 30 days using blunt needle. At the end of experiment, all the animals were scarified, their brain was dissected out and immersion fixed. The brain and cerebellum were separately weighed, and cerebellum was processed for routine histology and sectioned. The serially sectioned tissues of cerebellum was stained with toluidine blue and observed using light microscope. In the rats of all age groups, the body weight increment at the end of experimental period was significantly less in the treated ones than their respective controls at P< 0.01. Between the treated rats, this was less for the ET rats than the KT rats, although not statistically significant (P>0.05). Similarly, the weight of the brain as a whole and cerebellar weight, part of brain, of the treated rats were significantly less than their respective controls (P<0.01). These weights were also less for the ET rats than for the KT rats, though not statistically significant. In the rats of PND 6 group, the following results were found: The volume of cerebellar cortex as well as the total number of Purkinje neurons of the ET rats were significantly less than the controls and KT rats at P<0.01 and P<0.05, respectively. However, no statistically significant difference was observed between the controls and KT rats. The numerical density and volume fractionof Purkinje neurons of ET rats was found to be significantly greater than those of control or KT rats (P<0.05). In addition, the numerical density and volume fraction of Purkinje neurons were greater in the KT rats than their corresponding controls, but no Xi statistically significant difference was observed. The mean diameter of Purkinje neurons was significantly less in the ET rats than in KT rats which in turn was significantly less than the control rats (P<0.01).In the rats of PND 13 and 30, the patterns of the results of all the different parameters investigated consistently followed those of the rats of PND 6 as summarized above, However, the values were found to be statistically non- significant. In addition, the results of all the parameters for the CT rats of PND 30 rats showed values in between KT and ET rats, though these were also statistically non- significant. However, CT rats of PND 6 and 13 died after two days of treatment. In conclusion, the study depicted that PND 6 is an extremely vulnerable period during which the rat cerebellar Purkinje neurons are particularly susceptible to the effect of high dose of ethanol. However, a similar level and duration of ethanol exposure commencing during PND 13 and 30 has no significant effect on the volume of cerebellar cortex, numerical density of Purkinje neurons, total number of Purkinje neurons and volume fraction of Purkinje neurons. Treatment of khat and combination of khat and ethanol is lethal at an early age, however it does not significantly change the above mentioned parameters at the latter ages (PND 30) Key words: Cerebellar cortex, Purkinje neurons, Stereology, Khat, Ethanol, Post natal day
  • No Thumbnail Available
    Item
    Assessment of Bacterial Profile and Antimicrobial Susceptibility Pattern of Catheter-Associated Urinary Tract Infections in Comparison with non-Catheterized Urinary Tract Infections in Jimma University Hospital, Southwest Ethiopia
    (Addis Ababa University, 2005-06) Teshager, Lule; Asrat, Daniel(PhD)
    Urinary tract infections (UTIs) are among the most common bacterial infection. They have become the most common hospital acquired infections, accounting for as many as 35% of nosocomial infections, and are usually associated with catheterization. The aim of this study is to assess the bacterial profile and antimicrbial resistance pattern of catheter associated urinary tract infection in comparison with non-catheter associated UTI. One hundred and twenty urine specimens (30 from catheterized patients and 90 from non-catheterized patients with symptoms of UTI) were screened for the presence of significant bacteruria from January to March 2005. Bacteriological screening of catheterized urine and clean catch mid-stream urine revealed that 13/30 (43.3%) and 20/90 (22.3%) had significant bacteriuria, respectively (P<0.05). All samples taken from patients who have been catheterized for 2 weeks or more showed significant bacteruria. In both group the rate of infection was higher in female patients. Older patients (>50years old) were found to be the most affected age group (46%) among catheterized patients whereas most of the non-catheterized patients with significant bacteruria belonged to age group 11-12 years. Among catheterized patients, Escherichia coli and Klebsiella species were found to be the most frequently isolated pathogens (each of them accounts 23 %) followed by coagulase negative Staphylococci (15 %). The most frequently isolated species from non-catheterized patients was Klebsiella (40 %) followed by E. coli (30 %). Resistance rates (56.3 % to 100%) to Ampicillin, amoxicillin, cephalexin, carbenicillin, and Trimethoprime /sulfamethoxazole were observed in all organisms isolated from both groups. In addition, resistance rates to gentamicin, nitrofurantoin, and nalidixic acid were observed in all bacteria isolated from catheterized patients. In general, in this study, high level multidrug resistance in both groups indicated that it is time to reconsider the empirical use of the commonly used antimicrobial agents in Ethiopia. Particularly, increasing vii resistance in pathogens isolated from catheterized patients is frustrating. Because the most important risk factors for UTI is duration of catheterization indwelling urinary catheterization should be avoided or at least minimized
  • No Thumbnail Available
    Item
    Characterization of Mycobacterial Isolates from Lymph Nodes of Patients with Tuberculous Lymph Adenitis in Dera Woreda, North Showa, Ethiopia
    (Addis Ababa University, 2005-07) Seyoum, Berhanu; Wolde, Yimtubezanash (PhD); Aseffa, Abraham(PhD)
    Tuberculosis is a major health problem throughout the world causing a large number of deaths, more than that from any other single infectious disease. Extra pulmonary tuberculosis can occur in isolation or along with a pulmonary focus as in the case of patients with a disseminated form of tuberculosis. Tuberculous lymphadenitis (TBLN) is a common form of extra pulmonary tuberculosis. Lymph nodes (cervical, axillary and inguinal) are the most common sites of involvement. Diagnosis of TBLN is a formidable challenge in developing countries where there is high rate of human immunodeficiency virus infection. The aim of this study was to identify the etiological species of Mycobacteria responsible for TBLN in Derra, rural Ethiopia, where the status of TBLN was not known. A total of 153 patients who fulfilled the inclusion criteria were included in the present study during the study period between January 2004 and February 2005. Out of 153 study participants, fine needle aspirate specimens from 145 study participants were processed and analyzed using Ziehl Neelsen staining, culture, cytology and polymerase chain reaction. Out of 145 FNA samples, 66 (45.5%) of the isolates demonstrated growth on Lowenstein - Jensen medium. Among 145 clinically suspected TBLN patients, 115 (79.3%) were confirmed as TBLN cases by the combined results of AFB smear examination, culture, cytology and PCR. Two primer sets were used to identify the etiological agent at the complex (targeting the IS6110 insertion sequence) and species level (targeting the pncA gene allelic variation). From a total of 145 clinically suspected TBLN cases, 108 (75%) were positive by PCR at the complex levels. Based on PCR for detection of allelic variation at position 169, 107/108 (99.1%) were positive for M. tuberculosis and only 1(0.9%) was positive for M. bovis. The results indicated that M. tuberculosis is the causative species for tuberculous lymphadenitis in Dera.
  • No Thumbnail Available
    Item
    Characterization of Group A Streptococci Isolated from Throat of Healthy School Children in Ethiopia
    (Addis Ababa University, 2005-07) Abdissa, Alemseged; Asrat, Daniel(PhD)
    Post-streptococcal complications such as acute rheumatic fever (ARF) are reported to be common among Ethiopian children. Little is known, however, about the epidemiology of b-hemolytic streptococci, and Group A streptococci (GAS) in Ethiopia. A total of 937 randomly selected healthy schoolchildren residing in Addis Ababa (n=491), Gondar (n=265) and Dire-Dawa (n=181) were studied during a period November 2004 and January 2005. Throat specimens were collected and b-hemolytic streptococci were isolated on Columbia blood agar supplemented with Colistin-oxolonic acid. Gram reaction, catalase test Bacitracin susceptibility test and serological test were used to differentiate the organisms. In addition biochemical testing (API) was used to identify the species of isolates that could not be serogrouped. GAS were the predominant b-hemolytic streptococci with a proportion of 55% in Addis Ababa, 61% in Gondar, and 47% in Dire-Dawa of the serogroups. The carrier rate of GAS in healthy schoolchildren was 10.8% in Addis Ababa, 8.7% in Gondar and 9.4% in Dire- Dawa. Seven isolates that were nongroupable confirmed to be Streptococcus constellatus with API biochemical testing. Molecular (emm gene) typing was performed on 82 GAS isolates and 44 different emm types were detected. Among the 82 isolates 18 strains belonged to 13 new, previously undescribed emm subtypes. Known rheumatogenic strains accounted for 56% of isolates in Addis Ababa, 35% in Gondar and 0% in Dire-Dawa. Of the emm types prevalent in the study communities, 60% were not included in the 26 valent vaccine that was formulated for western countries. The distribution of emm types described in this study was compared with the study conducted on isolates collected 13 years ago in Addis Ababa, only 3/20 emm types identified in earlier study had been represented in the present study. Moreover, the type, which was predominant in the previous study, was not detected in the current one and the type that was predominant in our study was not detected in the previous one. x In conclusion, Group A was the most frequent serogroup among b hemolytic streptococci isolated from throat swabs of healthy schoolchildren in the selected three sites of Ethiopia and the carriage rate of GAS ranged from 8.7 to 10.8%. Tremendous diversity of emm types was observed in this first large scale emm type survey in Africa, and a significant proportion of them are known to be rheumatogenic. The association of the prevalent emm types not previously linked to rheumatic fever needs to be explored particularly in Dire-Dawa. Key Words: Beta-hemolytic streptococci, Group A Streptococci, Streptococcus pyogenes, M protein, emm typing
  • No Thumbnail Available
    Item
    Microbiology of Burn Unit at Yekatit 12 Hospital, Addis Ababa
    (Addis Ababa University, 2005-10) Negeri, Challa; W/Amanuel, Yimtubezinash (PhD)
    Burn patients are at risk of acquiring infection because of the loss of skin barrier and suppressed immune system, compounded by prolonged hospitalization and invasive therapeutic procedures. Since specialized burn units were non-existent in Ethiopia before the establishment of one at Yekatit 12 hospital, Addis Ababa, no study was done on burn patients in the country. Hence, to study the microbiology of burn patients admitted at Yekatit 12 hospital, a prospective study was undertaken on 52 patients from March to August 2005. Periodic swabs were taken from the burn patients as well as from the patients’ attendants, attending staffs, and the burn unit environment in order to associate prevailing burn pathogens with endogenous or exogenous sources. The pattern of colonization in the burn wound changed during the hospital stay from a predominance of Gram-positive bacteria (69.8%) at admission to Gram-negative bacteria (68.6%) after the second week. On comparing infected patients (n=38) with non-infected patients (n=14), there was significant difference in age distributions (p=0.035), in burn types (p=0.017), hospital stay (p<0.0001), and total burned surface area (p=0.005) but no significant difference in the frequency of infections by sex (p=0.535). Among the 33 patients without infection on admission, 20(60.6%) developed at least 1 type of nosocomial infection with the most frequent nosocomial infection being burn wound infection (N=20; 60.6%), followed by urinary tract infection (N= 10; 30.3%), bloodstream infection (N=4; 12.1 %) and pneumonia (N=1; 3.0%). Fifty five isolates were recovered from the swabs of infected wounds, of which S. aureus accounted for 40.0% (22/55), and P. aeruginosa for 27.3 %( 15/55). All of the isolates of S. aureus were sensitive to methicillin, clindamycin and vancomycin and were moderately sensitive to chloramphenicol, cephalothin, and augmentin but highly resistant to ampicillin and penicillin G. Thirteen isolates of P. aeruginosa (86.7%) strains were designated multi drug resistant to the commonly used drugs in the burn unit and the country at large. Burn wound infection was the most common infection in the burn unit and S. aureus and P. aeruginosa with high degree of resistance to the commonly used antibiotics in the burn unit were the most commonly isolated organisms from the burn wounds. Since bacterial isolates with identical sensitivity pattern to the clinical isolates were identified from both endogenous sources and exogenous ones, it can be deduced that acquisition of the major burn pathogens was likely multifactorial.
  • No Thumbnail Available
    Item
    Dilemmas in the Diagnosis of Lymph Node Enlargement in Ethiopia: A Study from Four Sites with High Notification of Lymph Node Tuberculosis
    (Addis Ababa University, 2005-12) Iwnetu, Rahel
    The proportion of extra-pulmonary tuberculosis has risen to over a third of the cases of tuberculosis in Ethiopia. The majority of this form of tuberculosis is reported as lymph node tuberculosis (LNTB). We evaluated the national algorithm currently in use for the diagnosis of lymph node enlargement in Ethiopia. One hundred and fifty suspected cases of lymph node tuberculosis, aged 5-65 years, with extra-inguinal lymphadenopathy were recruited following the national algorithm, from October 2004 to August 2005. Out of these individuals, 117 (78%) were diagnosed as LNTB on positive culture of fine needle (FNA) and/or biopsy specimens. FNA cytology (FNAC) and histopathology detected 88 (75%) and 105 (97%) of the culture proven LNTB patients, respectively. Eighty percent of DNA extracted from biopsy tissues gave signal for M. tuberculosis. All of the strains isolated from culture were identified as M. tuberculosis. Ziehl-Neelsen (ZN) staining of FNA and biopsy smears detected acid fast bacilli (AFB) in 28% and 25% of the patients, respectively. Macroscopic caseation in excised lymph node and aspirated material was found to be comparable with 79 (68%) of the nodes and 78 (67%) of the fine needle aspirates demonstrating caseation. Statistically significant association was found between the presence of caseation and the diagnosis of LNTB in both types of specimens (p=0.002). Combination of FNAC, ZN staining of FNA materials and macroscopic examination of aspirates detected 112 (96%) of the culture proven LNTB patients. The proportion of HIV seropositive individuals among the culture proven LNTB patients were 24%. There was statistically significant association between urban residence (p=0.002), female gender (p=0.006) and HIV in LNTB patients. There was no statistically significant association between LNTB and HIV. We found that the currently used algorithm detects a significant amount of culture proven LNTB patients even though it suffers from shortcomings. It is hoped that this will encourage wider consultation to review and revise the existing algorithm and improve LNTB diagnosis and reporting nationwide
  • No Thumbnail Available
    Item
    Symbiotic and Phenotypic Diversity of Rhizobium leguminosarum var viceae Isolates (Vicia faba) from Northern Gondar, Ethiopia
    (Addis Ababa University, 2006-05) Belay, Zerihun; Assefa, Fassil(PhD)
    Twenty-one strains of Rhizobium leguminosarum var. viceae spp (Vicia faba) from 21 sites of North Gondar were isolated from a range of pH 5.8-7.5 to induce nodulation on “Degaga" cultivar of faba bean. Isolates were authenticated as root nodule bacteria by their ability to form nodules on their host up on re-inoculation, except AUFR13. All of the morphological features displayed by all isolates were characteristics of fast growing Rhizobium leguminosarum var viceae, except AUFR13. Almost all of the isolates grew between 150C and 350C and failed to grow at 400C, except AUFR22 and AUFR28. All isolates failed to grow at 1% NaCl, except AUFR12 and AUFR28. AUFR18 was the only osmotolerant strain capable of growing at a concentration of 5%. The isolates also grew on a wide range of moderate acidity and alkalinity but only 10% of the isolates grew at pH5.5. With the exception of gluconate, citrate, and tartarate, almost all isolates grew on 14 out of the tested carbohydrates. The Intrinsic Antibiotic Resistance (IAR) was found to be the best of all tested physiological characters to identify the heterogeneity of Rhizobium leguminosarum var. viceae, so that 95% of the tested isolate were resist erythromycin and chloromphenicol, and 14%, 24%, 38%, 38% and 43% of the isolates tolerated streptomycin, ampicillin, rifampcin, kanamycin and naldixic acid at highest concentration, respectively. The relative effectiveness expressed as percentage of shoot dry mass of inoculants over TN control, showed that 24%, 57%, 4.7% and 9.5% of the isolates were found to be highly effective, effective, lowly effective and ineffective, respectively. The highest scores of 88-100% effectiveness of symbiotic nitrogen fixation were displayed by AUFR14, AUFR15, AUFR24, AUFR28 and AUFR32. Selected strains on soil culture were found to accumulate 81-92% on Holeta soil and 90-103% on Ambagiorgis soil of their shoot dry mass compared to their respective N-fertilized controls. All isolates were also found to increase shoot dry weight by 0- 43% higher than their respective sand cultures and response of the Holetta soil to inoculation by selected effective strains was much pronounced (47-67%) than Ambaghiorgis soil (8-25%) compared to the negative (N-) controls. The lower dry matter accumulation by Holeta soil indicates that the low pH and other soil-related factors severely affected survival, nodulation and nitrogen fixation of their indigenous rhizobia and the process can be rectified by inoculation of effective rhizobia. Key words: Faba bean, Rhizobia, Phenotypic diversity, Symbiotic effectiveness.
  • No Thumbnail Available
    Item
    Preliminary Investigation on Immune Response of Schistosoma Mansoni in Grivet Monkeys (Cercopithecus Aethiops Aethiops) Infected with Different Cercarial Doses
    (Addis Ababa University, 2006-07) Demelash, Tariku; Hailu, Asrat(Professor)
    In order to evaluate grivet monkey (Cercopithecus aethiops aethiops) as an animal model for the immune response of mansonian schistosomiasis, groups of three or four grivet monkeys were exposed individually to 100, 200, and 300 cercariae per monkey. Infection and clinical manifestations were observed; EPG of stool was determined and different cytokines (IL-12, IFN- , TNF- , IL-4 and IL-10) were measured. Infected monkeys began to release eggs 7 weeks post infection. Most of them became ill 7 to 9 weeks after initial exposure and exhibit most of the clinical manifestations typical of human acute schistosomiasis. The fecal egg count confirmed there is significant (P<0.05) variation between groups in terms of numbers of eggs released in stools, where the group that receives the lowest cercariae dose exhibiting the highest egg output. There was a significant difference in the level of cytokine production between those infected and the controls. Th1 cytokine (IL-12, INF-gamma, and TNF-alpha) levels reached their highest before their Th2 counter part (IL-4). Cytokine levels, however, were not found to be dose-dependent as anticipated. Comparison of this study with studies on related primates suggests that grivet monkey closely resemble the baboons in their immune response to Schistosoma mansoni infections. Thus, this work may underline the potential of the grivet monkey to provide a cheaper, more readily available primate model for the study of the immune response and the acute stage of infection by S. mansoni
  • No Thumbnail Available
    Item
    Diversity of Arabica Coffee Populations in Afromontane Rainforests of Ethiopia in Relation to Colletotrichum Kahawae and Gibberella Xylarioides
    (Addis Ababa University, 2006-07) Zeru, Arega; Asefa, Fasil (PhD); Adugna, Girma (PhD)
    Coffee berry disease (CBD), caused by Colletotrichum kahawae and coffee wilt disease (CWD), which is caused by Gibberella xylarioides, are the major coffee diseases in Ethiopia. Assessment of CBD and CWD was conducted in Harena, Bonga, Birhan-Kontir and Yayu from July to September 2005. These diseases were prevalent in all surveyed forest coffee areas of Ethiopia. The mean percent incidence and intensity of CBD varied from 6.0-40.0% and 2.0-17.9% across forest coffee areas. The mean incidence of CWD varied from 2.4 to 16.9% across forest coffee areas. Seedling inoculation tests conducted on indigenous forest coffee selections from 4 different forest coffee areas revealed significant variations (P < 0.05) among the selections both in percent seedling CBD infection, inoculated with C. kahawae and in percent wilt seedlings, inoculated with G. xylarioides. Selections from Yayu, Bonga, Berhan-Kontir and Harena showed mean seedling CBD infection rate from 69.0-100%, 57.5-100%, 75.3-100% and 23.3-100% where as percent wilt seedlings varied from 58.0-97.2%, 26.2-97.3%, 72.7-100% and 0-94%, respectively. This indicated that in the course of resistant coffee variety development it is possible to get wider alternative resistant gene pool from Harena and Bonga, followed by Yayu indigenous forest coffee germplasms. These observations allow first remarks on possible CBD and CWD tolerant or resistant selections in the indigenous forest coffee of Ethiopia, which increase the value of afromontane rainforest coffee. Hence it is important to conserve and use sustainably the indigenous coffee germplasms both insitu, and exsitu, by conducting intensive selection from more diverse coffee population and evaluation for diseases resistant (priority on CBD and CWD), high yield, better quality and other characteristics. 15 representative C. kahawae isolates were obtained from forest coffee areas of Ethiopia and 2 isolates from Gera were studied based on their cultural and morphological characters. Isolates could be grouped into 3 based on their colony color manifestation on the obverse side of potato dextrose agar (PDA) and malt extract agar (MEA). The cultures exhibited lightgray, darkgray and gray mycelia forms. Mean radial colony growth rate of C. kahawae isolates ranged between 0.6 and 5.5 millimeter (mm)/24 hour (hr), and between 1.2 and 6.1mm/24 hr on PDA and MEA, respectively. Conidia width and length ranged as 3.6–4.8 μm and 12.7–15.5 μm, respectively. Highly significant (P < 0.05) variation was observed among C. kahawae isolates in their sporulation capacity, and varied between 25.93 x 104 and 253.22 x 104 conidia/ml. No race difference was observed within C. kahawae isolates; however, certain cultural, morphological variations as well as significant variation in aggressiveness were detected among them. Pathogenicity test of 12 isolates on seedlings of 4 Coffea arabica L. cultivars indicated that there was a highly significant difference (P < 0.05) among cultivars, isolates, and cultivar x isolate interactions. The resistance manifested by cultivars was horizontal or non-biotype specific. The difference in virulence and aggressiveness implies that care should be taken in while developing resistant varieties. Aggressive isolates should be used for successful screening of resistant coffee germplasms before releasing any newly developed coffee cultivar(s). Key words/phrases: Afromontane rainforest indigenous coffee, Coffea arabica, Colletotrichum kahawae, Gibberella xylarioides
  • No Thumbnail Available
    Item
    Hemoglobin Profile of Anemic Ethiopian Patients Attending Tikur Anbessa Specialized Hospital
    (Addis Ababa University, 2006-09) Degef, Maria; Worku, Yesehek (PhD)
    Hemoglobinopathies are inherited abnormalities of hemoglobin molecule that affect the production, structure and function of Hb. Hb is the protein of the red blood cells that binds oxygen reversibly and transport it from the lungs to the tissue and return carbon dioxide from the tissue back to the lungs. Hemoglobin genes are subject to mutations that alter the synthesis and structure of the protein. These diseases are common lethal genetic defects in some part of the world. This study was undertaken to find out the hemoglobin profile of anemic patients attending follow-up clinics at the TASH. The study subjects included both genders, between 3 months to 68 years of age. Information was collected from the patients by a questionnaire designed to find out the relationship of hemoglobin variants with gender, age, family relation ship, etc. Blood films were prepared to look for morphological appearances of red cells and also malaria parasites. Out of 113 patients studied, only one was found to have malaria parasite on blood film. 90 % of the morphologies revealed variable size and shape of the red blood cells. The CBC revealed that the Hb of the patients ranged from 3.0 to 12.0 gm/dl and the MCV and MCH were 56.1-122.0 fl and 14.1-50.5pg respectively. The hemolysate that was subjected to agarose and Native-PAGE revealed that all the patients had HbA, HbF and HbA2 and three patients (2.65 %) of the participants had sickle hemoglobin band. There were six patients (5.3 %) with thick HbA2 band. It is clear from this study that there is a need to conduct this type of research on larger sample using sensitive methods, including DNA analysis to investigate the prevalence and distribution of Hemoglobinopathies in Ethiopia
  • No Thumbnail Available
    Item
    Prevalence and Antimicrobial Profile of Listeria Monocytogenes in Retail Meat and Dairy Products in Addis Ababa and Its Surrounding Towns, Ethiopia
    (Addis Ababa university, 2007-03) Abera, Firehiwot; Monga, DP (Professer)
    Listeriosis is a disease of humans and animals, which is mostly caused by Listeria monocytogenes, as the result of food and environmental contamination as well as zoontic infections. In the world, this disease is becoming an emerging bacterial disease, with low incidence but high case fatality rate. The objective of this study was to isolate L. monocytogenes from retail meat and diary products (raw milk, cottage cheese, cream cake) and to detect their antimicrobial profile. Two hundred and forty food samples were purchased from food vendors, shops and supermarkets, using cross-sectional study design, from July to December 2006. L. monocytogenes isolation were performed according to the standard procedures using Listeria enrichment broth, Modified Fraser broth, Polymyxin Acriflavine Lithium Chloride Ceftazidime Aesculine Mannitol (PALCAM) and Oxford Agar (OXA) media as well as confirmatory broths like rhamnose, xylose, mannitol; blood agar and Christe Atkins Munch Peterson (CAMP) test. The antimicrobial profile of L. monocytogenes was also assessed by using the standard disk diffusion method (Kirby Bauer, Muller Hinton agar) and it was tested against 14 antimicrobial drugs. Out of 240 food samples tested, 66(27.5%) were positive for Listeria species. The prevalence rate of L. monocytogenes was found to be 13 (5.4%). The antimicrobial profile of L. monocytogenes was also assesed and it was found that L. monocytogenes was sensitive to most drugs except clindamycin which showed the highest resistance rate (100%) and also to certain extent, to chloramphenicol (53.9%), tetracycline (31.8%) penicillin (23.1%), and rifampicin (15.4%).
  • No Thumbnail Available
    Item
    Investigation of Cutaneous Leishmaniasis Using Conventional and Molecular Methods in Silti Woreda, Ethiopia
    (Addis Ababa University, 2007-05) Negera, Edessa; Aseffa, Abraham(PhD)
    Man-made risk factors for leishmaniasis are increasing while knowledge of risk factors, accurate diagnosis and treatment of leishmaniasis is poor. As a result, deadly epidemics of leishmaniasis occur periodically, but tools for prediction and prevention are lacking. Hence, research is needed to address these constraints. Leishmaniasis in Ethiopia is mainly due to L. donovani and L. aethiopica, which causes visceral and cutaneous leishmaniasis respectively. Although the exact magnitude of the problem is not known, several surveys have indicated the importance of the diseases as a public health problem. A complete mapping of the diseases remains to be accomplished in view of the increasing number of patients reporting from regions hitherto unknown to be endemic. Therefore, the main aim of this work is to describe the epidemiology of the disease through identification of the causative agent using molecular epidemiological tools in Silti Woreda. The study was conducted in two Phases: in phase I, house-to-house survey was conducted and in phase II, parasitological identification was done. The treatment response of L. aethiopica to liquid nitrogen (cryotherapy) and pentostam was documented as follow up activity. The prevalence of the disease in the area was found to be 4.82% with highest prevalence among age group 10-20 years. Some plants like Adathoda shimperina and Acacia spp. and hyraxes and domestic animals were associated with increased risk of cutaneous leishmaniasis. The sole causative agent identified was L. aethiopica. The disease was found to be recently introduced in the area. In conclusion, the importance of the risk factors identified in this study should be investigated further and molecular epidemiological studies should be conducted in other areas to map the exact magnitude of the disease in the country. The clinical service in the outbreak site (Silti) needs to be prepared to provide the required care and treatment of patients who will keep coming from the area. Leishmaniasis control program has to be initiated in Ethiopia so as to prevent the disease from expanding. Keywords/Phrases: Cutaneous leishmaniasis, Risk-factor, Molecular epidemiology, Prevalence, Treatment, L. aethiopica
  • No Thumbnail Available
    Item
    Validation of the Bleach Methods for the Diagnosis of Pulmonary Tuberculosis
    (Addis Ababa University, 2007-07) Merid, Yared; Kumar, Raja(Professor); Aseffa, Abraham(PhD)
    Bacteriological diagnosis of tuberculosis is largely dependent on direct microscopy of sputum smears. It is the most widely available diagnostic test, especially in developing countries where the other options are usually not practical due to the limited resources available. However, its sensitivity is not optimal when used in control programs, usually ranging from 8.8% to 46.4% in most African laboratories. The sensitivity of the technique is further undermined in areas with high HIV prevalence. If sensitivity could be improved, the method has the potential to become an even more valuable tool for National TB Control Programs. Treating the sputum with house bleach (NaOCl) has been reported to increase sensitivity of direct microscopy. Therefore, the aim of this study was to compare the diagnostic performance of the three different bleach methods reported so far: centrifugation, overnight sedimentation and short term bleach digestion (30 min), with conventional direct microscopy and validate against culture as a gold standard on a given group of specimens. This cross sectional study was conducted at Awassa Health Center and Bushulo Major Health Center in Awassa. Five hundred (500) consecutive new TB suspects presenting at the health facilities during July to December, 2006 were enrolled in the study. Direct smears were prepared and stained using Ziehl-Neelsen technique and specimens were decontaminated and inoculated onto Lowenstein-Jensen media for culture. The left over sputum samples were pooled, equal amount of bleach was added and then divided in three portions for the three bleach treatment techniques. Smears were prepared after centrifugation, overnight sedimentation and short term digestion. The direct and bleach treated smears were read blindly by two independent microscopists. Ten percent of the negative and 20% of all the positive smears were retained for quality control. Smears were graded using the WHO/IUATLD scale. Considering smears graded scanty (<10 Acid-fast bacilli per 100 fields) as negative, the direct smear was positive in 21%, short term digestion in 20%, overnight sedimentation in 23%, centrifugation in 31% and culture in 47%. The sensitivity of direct smear microscopy under the experimental condition was 41.9%. Among the bleach techniques, sensitivity was best for centrifugation (54.6%) followed by overnight sedimentation (43.7%) and short term digestion (38.9%). The bleach centrifugation method can clearly X increase the sensitivity of smear microscopy and would thus be a useful tool to improve case detection in the National Tuberculosis Programme. Key words: tuberculosis, diagnosis, bleach methods, validation
  • No Thumbnail Available
    Item
    Prevalence of Specific Antibodies to Chlamydia Trachomatis Among Women on Routine Gynecological Visit to Jimma University Specialized Hospital, Jimma, South – West Ethiopia
    (Addis Ababa University, 2008) Sahlemariam, Zewdineh; Monga, D.P. (Professor)
    Genital Chlamydia trachomatis infection is a key global issue facing women’s reproductive health. The worldwide prevalence of Chlamydia trachomatis genital infection (CTGI) is estimated to be 700 million, with highest prevalences in sub-Saharan Africa. To determine the prevalence of antibodies to genital Chlamydia trachomatis infection and to assess related socio-demographic and reproductive factors, 184 women routinely visiting the gynecology out-patient department of Jimma University Specialized Hospital (JUSH) were investigated during March 2005 – February 2006. Specific IgG and IgM antibodies to Chlamydia trachomatis were detected using an Enzyme Linked Immunosorbent Assay (ELISA) system on 184 sera collected from these women. Socio-demographic information as well as gynecologic/reproductive information was collected by interviewing. Physical examination was also done for the patients. Complete data were obtained for 184 women. The majority of the women (47.3%) were in the 20-29 year age group. The minimum age of the study participants was 12 years. The prevalence of antibodies showing exposure to genital Chlamydia trachomatis was: IgG 45.6% and IgM 5.4%. Seven women (3.8%) had positive serology for both IgG and IgM. Higher prevalence of IgG antibodies was found in women in the 20-29 year and 30-39 year age groups which was 21.7% and 12.5%, respectively, although the difference in the different age groups was not significant (p>0.05). Thirty-four percent of the study subjects had a history of one or more abortion, of whom 17.4% had positive IgG serology. The minimum and mean ages of the women at first sexual intercourse were 12 years and 16 years, respectively. Physical examination revealed no symptoms of reproductive tract infection (RTI), sexually transmitted infection (STI), urinary tract infection (UTI) or other gynecologic abnormalities in 19% of the women. Evidence of Chlamydial infection was found in half of the women who were asymptomatic. The majority of the women (81%) had either one or multiple symptoms on clinical evaluation. History of previous episodes of pelvic inflammatory disease (PID) was documented in 14 women, of whom 6 showed positive IgG serology. The most frequent complaints at presentation were: lower abdominal pain/tenderness (39%), vaginal discharge (32%) and vi vaginal bleeding (18.5%). Positive serology to Chlamydia trachomatis IgG antibodies was identified in 14.1% and 16.8% of all women with vaginal discharge and lower abdominal pain, respectively. Thirty-five percent of the study subjects claimed to have had 2 or more sexual partners. Forty-nine percent of the women had their first sexual intercourse at an age of 12 – 16 years, of whom 23.4.8% had positive IgG serology. This study has highlighted high prevalence of antibodies to genital Chlamydia trachomatis and high frequency of behavioral and reproductive risk factors among the study participants. Health care providers should be aware of the high prevalence of Chlamydial infection in women. Similar population-based studies of chlamydia prevalence should be conducted in different communities to elucidate the actual burden of the problem in Ethiopia and design intervention strategies.