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Alelign A, Mulualem N, Tekeste Z. Prevalence of intestinal parasitic infections and associated risk factors among patients attending Debarq Primary Hospital, northwest Ethiopia. PLoS One 2024; 19:e0298767. [PMID: 38451932 PMCID: PMC10919636 DOI: 10.1371/journal.pone.0298767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024] Open
Abstract
Intestinal parasitic infections (IPIs) are major public health problems in developing countries. This study was conducted to determine the prevalence and associated risk factors of IPIs at Debarq Primary Hospital in northwest Ethiopia. A health facility-based cross-sectional study was conducted from March 2022 to June 2022. The study participants were recruited from patients who visited Debarq Primary Hospital during the study period. Stool samples were collected from each participant and examined for intestinal parasites using direct wet-mount and formal-ether concentration techniques. Socio-demographic data were collected using a structured questionnaire. Out of 422 individuals examined, 33.64% were infected with at least one intestinal parasite species. Entamoeba histolytica/dispar, Giardia intestinalis, Ascaris lumbricoides, and hookworm were found in 12.79%, 8.53%, 7.10%, and 1.65% of the participants, respectively. Double and triple parasite infections were found in 2.37% and 0.23% of the participants, respectively. A habit of eating unwashed vegetables (Adjusted odds ratio (AOR) = 9.98, 95% confidence interval (CI) = 2.68-37.14) and low income (AOR = 6.66, 95% CI = 1.87-23.70) were associated with increased odds of IPIs. Participants with a habit of hand washing after using the toilet had 0.05 (95% CI = 0.13-0.22) lower odds of IPIs than those who did not. In conclusion, IPIs are common among Debarq Primary Hospital patients and are associated with factors such as low income, not washing hands after using the toilet, and eating unwashed vegetation, necessitating control and prevention efforts in the study area that include health education and the provision and use of sanitary facilities.
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Affiliation(s)
- Amir Alelign
- Department of Biology, College of Natural and Computational Science, University of Gondar, Gondar, Ethiopia
| | - Nigus Mulualem
- Department of Biology, College of Natural and Computational Science, University of Gondar, Gondar, Ethiopia
| | - Zinaye Tekeste
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Intestinal parasite infection and associated factors among food handlers in Feres Bet town, North West Amhara, Ethiopia, 2021. Heliyon 2023; 9:e14075. [PMID: 36915516 PMCID: PMC10006486 DOI: 10.1016/j.heliyon.2023.e14075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023] Open
Abstract
Introduction Intestinal parasite infections are one of the most serious public health issues in the globe. Individuals' health is harmed by a high prevalence of intestinal parasite infections, which primarily affect physical and mental growth, resulting in malnutrition, anemia, stunting, cognitive impairment, reduced educational achievement, and inefficiency. Objective The aim of this study is to determine the prevalence of intestinal parasite infection and associated factors among food handlers in Feres Bet town, North West Amhara, Ethiopia, 2021. Methods From March to April 2021, a facility-based cross-sectionalstudy was undertaken in Feres Bet town among food handlers and drinking establishments. A total of 370 study participants were enrolled in the study utilizing a basic random sampling procedure. Epi data version 3.1 was used to enter the data, and statistical product service solution version 25 was used to clean and analyze it. To show the relationship between dependent and independent variables, a binary logistic regression statistical model was built. Adjested odd ratios with a 95% confidence interval and a p-value of less than 0.05 were declared statistically significant. Tables and graphs were used to convey the report. Result The study included 370 food handlers out of a total of 399. Approximately 166 (44.9%) of food workers tested positive for at least one intestinal parasite. Hand washing practice after toilet [(AOR: 6.25, 95% CI: 2.05-19.02)], hand washing practice after touching dirty materials [(AOR: 3.71, 95% CI: 1.72-8.03)], hand washing practice before meal (AOR = 12.49, 95% CI = 4.92-31.72), periodic medical checkup [(AOR = 3.42, 95% CI = 1.29-9.06)], were variables significantly associated with intestinal parasite. Conclusions The prevalence of intestinal parasite infection among food and drink handlers was found to be 44.9% in this investigation.
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Desalegn W, Birke W, Teshome T, Bacha K, Tamene A, Tesfaye L, Tagesse M. Intestinal Parasitosis and Associated Factors Among Food Handlers Working in the University of Southern Ethiopia. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221128455. [PMID: 36277839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Intestinal parasite infections are major global public health problems. The majority of persons infected reside in Sub-Saharan Africa with a high burden of the disease. Very few studies have been done in Ethiopia and none exist at Wachemo University, Southern Ethiopia. The present study aimed to investigate intestinal parasitic infections and associated factors among Wachemo University students' cafeteria food handlers. METHODS Institution-based cross-sectional study was conducted on 212 randomly selected food handlers from 15, February to 05, March/2019. A structured questionnaire was used to collect data and standard laboratory procedures were employed to collect stool and finger specimens and analyzed them for intestinal parasites. Data were edited, cleaned, entered, using EPI data 3.3.1, and analyzed by statistical package for social science version 20. A stepwise logistic regression model was used to calculate the odds ratios and 95% confidence interval for the different factors. RESULTS Of 212, the majority 63.7% were females and 48.1% attended grades 9 to 10. Of the stool and fingernail specimens examined, 29.7 % and 5.6% were positive for different parasites, respectively. The most prevalent parasite is Ascaris lumbricoides (12.7%) followed by Hookworm (6.6%), Giardia lamblia (4.7%), Taenia saginata (2.4%), and mixed infection (3.3%). Although several factors showed significant association with intestinal parasitosis, attending secondary level education 94.5% (AOR: 0.055; 95% CI [0.007-0.413]), fingernail status (AOR: 0.330; 95% CI [0.113-0.965]), and hand washing with soap and water after toilet use (AOR: 0.332; 95% CI [0.125-0.884]) were the significant variables in multivariable analysis (P < .05). CONCLUSIONS The results demonstrated intestinal parasite infections as a public health issue in Ethiopia that requires attention. Appropriate intervention programs like encouraging food handlers to practice good hygiene, routine hand washing at key times, and nail trimming should be implemented.
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Affiliation(s)
- Wondimagegn Desalegn
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
| | - Wondwossen Birke
- Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Tizita Teshome
- Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Ketema Bacha
- Department of Biology, College of Natural Sciences, Jimma University, Jimma, Ethiopia
| | - Aiggan Tamene
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
| | - Legesse Tesfaye
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
| | - Mihretu Tagesse
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
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Prevalence and Associated Risk Factors of Intestinal Parasites and Enteric Bacterial Infections among Selected Region Food Handlers of Ethiopia during 2014-2022: A Systematic Review and Meta-Analysis. ScientificWorldJournal 2022; 2022:7786036. [PMID: 36277127 PMCID: PMC9581692 DOI: 10.1155/2022/7786036] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
Food-borne disease due to intestinal parasites (IPs) and enteric bacterial infections (EBIs) remain a major public health problem. Food handlers, individuals involved in preparing and serving food, working with poor personal hygiene could pose a potential threat of spreading IPs and EBIs to the public. The aim of this study was to examine the overall prevalence and risk factors of IPs and EBIs among food handlers in four selected regions of Ethiopia. Scientific articles written in English were recovered from PubMed, ScienceDirect, Web of Science, Google Scholar, Cochrane Library, and other sources from Google Engine and University Library Databases. “Prevalence,” “Intestinal Parasites,” “Enteric Bacterial Infections,” “Associated Factors,” “Food Handlers,” and “Ethiopia” were the search terms used for this study. For critical appraisal, PRISMA 2009 was applied. Stata software version 16 was used to perform the meta-analysis. Heterogeneity and publication bias were evaluated using Cochran's Q, inverse variance (I2), and funnel plot asymmetry tests. A random-effects model was used to calculate the pooled burden of IPs and EBIs and its associated factors among food handlers, along with the parallel odds ratio (OR) and 95% confidence interval (CI). For this meta-analysis, a total of 5844 food handlers were included in the 20 eligible studies. The overall pooled prevalence of IPs and EBIs among food handlers in four selected regions of Ethiopia was 29.16% (95% CI: 22.61, 35.71), with covering (25.77%) and (3.39%) by IPs and EBIs, respectively. Ascaris lumbricoides, Entamoeba histolytica/dispar, Giardia lamblia, and hookworm were the most prevalent IPs among food handlers with a pooled prevalence of 7.58%, 6.78%, 3.67%, and 2.70%, respectively. Salmonella and Shigella spp. were the most prevalent EBIs among food handlers with a pooled prevalence of 2.78% and 0.61%, respectively. A high prevalence of IPs and EBIs among food handlers was observed in Oromia (38.56%; 95% CI: 29.98, 47.14), while a low prevalence was observed in the Tigray region (19.45%; 95% CI: 6.08, 32.82). Food handlers who had not taken food hygiene training (OR: 0.68, 95% CI: −0.34, 1.69), untrimmed finger nail (OR: 2.23, 95% CI: 1.47, 2.99), lack of periodic medical checkup (OR: 1.52, 95% CI: 0.41, 2.64), lack of handwashing habits (OR: 1.97, 95% CI: 0.53, 3.41), and eating raw vegetables and meat (OR: 2.63, 95% CI: 0.92, 4.34) were factors significantly associated with the prevalence of IPs and EBIs. The prevalence of IPs and EBIs was high in the selected Ethiopian region (Amhara, Oromia, SNNPR, and Tigray) food handlers along an increasing prevalence trend from 2014 to 2022. Therefore, this study recommends the provision of proper health education and training regarding personal hygiene, hand washing, food handling, medical checks, as well as raw vegetable and meat safety.
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Prevalence and Associated Risk Factors of Human Intestinal Helminths Parasitic Infections in Ethiopia: A Systematic Review and Meta-Analysis. ScientificWorldJournal 2022; 2022:3905963. [PMID: 36093316 PMCID: PMC9451958 DOI: 10.1155/2022/3905963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background Intestinal helminth infections are still public health problems in tropical and subtropical countries including Ethiopia. This review and meta-analysis aimed to produce the pooled prevalence and associated risk factors of human intestinal helminth parasitic infections (HIHPIs) in Ethiopia. Methods Articles written in English were searched from online databases. Sixty-seven studies were included. Meta-analysis was computed using STATA version 14. Result The pooled prevalence of HIHPIs was (33.35%, 95% CI: 28.85%, 37.86%). Ascaris lumbricoides (10.84%, 95% CI: 9.34, 12.34), hookworm spp. (8.89%, 95% CI: 7.75, 10.04), Schistosoma mansoni (4.22%, 95% CI: 3.64, 4.81), Trichuris trichiura (2.51%, 95% CI: 2.17, 2.86), Hymenolepis nana (2.29%, 95% CI: 1.96, 2.63), Taenia species (1.01%, 95% CI: 0.80, 1.22), Strongyloides stercoralis (1.17%, 95% CI: 0.92, 1.41), and Enterobius vermicularis(0.71%, 95% CI: 0.52, 0.90) were recorded. Handwashing before food (OR: 5.22,95% CI: 3.49, 6.94), handwashing after toilet (OR: 3.03, 95%; CI: 1.01, 5.05), age (OR: 1.66, 95% CL. 1.09, 2.23), open defecation (OR: 2.42, 95% CI: 1.60, 3.24), eating raw and unwashed vegetables/fruits (OR: 1.98, 95%; CI: 1.30, 2.66), maternal education (OR: 1.81, 95% CI: 0.91, 2.72), family income (OR: 2.00, 95% CI: 0.87, 3.31), source of drinking water (OR: 3.12, 95% CI: 1.96, 4.27), swimming/contact with river water (OR: 1.90, 95% CI: 1.11, 2.69), barefoot (OR: 3.28, 95% CI: 1.67, 4.88), playing with soil (OR: 2.64, 95% CI: 1.40, 3.88), and family size (OR: 3.75, 95% CI: 2.03, 5.46) were factors associated with HIHPIs in Ethiopia. High heterogeneity of the prevalence of HIHPIs was observed among the studies within and among regions (I2 > 99.6% and P ≤ 0.001). Conclusion HIHPIs in Ethiopia were significantly high. Therefore, special attention should be given by all stakeholders to minimize HIHPIs in Ethiopia.
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Abera W, Gintamo B, Shitemaw T, Mekuria ZN, Gizaw Z. Prevalence of intestinal parasites and associated factors among food handlers in food establishments in the Lideta subcity of Addis Ababa, Ethiopia: an institution-based, cross-sectional study. BMJ Open 2022; 12:e061688. [PMID: 35858725 PMCID: PMC9305799 DOI: 10.1136/bmjopen-2022-061688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study was conducted to assess the prevalence of intestinal parasites and the associated factors among food handlers in the Lideta subcity of Addis Ababa, Ethiopia. DESIGN An institution-based, cross-sectional study design was used. Stool samples were collected from food handlers and examined using direct wet mount and formalin-ether concentration techniques. Personal and establishment-related information was collected using a pretested questionnaire, with a structured observation. Multivariable binary logistic regression was used to identify factors associated with the prevalence of intestinal parasites on the basis of adjusted OR (AOR) and 95% CI and p values <0.05. SETTING Food establishments in the Lideta subcity of Addis Ababa, Ethiopia. PARTICIPANTS 411 food handlers participated in the study. OUTCOME MEASURES The primary outcome was the prevalence of intestinal parasites, defined as the presence of one or more intestinal parasitic species in stool samples. RESULTS One or more intestinal parasites were detected in 171 (41.6%; 95% CI 36.6% to 46.4%) stool samples. The most common intestinal parasites were Entamoeba histolytica/dispar (12.7%), Giardia duodenalis (11.2%) and Ascaris lumbricoides (8.3%). The presence of intestinal parasites among food handlers was associated with low monthly income (AOR: 2.83, 95% CI 1.50 to 8.84), untrimmed fingernails (AOR: 4.36, 95% CI 1.98 to 11.90), no food safety training (AOR: 2.51, 95% CI 1.20 to 5.58), low level of education (AOR: 3.13, 95% CI 1.34 to 7.44), poor handwashing practice (AOR: 2.16, 95% CI 1.03 to 4.22) and lack of medical check-up (AOR: 2.31, 95% CI 1.18 to 6.95). CONCLUSION The prevalence of intestinal parasites among food handlers in food establishments in the Lideta subcity of Addis Ababa was high. The presence of intestinal parasites was linked to socioeconomic conditions, poor hand hygiene conditions and absence of food safety training. It is crucially important to promote handwashing practices and provide food hygiene and safety training in these settings.
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Affiliation(s)
- Woinishet Abera
- Department of Public Health, Yanet Health College, Addis Ababa, Ethiopia
| | - Binyam Gintamo
- Department of Public Health, Yanet Health College, Addis Ababa, Ethiopia
- Department of Public Health, Addis Ababa Medical and Business College, Addis Ababa, Ethiopia
| | - Tewoderos Shitemaw
- Department of Public Health, Yanet Health College, Addis Ababa, Ethiopia
- Anesthesia Department, Menelik II Health and Medical Science College, Kotebe Metropolitan University, Addis Ababa, Ethiopia
| | - Zelalem Negash Mekuria
- Department of Public Health, Yanet Health College, Addis Ababa, Ethiopia
- Department of Public Health, Addis Ababa Medical and Business College, Addis Ababa, Ethiopia
| | - Zemichael Gizaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Predictors of Intestinal Parasites among Food Handlers in Goba Town, Southeast Ethiopia, 2020. J Parasitol Res 2022; 2022:3329237. [PMID: 35711671 PMCID: PMC9197605 DOI: 10.1155/2022/3329237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background Globally, around 1.9 million people were dying due to food-borne diseases annually, and intestinal parasites infected one-third of the population, according to estimates and more prevalent in developing countries due to poverty. This study assessed predictors of intestinal parasites among food handlers working in Goba towns. Methods A laboratory-based cross-sectional study was conducted from October to December 2020. Clean, dry, and leak-proof stool cups were used to collect the samples. The SPSS version 20 computer software was used to enter and clean the data, code it, and analyze it. The researchers performed binary and multivariable logistic regression analyses, with a p value of 0.05 considered significant. Result A total of 98 (34%) of the 288 food workers tested positive for various intestinal parasites. Giardia lamblia was the most common parasite, with 42 (14.6%), followed by Entamoeba histolytica/dispar with 31 (10.8%), Ascaris lumbricoides with 8 (2.8%), Taenia species with 5 (1.7%), and E. vermicularis with 4 (1.4%). Six (2%) of the 98 positive food handlers had two infections. E. histolytica and G. lamblia were the most common parasites found in mixed infections. Hand washing with soap and water before handling food (AOR: 3.06, 95% CI: 1.16, 7.26) and untrimmed fingernail status (AOR: 2.3, 95% CI: 1.14, 4.34) were found to be strongly linked to intestinal parasite infection. Conclusion In this investigation, intestinal parasite species were found in 34% of stool samples. Independent predictors of intestinal parasite infection were fingernail status and hand washing with water and soap use before food handling. To control intestinal parasite infection among food handlers in the research area, personal hygiene and ambient cleanliness should be improved.
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Prevalence of Intestinal Protozoa and Soil Transmitted Helminths Infections among School Children in Jaragedo Town, South Gondar Zone of Ethiopia. J Trop Med 2022; 2022:5747978. [PMID: 35313547 PMCID: PMC8934235 DOI: 10.1155/2022/5747978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 01/31/2022] [Indexed: 11/17/2022] Open
Abstract
Background Parasitism is a relationship where one, the parasite, harms the host or lives at the expense of the host. Intestinal parasites (protozoa and STHs-soil-transmitted helminths) cause gastrointestinal tract infection in humans and animals. Intestinal parasitic infections (IPIs) predominate the tropics and subtropics and affect poor countries, where school children suffer the most. To prevent and control these infections, local risk factors must first be identified. The aim of the study was to determine the prevalence of intestinal parasitic infections and associated risk factors among school children in Jaragedo town schools, South Gondar Zone of Ethiopia. Methods A cross-sectional study was conducted from October 2018 to April 30, 2019, involving 396 students from one elementary and one secondary school. Stratified simple random sampling method was used. A questionnaire was prepared to collect sociodemographic and socioeconomic data of the study subjects. Stool samples were collected and examined using formalin-ether concentration technique. Data were analyzed using SAS software version 9.4. Descriptive statistics were used to give a clear picture of population characteristics. Logistic regression was also used to determine the relationship between dependent variables (primary infection) with independent (explanatory) variables using SAS software. Results Results showed that the overall prevalence of intestinal parasitic infections was 65.4%. E. histolytica was the most prevalent intestinal parasite (12–14%) followed by G. lamblia (8–9%); other parasites could not infect more than 5% of the study subjects. Generally, parasitism did not vary between the sexes. The logistic regression analysis showed that grade, level of students, water source, habit of consuming raw meat, and level of income had a strong effect on intestinal parasitic infection (P < 0.05). Other explanatory variables were not significant (P > 0.05). High prevalence of parasites indicates improper disposal of waste, low socioeconomic level, low living standard, and poor water quality. Conclusion Therefore, short-term and long-term intervention strategies are required to minimize rates of infection.
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Food Safety Practices and Associated Factors among Food Handlers of Fiche Town, North Shewa Zone, Ethiopia. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2021; 2021:6158769. [PMID: 34956372 PMCID: PMC8709767 DOI: 10.1155/2021/6158769] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/16/2021] [Accepted: 12/01/2021] [Indexed: 11/17/2022]
Abstract
Background Foodborne diseases remain a major public health problem globally, but the problem is severe in developing countries like Ethiopia. The objective of this study was to assess food safety practices and associated factors among food handlers of Fiche town. Methods A cross-sectional study was conducted among 422 food handlers working in food and drink establishments. The data were collected using a structured questionnaire and observational checklist. Data were entered and coded into SPSS for analysis. Multivariable logistic regression was used to identify the predictor variables associated with the practice of food handlers (p < 0.05). Result 61.6% of food handlers knew the potential risk of contaminating food with dirty hands, and 70% washed hands with soap before working with food. 52.8% of food handlers covered the hair with restraints. 66.8% of food handlers used outer garments, and the majority of food handlers (71.1%) had a trimmed fingernail. Two hundred thirteen (50.5%) of food handlers had good food handling practices. Medical checkup (AOR = 3.16; 95% CI 1.89, 5.26), sanitary inspection (AOR = 1.76; 95% CI 1.16, 2.69), knowledge (AOR = 2.31; 95% CI 1.53, 3.48), service year (AOR = 3.11; 95% CI 1.53, 6.31), and educational status (AOR = 3.42, 95% CI 1.29, 9.04) were found to be significantly associated with food handling practices. Conclusion The food handlers should take various training concerning food hygiene and safety to enhance their knowledge and practice. Regular sanitary inspection of food and drink establishments is recommended.
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Kitvatanachai S, Jantrapanukorn B, Supcharoengoon U, Atasilp C. Enteropathogenic Bacterial and Intestinal Parasitic Infections among Asymptomatic Food Handlers in Rangsit University Canteens, Central Thailand. J Parasitol Res 2021; 2021:5565014. [PMID: 33936804 PMCID: PMC8055383 DOI: 10.1155/2021/5565014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/01/2022] Open
Abstract
Food handlers play an important role in the transmission of foodborne diseases. 108 asymptomatic food handlers work in RSU canteens and have never been checked for intestinal bacteria and parasites, which might be a potential source of infection for customers. This study is aimed at estimating the prevalence of enteropathogenic bacterial and intestinal parasitic infections among food handlers in Rangsit University canteens, central Thailand. A total of 79 food handlers were enrolled, and each provided one stool sample (response rate of 73.2%). Females comprised 93.7% of study participants, and the largest age group was 41-50 years (34.2%). The prevalence of enteropathogenic bacteria in stool cultures was 2.5%, and only Aeromonas spp. were detected. The pathogenic protozoa Giardia duodenalis was detected in 1.3% of samples, and nonpathogenic protozoa was found in 11.4%. No helminths were found in any samples. Approximately 80% of food handlers demonstrated good hygiene practices, including regular hand washing after visiting the toilet, regular hand washing when preparing food, using soap when washing hands, wearing uniforms/gowns, practicing correct hand washing techniques, and having short fingernails. However, the results showed a lack of personal hygiene training and routine medical care (>50% of samples). Stronger intervention would help to eliminate future infections.
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Affiliation(s)
| | | | | | - Chalirmporn Atasilp
- Faculty of Medical Technology, Rangsit University, Pathumthani 12000, Thailand
- Chulabhorn International college of Medicine, Thammasat University, Pathumthani 12121, Thailand
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Asfaw Geresu M, Assefa Wayuo B, Mamo Kassa G. Occurrence and Antimicrobial Susceptibility Profile of Salmonella Isolates from Animal Origin Food Items in Selected Areas of Arsi Zone, Southeastern Ethiopia, 2018/19. Int J Microbiol 2021; 2021:6633522. [PMID: 33859696 PMCID: PMC8026285 DOI: 10.1155/2021/6633522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/22/2021] [Accepted: 03/22/2021] [Indexed: 11/28/2022] Open
Abstract
The status of Salmonella and its antimicrobial susceptibility profile in animal origin food items from different catering establishments in Ethiopia is scarce. Hence, this study aimed to investigate the occurrence and antimicrobial susceptibility profile of Salmonella isolates from animal origin food items in the selected areas of Arsi Zone. One hundred ninety-two animal origin food samples were collected and processed for Salmonella isolation. Isolates were tested for their susceptibility to 13 antimicrobials using Kirby-Bauer disk diffusion assay. An overall prevalence of 9.4% (18/192) Salmonella spp. isolates were recovered from animal origin food samples collected from different catering establishments. Seven (21.9%) of "Dulet," 4 (12.5%) of "Kitfo," 3 (9.4%) of "Kurt," 2 (6.3%) of raw milk, 1 (3.1%) of egg sandwich and 1 (3.1%) of cream cake samples were positive for Salmonella. Catering establishments, protective clothing, source of contamination, manner of hand washing, and money handling were among the putative risk factors that were significantly associated (p < 0.05) with Salmonella spp. occurrence. Ampicillin, nitrofurans, and sulphonamide resistance were significantly associated (p < 0.05) with Salmonella spp. occurrence in the selected food items. Three (16.7%), 5 (27.8%), 5 (27.8%), and 4 (22.2%) of the isolates were resistant to 3, 4, 5, and 6 antibiotics, respectively, whereas only a sole isolate was resistant to two antibiotics (viz. ampicillin and kanamycin). In conclusion, the general sanitary condition of the catering establishments, utensils used, and personnel hygienic practices were not to the recommended standards in the current study. Besides, detection of multidrug-resistant strains of Salmonella in animal origin food items from different catering establishments suggests the need for detailed epidemiological and molecular characterization of the pathogen so as to establish the sources of acquisition of resistant Salmonella strains. Hence, implementation of Salmonella prevention and control strategies from farm production to consumption of animal origin food items are crucial.
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Affiliation(s)
- Minda Asfaw Geresu
- Department of Veterinary Science, College of Agriculture and Environmental Science, Arsi University, Asella, Ethiopia
| | - Behailu Assefa Wayuo
- Department of Veterinary Science, College of Agriculture and Environmental Science, Arsi University, Asella, Ethiopia
| | - Gezahegne Mamo Kassa
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, Ethiopia
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Prevalence of Intestinal Parasites and Salmonella typhi among Food Handlers Working in Catering Establishments of Public Institutes Found in Dawuro Zone, South-Western Ethiopia. J Parasitol Res 2021; 2021:8889302. [PMID: 33510904 PMCID: PMC7826225 DOI: 10.1155/2021/8889302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/16/2020] [Accepted: 01/04/2021] [Indexed: 11/18/2022] Open
Abstract
Background Food borne disease, which is the result of ingestion of foodstuffs contaminated with microorganisms, parasites, or chemicals, encompasses a wide spectrum of illness and public health problem worldwide. Ethiopia is placed on second, third, and fourth position due to the highest burden of ascariasis, hookworm, and trichuriasis, respectively, in sub-Saharan Africa. The present study is aimed at determining the prevalence of Salmonella typhi and intestinal parasites among food handlers working in catering establishments of public institutes found in Dawuro Zone, South-Western Ethiopia. Methods A cross-sectional study is conducted among food handlers working in catering establishments of public institutions found in Dawuro Zone from March to July 2019. The data was collected by using pretested structured questionnaires. Stool and blood samples were taken from each participant for parasitic examinations concurrently using direct and modified formol ether concentration wet smear techniques and Widal test by slide test and tube serial dilution technique, respectively. The data entered into Epi info version 3.5.1 and then exported into SPSS window version 20.0 for analysis. Logistic regressions were performed to assess the association between binary outcomes and different explanatory variables. P value <0.05 was considered statistically significant. Result The study included 402 (293 females and 109 males) food handlers. Of 402 stool specimens, 20.4% were found to be positive for different parasite species, comprising protozoa (35.9%) and helminths (64.1%). A. lumbricoides was the most prevalent parasite (8.0%), followed by E. histolytica/dispar (4.23%). Twenty-six (6.5%) of food handlers were positive for Widal test. Ages ≥ 40 years (AOR: 0.436; 95% CI: 0.203, 0.937), attending no education (AOR: 2.142; 95% CI: 1.048, 4.378), not washing hands after using latrine (AOR: 4.355; 95% CI: 1.771, 10.708), not covering mouth with tissue paper (AOR: 0.530; 95% CI: 0.312, 0.899), no medical checkup (in the last four months) (AOR: 0.278; 95% CI: 0.116, 0.667), and untrimmed fingernails (AOR: 0.382; 95% CI: 0.229, 0.635) were significantly associated with intestinal parasitic or Salmonella typhi infections. Conclusion The prevalence of intestinal parasitic infection (IPI) and Salmonella among food handlers in the present study is relatively high compared to other different studies conducted in developed and developing countries. Therefore, biannually screening of food handlers for intestinal parasites (IPs) and periodic deworming of infected cases along with provision of food safety measures focusing on personal hygiene and environmental sanitation are recommended to control the parasitic infection in food handlers.
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Jorga E, Van Damme I, Mideksa B, Gabriël S. Identification of risk areas and practices for Taenia saginata taeniosis/cysticercosis in Ethiopia: a systematic review and meta-analysis. Parasit Vectors 2020; 13:375. [PMID: 32727549 PMCID: PMC7391523 DOI: 10.1186/s13071-020-04222-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/13/2020] [Indexed: 01/28/2023] Open
Abstract
Background Bovine cysticercosis (BCC) is an infection of cattle with the metacestode stage of Taenia saginata, the beef tapeworm, which causes taeniosis in humans. BCC is responsible for considerable economic losses in the meat sector worldwide. This systematic review and meta-analysis summarizes the prevalence, risk factors and treatment efforts made so far on T. saginata infections in Ethiopia, providing a detailed analysis of different factors influencing the varying prevalence estimates in Ethiopia to gain more insight into the occurrence and risk factors of T. saginata taeniosis and cysticercosis to date. Methods A systematic review and meta-analysis was conducted on data collected from published and grey literature accessed through an electronic database and manual search. Results The literature search resulted in 776 outputs of which 132 conformed to the predefined criteria. The average zonal prevalence of meat inspection-based BCC ranged from 2% in Buno-Bedele to 24.6% in Sidama zone. The pooled prevalence of BCC was influenced by the number of muscle/organs inspected, ranging from 3.4% (95% CI: 1.7–5.1%) using fewer predilection sites to 19.4% (95% CI: 13.3–25.4%) using inspection of a maximum number of predilection sites. None of the tested variables were significantly associated with BCC. Questionnaire-based taeniosis ranged between 19.0% in Halaba special woreda to 70.0% in Gedeo zone and stool test-based taeniosis varied from 0.6% in central Tigray to 10.7% in Gurage zone. Questionnaire-based prevalence of taeniosis was higher in people with a frequent raw beef consumption habit (pooled OR, pOR: 10.5, 95% CI: 6.0–17.9), adults (pOR: 2.5, 95% CI: 1.7–3.6), men (pOR: 2.8, 95% CI: 2.1–3.6), and Christians (pOR: 2.0, 95% CI: 1.4–2.8) compared to less frequent raw beef consumers, younger people, women and Muslims, respectively. Conclusions This review revealed a widespread but variable occurrence of BCC and taeniosis in Ethiopian regions and zones, urging for harmonized and enhanced detection for improved control of the parasite. Accurate prevalence estimates using more sensitive tests, detailed risk factor analysis, as well as data on financial losses are needed to develop effective control strategies for the Ethiopian epidemiologic condition.![]()
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Affiliation(s)
- Edilu Jorga
- Department of Veterinary Science, College of Agriculture and Veterinary Sciences, Ambo University, P.O. Box 19, Ambo, Ethiopia
| | - Inge Van Damme
- Department of Veterinary Public Health, Laboratory of Foodborne Parasitic Zoonoses, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium
| | - Bizunesh Mideksa
- Department of Veterinary Science, College of Agriculture and Veterinary Sciences, Ambo University, P.O. Box 19, Ambo, Ethiopia
| | - Sarah Gabriël
- Department of Veterinary Public Health, Laboratory of Foodborne Parasitic Zoonoses, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium.
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Prevalence and Associated Risk Factors of Salmonella, Shigella, and Intestinal Parasites among Food Handlers in Motta Town, North West Ethiopia. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2020; 2020:6425946. [PMID: 32399124 PMCID: PMC7201477 DOI: 10.1155/2020/6425946] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/13/2019] [Accepted: 12/19/2019] [Indexed: 11/18/2022]
Abstract
Background Intestinal parasite, Salmonella, and Shigella infections are the main public health concerns in the world, especially in developing countries due to inaccessibility of safe water and unhygienic food handling practices of food handlers. Methods A cross-sectional study was conducted in food handlers in Motta town, from February 2019 to April 2019. The study was undertaken to determine the prevalence and associated risk factors of Salmonella, Shigella, and intestinal parasites among 243 food handlers. Sociodemographic and risk factors were collected using pretested structured questionnaire. The stool sample was collected and examined with direct wet mount and concentration techniques. Culture was performed using xylose lysine deoxycholate agar and MacConkey agar and biochemical tests like Klinger iron agar (KIA), lysine iron agar (LIA), Simmons citrate agar, sulphide indole motility test, citrate utilization, and urease production test were conducted to isolate Salmonella species and Shigella species. An antibiotics susceptibility test was performed with Mueller-Hinton agar using the disk diffusion method. Data were entered using statistical package Epi-Data Version 3.1 and analysed with logistic regression using SPSS version 25 and Fisher's exact test. A p value < 0.05 at 95% CI was considered as statistically significant. Results The prevalence of intestinal parasite, Salmonella, and Shigella was 27.6%, 2.5%, and 1.6%, respectively, and hookworm was the predominant intestinal parasite detected in the stool. Antimicrobial resistance was observed in ampicillin and tetracycline (100%) in Salmonella species and Shigella species. Risk factors like fingernail status, fruit washing before eating, cleaning utensils, and regular shoe wearing habit were associated with intestinal parasite, whereas fingernail status and wearing kitchen gown during food service were significantly associated with Salmonella and Shigella infections. Conclusion The prevalence of intestinal parasitic infections, Salmonella, and Shigella infections in this study indicates the importance of food handlers as probable sources of enteropathogenic infections. Food handlers should have follow-up on the order of food safety rules and keep their personal hygiene. Hotel owners are responsible to control the health status and their created awareness by given food hygiene training for food handlers. Therefore, policy-makers and implementers should focus on the risk factors to reduce the prevalence below the level of public health importance.
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Alemnew B, Gedefaw G, Alen GD, Bizuneh AD. Prevalence and factors associated with intestinal parasitic infections among food handlers working at higher public University student's cafeterias and public food establishments in Ethiopia: a systematic review and meta-analysis. BMC Infect Dis 2020; 20:156. [PMID: 32075585 PMCID: PMC7031974 DOI: 10.1186/s12879-020-4884-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 02/12/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Intestinal infection is still an important public health problem in low-income countries. Food handlers may be infected by a wide range of enteropathogens and have been implicated in the transmission of many infections to the public. Therefore, the aim of this review was to produce the pooled prevalence and factors associated with intestinal parasitic infections among food handlers working at higher public University student's cafeterias and public food establishments in Ethiopia. METHODS Articles published in PubMed/Medline, Hinari, Web of Science, Science Direct, and Google Scholar were used using a search strategy. Observational studies (cross-sectional) revealing the prevalence and factors associated with intestinal parasitic infections at higher public University student's cafeterias and public food establishments were incorporated. Meta-analysis was computed using STATA version 14 statistical software. Heterogeneity of the study was assessed using Cochrane Q test statistics and I2 test. The pooled prevalence of the intestinal parasitic infection and associated factors among food handlers was calculated by the random-effect model. RESULTS Out of 138 reviewed studies, 18 studies were included to estimate the pooled prevalence of intestinal parasitic infections among food handlers in Ethiopia. All the eighteen articles were included in the analysis. This study revealed that the pooled prevalence of intestinal parasitic infections was 28.5% (95% CI: 27.4, 29.7). E. hystolitica /E. dispar complex 6.38 (95% Cl: 5.73, 7.04), A.lumbricodes 4.12 (95% Cl: 3.56, 4.67), and G. lamblia 3.12(95% Cl: 2.65, 3.60) were the most common intestinal parasitic infections in this study. Untrimmed fingernail 3.04 (95% CI: 2.19, 4.22), do not washing hands after defecation 2.71 (95% CI: 1.93, 3.82), do not washing hands after touching any body parts 2.41 (95% CI: 1.64, 3.56), do not made medical checkup 2.26 (95% CI: 1.57, 3.25), and do not receive food safety training 1.79 (95% CI: 1.30, 2.45) were factors significantly and positively associated with intestinal parasitic infections. CONCLUSION Parasitic infections among food handlers were significantly high. Untrimmed fingernail, do not washing hands after defecation, do not washing hands after touching any body parts, do not made regular medical checkup and do not receive food safety training were factors that increase the prevalence of intestinal parasitic infections.
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Affiliation(s)
- Birhan Alemnew
- Department of Medical Laboratory Sciences, College of Health Sciences, Woldia University, P.O.Box:400, Woldia, Ethiopia
| | - Getnet Gedefaw
- Department of Midwifery, College of Health Sciences, Woldia University, P.O.Box:400, Woldia, Ethiopia
| | - Gedefaw Diress Alen
- Department of Public Health, College of Health Sciences, Woldia University, P.O.Box:400, Woldia, Ethiopia
| | - Asmamaw Demis Bizuneh
- Department of Nursing, College of Health Sciences, Woldia University, P.O.Box:400, Woldia, Ethiopia.
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Yimam Y, Woreta A, Mohebali M. Intestinal parasites among food handlers of food service establishments in Ethiopia: a systematic review and meta-analysis. BMC Public Health 2020; 20:73. [PMID: 31948421 PMCID: PMC6966842 DOI: 10.1186/s12889-020-8167-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 01/07/2020] [Indexed: 11/17/2022] Open
Abstract
Background Intestinal parasites remain considerable public health problems in low-income countries where poor food hygiene practice is common. Food handlers, people involved in preparing and serving food, working with poor personal hygiene could pose a potential threat of spreading intestinal parasites to the public in a community. The aim of this systematic review and meta-analysis was, therefore, to synthesize the pooled prevalence estimate of intestinal parasites and associated pooled odds ratio of hygienic predictors among food handlers of food service establishments in Ethiopia that could aid to further bringing down the burden of intestinal parasites and it can also be used as a springboard for future studies. Methods We searched exhaustively for studies Published before 20 April 2019 using eight Databases; PubMed, Science Direct, Web of Science, Scopus, Embase, Google Scholar, ProQuest, and Ovid MEDLINE® complemented by the gray literature search. In the final synthesis, we included twenty study reports. We used the Cochrane Q test and I2 test to assess heterogeneity of studies, while we employed a funnel plot followed by Egger’s regression asymmetry test and Begg rank correlation methods to evaluate publication bias. We also performed a point estimates and 95% confidence interval for each study using STATA version 14 statistical software. Results The overall pooled prevalence estimate of intestinal parasites among food handlers of food service establishments in Ethiopia was 33.6% (95%CI: 27.6–39.6%). Among ten intestinal parasites identified from food handlers, Entamoeba histolytica/ dispar (11, 95%CI: 7.9–14.1%) and Ascaris lumbricoides (8.8, 95%CI: 6.4–11.2%) were the most predominant intestinal parasites. Food handlers who washed hands after toilet use had 54% (OR, 0.46, 95% CI: 0.23–0.94) protection from intestinal parasites compared to those who did not. Conclusions This study revealed that intestinal parasitic infections are notable among food handlers of food service establishments in Ethiopia, which may be a risk for transmitting intestinal parasites to food and drinks consumers through the food chain. Thus, periodic stool checkup, training on intestinal parasitic infections and personal hygiene should be applied to reduce public health and socio-economic impacts of parasitic infections.
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Affiliation(s)
- Yonas Yimam
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Biology, Faculty of Natural and Computational Sciences, Woldia University, Woldia, Ethiopia.
| | - Ambachew Woreta
- Department of Biology, Faculty of Natural and Computational Sciences, Woldia University, Woldia, Ethiopia.,Department of Microbial Cellular and Molecular Biology, College of Natural Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Endemic Parasites, Tehran University of Medical Sciences, Tehran, Iran
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Magnitude of intestinal parasitic infections and associated factors among food handlers working at Woldia University student's cafeteria, Northeastern Ethiopia: an institution based cross-sectional study. BMC Res Notes 2019; 12:736. [PMID: 31711535 PMCID: PMC6844021 DOI: 10.1186/s13104-019-4777-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/01/2019] [Indexed: 12/13/2022] Open
Abstract
Objectives The main aim of this study was to assess the Magnitude of intestinal parasitic infections and associated factors among food handlers working at Woldia University Student’s cafeteria, Northeastern Ethiopia. Institutional based cross-sectional study was conducted among 256 study participants in Woldia university student’s cafeteria, Northern Ethiopia. Systematic random sampling method was used to select the study participants. Data was collected using a standardized questionnaire by direct interviewing of study participants. Logistic regression was carried out to identify factors associated with intestinal parasitic infections. Results A total of 256 food handlers were enrolled making the overall magnitude of the intestinal parasite which was stool specimens positive for different diagnostic stages of parasites was found to be 43 (16.8%). Entamoeba histolytica/dispar was the most prevalent parasites 14 (5.5%), followed by Giardia lamblia 10 (3.9%). Lack of food safety training (AOR = 6.58; 95% CI 2.46–17.62), no regular medical checkup (AOR = 2.41; 95% CI 1.47–4.24), no handwashing practice after toilet by soap (AOR = 3.24; 95% CI 1.28–8.19), no handwashing practice before eating by soap (AOR = 4.03; 95% CI 1.64–9.91) and haven’t food preparation license (AOR = 6.13; 95% CI 2.18–17.22) were significantly associated with parasitic infection among food handlers.
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Kebede E, Seid A, Akele S. Prevalence and associated risk factors of intestinal parasitic infections among asymptomatic food handlers in Wollo University student's cafeteria, Northeastern Ethiopia. BMC Res Notes 2019; 12:139. [PMID: 30871610 PMCID: PMC6419491 DOI: 10.1186/s13104-019-4182-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 03/11/2019] [Indexed: 11/17/2022] Open
Abstract
Objective Intestinal parasitic infections (IPIs) are among the major public health and socioeconomic problems in developing countries like Ethiopia. Food-handlers that directly deal with production and distribution of foods between societies are one of the most important sources to transmit parasitic infections to humans. The aim of this study was to assess the prevalence and associated risk factors of intestinal parasites among asymptomatic food-handlers working in students’ cafeteria of Wollo University, Northeastern Ethiopia. Result A cross-sectional study was conducted among 200 asymptomatic food handlers at Wollo University from January 1 to February 20, 2018. Among the total participants 30 (15%) were infected with at least one intestinal parasites. The dominant parasite was E. histolytica (5.5%) followed by A. lumbricoides (4%) and then G. lamblia (3%). Finger nail trimming (p = 0.002, AOR: 4.35, 95% CI 1.71–11.04), medical checkup (p = 0.012, AOR: 4.01, 95% CI 1.37–12.25) and residence (p = 0.014, AOR: 3.16, 95% CI 1.26–7.95) were independent predictors of intestinal parasitic infection among the food handlers.
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Affiliation(s)
- Edosa Kebede
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Abdurahaman Seid
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Senayt Akele
- Department of Medical Laboratory Sciences, Students Clinic, Wollo University, Dessie, Ethiopia
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