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Gemechu DS, Worku Y, Edae ZA, Feyisa YD, Watere SH, Woyessa AB, Dukessa A, Gerema U. Epidemiological analysis of rubella-confirmed cases from measles suspected cases in Ethiopia: Threat for Congenital Rubella Syndrome. Epidemiol Infect 2022; 150:1-18. [PMID: 35225215 PMCID: PMC8915192 DOI: 10.1017/s0950268822000279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/05/2022] [Accepted: 02/08/2022] [Indexed: 11/09/2022] Open
Abstract
Rubella is a highly contagious mild viral illness. It is a leading cause of congenital rubella syndrome (CRS). Routine data of rubella do not exist in Ethiopia. However, laboratory-based conformation of rubella cases from measles negative samples were collected from a measles surveillance system. The current study was to analyse the epidemiological distribution of rubella cases from measles-suspected cases in Ethiopia from 2011 to 2015. National-based secondary data analysis of rubella through measles-based surveillances was carried out. Measles-suspected cases were investigated using the case investigation form, and a serum sample collected and sent to the Ethiopian laboratory for conformation. Samples tested for measles immunoglobulin M (IgM) were tested for rubella. The investigation results were entered into an electronic database using SPSS version 25 for analysis. Out of 11749 samples tested for rubella IgM from 2011 to 2015, 2295 (19.5%) were positive for rubella IgM and 51% of rubella-positive cases were female. Five per cent of all cases were female aged between 15 and 49. Cases were confirmed from all regions, two administrative towns and seasonal variations were observed with peaks in the first and fourth seasonal periods of the years. As fear of congenital abnormality (CRS), the Ethiopian government should focus on rubella syndrome surveillance with the aim of starting a rubella vaccine.
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Affiliation(s)
| | - Yoseph Worku
- Saint Paul's Hospital Millennium Medical College,
| | | | | | | | | | - Abebe Dukessa
- Department of biomedical sciences, Institute of health, Jimma University, ,
| | - Urge Gerema
- Department of biomedical sciences, Institute of health, Jimma University, ,
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Gutu MA, Bekele A, Seid Y, Mohammed Y, Gemechu F, Woyessa AB, Tayachew A, Dugasa Y, Gizachew L, Idosa M, Tokarz RE, Sugerman D. Another dengue fever outbreak in Eastern Ethiopia-An emerging public health threat. PLoS Negl Trop Dis 2021; 15:e0008992. [PMID: 33465086 PMCID: PMC7845954 DOI: 10.1371/journal.pntd.0008992] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 01/29/2021] [Accepted: 11/17/2020] [Indexed: 12/15/2022] Open
Abstract
Background Dengue Fever (DF) is a viral disease primarily transmitted by Aedes (Ae.) aegypti mosquitoes. Outbreaks in Eastern Ethiopia were reported during 2014–2016. In May 2017, we investigated the first suspected DF outbreak from Kabridahar Town, Somali region (Eastern Ethiopia) to describe its magnitude, assess risk factors, and implement control measures. Methods Suspected DF cases were defined as acute febrile illness plus ≥2 symptoms (headache, fever, retro-orbital pain, myalgia, arthralgia, rash, or hemorrhage) in Kabridahar District residents. All reported cases were identified through medical record review and active searches. Severe dengue was defined as DF with severe organ impairment, severe hemorrhage, or severe plasma leakage. We conducted a neighborhood-matched case-control study using a subset of suspected cases and conveniently-selected asymptomatic community controls and interviewed participants to collect demographic and risk factor data. We tested sera by RT-PCR to detect dengue virus (DENV) and identify serotypes. Entomologists conducted mosquito surveys at community households to identify species and estimate larval density using the house index (HI), container index (CI) and Breteau index (BI), with BI≥20 indicating high density. Results We identified 101 total cases from May 12–31, 2017, including five with severe dengue (one death). The attack rate (AR) was 17/10,000. Of 21 tested samples, 15 (72%) were DENV serotype 2 (DENV 2). In the case-control study with 50 cases and 100 controls, a lack of formal education (AOR [Adjusted Odds Ratio] = 4.2, 95% CI [Confidence Interval] 1.6–11.2) and open water containers near the home (AOR = 3.0, 95% CI 1.2–7.5) were risk factors, while long-lasting insecticide treated-net (LLITN) usage (AOR = 0.21, 95% CI 0.05–0.79) was protective. HI and BI were 66/136 (49%) and 147 per 100 homes (147%) respectively, with 151/167 (90%) adult mosquitoes identified as Ae. aegypti. Conclusion The epidemiologic, entomologic, and laboratory investigation confirmed a DF outbreak. Mosquito indices were far above safe thresholds, indicating inadequate vector control. We recommended improved vector surveillance and control programs, including best practices in preserving water and disposal of open containers to reduce Aedes mosquito density. In 2017 an outbreak of Dengue fever (DF) was reported in Kabridahar Town, Ethiopia. This mosquito transmitted disease was recently detected in Ethiopia only four years prior, with this being the first time it was identified in the area. In response, our team was dispatched to confirm the presence of the disease, identify potential causes, and implement mitigation and control measures. We identified and compared suspected cases and suspected non-cases to identify the potential risk factors of infection. Laboratory confirmation of infection and disease-type was also performed. Due to the entomological nature of disease transmission, additional entomological investigations were conducted at the households of both groups to understand its influence at the household level. Through these measures, we were able to establish the presence of DF in Kabridahar Town and identify risk factors leading to infection. Risk factors included a lack of formal education and open water containers near the home, while the presence of long-lasting insecticide-treated nets were found to be protective. Mitigation and control measures were implemented to combat or promote the identified risk and protective factors respectively. Cases counts began to reduce five days after the onset of these measures. Recommendations were made based on our findings to prevent future outbreaks. The last case was recorded ten days after implementation of the mitigation and control measures.
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Affiliation(s)
- Mulugeta Asefa Gutu
- Ethiopian Field Epidemiology Training Program, Addis Ababa, Ethiopia
- * E-mail:
| | | | - Yimer Seid
- Addis Ababa University, Addis Ababa, Ethiopia
| | - Yusuf Mohammed
- World Health Organization Country Office for Ethiopia, Addis Ababa, Ethiopia
| | - Fekadu Gemechu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Adamu Tayachew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yohanis Dugasa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Lehageru Gizachew
- Ethiopian Field Epidemiology Training Program, Addis Ababa, Ethiopia
| | - Moti Idosa
- Ethiopian Field Epidemiology Training Program, Addis Ababa, Ethiopia
| | - Ryan E. Tokarz
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - David Sugerman
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Tadesse M, Mengesha M, Tayachew A, Belay D, Hassen A, Woyessa AB, Zemelak E, Beyene B, Kassa W, Ayele W, Teshome B, Mekonen M, Assefa Z, Moges B. Burden and seasonality of medically attended influenza like illness (ILI) in Ethiopia, 2012 to 2017. BMC Infect Dis 2020; 20:148. [PMID: 32070275 PMCID: PMC7029599 DOI: 10.1186/s12879-020-4827-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 01/28/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The influenza virus spreads rapidly around the world in seasonal epidemics, resulting in significant morbidity and mortality. Influenza-related incidence data are limited in many countries in Africa despite established sentinel surveillance. This study aimed to address the information gap by estimating the burden and seasonality of medically attended influenza like illness in Ethiopia. METHOD Influenza sentinel surveillance data collected from 3 influenza like illness (ILI) and 5 Severe Acute Respiratory Illness (SARI) sites from 2012 to 2017 was used for analysis. Descriptive statistics were applied for simple analysis. The proportion of medically attended influenza positive cases and incidence rate of ILI was determined using total admitted patients and catchment area population. Seasonality was estimated based on weekly trend of ILI and predicted threshold was done by applying the "Moving Epidemic Method (MEM)". RESULT A total of 5715 medically attended influenza suspected patients who fulfills ILI and SARI case definition (77% ILI and 23% SARI) was enrolled. Laboratory confirmed influenza virus (influenza positive case) among ILI and SARI suspected case was 25% (1130/4426) and 3% (36/1289). Of which, 65% were influenza type A. The predominantly circulating influenza subtype were seasonal influenza A(H3N2) (n = 455, 60%) and Influenza A(H1N1)pdm09 (n = 293, 38.81%). The estimated mean annual influenza positive case proportion and ILI incidence rate was 160.04 and 52.48 per 100,000 population. The Incidence rate of ILI was higher in the age group of 15-44 years of age ['Incidence rate (R) = 254.6 per 100,000 population', 95% CI; 173.65, 335.55] and 5-14 years of age [R = 49.5, CI 95%; 31.47, 130.43]. The seasonality of influenza has two peak seasons; in a period from October-December and from April-June. CONCLUSION Significant morbidity of influenza like illness was observed with two peak seasons of the year and seasonal influenza A (H3N2) remains the predominantly circulating influenza subtype. Further study need to be considered to identify potential risks and improving the surveillance system to continue early detection and monitoring of circulating influenza virus in the country has paramount importance.
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Affiliation(s)
- Musse Tadesse
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia.
| | - Mesfin Mengesha
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Adamu Tayachew
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Desalegn Belay
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Abdulhafiz Hassen
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Abyot Bekele Woyessa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Etsehiwot Zemelak
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Berhan Beyene
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Wubayehu Kassa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Workenesh Ayele
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Bethel Teshome
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Mikias Mekonen
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Zewdu Assefa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Beyene Moges
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
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Affiliation(s)
- Mulugeta Asefa Gutu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Corresponding author: Mulugeta Asefa Gutu, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | | | - Yimer Seid
- Addis Ababa University School of Public Health, Addis Ababa, Ethiopia
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Woyessa AB, Ali MS, Korkpor TK, Tuopileyi R, Kohar HT, Dogba J, Baller A, Monday J, Abdullahi S, Nagbe T, Mulbah G, Kromah M, Sesay J, Yealue K, Nyenswah T, Gebrekidan MZ. Rubella transmission and the risk of congenital rubella syndrome in Liberia: a need to introduce rubella-containing vaccine in the routine immunization program. BMC Infect Dis 2019; 19:813. [PMID: 31533658 PMCID: PMC6751791 DOI: 10.1186/s12879-019-4464-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 09/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rubella is an RNA virus in the genus Rubivirus within the Matonaviridae family. Rubella remains a leading vaccine-preventable cause of birth defects. Most African countries including Liberia do not currently provide rubella-containing vaccine (RCV) in their immunization program. We analyzed the existing surveillance data to describe rubella cases and identify the at-risk population. METHODS We conducted a retrospective descriptive statistics on the suspected-measles case-based surveillance data that obtained from the national database. Suspected-measles cases who were negative and indeterminate for measles IgM and tested for rubella IgM were extracted from the database. We used only rubella IgM positive cases to calculate trends and percentages by person, place and time. The cumulative-percent curve was used to visually describe the age distribution of rubella cases. RESULTS During 2017-2018, a total of 2027 suspected-measles cases with known laboratory results were reported; of which, 1307 were tested for rubella IgM. Among tested cases, 472 (36%) were positive, 769 (59%) were negative and 66 (5%) were indeterminate for rubella IgM. Female contributed 269 (57%) of the confirmed rubella cases respectively. The median age was 7 years with an interquartile range of 5-10 years. From the total rubella cases, 6 (1%) were under 1 year, 109 (23%) were 1-4 years, 207 (44%) were 5-9 years, 87 (18%) were 10-14 years and 56 (12%) were more than or equal to 15 years. Women in their reproductive-age contributed 23 (5%) of rubella cases with 17% positivity rate. Two-thirds or 307 (65%) of the cases were reported from February to May which is dry season in Liberia. CONCLUSIONS Our analysis revealed that rubella was widely circulating in Liberia. Majority of the cases were reported among children < 15 years. However, rubella was also reported among women of reproductive age and infants < 1 year with no report of congenital rubella syndrome (CRS). Detail investigation of rubella cases among infants of < 1 year and women of reproductive age is important to uncover CRS. Establishment of CRS surveillance and the introduction of RCV in the immunization program are crucial to prevent rubella infection and avert the risk of CRS.
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Affiliation(s)
| | - Mohammed Seid Ali
- World Health Organization Country office for Liberia, Monrovia, Liberia
| | - Tiala K. Korkpor
- World Health Organization Country office for Liberia, Monrovia, Liberia
| | - Roland Tuopileyi
- World Health Organization Country office for Liberia, Monrovia, Liberia
| | - Henry T. Kohar
- Republic of Liberia Ministry of Health, Monrovia, Liberia
| | - John Dogba
- National Public Health Institute of Liberia, Monrovia, Liberia
| | - April Baller
- World Health Organization Country office for Liberia, Monrovia, Liberia
| | - Julius Monday
- World Health Organization Country office for Liberia, Monrovia, Liberia
| | - Suleman Abdullahi
- World Health Organization Country office for Liberia, Monrovia, Liberia
| | - Thomas Nagbe
- National Public Health Institute of Liberia, Monrovia, Liberia
| | - Gertrude Mulbah
- World Health Organization Country office for Liberia, Monrovia, Liberia
| | - Mohammed Kromah
- World Health Organization Country office for Liberia, Monrovia, Liberia
| | - Jeremy Sesay
- World Health Organization Country office for Liberia, Monrovia, Liberia
| | - Kwuakuan Yealue
- World Health Organization Country office for Liberia, Monrovia, Liberia
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Woyessa AB, Maximore L, Keller D, Dogba J, Pajibo M, Johnson K, Saydee E, Monday J, Tuopileyi R, Mahmoud N. Lesson learned from the investigation and response of Lassa fever outbreak, Margibi County, Liberia, 2018: case report. BMC Infect Dis 2019; 19:610. [PMID: 31296177 PMCID: PMC6624965 DOI: 10.1186/s12879-019-4257-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 07/04/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Lassa fever (LF) is a viral hemorrhagic disease caused by the Lassa virus (LASV) and endemic in West African countries with an estimation of 300,000 to 500,000 cases and 5,000 deaths annually. The Margibi County Health Team of Liberia received a report of an unidentified febrile illness case from the Kakata district. We conducted the investigation to identify the causative agent and the source of infection to support treatment, control and prevention interventions. CASE PRESENTATION We identified LASV in the blood specimens' of two patients by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Both the confirmed cases have manifested respiratory distress, weakness, and difficulty of swallowing, muscle, joint and back pains, and vomiting with blood. The symptoms started with mild fever and gradually developed. Initially, the primary health facilities have miss-diagnosed the patients as malaria and respiratory tract infections. The primary health facilities have referred the patients to the referral hospital as the patients have failed to respond to antimalarial and antibiotics. The hospital suspected LF and sent blood specimens to the National Reference Laboratory while the patients were on supportive treatment in the isolation room. At the time when the laboratory result returned to the hospital, the patients died of LF illness before ribavirin administered. CONCLUSIONS Our investigation revealed that the two hospitalized and deceased febrile cases were associated with LASV. The primary health facilities have failed to recognize the cases as suspected LF at the earliest time possible. The clinicians and health facilities, especially primary health facilities, need to consider LF as a differential diagnosis when the patient failed to respond to anti-malaria and broad-spectrum antibiotics.
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Affiliation(s)
| | | | - Darius Keller
- World Health Organization Country Office for Liberia, Monrovia, Liberia
| | - John Dogba
- National Public Health Institute of Liberia, Monrovia, Liberia
| | | | | | | | - Julius Monday
- World Health Organization Country Office for Liberia, Monrovia, Liberia
| | - Roland Tuopileyi
- World Health Organization Country Office for Liberia, Monrovia, Liberia
| | - Nuha Mahmoud
- World Health Organization Country Office for Liberia, Monrovia, Liberia
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Woyessa AB, Abebe A, Beyene B, Tefera M, Assefa E, Ketema H, Teshome B, Bekele A, Dugasa Y, Habebe S, Assefa Z, Sufa D, Alemu D, Tilahun H, Biru M, Shume G. Rotavirus-associated acute diarrhea outbreak in West Shewa Zone of Oromia Regional State, Ethiopia, 2017. Pan Afr Med J 2019; 32:202. [PMID: 31312314 PMCID: PMC6620077 DOI: 10.11604/pamj.2019.32.202.18188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/07/2019] [Indexed: 12/21/2022] Open
Abstract
Introduction Rotavirus causes severe-diarrheal diseases in infants. An estimation of 138 million rotavirus-associated diarrheal cases and 215,000 deaths occur every year globally. In December 2016, West-Shewa zone in Ethiopia reported unidentified gastrointestinal diarrhea outbreak. We investigated to identify the causative agent of the outbreak to support response operations. Methods Medical records were reviewed, and the daily line list was collected from health facilities. Descriptive data analysis was done by time, person and place. Stool specimens were first tested by antigen capture enzyme immunoassay (EIA) technique and further confirmed by reverse-transcription polymerase chain reaction (RT-PCR) as a gold standard. The product of RT-PCR was genotyped for each gene using G1-G4, G8-G9 and G12 primers for VP7 gene and P(4), P(6), P(8) and P(14) primers for VP4 gene. Results A total of 1,987 diarrheal cases (5.7 per 1000) and five deaths (case-fatality rate 0.25%) were identified and epidemiologically-linked to confirmed rotavirus from December 2016 to February 2017. Among the cases, 1,946 (98%) were < 5 children. Fourteen (74%) of the 19 tested stool specimens were positive for rotavirus by EIA and RT-PCR. Majority of strains detected were G12P(6) (25%) and G-negative P(8) (25%) followed by G9P(8) (19%), G1P(8) (13%) and G3/G2 P(8), G12P(8), and G-negative P(6) (6% each). Conclusion Diarrheal outbreak which occurred in West-Shewa zone of Ethiopia was associated with rotavirus and relatively more affected districts with low vaccination coverage. Routine rotavirus vaccination quality and coverage should be evaluated and the surveillance system needs to be strengthened to detect, prevent and control a similar outbreak.
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Affiliation(s)
- Abyot Bekele Woyessa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Almaz Abebe
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Berhane Beyene
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mesfin Tefera
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Esete Assefa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Hiwot Ketema
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Birke Teshome
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ayenachew Bekele
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yohanis Dugasa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Shambel Habebe
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Zewdu Assefa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Diriba Sufa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Habtamu Tilahun
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mengistu Biru
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Gemechu Shume
- Oromia Regional Health Bureau, Addis Ababa, Ethiopia
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Woyessa AB, Mengesha M, Belay D, Tayachew A, Ayele W, Beyene B, Kassa W, Zemelak E, Demissie G, Amare B, Boulanger L, Granados C, Williams T, Tareke I, Rajatonirina S, Jima D. Epidemiology of influenza in Ethiopia: findings from influenza sentinel surveillance and respiratory infection outbreak investigations, 2009-2015. BMC Infect Dis 2018; 18:449. [PMID: 30176806 PMCID: PMC6122732 DOI: 10.1186/s12879-018-3365-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/29/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Influenza is an acute viral disease of the respiratory tract which is characterized by fever, headache, myalgia, prostration, coryza, sore throat and cough. Globally, an estimated 3 to 5 million cases of severe influenza illness and 291 243-645 832 seasonal influenza-associated respiratory deaths occur annually. Although recent efforts from some African countries to describe burden of influenza disease and seasonality, these data are missing for the vast majority, including Ethiopia. Ethiopia established influenza sentinel surveillance in 2008 aiming to determine influenza strains circulating in the country and know characteristics, trend and burden of influenza viruses. METHODS We used influenza data from sentinel surveillance sites and respiratory disease outbreak investigations from 2009 to 2015 for this analysis. We obtained the data by monitoring patients with influenza-like illness (ILI) at three health-centers, severe acute respiratory infection (SARI) at five hospitals and investigating patients during different respiratory infection outbreaks. Throat-swab specimens in viral transport media were transported to the national reference laboratory within 72 h of collection using a cold-chain system. We extracted viral RNA from throat-swabs and subjected to real-time PCR amplification. We further subtyped and characterized Influenza A-positive specimens using CDC real-time reverse transcription PCR protocol. RESULTS A total of 4962 throat-swab samples were collected and 4799 (96.7%) of them were tested. Among them 988 (20.6%) were influenza-positive and of which 349 (35.3%) were seasonal influenza A(H3N2), 321 (32.5%) influenza A(H1N1)pdm2009 and 318 (32.0%) influenza B. Positivity rate was 29.5% in persons 5-14 years followed by 26.4% in 15-44 years, 21.2% in > 44 years and 6.4% in under five children. The highest positivity rate observed in November (37.5%) followed by March (27.6%), December (26.4%), October (24.4%) and January (24.3%) while the lowest positivity rate was in August (7.7%). CONCLUSION In Ethiopia, seasonal Influenza A(H3N2), Influenza A(H1N1)pdm2009 and Influenza B viruses were circulating during 2009-2015. Positivity rate and number of cases peaked in November and December. Influenza is one of public health problems in Ethiopia and the need to introduce influenza vaccine and antivirus is important to prevent and treat the disease in future.
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Affiliation(s)
- Abyot Bekele Woyessa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Mesfin Mengesha
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Desalegn Belay
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Adamu Tayachew
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Workenesh Ayele
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Berhane Beyene
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Woubayehu Kassa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Etsehiwot Zemelak
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Gelila Demissie
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | | | | | | | | | | | | | - Daddi Jima
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
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Hassen MN, Woyessa AB, Getahun M, Beyene B, Buluanger L, Ademe A, Bekele A, Addissie A, Kebede A, Jima D. Epidemiology of measles in the metropolitan setting, Addis Ababa, Ethiopia, 2005-2014: a retrospective descriptive surveillance data analysis. BMC Infect Dis 2018; 18:400. [PMID: 30107824 PMCID: PMC6092798 DOI: 10.1186/s12879-018-3305-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 08/02/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Measles is a highly infectious and serious respiratory viral disease which caused by a virus. It is a significant cause of illness and death worldwide. This data analysis was conducted to describe the trend and determine the reporting rate of measles cases in Addis Ababa to make recommendation for the government of the city to strengthening measles control interventions. METHODS We obtained and extracted ten years (2005-2014) Addis Ababa city's measles surveillance data from national database. We carried out retrospective descriptive data analysis by time, place and person variables. We calculated cumulative and specific reporting rates by dividing measles cases (lab confirmed, epidemiologically linked and compatible cases) to respective population and multiplying by 100,000. We divided average of ten years measles cases to midyear population and multiplied by 100,000 to calculate annualized reporting rate. We analyzed non-measles febrile rash rate by dividing laboratory negative cases to total population and multiplying by 100,000. RESULTS A total of 4203 suspected measles cases were identified. Among them 1154 (27.5%) were laboratory confirmed, 512 (12.2%) were clinically compatible, 52 (1.2%) were epidemiologically linked cases and the rest 2485 (59.1%) were IgM negative for measles which makes total measles cases 1718 (40.9%). Median age was 5 years with 2-18 years interquartile-range. The annualized measles reporting rate was 5.9, which was 40.2 among > 1 year, 11.5 among 1-4 years, 6.0 among 5-14 years, 4.1 among 15-44 years and 0.01 among ≥ 45 years per 100,000 population. Among the total measles cases; 380 (22%) were received at least one dose of measles containing vaccine (MCV) while 415 (24%) cases were not vaccinated and the vaccination status of 923 (54%) cases were not known. CONCLUSION Our analysis revealed that the reporting rate was higher among young children than older age group. Among all the patients 22% were received at least one dose of measles vaccine whereas 13% were not vaccinated against measles antigen. Routine immunization should be strengthened to reach all children through well monitored vaccine cold chain management.
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Affiliation(s)
| | - Abyot Bekele Woyessa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Mekonen Getahun
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Berhane Beyene
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | | | | | - Alemayehu Bekele
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
- Ethiopian Public Health Association, Addis Ababa, Ethiopia
| | | | - Amha Kebede
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
| | - Daddi Jima
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, PO BOX 1242, Addis Ababa, Ethiopia
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Tegegne AA, Fiona B, Shebeshi ME, Hailemariam FT, Aregay AK, Beyene B, Asemahgne EW, Woyessa DJ, Woyessa AB. Analysis of acute flaccid paralysis surveillance in Ethiopia, 2005-2015: progress and challenges. Pan Afr Med J 2017; 27:10. [PMID: 28890751 PMCID: PMC5578723 DOI: 10.11604/pamj.supp.2017.27.2.10694] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/04/2017] [Indexed: 11/23/2022] Open
Abstract
Introduction Ethiopia joined the global effort to eradicate polio in 1996, and interrupted indigenous wild poliovirus transmission by December 2001. However, the country experienced numerous separate importations during 2003-2013. Sensitive Acute Flaccid (AFP) surveillance is critical to rule out undetected circulation of WPV and VDPVs. Methods In this study described, we used a retrospective descriptive study design to characterize the surveillance performance from 2005 to 2015. Results The none-polio AFP rate improved from 2.6/100,000 children <15 years old in 2005 to 3.1 in 2015, while stool adequacy has also improved from 78.5% in 2005 to 92 % in 2015. At the national level, most AFP surveillance performance indicators are achieved and maintained over the years, however, AFP surveillance performance at sub-national level varies greatly particularly in pastoralist regions. In addition, the minimum standard for non-polio enterovirus isolation rate (10%) was not achieved except in 2007 and 2009. Nevertheless, the proportion of cases investigated within 2 days of notification and the proportion of specimens arriving in good condition within 3 days to the laboratory were maintained throughout all the years reviewed. Conclusion We found that the AFP surveillance system was efficient and progressively improved over the past 10 years in Ethiopia. However, the subnational AFP surveillance performance varies and were not maintained, particularly in pastoralist regions, and the non-polio enterovirus isolation rate declined since 2010. We recommend the institution of community-based surveillance in pastoralist regions and conduct detail review of the laboratory sensitivity and the reverse cold chain system.
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Affiliation(s)
| | - Braka Fiona
- World Health Organization Country Office, Nigeria
| | | | | | | | - Berhane Beyene
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Wassie E, Ademe A, Gallagher K, Braka F, Beyene B, Woyessa AB, Jima D. Assessment of reporting sites for acute flaccid paralysis surveillance in Ethiopia: implications for planning of active case search visits. Pan Afr Med J 2017; 27:8. [PMID: 28983396 PMCID: PMC5619921 DOI: 10.11604/pamj.supp.2017.27.2.10731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 01/23/2017] [Indexed: 11/11/2022] Open
Affiliation(s)
- Eshetu Wassie
- World Health Organization, Ethiopia Country Office
- Corresponding author: Eshetu Wassie, World Health Organization, Ethiopia Country Office ()
| | | | | | - Fiona Braka
- World Health Organization, Nigeria Country Office
| | - Berhane Beyene
- National Polio Laboratory, Ethiopian Public Health Institute
| | - Abyot Bekele Woyessa
- Center for Public Health Emergency Management, Ethiopian Public Health Institute
| | - Daddi Jima
- Center for Public Health Emergency Management, Ethiopian Public Health Institute
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Woyessa AB, Omballa V, Wang D, Lambert A, Waiboci L, Ayele W, Ahmed A, Abera NA, Cao S, Ochieng M, Montgomery JM, Jima D, Fields B. An outbreak of acute febrile illness caused by Sandfly Fever Sicilian Virus in the Afar region of Ethiopia, 2011. Am J Trop Med Hyg 2014; 91:1250-3. [PMID: 25266349 DOI: 10.4269/ajtmh.14-0299] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In malaria-endemic regions, many medical facilities have limited capacity to diagnose non-malarial etiologies of acute febrile illness (AFI). As a result, the etiology of AFI is seldom determined, although AFI remains a major cause of morbidity in developing countries. An outbreak of AFI was reported in the Afar region of Ethiopia in August of 2011. Retrospectively, 12,816 suspected AFI cases were identified by review of medical records. Symptoms were mild and self-limiting within 3 days after the date of onset; no fatalities were identified. All initial test results of AFI patient specimens were negative for selected pathogens using standard microbiological and molecular techniques. High-throughput sequencing of nucleic acid extracts of serum specimens from 29 AFI cases identified 17 (59%) of 29 samples as positive for Sandfly Fever Sicilian Virus (SFSV). These results were further confirmed by specific reverse transcription polymerase chain reaction. This is the first study implicating SFSV as an etiological agent for AFI in Ethiopia.
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Affiliation(s)
- Abyot Bekele Woyessa
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Victor Omballa
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David Wang
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amy Lambert
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lilian Waiboci
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Workenesh Ayele
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Abdi Ahmed
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Negga Asamene Abera
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Song Cao
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Melvin Ochieng
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joel M Montgomery
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Daddi Jima
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Barry Fields
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Global Disease Detection Program, Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya; Departments of Molecular Microbiology and Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; Division of Vector-Borne Disease, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Woyessa AB, Ayele W, Ahimed A, Nega A. Investigation of acute febrile illness outbreak- Asyaita and Dupti districts, Afar Region, Ethiopia, February 2011. Retrovirology 2012. [PMCID: PMC3360364 DOI: 10.1186/1742-4690-9-s1-p46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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