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G/meskel W, Desta K, Diriba R, Belachew M, Evans M, Cantarelli V, Urrego M, Sisay A, Gebreegziabxier A, Abera A. SARS-CoV-2 variant typing using real-time reverse transcription-polymerase chain reaction-based assays in Addis Ababa, Ethiopia. IJID Reg 2024; 11:100363. [PMID: 38634071 PMCID: PMC11021353 DOI: 10.1016/j.ijregi.2024.100363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/24/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
Objectives This study aimed to determine the SARS-CoV-2 variants in the first four COVID-19 waves using polymerase chain reaction (PCR)-based variant detection in Addis Ababa, Ethiopia. Methods A cross-sectional study was conducted using repository nasopharyngeal samples stored at the Ethiopian Public Health Institute COVID-19 testing laboratory. Stored positive samples were randomly selected from the first four waves based on their sample collection date. A total of 641 nasopharyngeal samples were selected and re-tested for SARS-CoV-2. RNA was extracted using nucleic acid purification instrument. Then, SARS-CoV-2 detection was carried out using 10 μl RNA and 20 μl reverse transcription-PCR fluorescent mix. Cycle threshold values <38 were considered positive. Results A total of 374 samples qualified for B.1.617 Lineage and six spike gene mutation variant typing kits. The variant typing kits identified 267 (71.4%) from the total qualifying samples. Alpha, Beta, Delta, and Omicron were dominantly identified variants from waves I, II, III, and IV, respectively. From the total identified positive study samples, 243 of 267 (91%) of variants identified from samples had cycle threshold values <30. Conclusions The study data demonstrated that reverse transcription-PCR-based variant typing can provide additional screening opportunities where sequencing opportunity is inaccessible. The assays could be implemented in laboratories performing SARS-CoV-2 molecular testing.
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Affiliation(s)
- Wodneh G/meskel
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, P.O.Box 1176, Addis Ababa, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, P.O.Box 1176, Addis Ababa, Ethiopia
| | - Regasa Diriba
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, P.O.Box 1176, Addis Ababa, Ethiopia
| | - Mahlet Belachew
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Martin Evans
- Global Public Health Programs, American Society for Microbiology, Washington, USA
| | - Vlademir Cantarelli
- Global Public Health Programs, American Society for Microbiology, Washington, USA
| | - Maritza Urrego
- Global Public Health Programs, American Society for Microbiology, Washington, USA
| | - Abay Sisay
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, P.O.Box 1176, Addis Ababa, Ethiopia
| | | | - Adugna Abera
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Abera A, Mamecha T, Abose E, Bokicho B, Ashole A, Bishaw T, Mariyo A, Bogale B, Terefe H, Tadesse H, Belachew M, Difabachew H, Eukubay A, Kinde S, Ali A, Regasa F, Seife F, Kebede Z, Wossen M, Tollera G, Hailu M, Manaye N, Van Reet N, Priotto G, van Griensven J, Pareyn M, Tasew G. Reemergence of Human African Trypanosomiasis Caused by Trypanosoma brucei rhodesiense, Ethiopia. Emerg Infect Dis 2024; 30:125-128. [PMID: 37967521 PMCID: PMC10756368 DOI: 10.3201/eid3001.231319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
We report 4 cases of human African trypanosomiasis that occurred in Ethiopia in 2022, thirty years after the last previously reported case in the country. Two of 4 patients died before medicine became available. We identified the infecting parasite as Trypanosoma brucei rhodesiense. Those cases imply human African trypanosomiasis has reemerged.
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Gebregziabher SM, Yalew AW, Sime H, Abera A. Molecular detection of waterborne pathogens in infants' drinking water and their relationship with water quality determinants in eastern Ethiopia: loop-mediated isothermal amplification (LAMP)-based study. J Water Health 2024; 22:1-20. [PMID: 38295069 PMCID: wh_2023_201 DOI: 10.2166/wh.2023.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Cryptosporidium, Shigella, toxin-producing Escherichia coli, and rotavirus were reported to be the most responsible for severe and fatal diarrhea among infants. This study aimed to investigate the presence of these pathogens in infants' drinking water samples and analyzing using water quality determinants in eastern Ethiopia. A molecular (LAMP)-based cross-sectional study design was employed. A total of 410 and 37 water samples were tested from infant point-of-use at household and corresponding water source, respectively, from June 2020 to May, 2021. Cryptosporidium, Shigella, toxin-producing E. coli, and rotavirus were detected in 28.5, 30.0, 26.3, and 32.2%, of water samples tested from infant point-of-use, respectively. About 13.2% of the water samples were positive for all (four) pathogens together. Cryptosporidium, Shigella, toxin-producing E. coli, and rotavirus were detected in 27.0, 32.4, 29.7, and 37.8%, of water samples tested from water sources, respectively. Positive significant correlation was observed between infant point-of-consumption and water sources from which it is drawn toward the presence of each targeted pathogen. Unimproved water source showed a strong significant association with the presence of Cryptosporidium, Shigella and toxin-producing E. coli. Therefore, efforts should be made in development of improved water sources, source protection safety and health education to caretakers of infants.
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Affiliation(s)
| | - Alemayehu Worku Yalew
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Heven Sime
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, EPHI, Addis Ababa, Ethiopia
| | - Adugna Abera
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, EPHI, Addis Ababa, Ethiopia
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Amare GA, Mekonnen GG, Kassa M, Addisu A, Kendie DA, Tegegne B, Abera A, Tadesse D, Getahun S, Wondmagegn YM, Merdekios B, Asres MS, van Griensven J, Van der Auwera G, van Henten S, Pareyn M. First report of cutaneous leishmaniasis caused by Leishmania donovani in Ethiopia. Parasit Vectors 2023; 16:457. [PMID: 38104111 PMCID: PMC10725588 DOI: 10.1186/s13071-023-06057-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Leishmaniasis is a common neglected tropical disease in Ethiopia. Visceral leishmaniasis (VL) caused by Leishmania donovani presents in the lowlands, while cutaneous leishmaniasis (CL) affects people living in the highlands. Although CL is described as being caused by Leishmania aethiopica, there is also evidence of L. tropica and L. major isolated from a patient, sand flies and potential reservoirs. Information on species causing CL in Ethiopia is patchy, and no nation-wide study has ever been done. Understanding which species are causing CL in Ethiopia can have important implications for patient management and disease prevention. METHODS We analyzed stored routine samples and biobanked DNA isolates from previously conducted studies of CL patients from different centers in the north, center and south of Ethiopia. Species typing was performed using ITS-1 PCR with high-resolution melt (HRM) analysis, followed by HSP70 amplicon sequencing on a selection of the samples. Additionally, sociodemographic, clinical and laboratory data of patients were analyzed. RESULTS Of the 226 CL samples collected, the Leishmania species could be determined for 105 (45.5%). Leishmania aethiopica was identified in 101 (96.2%) samples from across the country. In four samples originating from Amhara region, northwestern Ethiopia, L. donovani was identified by ITS-1 HRM PCR, of which two were confirmed with HSP70 sequences. While none of these four patients had symptoms of VL, two originated from known VL endemic areas. CONCLUSIONS The majority of CL was caused by L. aethiopica, but CL due to L. tropica and L. major cannot be ruled out. Our study is the first to our knowledge to demonstrate CL patients caused by L. donovani in Ethiopia. This should spark future research to investigate where, how and to which extent such transmission takes place, how it differs genetically from L. donovani causing VL and whether such patients can be diagnosed and treated successfully with the currently available tools and drugs.
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Affiliation(s)
| | | | | | | | | | | | - Adugna Abera
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | | | | | | | | | | | - Myrthe Pareyn
- Institute of Tropical Medicine Antwerp, Antwerp, Belgium
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Tamir Z, Animut A, Dugassa S, Belachew M, Abera A, Tsegaye A, Erko B. Plasmodium infections and associated risk factors among parturients in Jawi district, northwest Ethiopia: a cross-sectional study. Malar J 2023; 22:367. [PMID: 38037059 PMCID: PMC10691102 DOI: 10.1186/s12936-023-04803-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Pregnant women have an increased risk of Plasmodium infections and disease. Malaria in pregnancy is a major public health problem in endemic areas. Assessment of the burden and risk factors of malaria in pregnancy across different malaria transmission settings is required to guide control strategies and for malaria elimination. Thus, the current study is generating such evidence from parturient women in northwest Ethiopia. METHODS A cross-sectional study was conducted among 526 pregnant women admitted to the delivery rooms of selected health facilities in Jawi district, northwest Ethiopia, between November 2021 and July 2022. Data on the socio-demographic, clinical, obstetric, and malaria prevention practices of pregnant women were collected using interviewer-administered questionnaires and from women's treatment cards. Malaria was diagnosed by light microscopy, rapid diagnostic test, and multiplex real-time polymerase chain reaction. Risk factors for malaria were evaluated using bivariable and multivariable logistic regression models. A P-value of < 0.05 was considered statistically significant. RESULTS Among the examined parturient women, 14.3% (95% CI 11.4-17.5%) had Plasmodium infections. The prevalence of peripheral, placental, and congenital malaria was 12.2% (95% CI 9.5-15.3%), 10.9% (95% CI 8.2-14.1%), and 3.7% (95% CI 2.3-6.1%), respectively. About 90.6% of peripheral and 92% of placental Plasmodium infections were asymptomatic. Plasmodium infection at parturiency was independently predicted by maternal illiteracy (AOR = 2.03, 95% CI 1.11-3.74), primigravidity (AOR = 1.88, 95% CI 1.01-3.49), lack of antenatal care follow-up (AOR = 2.28, 95% CI 1.04-5.03), and history of symptomatic malaria during pregnancy (AOR = 4.2, 95% CI 2.32-7.59). Moreover, the blood group O phenotype was significantly associated with placental malaria among the primiparae. CONCLUSIONS Overall, asymptomatic Plasmodium infections were prevalent among parturients in northwest Ethiopia. Maternal illiteracy, primigravidity, lack of antenatal care follow-up, and history of symptomatic malaria during pregnancy were the risk factors for malaria during parturiency. Thus, promotion of a healthy pregnancy through ANC follow-up, strengthening malaria prevention and control practices, and screening of malaria in asymptomatic pregnant women are suggested to reduce its burden in pregnancy.
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Affiliation(s)
- Zemenu Tamir
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Abebe Animut
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sisay Dugassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mahlet Belachew
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adugna Abera
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Aster Tsegaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Ismail A, Yared S, Dugassa S, Abera A, Animut A, Erko B, Gebresilassie A. Sero-prevalence of visceral leishmaniasis and its associated factors among asymptomatic individuals visiting Denan health center, southeastern Ethiopia. Trop Dis Travel Med Vaccines 2023; 9:8. [PMID: 37430336 DOI: 10.1186/s40794-023-00196-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/12/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND In the Somali region of Ethiopia, visceral leishmaniasis (VL) is a public health concern. However, VL epidemiology and sand fly vectors have not been well studied in various areas of the regional state, including Denan district. Therefore, this study was conducted to determine the sero-prevalence, associated factors, and distribution of sand fly vectors of VL in Denan district, south-eastern Ethiopia. METHODS A facility-based cross-sectional study was conducted from April to September 2021 among VL patients with classic signs and symptoms visiting Denan Health Center in south-eastern Ethiopia. Using a convenience sampling method, 187 blood samples were collected from individuals who visited Denan Health Center during the study period. Blood samples were subjected to Direct Agglutination Test for the detection of antibodies to VL. A pre-tested structured questionnaire was also used to gather information on risk factors and other characteristics of knowledge and attitude assessment. Sand flies were also collected from indoor, peri-domestic, mixed forest, and termite mounds using light and sticky traps to determine the fauna and abundance. RESULTS The overall sero-prevalence rate was 9.63% (18/187). The sero-prevalence was significantly associated with outdoor sleeping (OR = 2.82), the presence of damp floors (OR = 7.76), and sleeping outdoor near animals (OR = 3.22). Around 53.48% of the study participants had previously heard about VL. Study participants practiced different VL control methods, including bed nets (42%), insecticide spraying (32%), smoking plant parts (14%), and environmental cleaning (8%). In total, 823 sand fly specimens, comprising 12 species in two genera (Phlebotomus and Sergentomyia), were trapped and identified. The most abundant species was Sergentomyia clydei (50.18%), followed by Phlebotomus orientalis (11.42%). Also, a higher proportion of P. orientalis was found in termite mounds (65.43%), followed by mixed forest (37.8%) and peri-domestic (20.83%) habitats. CONCLUSION The study demonstrated a 9.63% sero-positivity of VL and a remarkable gap in knowledge, attitude, and practices towards VL. P. orientalis was also detected, which could be a probable vector in this area. Thus, public education should be prioritized to improve the community's awareness of VL and its public health impact. In addition, detailed epidemiological and entomological studies are recommended.
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Affiliation(s)
- Ahmed Ismail
- College of Veterinary Medicine, Jigjiga University, Jigjiga, Ethiopia
| | - Solomon Yared
- Department of Biology, Jigjiga University, Jigjiga, Ethiopia
| | - Sisay Dugassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adugna Abera
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abebe Animut
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Araya Gebresilassie
- Department of Zoological Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
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Assefa A, Mohammed H, Anand A, Abera A, Sime H, Minta AA, Tadesse M, Tadesse Y, Girma S, Bekele W, Etana K, Alemayehu BH, Teka H, Dilu D, Haile M, Solomon H, Moriarty LF, Zhou Z, Svigel SS, Ezema B, Tasew G, Woyessa A, Hwang J, Murphy M. Correction: Therapeutic efficacies of artemether-lumefantrine and dihydroartemisinin-piperaquine for the treatment of uncomplicated Plasmodium falciparum and chloroquine and dihydroartemisinin-piperaquine for uncomplicated Plasmodium vivax infection in Ethiopia. Malar J 2023; 22:121. [PMID: 37041533 PMCID: PMC10091846 DOI: 10.1186/s12936-023-04537-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Affiliation(s)
- Ashenaf Assefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | | | - Anjoli Anand
- Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Adugna Abera
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Heven Sime
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Anna A Minta
- Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Samuel Girma
- ICAP at Columbia University, Addis Ababa, Ethiopia
- U.S. President's Malaria Initiative, USA Agency for International Development, Addis Ababa, Ethiopia
| | - Worku Bekele
- World Health Organization, Addis Ababa, Ethiopia
| | - Kebede Etana
- Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Hiwot Teka
- U.S. President's Malaria Initiative, USA Agency for International Development, Addis Ababa, Ethiopia
| | - Dereje Dilu
- Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Hiwot Solomon
- Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Leah F Moriarty
- U.S. President's Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Zhiyong Zhou
- Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Samaly Souza Svigel
- Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Bryan Ezema
- Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Geremew Tasew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adugna Woyessa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Jimee Hwang
- U.S. President's Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Matthew Murphy
- U.S. President's Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
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Assefa G, Desta K, Araya S, Girma S, Hailu E, Mihret A, Hailu T, Tilahun M, Diriba G, Dagne B, Atnafu A, Endalafer N, Abera A, Bekele S, Mengistu Y, Bobosha K, Aseffa A. Drug Resistance in Tuberculous Lymphadenitis: Molecular Characterization. Tuberc Res Treat 2023; 2023:3291538. [PMID: 37032734 PMCID: PMC10076118 DOI: 10.1155/2023/3291538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 02/27/2023] [Accepted: 03/11/2023] [Indexed: 03/31/2023] Open
Abstract
Background. Drug-resistant tuberculosis (TB) epidemic in high-TB-incidence countries, particularly Ethiopia, remains a significant challenge. As a result, we investigated the drug resistance, common gene mutation, and molecular characterization of mycobacterial isolates from patients with suspected tuberculous lymphadenitis (TBLN). Methodology. A cross-sectional study of 218 FNA samples from TBLN patients inoculated on Lowenstein-Jensen media was carried out. The culture isolates were identified as MTB by polymerase chain reaction (PCR) and the difference-9 (RD9) test region. In addition, the GenoType MTBDRplus assay tested the first and second-line MTB drugs, and the spoligotyping strain-dependent polymorphism test was determined. Results. Among the 50 culture-positive isolates, 14% (7/50) had drug resistance caused by a gene mutation. Out of these, 4 (8%) isolates were mono-resistant to isoniazid drug, which is caused by a gene mutation in katG in the region of interrogated at codon 315 in the amino acid sequence of S315T1, and 3 (6%) isolates were resistant to both rifampicin and isoniazid drugs. The mutation was observed for katG (at codon 315 with a change in the sequence of amino acid S315T) and rpoB (at codon 530–533 with a change in the sequence of amino acid S531L (S450L)) genes. The most prevalent spoligotypes were orphan and SIT53 strains. Conclusion. The predominance of INH mono-resistance poses a critical risk for the potential development of MDR-TB, as INH mono-resistance is a typical pathway to the occurrence of MDR-TB. The orphan and SIT53 (T) strains were the most common in the study area, and a drug-resistant strain caused by a common gene mutation could indicate the transmission of clonal-resistant strains in the community.
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9
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Assefa A, Mohammed H, Anand A, Abera A, Sime H, Minta AA, Tadesse M, Tadesse Y, Girma S, Bekele W, Etana K, Alemayehu BH, Teka H, Dilu D, Haile M, Solomon H, Moriarty LF, Zhou Z, Svigel SS, Ezema B, Tasew G, Woyessa A, Hwang J, Murphy M. Therapeutic efficacies of artemether-lumefantrine and dihydroartemisinin-piperaquine for the treatment of uncomplicated Plasmodium falciparum and chloroquine and dihydroartemisinin-piperaquine for uncomplicated Plasmodium vivax infection in Ethiopia. Malar J 2022; 21:359. [PMID: 36451216 PMCID: PMC9714156 DOI: 10.1186/s12936-022-04350-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/27/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Routine monitoring of anti-malarial drugs is recommended for early detection of drug resistance and to inform national malaria treatment guidelines. In Ethiopia, the national treatment guidelines employ a species-specific approach. Artemether-lumefantrine (AL) and chloroquine (CQ) are the first-line schizonticidal treatments for Plasmodium falciparum and Plasmodium vivax, respectively. The National Malaria Control and Elimination Programme in Ethiopia is considering dihydroartemisinin-piperaquine (DHA/PPQ) as an alternative regimen for P. falciparum and P. vivax. METHODS The study assessed the clinical and parasitological efficacy of AL, CQ, and DHA/PPQ in four arms. Patients over 6 months and less than 18 years of age with uncomplicated malaria mono-infection were recruited and allocated to AL against P. falciparum and CQ against P. vivax. Patients 18 years or older with uncomplicated malaria mono-infection were recruited and randomized to AL or dihydroartemisinin-piperaquine (DHA/PPQ) against P. falciparum and CQ or DHA/PPQ for P. vivax. Patients were followed up for 28 (for CQ and AL) or 42 days (for DHA/PPQ) according to the WHO recommendations. Polymerase chain reaction (PCR)-corrected and uncorrected estimates were analysed by Kaplan Meier survival analysis and per protocol methods. RESULTS A total of 379 patients were enroled in four arms (n = 106, AL-P. falciparum; n = 75, DHA/PPQ- P. falciparum; n = 142, CQ-P. vivax; n = 56, DHA/PPQ-P. vivax). High PCR-corrected adequate clinical and parasitological response (ACPR) rates were observed at the primary end points of 28 days for AL and CQ and 42 days for DHA/PPQ. ACPR rates were 100% in AL-Pf (95% CI: 96-100), 98% in CQ-P. vivax (95% CI: 95-100) at 28 days, and 100% in the DHA/PPQ arms for both P. falciparum and P. vivax at 42 days. For secondary endpoints, by day three 99% of AL-P. falciparum patients (n = 101) cleared parasites and 100% were afebrile. For all other arms, 100% of patients cleared parasites and were afebrile by day three. No serious adverse events were reported. CONCLUSION This study demonstrated high therapeutic efficacy for the anti-malarial drugs currently used by the malaria control programme in Ethiopia and provides information on the efficacy of DHA/PPQ for the treatment of P. falciparum and P. vivax as an alternative option.
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Affiliation(s)
- Ashenafi Assefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia. .,Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Hussein Mohammed
- grid.452387.f0000 0001 0508 7211Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Anjoli Anand
- grid.416738.f0000 0001 2163 0069Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA ,grid.416738.f0000 0001 2163 0069Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Adugna Abera
- grid.452387.f0000 0001 0508 7211Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Heven Sime
- grid.452387.f0000 0001 0508 7211Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Anna A. Minta
- grid.416738.f0000 0001 2163 0069Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA ,grid.416738.f0000 0001 2163 0069Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA
| | | | | | - Samuel Girma
- ICAP at Columbia University, Addis Ababa, Ethiopia ,U.S. President’s Malaria Initiative, USA Agency for International Development, Addis Ababa, Ethiopia
| | - Worku Bekele
- World Health Organization, Addis Ababa, Ethiopia
| | - Kebede Etana
- grid.414835.f0000 0004 0439 6364Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Hiwot Teka
- U.S. President’s Malaria Initiative, USA Agency for International Development, Addis Ababa, Ethiopia
| | - Dereje Dilu
- grid.414835.f0000 0004 0439 6364Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Mebrahtom Haile
- grid.414835.f0000 0004 0439 6364Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Hiwot Solomon
- grid.414835.f0000 0004 0439 6364Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Leah F. Moriarty
- grid.416738.f0000 0001 2163 0069U.S. President’s Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Zhiyong Zhou
- grid.416738.f0000 0001 2163 0069Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Samaly Souza Svigel
- grid.416738.f0000 0001 2163 0069Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Bryan Ezema
- grid.416738.f0000 0001 2163 0069Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Geremew Tasew
- grid.452387.f0000 0001 0508 7211Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adugna Woyessa
- grid.452387.f0000 0001 0508 7211Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Jimee Hwang
- grid.416738.f0000 0001 2163 0069U.S. President’s Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Matthew Murphy
- grid.416738.f0000 0001 2163 0069U.S. President’s Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA USA
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10
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Yigezu A, Zewdie SA, Mirkuzie AH, Abera A, Hailu A, Agachew M, Memirie ST. Cost-analysis of COVID-19 sample collection, diagnosis, and contact tracing in low resource setting: The case of Addis Ababa, Ethiopia. PLoS One 2022; 17:e0269458. [PMID: 35679290 PMCID: PMC9182302 DOI: 10.1371/journal.pone.0269458] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 05/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background Ethiopia has been responding to the COVID-19 pandemic through a combination of interventions, including non-pharmaceutical interventions, quarantine, testing, isolation, contact tracing, and clinical management. Estimating the resources consumed for COVID-19 prevention and control could inform efficient decision-making for epidemic/pandemic-prone diseases in the future. This study aims to estimate the unit cost of COVID-19 sample collection, laboratory diagnosis, and contact tracing in Addis Ababa, Ethiopia. Methods Primary and secondary data were collected to estimate the costs of COVID-19 sample collection, diagnosis, and contact tracing. A healthcare system perspective was used. We used a combination of micro-costing (bottom-up) and top-down approaches to estimate resources consumed and the unit costs of the interventions. We used available cost and outcome data between May and December 2020. The costs were classified into capital and recurrent inputs to estimate unit and total costs. We identified the cost drivers of the interventions. We reported the cost for the following outcome measures: (1) cost per sample collected, (2) cost per laboratory diagnosis, (3) cost per sample collected and laboratory diagnosis, (4) cost per contact traced, and (5) cost per COVID-19 positive test identified. We conducted one-way sensitivity analysis by varying the input parameters. All costs were reported in US dollars (USD). Results The unit cost per sample collected was USD 1.33. The unit cost of tracing a contact of an index case was USD 0.66. The unit cost of COVID-19 diagnosis, excluding the cost for sample collection was USD 3.91. The unit cost of sample collection per COVID-19 positive individual was USD 11.63. The unit cost for COVID-19 positive test through contact tracing was USD 54.00. The unit cost COVID-19 DNA PCR diagnosis for identifying COVID-19 positive individuals, excluding the sample collection and transport cost, was USD 37.70. The cost per COVID-19 positive case identified was USD 49.33 including both sample collection and laboratory diagnosis costs. Among the cost drivers, personnel cost (salary and food cost) takes the highest share for all interventions, ranging from 51–76% of the total cost. Conclusion The costs of sample collection, diagnosis, and contact tracing for COVID-19 were high given the low per capita health expenditure in Ethiopia and other low-income settings. Since the personnel cost accounts for the highest cost, decision-makers should focus on minimizing this cost when faced with pandemic-prone diseases by strengthening the health system and using digital platforms. The findings of this study can help decision-makers prioritize and allocate resources for effective public health emergency response.
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Affiliation(s)
- Amanuel Yigezu
- National Data Management Center for Health, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
- * E-mail:
| | - Samuel Abera Zewdie
- Partnership and Cooperation Directorate, Ministry of Health, Addis Ababa, Ethiopia
| | - Alemnesh H. Mirkuzie
- National Data Management Center for Health, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Adugna Abera
- Parasitology Department, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Alemayehu Hailu
- Bergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care Medicine, University of Bergen, Bergen, Norway
| | - Mesfin Agachew
- National Data Management Center for Health, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Solomon Tessema Memirie
- Addis Center for Ethics and Priority Setting, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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11
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Ayele M, Haile D, Alonso S, Sime H, Abera A, Balcha KH, Roba KT, Guma GT, Endris BS. Aflatoxin exposure among children of age 12-59 Months in Butajira District, South-Central Ethiopia: a community based cross-sectional study. BMC Pediatr 2022; 22:326. [PMID: 35655154 PMCID: PMC9161506 DOI: 10.1186/s12887-022-03389-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 05/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background The continued provision of safe food, free of aflatoxin remains a huge challenge in developing countries. Despite several favourable climatic conditions that facilitate aflatoxin contamination in Ethiopia, there is little information showing aflatoxin exposure in children. Therefore, this study assessed aflatoxin exposure among young children in Butajira district, South-Central Ethiopia. Methods Community based cross-sectional study stratified by agro-ecology was employed in Health and Demographic Surveillance Site (HDSS) of Butajira. The study included 332 children aged 12–59 months and were selected by simple random sampling technique using the HDSS registration number as a sampling frame. We collected data on dietary practice and aflatoxin exposure. Aflatoxin M1 concentration in urine was measured by Enzyme-Linked Immunosorbent assay (ELISA). The data analysis was carried out using STATA. Results Detectable urinary Aflatoxin M1 was found in 62.4% (95% CI: 56.9 – 67.5%) of the children at a level ranging from 0.15 to 0.4 ng/ml. Children living in lowland agro-ecological zone had [AOR = 2.11 (95% CI; 1.15, 3.88] odds of being exposed to aflatoxin as compared to children living in highland agro-ecological zone. Children at lower socio-economic status [AOR = 0.27 (95% CI; 0.14, 0.50] and medium socio-economic status [AOR = 0.47 (95% CI; 0.25, 0.87] had 73% and 53% lower odds of being exposed to aflatoxin as compared to children in the higher socio-economic status, respectively. Conclusions Aflatoxin exposure among young children was very high in South-Central Ethiopia. This high aflatoxin exposure might emphasize the need for aflatoxin exposure mitigation strategies in Ethiopia. Especially, raising awareness of the community towards aflatoxin exposure is very crucial. In addition, further research is required to assess long-term aflatoxin exposure and its association with child growth and development.
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Affiliation(s)
- Mary Ayele
- Doctors With Africa CUAMM, Medici Con L'Africa, Cuamm, Ethiopia.
| | - Demewoz Haile
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Silvia Alonso
- Animal and Human Health Program, International Livestock Research Institute, Addis Ababa, Ethiopia
| | - Heven Sime
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adugna Abera
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Kifle Habte Balcha
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Kedir Teji Roba
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Geremew Tasew Guma
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Bilal Shikur Endris
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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12
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Tameru K, Tsegaye B, Shikur M, Ergete W, Tasew G, Abera A, Wolday D. Case Report: Disseminated Strongloides stercoralis Presenting as an Ulcerated Gastric Mass in an HIV-1-infected Patient. Am J Trop Med Hyg 2022; 106:tpmd210791. [PMID: 35533694 PMCID: PMC9209934 DOI: 10.4269/ajtmh.21-0791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 03/06/2022] [Indexed: 11/07/2022] Open
Abstract
Disseminated Strongloides stercoralis is a common phenomenon among patients with immunosuppression. In this report, we present a case of disseminated Strongloides stercoralis presenting as a gastric mass in a 42-year-old male patient with a known history of HIV-1 infection and type 2 diabetes mellitus (T2DM). The patient presented with symptoms and signs suggestive of acute on chronic erosive gastritis, which included persistent vomiting. Endoscopic examination revealed a gastric mass with no signs of malignancy or dysplasia. There was noted to be chronic inflammation along with morphologic features consistent with the larvae and eggs of Strongloides nematodes in a biopsied gastric mass tissue and duodenum. The disease subsequently resulted in death despite the administration of ivermectin.
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Affiliation(s)
| | | | | | - Wondwossen Ergete
- Department of Pathology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Bacterial, Fungal and Zoonotic Diseases Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adugna Abera
- Bacterial, Fungal and Zoonotic Diseases Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dawit Wolday
- Mekelle University College of Health Sciences, Mekelle, Ethiopia
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13
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Nega D, Abebe A, Abera A, Gidey B, Gibretsadik A, Tasew G. M103 Low proficiency of microscopists with poor laboratory is a challenge for malaria diagnosis in Ethiopia. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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14
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Sisay A, Abera A, Dufera B, Endrias T, Tasew G, Tesfaye A, Hartnack S, Beyene D, Desta AF. Diagnostic accuracy of three commercially available one step RT-PCR assays for the detection of SARS-CoV-2 in resource limited settings. PLoS One 2022; 17:e0262178. [PMID: 35051204 PMCID: PMC8775315 DOI: 10.1371/journal.pone.0262178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/04/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background COVID-19 is an ongoing public health pandemic regardless of the countless efforts made by various actors. Quality diagnostic tests are important for early detection and control. Notably, several commercially available one step RT-PCR based assays have been recommended by the WHO. Yet, their analytic and diagnostic performances have not been well documented in resource-limited settings. Hence, this study aimed to evaluate the diagnostic sensitivities and specificities of three commercially available one step reverse transcriptase-polymerase chain reaction (RT-PCR) assays in Ethiopia in clinical setting. Methods A cross-sectional study was conducted from April to June, 2021 on 279 respiratory swabs originating from community surveillance, contact cases and suspect cases. RNA was extracted using manual extraction method. Master-mix preparation, amplification and result interpretation was done as per the respective manufacturer. Agreements between RT-PCRs were analyzed using kappa values. Bayesian latent class models (BLCM) were fitted to obtain reliable estimates of diagnostic sensitivities, specificities of the three assays and prevalence in the absence of a true gold standard. Results Among the 279 respiratory samples, 50(18%), 59(21.2%), and 69(24.7%) were tested positive by TIB, Da An, and BGI assays, respectively. Moderate to substantial level of agreement was reported among the three assays with kappa value between 0 .55 and 0.72. Based on the BLCM relatively high specificities (95% CI) of 0.991(0.973–1.000), 0.961(0.930–0.991) and 0.916(0.875–0.952) and considerably lower sensitivities with 0.813(0.658–0.938), 0.836(0.712–0.940) and 0.810(0.687–0.920) for TIB MOLBIOL, Da An and BGI respectively were found. Conclusions While all the three RT-PCR assays displayed comparable sensitivities, the specificities of TIB MOLBIOL and Da An were considerably higher than BGI. These results help adjust the apparent prevalence determined by the three RT-PCRs and thus support public health decisions in resource limited settings and consider alternatives as per their prioritization matrix.
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Affiliation(s)
- Abay Sisay
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Adugna Abera
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Boja Dufera
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tujuba Endrias
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abraham Tesfaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Diagnostic Unit, Center for Innovative Drug Development and Therapeutic Trials for Africa, CDT- Africa, Addis Ababa, Ethiopia
| | - Sonja Hartnack
- Section of Epidemiology, University of Zurich, Zurich, Switzerland
| | - Dereje Beyene
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adey Feleke Desta
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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15
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Nega D, Abera A, Gidey B, Mekasha S, Abebe A, Dillu D, Mehari D, Assefa G, Hailu S, Haile M, Etana K, Solomon H, Tesfaye G, Nigatu D, Destaw Z, Tesfaye B, Serda B, Yeshiwondim A, Getachew A, Teka H, Nahusenay H, Abdelmenan S, Reda H, Bekele W, Zewdie A, Tollera G, Assefa A, Tasew G, Woyessa A, Abate E. Baseline malaria prevalence at the targeted pre-elimination districts in Ethiopia. BMC Public Health 2021; 21:1996. [PMID: 34732150 PMCID: PMC8567662 DOI: 10.1186/s12889-021-12036-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 01/28/2021] [Accepted: 10/18/2021] [Indexed: 12/05/2022] Open
Abstract
Background Encouraged by the previous success in malaria control and prevention strategies, the Ethiopian ministry of health launched malaria elimination with a stepwise approach by primarily targeting the low-transmission Districts and their adjacent areas/zones in order to shrink the country’s malaria map progressively. Hence, this community survey was conducted to establish baseline malaria information at the preliminary phase of elimination at targeted settings. Methods A community-based cross-sectional survey was conducted at 20 malaria-elimination targeted Districts selected from five Regional states and one city administration in Ethiopia. The GPS-enabled smartphones programmed with Open Data Kit were used to enumerate 9326 study households and collect data from 29,993 residents. CareStart™ Malaria PAN (pLDH) Rapid Diagnostic Tests (RDTs) were used for blood testing at the field level. Armpit digital thermometers were used to measure axillary temperature. Result Overall malaria prevalence by RDTs was 1.17% (339/28973). The prevalence at District levels ranged from 0.0 to 4.7%. The proportion of symptomatic cases (axillary temperature > 37.5oc) in the survey was 9.2% (2760/29993). Among the 2510 symptomatic individuals tested with RDTs, only 3.35% (84/2510) were malaria positive. The 75.2% (255/339) of all malaria positives were asymptomatic. Of the total asymptomatic malaria cases, 10.2% (26/255) were under-five children and 89.8% (229/255) were above 5 years of age. Conclusion The study shows a decrease in malaria prevalence compared to the reports of previous malaria indicator surveys in the country. The finding can be used as a baseline for measuring the achievement of ongoing malaria elimination efforts. Particularly, the high prevalence of asymptomatic individuals (0.88%) in these transmission settings indicates there may be sustaining hidden transmission. Therefore, active case detection with more sensitive diagnostic techniques is suggested to know more real magnitude of residual malaria in the elimination-targeted areas.
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Affiliation(s)
- Desalegn Nega
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Adugna Abera
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Sindew Mekasha
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abnet Abebe
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dereje Dillu
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Degu Mehari
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Samuel Hailu
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Kebede Etana
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | | | | | - Zelalem Destaw
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Berhane Tesfaye
- Malaria Control and Elimination Partnership in Africa (MACEPA) at PATH, Addis Ababa, Ethiopia
| | - Belendia Serda
- Malaria Control and Elimination Partnership in Africa (MACEPA) at PATH, Addis Ababa, Ethiopia
| | - Asnakew Yeshiwondim
- Malaria Control and Elimination Partnership in Africa (MACEPA) at PATH, Addis Ababa, Ethiopia
| | - Assefaw Getachew
- Malaria Control and Elimination Partnership in Africa (MACEPA) at PATH, Addis Ababa, Ethiopia
| | - Hiwot Teka
- President's Malaria Initiative (PMI), Addis Ababa, Ethiopia
| | | | | | - Hailemariam Reda
- Clinton Health Access Initiative, Inc. (CHAI), Addis Ababa, Ethiopia
| | - Worku Bekele
- World Health Organization (WHO), Addis Ababa, Ethiopia
| | - Ayele Zewdie
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | | | | | - Geremew Tasew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adugna Woyessa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ebba Abate
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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16
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Abdella S, Riou S, Tessema M, Assefa A, Seifu A, Blachman A, Abera A, Moreno N, Irarrazaval F, Tollera G, Browning D, Tasew G. Prevalence of SARS-CoV-2 in urban and rural Ethiopia: Randomized household serosurveys reveal level of spread during the first wave of the pandemic. EClinicalMedicine 2021; 35:100880. [PMID: 34124630 PMCID: PMC8176122 DOI: 10.1016/j.eclinm.2021.100880] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/01/2021] [Accepted: 04/16/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The spread of SARS-CoV-2 in Sub-Saharan Africa is poorly understood and to date has generally been characterised by a lower number of declared cases and deaths as compared to other regions of the world. Paucity of reliable information, with insights largely derived from limited RT-PCR testing in high-risk and urban populations, has been one of the biggest barriers to understanding the course of the pandemic and informed policy-making. Here we estimate seroprevalence of anti-SARS-CoV-2 antibodies in Ethiopia during the first wave of the pandemic. METHODS We undertook a population-based household seroprevalence serosurvey based on 1856 participants in Ethiopia, in the capital city Addis Ababa, and in Jimma, a middle-sized town in the Oromia region, and its rural surroundings (districts of Seka and Mana), between 22 July and 02 September 2020. We tested one random participant per household for anti-SARS-CoV-2 antibodies using a high specificity rapid diagnostic tests (RDTs) and evaluated population seroprevalence using a Bayesian logistic regression model taking into account test performance as well as age and sex of the participants. FINDINGS In total, 2304 random households were visited, with 1856 individuals consenting to participate. This produced a sample of 956 participants in Addis Ababa and 900 participants in Jimma. IgG prevalence was estimated at 1.9% (95% CI 0.4-3.7%), and combined IgM/IgG prevalence at 3.5% (95% CI 1.7-5.4%) for Addis Ababa in early August 2020, with higher prevalence in central sub-cities. Prevalence in Jimma town was lower at 0.5% (95% CI 0-1.8%) for IgG and 1.6% (95%CI 0-4.1%) for IgM/IgG, while in rural Jimma IgG prevalence was 0.2% and IgM/IgG 0.4% in early September. INTERPRETATION More than four months after the first cases were detected in Ethiopia, Addis Ababa displayed a prevalence under 5% and likely as low as 2%, while rural Jimma displayed a prevalence of 0.2%. A 2% seroprevalence figure for the capital translated to a number of cases at least five times larger than those reported for the country as a whole. At the same time, it contrasts with significantly higher seroprevalence figures in large cities in Europe and America only two to three months after the first cases. This population-based seroepidemiological study thus provides evidence of a slower spread of SARS-CoV-2 in the Ethiopian population during the first wave of the pandemic and does not appear to support the notion that lower case numbers were simply a reflection of limited testing and surveillance. FUNDING Schmidt Family Foundation, Joachim Hertz Foundation, Nespresso, Peet's and Smuckers.
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Affiliation(s)
- Saro Abdella
- HIV/TB Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia
| | - Samuel Riou
- Enveritas, 24 Innis Lane, Old Greenwich, CT, USA
| | - Masresha Tessema
- Nutrition and Food Sciences Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia
| | - Ashenafi Assefa
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia
| | - Albab Seifu
- Enveritas, 24 Innis Lane, Old Greenwich, CT, USA
| | | | - Adugna Abera
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia
| | | | | | - Getachew Tollera
- HIV/TB Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia
| | | | - Geremew Tasew
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia
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17
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Gidey B, Nega D, Abera A, Abebe A, Mekasha S, Tasew G, Haile M, Dillu D, Mehari D, Assefa A, Liknew W, G/Tsadik A, Mohammed H, Woldie E, Getachew T, Ararso D, Yenealem D, Kebede A, Etana K, Kedida G, Solomon H, Tollera G, Woyessa A, Abate E. Mentorship on malaria microscopy diagnostic service in Ethiopia: baseline competency of microscopists and performance of health facilities. Malar J 2021; 20:115. [PMID: 33632208 PMCID: PMC7908686 DOI: 10.1186/s12936-021-03655-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/30/2020] [Accepted: 02/17/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In Ethiopia, malaria cases are declining as a result of proven interventions, and in 2017 the country launched a malaria elimination strategy in targeted settings. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop the continuation of transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. This study was carried out to evaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis. METHODS A cross-sectional study was conducted from 1 August to 30 September, 2019 in 9 regional states and one city administration. A standard checklist was used for on-site evaluation, archived patient slides were re-checked and proficiency of microscopists was tested using a WHO-certified set of slides from the national slide bank at the Ethiopian Public Health Institute (EPHI). The strength of agreement, sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS In this study, 102 health facilities (84 health centres and 18 hospitals) were included, from which 202 laboratory professionals participated. In slide re-checking, moderate agreement (agreement (A): 76.0%; Kappa (K): 0.41) was observed between experts and microscopists on malaria detection in all health facilities. The sensitivity and specificity of routine slide reading and the re-checking results were 78.1 and 80.7%, respectively. Likewise, positive predictive value of 65.1% and negative predictive value of 88.8% were scored in the routine diagnosis. By panel testing, a substantial overall agreement (A: 91.8%; K: 0.79) was observed between microscopists and experts in detecting malaria parasites. The sensitivity and specificity in the detection of malaria parasites was 92.7 and 89.1%, respectively. In identifying species, a slight agreement (A: 57%; K: 0.18) was observed between microscopists and experts. CONCLUSION The study found significant false positive and false negative results in routine microscopy on slide re-checking of Plasmodium parasites. Moreover, reduced grade in parasite species identification was reported on the panel tests. Implementing comprehensive malaria microscopy mentorship, in-service training and supportive supervision are key strategies to improve the overall performance of health facilities in malaria microscopy.
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Affiliation(s)
- Bokretsion Gidey
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia.
| | - Desalegn Nega
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Adugna Abera
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Abnet Abebe
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Sindew Mekasha
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Mebrahtom Haile
- Federal Ministry of Health (FMoH), Sudan Street, PO Box 80002, Addis Ababa, Ethiopia
| | - Dereje Dillu
- Federal Ministry of Health (FMoH), Sudan Street, PO Box 80002, Addis Ababa, Ethiopia
| | - Degu Mehari
- Federal Ministry of Health (FMoH), Sudan Street, PO Box 80002, Addis Ababa, Ethiopia
| | - Ashenafi Assefa
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Wondimeneh Liknew
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Abeba G/Tsadik
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Hussien Mohammed
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Ermias Woldie
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Tsegaye Getachew
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Desalegn Ararso
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Dereje Yenealem
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Adisu Kebede
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Kebede Etana
- Federal Ministry of Health (FMoH), Sudan Street, PO Box 80002, Addis Ababa, Ethiopia
| | - Gizachew Kedida
- Ethiopian Medical Laboratory Associations (EMLA), Tewodros Square, PO Box: 4866, Addis Ababa, Ethiopia
| | - Hiwot Solomon
- Federal Ministry of Health (FMoH), Sudan Street, PO Box 80002, Addis Ababa, Ethiopia
| | - Getachew Tollera
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Adugna Woyessa
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
| | - Ebba Abate
- Ethiopian Public Health Institute (EPHI), Patriot Street, Gulele Subcity, PO Box 1242, Addis Ababa, Ethiopia
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Abera A, Belay H, Zewude A, Gidey B, Nega D, Dufera B, Abebe A, Endriyas T, Getachew B, Birhanu H, Difabachew H, Mekonnen B, Legesse H, Bekele F, Mekete K, Seifu S, Sime H, Yemanebrhan N, Tefera M, Amare H, Beyene B, Tsige E, Kebede A, Tasew G, Tollera G, Abate E, Woyessa A, Assefa A. Establishment of COVID-19 testing laboratory in resource-limited settings: challenges and prospects reported from Ethiopia. Glob Health Action 2020; 13:1841963. [PMID: 33200686 PMCID: PMC7671712 DOI: 10.1080/16549716.2020.1841963] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Indexed: 10/31/2022] Open
Abstract
The Coronavirus pandemic is recording unprecedented deaths worldwide. The temporal distribution and burden of the disease varies from setting to setting based on economic status, demography and geographic location. A rapid increase in the number of COVID-19 cases is being reported in Africa as of June 2020. Ethiopia reported the first COVID-19 case on 13 March 2020. Limited molecular laboratory capacity in resource constrained settings is a challenge in the diagnosis of the ever-increasing cases and the overall management of the disease. In this article, the Ethiopian Public Health Institute (EPHI) shares the experience, challenges and prospects in the rapid establishment of one of its COVID-19 testing laboratories from available resources. The first steps in establishing the COVID-19 molecular testing laboratory were i) identifying a suitable space ii) renovating it and iii) mobilizing materials including consumables, mainly from the Malaria and Neglected Tropical Diseases (NTDs) research team at the EPHI. A chain of experimental design was set up with distinct laboratories to standardize the extraction of samples, preparation of the master mix and detection. At the commencement of sample reception and testing, laboratory contamination was among the primary challenges faced. The source of the contamination was identified in the master mix room and resolved. In summary, the established COVID-19 testing lab has tested more than 40,000 samples (August 2020) and is the preferred setting for research and training. The lessons learned may benefit the further establishment of emergency testing laboratories for COVID-19 and/or other epidemic/pandemic diseases in resource-limited settings.
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Affiliation(s)
- Adugna Abera
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Habtamu Belay
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Aboma Zewude
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Bokretsion Gidey
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Desalegn Nega
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Boja Dufera
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Abnet Abebe
- National Laboratories Capacity Building Directorate, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Tujuba Endriyas
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Birhanu Getachew
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Henok Birhanu
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Hailemariam Difabachew
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Bacha Mekonnen
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Helina Legesse
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Firdawek Bekele
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Kalkidan Mekete
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Seble Seifu
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Heven Sime
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Nebiyou Yemanebrhan
- National Laboratories Capacity Building Directorate, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Mesfin Tefera
- National Polio and Measles Laboratory, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Hiwot Amare
- Influenza and Arbovirus Research Laboratory, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Berhane Beyene
- Laboratory Coordinator, WHO Ethiopia Country Office , Addis Ababa, Ethiopia
| | - Estifanos Tsige
- Clinical Bacteriology and Mycology Case Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Adisu Kebede
- National Laboratories Capacity Building Directorate, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Geremew Tasew
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | | | - Ebba Abate
- Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Adugna Woyessa
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
| | - Ashenafi Assefa
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute , Addis Ababa, Ethiopia
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Aychiluhm SB, Gelaye KA, Angaw DA, Dagne GA, Tadesse AW, Abera A, Dillu D. Determinants of malaria among under-five children in Ethiopia: Bayesian multilevel analysis. BMC Public Health 2020; 20:1468. [PMID: 32993550 PMCID: PMC7526346 DOI: 10.1186/s12889-020-09560-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Ethiopia, malaria is one of the public health problems, and it is still among the ten top leading causes of morbidity and mortality among under-five children. However, the studies conducted in the country have been inconclusive and inconsistent. Thus, this study aimed to assess factors associated with malaria among under-five children in Ethiopia. METHODS We retrieved secondary data from the malaria indicator survey data collected from September 30 to December 10, 2015, in Ethiopia. A total of 8301 under-five-year-old children who had microscopy test results were included in the study. Bayesian multilevel logistic regression models were fitted and Markov chain Monte Carlo simulation was used to estimate the model parameters using Gibbs sampling. Adjusted Odd Ratio with 95% credible interval in the multivariable model was used to select variables that have a significant association with malaria. RESULTS In this study, sleeping under the insecticide-treated bed nets during bed time (ITN) [AOR 0.58,95% CI, 0.31-0.97)], having 2 and more ITN for the household [AOR 0.43, (95% CI, 0.17-0.88)], have radio [AOR 0.41, (95% CI, 0.19-0.78)], have television [AOR 0.19, (95% CI, 0.01-0.89)] and altitude [AOR 0.05, (95% CI, 0.01-0.13)] were the predictors of malaria among under-five children. CONCLUSIONS The study revealed that sleeping under ITN, having two and more ITN for the household, altitude, availability of radio, and television were the predictors of malaria among under-five children in Ethiopia. Thus, the government should strengthen the availability and utilization of ITN to halt under-five mortality due to malaria.
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Affiliation(s)
- Setognal Birara Aychiluhm
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Abay Woday Tadesse
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Adugna Abera
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dereje Dillu
- Ethiopian Ministry of Health, Addis Ababa, Ethiopia
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Girma S, Cheaveau J, Mohon AN, Marasinghe D, Legese R, Balasingam N, Abera A, Feleke SM, Golassa L, Pillai DR. Prevalence and Epidemiological Characteristics of Asymptomatic Malaria Based on Ultrasensitive Diagnostics: A Cross-sectional Study. Clin Infect Dis 2020; 69:1003-1010. [PMID: 30475992 DOI: 10.1093/cid/ciy1005] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/22/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND As the global public-health objectives for malaria evolve from malaria control towards malaria elimination, there is increasing interest in the significance of asymptomatic infections and the optimal diagnostic test to identify them. METHOD We conducted a cross-sectional study of asymptomatic individuals (N = 562) to determine the epidemiological characteristics associated with asymptomatic malaria. Participants were tested by rapid diagnostic tests (CareStart, Standard Diagnostics [SD] Bioline, and Alere ultrasensitive RDT [uRDT]), loop-mediated isothermal amplification (LAMP), and quantitative reverse transcription polymerase chain reaction (qRT-PCR) to determine malaria positivity. Hemoglobin values were recorded, and anemia was defined as a binary variable, according to World Health Organization guidelines. RESULTS Compared to reference qRT-PCR, LAMP had the highest sensitivity (92.6%, 95% confidence interval [CI] 86.4-96.5), followed by uRDT Alere Malaria (33.9%, 95% CI 25.5-43.1), CareStart Malaria (14.1%, 95% CI 8.4-21.5), microscopy (5.0%, 95% CI 1.8-10.5), and SD Bioline (5.0%, 95% CI 1.8-10.5). For Plasmodium falciparum specimens only, the sensitivity for uRDT Alere Malaria was 50.0% (95% CI 38.8-61.3) and SD Bioline was 7.3% (95% CI 2.7-15.3). Based on multivariate regression analysis with qRT-PCR as the gold standard, for every 3.2% increase in the prevalence of asymptomatic malaria, hemoglobin decreased by 1 gram per deciliter (prevalence ratio 0.968, 95% CI 0.940-0.997; P = .032). Deletions (4.8%) in hrp2 were noted. CONCLUSIONS While uRDT Alere Malaria has superior sensitivity to rapid diagnostic tests and microscopy in detecting asymptomatic malaria, LAMP is superior still. Ultrasensitive diagnostics provide the accurate prevalence estimates of asymptomatic malaria required for elimination.
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Affiliation(s)
- Seble Girma
- Ethiopian Public Health Institute, Addis Ababa University, Ethiopia.,Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
| | - James Cheaveau
- Clinical Section of Microbiology, Calgary Laboratory Services, Alberta.,Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Alberta
| | - Abu Naser Mohon
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Alberta
| | - Dewdunee Marasinghe
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec
| | - Ruth Legese
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Alberta
| | - Nirujah Balasingam
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Alberta
| | - Adugna Abera
- Ethiopian Public Health Institute, Addis Ababa University, Ethiopia
| | - Sindew M Feleke
- Ethiopian Public Health Institute, Addis Ababa University, Ethiopia
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
| | - Dylan R Pillai
- Clinical Section of Microbiology, Calgary Laboratory Services, Alberta.,Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Alberta.,Department of Pathology and Laboratory Medicine, Alberta, Canada.,Department of Medicine, University of Calgary, Alberta, Canada
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Tasew G, Gadisa E, Abera A, Chanyalew M, Abebe M, Howe R, Ritter U, Aseffa A, Laskay T. Whole blood-based in vitro culture reveals diminished secretion of pro-inflammatory cytokines and chemokines in visceral leishmaniasis. Cytokine 2020; 145:155246. [PMID: 32828639 DOI: 10.1016/j.cyto.2020.155246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/18/2020] [Accepted: 08/08/2020] [Indexed: 11/28/2022]
Abstract
The likelihood of being bitten by sand flies infected with Leishmania (L.) donovani is considered to be high for all inhabitants living in the endemic areas, but only a small ratio of the population develop symptomatic visceral leishmanisis (VL). Since adequate activation of antimicrobial immune response plays a key role in control of pathogens early after infection we hypothesized that a dysfunction of essential cells of the immune system is associated with disease development after infection with L. donovani. In order to obtain insights into the capacity of leukocytes to respond to L. donovani, a whole blood based assay was applied to evaluate the production of cytokines and chemokines in clinical VL versus Ethiopian endemic healthy control (EHC). In response to L. donovani, VL blood cultures showed significantly lower secretion of IL-12p70, IL-6, IL-17, IL-8 and IP-10 compared to EHC. On the contrary, there was a significantly higher secretion of IL-10 observed in VL compared to EHC. In response to LPS also a lower IL-1β, IL-12p70 and IL-6 secretion was observed in VL as compared to EHC. The data clearly indicate a diminished ability of blood leukocytes in VL to respond to L. donovani and to the TLR ligand LPS. This compromised response in VL may contribute to the severe disease development and enhanced susceptibility to secondary infections in VL.
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Affiliation(s)
- Geremew Tasew
- Ethiopian Public Health Institute, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, P.O. Box 1242, Addis Ababa, Ethiopia.
| | - Endalamaw Gadisa
- Armauer Hansen Research Institute, Neglected Tropical Diseases and Malaria Research Team, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Adugna Abera
- Ethiopian Public Health Institute, Bacterial, Parasitic and Zoonotic Diseases Research Directorate, P.O. Box 1242, Addis Ababa, Ethiopia
| | - Menberework Chanyalew
- Armauer Hansen Research Institute, Neglected Tropical Diseases and Malaria Research Team, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Markos Abebe
- Armauer Hansen Research Institute, Neglected Tropical Diseases and Malaria Research Team, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Rawleigh Howe
- Armauer Hansen Research Institute, Neglected Tropical Diseases and Malaria Research Team, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Uwe Ritter
- Regensburg Center for Interventional Immunology (RCI), Institute of Immunology, University Medical Center Regensburg and University of Regensburg, Regensburg, Germany
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Neglected Tropical Diseases and Malaria Research Team, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Tamás Laskay
- Department of Infectious Diseases and Microbiology, University of Lübeck, Ratzeburger Allee 160, D-23560 Lübeck, Germany
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Getahun D, Van Henten S, Abera A, Senkoro M, Owiti P, Lombamo F, Girma B, Ashenefe B, Deressa A, Diro E. Cysts and parasites in an abattoir in Northwest Ethiopia; an urgent call for action on "one health". J Infect Dev Ctries 2020; 14:53S-57S. [PMID: 32614797 DOI: 10.3855/jidc.11713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 10/03/2019] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Zoonotic parasitic infections such as echinococcosis affect cattle, sheep and goats by lowering quality of meat and hides as well as decreasing milk production. The burden of such diseases among humans is usually underestimated as they are difficult to diagnose. We used abattoir data to estimate the prevalence of zoonotic parasitic infections in animals. METHODOLOGY Data from 2005-2018 was used from the registry of an abattoir in Northwest Ethiopia. Frequencies, proportions and trends over time were analyzed. Meat inspection was conducted by visualization, palpation and incision. RESULTS A total of 58,787 animals were slaughtered in the abattoir during the study period. These included 51,956 (88 %) cattle, 5,890 (10%) sheep and 941 (2%) goats. The detected parasites included Echinococcus in 12,334/58,787 (21%) and Fasciola in 10,551/58,787 (18%) animals. Echinococcus infection was highest among goats (267/941, 28%), followed by cattle (11,591/51,956, 22%) and sheep (476/5,890, 8%). Fasciolosis was detected in 9,877/51,956 (19%) cattle and 178/941 (19%) goats. The number of animals slaughtered strongly decreased over time from 8,405 in 2006 to 1,605 in 2018. However, the proportion of parasitic infections remained high with some fluctuations over the study period. CONCLUSIONS Echinococcosis and fasciolosis were very common with one out of five animals slaughtered infected. This is of public health concern and needs urgent multi-sectorial efforts from stakeholders at the national and regional level for control of these diseases. One health program approaches may warrant the control of transmission to humans.
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Affiliation(s)
| | | | - Adugna Abera
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Mbazi Senkoro
- National Institute for Medical Research, Muhimbili Centre, Dar es Salaam, Tanzania.
| | | | - Fantu Lombamo
- Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
| | - Blen Girma
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | | | - Asefa Deressa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Ermias Diro
- Department of Internal Medicine, University of Gondar, Gondar, Ethiopia.
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Nega D, Abebe A, Abera A, Gidey B, G/Tsadik A, Tasew G. Comprehensive competency assessment of malaria microscopists and laboratory diagnostic service capacity in districts stratified for malaria elimination in Ethiopia. PLoS One 2020; 15:e0235151. [PMID: 32584866 PMCID: PMC7316265 DOI: 10.1371/journal.pone.0235151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 06/09/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Federal Ministry of Health (FMoH) Ethiopia achieved significant declines in malaria mortality and incidence and has recently launched malaria elimination in selected low transmission settings. Successful malaria elimination calls for rapid and accurate diagnosis of cases so that the patients can promptly be treated before the occurrence of transmission. Therefore, this study assessed the competency of malaria microscopists using panal slides, and laboratory service availability and readiness in terms of supplies and equipments in malaria elimination targeted districts in Ethiopia. METHOD A cross-sectional study was conducted from February to June 2018 in all hospitals, health centers and private clinics in 20 malaria elimination targeted districts, selected out of the 6 regional states in Ethiopia. All malaria microscopists available in the study health facilities during the study period were included in the study. Questionnaires were used for interviewing sociodemography of personnel and laboratory supplies. Per World Health Organization (WHO) criteria set for proficiency testing, 10 Giemsa stained malaria slide panels (8 positive low/high density pf/pv/Mixed and 2 negative slides) were administered to each study participant for performance assessment on malaria parasite detection, species identification and parasite count using light microscopy. The slide panels are PCR confirmed and WHO approved ones, which have been stored in the slide banks at the national reference laboratory in Ethiopian Public Health Institute. RESULT In this assessment, 17(16%) district hospitals, 71(67%) health centers (HCs) and 18(17%) private clinics (PCs) were included. Of the 18 PCs, only 10(55.6%) had license certificate. Of the study facilities, 91.5%(97) use light microscopy, 2.83%(3) use RDTs and 2.9%(3) use both microscopy and RDT to detect malaria. Accessible and appropriate storage of Giemsa was reported by 58.8%(10) hospitals, 81.7%(58) HCs & 72.2%(13) private clinics. Of the 1896 malaria positive & 474 negative slides administered to 237 study participants, 318(16.8%) slides reported falsely negative & 47(9.9%) reported falsely positive. The participants achieved "good" grade [Agreement(A): 84.6%, Kappa(K): 0.6] on parasite detection and "poor" agreement (A: 43.8%; K: 0.11) on every species identification. No or slight agreement seen on differentiation of P. falciparum from other species (A: 28.41%; K:0.29). Above 95%(201) of participants, did not count or used plus system of parasite estimation which is the least accurate and unreccomended method per WHO guideline. CONCLUSION In the current study, low performance of malaria microscopists particularly in species identification & poor to moderate capacity of laboratories observed. This is really a great obstacle to malaria elimination strategy of the country. Therefore, national malaria control and elimination program in collaboration with partners is supposed to provide comprehensive training for professionals giving laboratory service and to fulfill laboratory supplies to have the gold standard service.
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Affiliation(s)
- Desalegn Nega
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- * E-mail: (AA); (DN)
| | - Abnet Abebe
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- * E-mail: (AA); (DN)
| | - Adugna Abera
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Abeba G/Tsadik
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Gizaw N, Abera A, Sisay S, Desta K, Kreibich S, Gerwing-Adima L, Gebre-Selassie S. The yield of Auramine O staining using led microscopy with bleach treated sputum samples for detection of pulmonary tuberculosis at St. Peter tuberculosis specialized hospital, Addis Ababa, Ethiopia. J Clin Tuberc Other Mycobact Dis 2020; 18:100140. [PMID: 31909226 PMCID: PMC6939099 DOI: 10.1016/j.jctube.2019.100140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Smear microscopy is the mainstay for diagnosis of Tuberculosis (TB) in Ethiopia. This technique; however, is insensitive to detect Mycobacteria from most clinical specimens. Currently, light emitting diode (LED) fluorescence microscope is advocated to be used in high Tuberculosis (TB) burden settings by World Health Organization (WHO). However, the utility of this method is not evaluated for bleach treated sputum samples in Ethiopia. Objective The objective of the study is to evaluate the diagnostic importance of Auramine O (AO) staining in direct and concentrated sputum against conventional Zehil-Neelsen (ZN) and culture from the sputum samples of suspected pulmonary tuberculosis patients. Methods A cross-sectional study was conducted on 346 adult new pulmonary TB suspected patients at St. Peter's Specialized Hospital, Addis Ababa, Ethiopia. Three sputum samples (spot-morning-spot) were collected in sterile cups for direct Zehil-Neelsen and AO staining. Morning sputum samples were used for Mycobacterial culture on Mycobacterial Growth Indicator Tube (MGIT) 960. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were evaluated against the gold standard culture method. Data were analyzed using STATA version 13.0. All statistical tests were considered as statistically significant if the two sided P-value was < 0.05. Results Bleach treated sputum samples with AO staining yielded more cases as compared to direct ZN and direct AO by 6.3% and 11.5%, respectively. The sensitivity of concentrated AO and direct AO were remarkably high as compared to conventional ZN (71.8% vs. 44.5% and 62.7% vs. 44.5%). The concentrated sputum with staining of AO had a high rate (18.6%) of detecting scanty graded smears as compared to conventional ZN method. Conclusions Our findings indicated that the concentrated sputum with AO staining yielded high rate of sensitivity (71.8%) as compared to the conventional ZN method (44.5%). Moreover, the concentrated sputum with AO staining had superior ability in detecting scanty graded smears compared to the conventional ZN method. Therefore, it is recommended to utilize AO staining with LED microscopy for better diagnosis of Acid Fast Bacilli (AFB) from TB suspected cases and patients with pauci-bacillary TB in Ethiopia.
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Affiliation(s)
- Nebiyu Gizaw
- Department of Medical Microbiology, Immunology and Parasitology, College of Health Science, Addis Ababa University, Ethiopia
| | - Adugna Abera
- Ethiopian Public Health Institute, P.O. BoX 1242, Addis Ababa, Ethiopia
| | - Solomon Sisay
- Division of Medical, GLRA-Ethiopia, P.O. Box 5036, Addis Ababa, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, Ethiopia
| | - Saskia Kreibich
- Medical and Social Projects Department, DAHW, Wurzburg, Germany
| | | | - Solomon Gebre-Selassie
- Department of Medical Microbiology, Immunology and Parasitology, College of Health Science, Addis Ababa University, Ethiopia
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Berhanu A, Abera A, Nega D, Mekasha S, Fentaw S, Assefa A, Gebrewolde G, Wuletaw Y, Assefa A, Dugassa S, Tekie H, Tasew G. Isolation and identification of microflora from the midgut and salivary glands of Anopheles species in malaria endemic areas of Ethiopia. BMC Microbiol 2019; 19:85. [PMID: 31035931 PMCID: PMC6489185 DOI: 10.1186/s12866-019-1456-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 07/04/2018] [Accepted: 04/11/2019] [Indexed: 11/22/2022] Open
Abstract
Background Anopheles mosquitoes are of great importance to human health. A number of studies have shown that midgut and salivary gland microflora have an impact on malaria parasite burden through colonization mechanisms, involving either direct Plasmodium microbiota interaction or bacterial-mediated induction of mosquito immune response. The objective of this study was to isolate and identify the microflora from the midgut and salivary glands of Anopheles species. Methods A total of 20 pools (ten per pool) from insectary-reared and 56 pools (five per pool) of field-collected Anopheles mosquitoes were anesthetized by chloroform and dissected. 70% of ethanol was used for surface sterilization of mosquitoes and laboratory equipment, followed by rinsing Anopheles mosquitoes four times with 1X PBS. Each pool of dissected midgut and salivary gland sample was transferred in 1X PBS and squashed, incubated in the water bath and enriched in tryptic soya broth for 24 h at 35 ± 2 °C. As a control, the PBS solutions used to rinse the mosquitoes were also incubated in tryptic soya broth in the same conditions as the sample. After enrichment, a loopful of each sample was taken and inoculated on Blood, Chocolate, MacConkey, and Sabouraud Dextrose agar. Finally, the microbiota was isolated by colony characteristics, biochemical tests, and automated VITEK 2 Compact Analyzer. Results From all field and laboratory mosquitoes, Pseudomonas was found to be the dominant microbiota identified from all species of Anopheles mosquitoes. Acinetobacter and Klebsiellapneumonia and other families of gram-positive and gram-negative bacteria were identified. Conclusions A number of bacteria were isolated and identified. This is the first report on isolation and identification of microbiota from midgut and salivary glands of Anopheles species in Ethiopia. It can be used as a baseline for studying the relationship between microbiota and mosquitoes, and for the development of a new malaria biological control.
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Affiliation(s)
- Abib Berhanu
- Insect Science Stream, Department of Zoological Sciences, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adugna Abera
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, P.O. Box: 1242, Addis Ababa, Ethiopia.
| | - Desalegn Nega
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, P.O. Box: 1242, Addis Ababa, Ethiopia
| | - Sindew Mekasha
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, P.O. Box: 1242, Addis Ababa, Ethiopia
| | - Surafel Fentaw
- Clinical Bacteriology and Mycology Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abebe Assefa
- Clinical Bacteriology and Mycology Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Gashaw Gebrewolde
- Vaccine and Diagnostic Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yonas Wuletaw
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, P.O. Box: 1242, Addis Ababa, Ethiopia
| | - Ashenafi Assefa
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, P.O. Box: 1242, Addis Ababa, Ethiopia
| | - Sisay Dugassa
- Vector Biology and Control Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa, Ethiopia
| | - Habte Tekie
- Insect Science Stream, Department of Zoological Sciences, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, P.O. Box: 1242, Addis Ababa, Ethiopia
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Aberra L, Abera A, Belay T, Kebede A, Gadisa E, Tasew G. Evaluation of microcapillary culture method for the isolation of Leishmania aethiopica parasites from patients with cutaneous lesions in Ethiopia. Diagn Progn Res 2019; 3:4. [PMID: 31093574 PMCID: PMC6460804 DOI: 10.1186/s41512-019-0051-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 01/30/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND In addition to direct slide microscopy, traditional culture method (TCM) has long been considered as a gold standard method for the diagnosis of cutaneous leishmaniasis (CL). However, TCM is relatively expensive and time-consuming compared to the newly introduced microculture method (MCM), which has shown to be sensitive and rapid diagnostic method elsewhere for different Leishmania parasite species other than Leishmania (L.) aethiopica. The objective of this study was to evaluate the diagnostic performance of MCM for the diagnosis of CL caused by L. aethiopica. METHODS One hundred forty-three lesion aspirates were collected from 124 suspected CL patients prospectively based on their consecutive series. Portion of the aspirates were cultured in duplicate in TCM with modified Novy-MacNeal-Nicolle (NNN) in tissue culture flask and microcapillary tubes containing RPMI 1640 with 10% fetal bovine serum (FBS) for MCM. Smears on glass slides from the remaining portion of the aspirate were used for direct microscopy to detect the parasite after stained with Giemsa staining solution. Up on a consensus, positive result in any two of the three tests was used as a reference standard to analyze sensitivity. RESULTS As per consensus standard criteria, 52 of the lesions were qualified to evaluate MCM versus TCM. Forty-eight lesion samples were positive by MCM, 36 by TCM, and 37 by smear microscopy. The representative DNA from parasite culture isolates revealed the causative Leishmania parasite was L. aethiopica by ITS1 polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Culturing L. aethiopica in vitro by MCM is more sensitive (92.3%) than by TCM (69.2%), P = 0.003. The median time for L. aethiopica promastigotes emergence in the culture was 3 days for MCM and 6 days for TCM, P < 0.001. CONCLUSIONS Our finding indicated that MCM is a sensitive and a rapid culturing method for the isolation of L. aethiopica than TCM and smear microscopy.
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Affiliation(s)
- Lensa Aberra
- Armauer Hansen Research Institute, Malaria and Neglected Tropical Diseases Research Directorate, P. O. Box 1005, Addis Ababa, Ethiopia
| | - Adugna Abera
- Ethiopia Public Health Institute, Malaria and Neglected Tropical Diseases Research Team, P. O. Box 1242, Addis Ababa, Ethiopia
| | - Tariku Belay
- College of Public and Medical Health, Department of Medical Laboratory and Pathology, Jimma University, P. O. Box 378, Jimma, Ethiopia
| | - Amha Kebede
- Ethiopia Public Health Institute, Malaria and Neglected Tropical Diseases Research Team, P. O. Box 1242, Addis Ababa, Ethiopia
| | - Endalamaw Gadisa
- Armauer Hansen Research Institute, Malaria and Neglected Tropical Diseases Research Directorate, P. O. Box 1005, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Ethiopia Public Health Institute, Malaria and Neglected Tropical Diseases Research Team, P. O. Box 1242, Addis Ababa, Ethiopia
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Sisay S, Mekonen A, Abera A, Berhan Y, Kebede T, Ferede A. An evaluation of collaboration in the TB and HIV control programme in Oromia Region, Ethiopia: Seven years of retrospective data. Int J Infect Dis 2018; 77:74-81. [PMID: 30336266 DOI: 10.1016/j.ijid.2018.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/30/2018] [Accepted: 10/02/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Globally, HIV and tuberculosis (TB) are a leading cause of death if they occur as co-morbidities in affected individuals. The aim of this study was to evaluate the collaboration between TB and HIV control activities by determining the co-morbidity rate in Oromia Region, Ethiopia, during the period 2009-2015. METHODS A retrospective health facility-based study was conducted. Data were collected from health facilities implementing the directly observed treatment short-course (DOTS) strategy in the region. A structured World Health Organization (WHO) reporting format was used as the data collection tool. Pre-antiretroviral therapy (ART)/voluntary counselling and testing for HIV (VCT) and TB unit registers were considered as the data sources. Data were collected quarterly and analyzed using IBM SPSS Statistics version 20. The odds ratio was used to assess statistical differences among variables. RESULTS A total of 115268 TB patients were counselled and tested for HIV during the study period. Among the patients tested, 60086 (52.1%) were male, of whom 13680 (11.8%) were found to have an HIV infection. Among TB patients who were co-infected with HIV, there were slightly higher odds of HIV infection in females than in males (odds ratio 1.13, 95% confidence interval 1.09-1.17). Between 2009 and 2013, about 56% of TB and HIV co-morbid patients were put on co-trimoxazole preventive therapy (CPT) and 35% on ART. HIV infection occurred predominantly within the age group of 25-34 years (31%). On the other hand, 197152 HIV-infected patients were screened for TB symptoms and 8.4% were found to have active TB. The odds of having TB among males who were initially infected with HIV were higher as compared to females (odds ratio 1.31, 95% confidence interval 1.27-1.37). CONCLUSIONS The prevalence of TB and HIV co-morbidity was 11.8% at TB clinics in the region. Low proportions of co-infected patients were put on CPT and ART. Therefore, it is essential to strengthen the WHO recommended TB and HIV collaborative activities in the region to reduce the burden of co-morbidity and mortality.
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Affiliation(s)
- Solomon Sisay
- Department of Clinical, Johns Hopkins University - TSEHAI Project, PO Box 5606, Addis Ababa, Ethiopia.
| | - Ayehu Mekonen
- Management Science for Health, Addis Ababa, Ethiopia.
| | - Adugna Abera
- Leishmaniasis Research Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Yifru Berhan
- Federal Ministry of Health, Addis Ababa, Ethiopia.
| | - Tadele Kebede
- Department of Medical, GLRA-Ethiopia, Addis Ababa, Ethiopia.
| | - Abebe Ferede
- Arsi University, College of Health Science, Department of Public Health, Asella, Ethiopia.
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Tafess K, Beyen TK, Abera A, Tasew G, Mekit S, Sisay S, Tadesse L, Siu GKH. Treatment Outcomes of Tuberculosis at Asella Teaching Hospital, Ethiopia: Ten Years' Retrospective Aggregated Data. Front Med (Lausanne) 2018; 5:38. [PMID: 29516002 PMCID: PMC5826330 DOI: 10.3389/fmed.2018.00038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/31/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Directly Observed Treatment Short-course (DOTS) has been one of the major strategies to combat the epidemic of tuberculosis (TB) globally. This study aimed to evaluate TB treatment outcomes between September 2004 and July 2014 under the DOTS program at one of the largest public hospitals in Ethiopia. METHODS A retrospective data of TB patients registered at Asella Teaching Hospital between September 2004 and July 2014 were obtained from hospital registry. Treatment outcomes and types of TB cases were categorized according to the national TB control program guideline. Binomial and multinomial logistic regression models were used to analyze the association between treatment outcomes and potential predictor variables. RESULTS A total of 1,755 TB patients' records were included in the study. Of these, 945 (53.8%) were male, 480 (27.4%) smear-positive TB, 287 (16.4%) HIV positive, and 1,549 (88.3%) new cases. Among 480 smear-positive pulmonary TB cases, 377 (78.5%) patients were cured, 21 (4.40) completed the treatment, 35 (7.3%) transferred out, 19 (4.0%) died, 24 (5.0%) defaulted, and 4 (0.8%) failure. Overall, 398 (82.9%) smear-positive pulmonary TB patients were successfully treated. For smear-negative TB (n = 641) and extrapulmonary TB cases (n = 634), 1,036 (81.3%) completed the treatment and demonstrated favorable response. Taking all TB types into account, 1,434 (81.7%) were considered as successfully treated. In the multivariate binary logistic model, patients in older age group (AOR = 0.386, 95% CI: 0.250-0.596) and retreatment cases (AOR = 0.422, 95% CI: 0.226-0.790) were less likely to be successfully treated compared to younger and new cases, respectively. In multinomial logistic regression, age increment by 1 year increased the risk of death and default of TB patients by 0.05 (adjusted β = 0.05; 95% CI: 0.03, 0.06) and 0.02 (adjusted β = 0.02; 95% CI: 0.01, 0.04). The odds of TB patients who died during treatment were higher among HIV-infected TB patients (adjusted β = 2.65; 95% CI: 1.28, 5.50). CONCLUSION The treatment success rate of TB patients was low as compared to the national target. TB control needs to be strengthened for the enhancement of treatment outcome.
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Affiliation(s)
- Ketema Tafess
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
- Department of Medical Laboratory, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Teresa Kisi Beyen
- Department of Public Health, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Adugna Abera
- Leishmaniasis Research Laboratory, Ethiopia Public Health Institute, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Leishmaniasis Research Laboratory, Ethiopia Public Health Institute, Addis Ababa, Ethiopia
| | - Shimelis Mekit
- Department of Pharmacy, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Solomon Sisay
- Department of Medical, GLRA-Ethiopia, Addis Ababa, Ethiopia
| | - Legesse Tadesse
- Department of Public Health, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Gilman K. H. Siu
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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Bsrat A, Berhe M, Gadissa E, Taddele H, Tekle Y, Hagos Y, Abera A, G/micael M, Alemayhu T, Gugsa G, Aseffa A. Serological investigation of visceral Leishmania infection in human and its associated risk factors in Welkait District, Western Tigray, Ethiopia. Parasite Epidemiol Control 2018; 3:13-20. [PMID: 29774295 PMCID: PMC5952676 DOI: 10.1016/j.parepi.2017.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 09/15/2017] [Revised: 10/31/2017] [Accepted: 10/31/2017] [Indexed: 12/02/2022] Open
Abstract
Visceral leishmaniasis (VL) is major neglected public health problem in terms of geographical spread and incidence in Ethiopia. Magnitude, public health impact and dynamics of VL were not well studied in Welkait District, Western Tigray, though the area is known for VL. Hence, this study aimed to determine sero-prevalence of human VL and associated risk factors in Welkait as new foci. A cross sectional study design was employed in this study. Two stage stratified random sampling method was used to select study participants. Hence, a total of 329 human study participants were included for serological survey using ITleish and leishmanin skin tests. Semi structured questionnaire was also used to identify VL associated risk factors. Univariate and multivariate logistic regression statistical methods were used to determine the degree of association. The overall sero-prevalence of human VL in the study area was found to be 8.81%. Statistical significant difference in the prevalence of the disease was found among Sub-districts, sex, re-settlement, sleeping outdoor and dog ownership (P < 0.05). Participants who resettled from their original place were found 2 times (AOR = 2.143; 95% CI = 1.02, 14.20) more vulnerable to VL infection. Those who had an experience of sleeping outdoor were found almost 4 times (AOR = 4.29; 95% CI = 1.58, 11.69) more likely to be at risk of acquiring VL infection than those sleep indoor. Furthermore, individuals who owned dogs were 3 times more prone to the VL infection than their counterparts (AOR = 3.37; 95% CI = 1.29, 8.76). Alarming sero-positivity of human VL was recorded from new foci. Hence, it is recommended to improve the VL health services in the study area. The investigation also invites further study on VL dynamics in the study area.
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Affiliation(s)
- Abrha Bsrat
- Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia
| | - Mebrahtu Berhe
- Veterinary Drug and Feed Administration and Control Authority, Tigray, Ethiopia
| | | | - Habtamu Taddele
- Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia
| | - Yohannes Tekle
- Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia
| | - Yohannes Hagos
- Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia
| | - Adugna Abera
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Messele G/micael
- Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia
| | - Tehetna Alemayhu
- Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia
| | - Getachew Gugsa
- Wollo University College of Veterinary Medicine, Dessie, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
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Berhe M, Bsrat A, Taddele H, Gadissa E, Hagos Y, Tekle Y, Abera A. Knowledge Attitude and Practice towards Visceral Leishmaniasis among Residents and Health Professionals in Welkait District, Western Tigray, Ethiopia. ACTA ACUST UNITED AC 2018. [DOI: 10.4172/2329-891x.1000257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Gadisa E, Tasew G, Abera A, Gelaye W, Chanyalew M, Abebe M, Laskay T, Aseffa A. Serological signatures of clinical cure following successful treatment with sodium stibogluconate in Ethiopian visceral leishmaniasis. Cytokine 2016; 91:6-9. [PMID: 27940090 DOI: 10.1016/j.cyto.2016.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 11/15/2016] [Accepted: 11/29/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND In Ethiopia, visceral leishmaniasis (VL) is a growing public health threat. Among the key challenges in VL control in Ethiopia is lack of an effective test of cure. The recommended test of cure is parasite detection. As sterile cure is not expected with the current widely used drugs, the value of parasite detection as test of cure is questionable. Moreover, the sampling is invasive, requires a well-equipped facility and highly skilled personnel, which are all hardly found in endemic set-ups. OBJECTIVE Our aim was to assess the value of sCD40L, MMP9 and IL-10 serum levels as signature biomarkers of clinical cure in VL cases from Ethiopia. METHODS A total of 45 VL cases before and after treatment and 30 endemic healthy controls were included in the study. Sandwich ELISA was used to measure serum levels of sCD40L, MMP9 and IL-10. RESULT The mean sCD40L, MMP9 and IL-10 serum levels changed significantly at clinical cure. At individual case level sCD40L and MMP9 showed an increasing trend. Yet, the degree of increase in serum level of MMP9 seems to be affected by nutritional status of the individual VL case. The mean IL-10 serum level was significantly reduced at clinical cure. As seen on case by case basis, all demonstrated a declining trend except that two VL cases had a high IL10 level at clinical cure. CONCLUSION Our result is suggestive of the possibility of developing a signature biomarker to monitor VL treatment in Ethiopia using one or a combination of parameters.
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Affiliation(s)
| | - Geremew Tasew
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia; Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Adugna Abera
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
| | - Woyneshet Gelaye
- Amhara Regional State Referral and Research Laboratory, Bahir Dar, Ethiopia.
| | | | - Markos Abebe
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
| | | | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
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Abera A, Tasew G, Tsegaw T, Kejella A, Mulugeta A, Worku D, Aseffa A, Gadisa E. Visceral Leishmaniasis in Benishangul-Gumuz Regional State, Western Ethiopia: Reemerging or Emerging? Am J Trop Med Hyg 2016; 95:104-8. [PMID: 27139445 DOI: 10.4269/ajtmh.15-0738] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 02/19/2016] [Indexed: 11/07/2022] Open
Abstract
Kala-azar is a growing public health problem in Ethiopia. Benishangul-Gumuz regional state was previously not known to be endemic for the disease. In response to a case report from the region, we conducted a rapid assessment survey. A pretested questionnaire was used to capture sociodemographic and clinical histories pertinent to kala-azar. Study participants with complaints of fever and headache for 2 weeks or more were tested for kala-azar and malaria. All participants were screened with the leishmanin skin test and the direct agglutination test for exposure to Leishmania, defined as a positive result with either or both tests. Of 275 participants, 20 were exposed giving an overall leishmaniasis seroprevalence rate of 7.3%. Among the 20 positive individuals, 19 were farmers and nine of them reported no travel history outside their district. It appears that kala-azar is emerging in Dangur and Guba districts of Benishangul-Gumuz regional state, probably in connection with human encroachment into one or several previously out-of-reach zoonotic foci. We recommend integrated epidemiological surveys for confirmation and early containment of disease transmission in the area.
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Affiliation(s)
- Adugna Abera
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia. Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Teshome Tsegaw
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Asfaw Kejella
- Benishangul-Gumuz Regional Health Bureau, Assosa, Ethiopia
| | - Abate Mulugeta
- Disease Prevention and Control Programs, World Health Organization, Ethiopia Country Office, Addis Ababa, Ethiopia
| | - Dagimlidet Worku
- KalaCORE Consortium, Ethiopia Country Office, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
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Tasew G, Gadisa E, Abera A, Zewude A, Chanyalew M, Aseffa A, Abebe M, Ritter U, van Zandbergen G, Laskay T, Tafess K. In vitro permissiveness of bovine neutrophils and monocyte derived macrophages to Leishmania donovani of Ethiopian isolate. Parasit Vectors 2016; 9:218. [PMID: 27090082 PMCID: PMC4836163 DOI: 10.1186/s13071-016-1441-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 09/02/2015] [Accepted: 03/09/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Epidemiological studies in Ethiopia have documented that the risk of visceral leishmaniasis (VL, Kala-azar) is higher among people living with domestic animals. The recent report on isolation of Leishmania donovani complex DNA and the detected high prevalence of anti-leishmanial antibodies in the blood of domestic animals further strengthen the potential role of domestic animals in the epidemiology of VL in Ethiopia. In mammalian hosts polymorphonuclear cells (PMN) and macrophages are the key immune cells influencing susceptibility or control of Leishmania infection. Thus to substantiate the possible role of cattle in VL transmission we investigate the permissiveness of bovine PMN and monocyte derived macrophages (MDM) for Leishmania (L.) donovani infection. METHODS Whole blood was collected from pure Zebu (Boss indicus) and their cross with Holstein Friesian cattle. L. donovani (MHOM/ET/67/HU3) wild and episomal green fluorescent protein (eGFP) labelled stationary stage promastigotes were co-incubated with whole blood and MDM to determine infection of these cells. Engulfment of promastigotes by the cells and their transformation to amastigote forms in MDM was studied with direct microscopy. Microscopy and flow cytometry were used to measure the infection rate while PCR-RLFP was used to confirm the infecting parasite. RESULTS L. donovani infected bovine whole blood PMN in the presence of plasma factors and all cellular elements. Morphological examinations of stained cytospin smears revealed that PMN engulfed promastigotes. Similarly, we were able to show that bovine MDM can be infected by L. donovani, which transformed to amastigote forms in the cells. CONCLUSIONS The in vitro infection of bovine PMN and MDM by L. donovani further strengthens the possibility that cattle might serve as source of L. donovani infection for humans.
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Affiliation(s)
- Geremew Tasew
- />Ethiopia Public Health Institute, Leishmaniasis Research Laboratory, P.O. Box 1242, Addis Ababa, Ethiopia
- />Armauer Hansen Research Institute, Leishmaniasis Research Laboratory, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Endalamaw Gadisa
- />Armauer Hansen Research Institute, Leishmaniasis Research Laboratory, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Adugna Abera
- />Armauer Hansen Research Institute, Leishmaniasis Research Laboratory, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Aboma Zewude
- />Armauer Hansen Research Institute, Leishmaniasis Research Laboratory, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Menberework Chanyalew
- />Armauer Hansen Research Institute, Leishmaniasis Research Laboratory, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- />Armauer Hansen Research Institute, Leishmaniasis Research Laboratory, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Markos Abebe
- />Armauer Hansen Research Institute, Leishmaniasis Research Laboratory, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Uwe Ritter
- />Department of Immunology, University of Regensburg, Franz-Josef-Strauß-Allee 11, D-93042 Regensburg, Germany
| | - Ger van Zandbergen
- />Paul-Ehrlich-Institute, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - Tamás Laskay
- />Institute for Medical Microbiology and Hygiene, University of Lübeck, Ratzeburger Allee 160, D-23560 Lübeck, Germany
| | - Ketema Tafess
- />Department of Medical Laboratory Science, College of Health Sciences, Arsi University, P.O. Box 193, Asella, Ethiopia
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Abera A, Tasew G, Degu A, Almneh M, Mulugeta A, Aseffa A, Gadisa E. VISCERAL LEISHMANIASIS FROM AN AREA PREVIOUSLY NOT KNOWN TO BE ENDEMIC; DANGUR, BENSHANGUL-GUMUZ, REGIONAL STATE, NORTHWEST ETHIOPIA: A CASE REPORT. Ethiop Med J 2016; 54:33-36. [PMID: 27191028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Visceral leishmaniasis (VL) is a ftial and growing public health problem in Ethiopia. VL is recently reported outside the major endemic foci, the lowlands in the northwest and the Omo and Abaroba-plain, Segen and Woito valleys in the southwest. Here, we report a visceral leishmaniasis case from Benishangul-Gumuz Regional state near the Guba area. The patient had no history of travel to known VL endemic areas. The patient is a temporary farm laborer from West Go'jam Zone, Wanbermna District in Amhara Regional State. While in Benishangul-Gumuz, the patient was diagnosed with prolonged and intermittentfever, epistaxis, splenomegaly, skin pallor, diarrhea, cough and oedema. Laboratory diagnosis results showed that he had marked leucopenia, thrombocytopenia and anemia. The patient was suspected of having VL and checked with rK39 immunochromnatography and direct agglutination tests which were positive for anti leishmanial antibodies. After getting full dose of sodium stibogluconate as per the national visceral leishmaniasis treatment guideline, was clinically cured. As the area in Benshangul-Gumuz where this patient contracted visceral leishmaniasis is under social and ecological transformation with large scale projects attracting huge influx of temporary laborers and settlers, due attention is needed with respect to introduction or emergence of VL transmission.
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Gadisa E, Tsegaw T, Abera A, Elnaiem DE, den Boer M, Aseffa A, Jorge A. Eco-epidemiology of visceral leishmaniasis in Ethiopia. Parasit Vectors 2015; 8:381. [PMID: 26187584 PMCID: PMC4506599 DOI: 10.1186/s13071-015-0987-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 07/05/2015] [Indexed: 12/25/2022] Open
Abstract
Visceral leishmaniasis (VL, Kala-azar) is one of the growing public health challenges in Ethiopia with over 3.2 million people at risk and estimated up to 4000 new cases per year. Historically, VL was known as the diseases of the lowlanders; in the lower and upper Kola agro-ecological zones of Ethiopia. The 2005–07 out breaks in highlands of Libo Kemkem and Fogera, in the Woina Degas, that affected thousands and claimed the life of hundreds misdiagnosed as drug resistance malaria marked that VL is no more the problem of the lowlanders. The Kola (lower and upper) and the Woina Dega are the most productive agroecological zones, supporting both the ongoing and planned expansions of large or small scale agriculture and/or agriculture based industries. Thus, the (re)emergence of VL is not only a public health and social problem but also have a direct implication on the country’s economy and further development. Thus is high time for its control and/or elimination. Yet, the available data seem incomplete to plan for a cost-effective and efficient VL control strategy: there is a need to update data on vector behaviour in specific ecosystems and the roles of domestic animals need to be ascertained. The effectiveness and social acceptability of available vector control tools need be evaluated. There is a need for identifying animal reservoir(s), or establish the absence of zoonosis in Ethiopia. The planning of prevention of (re)emergence and spread of VL to areas adjacent to endemic foci need be supported with information from spatio-temporal mapping. In affected communities, available data showed that their knowledge about VL is generally very low. Thus, well designed studies to identify risk factors, as well as better tools for social mobilization with the understanding of their knowledge, aptitude and practice towards VL are necessary.
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Affiliation(s)
| | - Teshome Tsegaw
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Adugna Abera
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Dia-Eldin Elnaiem
- Department of Natural Sciences, University of Maryland Eastern Shore (for KalaCORE consortium), 1Backbone Rd, Princess Anne, MD, 21853, USA
| | | | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Alvar Jorge
- Visceral Leishmaniasis Program, Drugs for Neglected Diseases Initiative (DNDi), Addis Ababa, Ethiopia
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Bsrat A, Berhe N, Balkew M, Yohannes M, Teklu T, Gadisa E, Medhin G, Abera A. Epidemiological study of cutaneous leishmaniasis in Saesie Tsaeda-emba district, eastern Tigray, northern Ethiopia. Parasit Vectors 2015; 8:149. [PMID: 25889827 PMCID: PMC4359476 DOI: 10.1186/s13071-015-0758-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 02/20/2015] [Indexed: 11/10/2022] Open
Abstract
Background Cutaneous leishmaniasis (CL) is one of the endemic and neglected diseases known to exist in Ethiopian highlands. However, little is known about its epidemiological characteristics. Hence, this study was initiated and conducted from November 2011 to April 2012 to assess the epidemiological situation of CL in Saesie Tsaeda-emba District. Methods A cross sectional design was employed in six randomly selected Peasant associations and a house to house survey was carried out in the District. Detailed clinical assessment, and smear and culture for Leishmania parasite detection were done to confirm clinical suspension. Polymerase Chain Reaction and Restriction Fragment Length Polymorphism (PCR-RFLP) analysis of the ribosomal DNA Internal Transcribed Spacer (ITS-1) sequences was used to type isolates. Sandfly collection was also conducted in possible micro-habitats of the target areas. Results The overall prevalence of CL in the District was 14.0% (6.7% for active lesion and 7.3% for scar) with the highest prevalence amongst the age group of 10–19 years. Field isolates typed were L. aethiopica. Environmental and host risk factors significantly associated with CL distribution were age, study Peasant associations, presence of cave/gorge, walls with cracks and/or holes, presence of hyrax, animal burrow, animal dung and farm land near to residents’ houses. Five phlebotomine sandflies, Phlebotomus longipes, Sergentomyia bedfordi, S.africana, S.schwetzi and S.antenata were captured. Conclusion All the precipitating factors in the area are indicative of the public health importance of CL although there has been little attention given. The present study is a starter for wider investigation into the mode of its transmission, incrimination of sandfly vectors and possible animal reservoirs. Detailed information will be the basis to launch effective control of CL in the area. Electronic supplementary material The online version of this article (doi:10.1186/s13071-015-0758-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abrha Bsrat
- College of Veterinary Medicine, Mekelle University, P O Box 231, Mekelle, Ethiopia.
| | - Nega Berhe
- Aklilu Lemma Institution of Pathobiology, Addis Ababa University College of Health Sciences, P O Box 1176, Addis Ababa, Ethiopia.
| | - Meshesha Balkew
- Aklilu Lemma Institution of Pathobiology, Addis Ababa University College of Health Sciences, P O Box 1176, Addis Ababa, Ethiopia.
| | - Mekonnen Yohannes
- Mekelle University College of Health Sciences, P O Box 231, Mekelle, Ethiopia.
| | - Tsigemariam Teklu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia. .,Tigray Regional Health Bureau, Mekelle, Ethiopia.
| | | | - Girmay Medhin
- Aklilu Lemma Institution of Pathobiology, Addis Ababa University College of Health Sciences, P O Box 1176, Addis Ababa, Ethiopia.
| | - Adugna Abera
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
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Seid A, Gadisa E, Tsegaw T, Abera A, Teshome A, Mulugeta A, Herrero M, Argaw D, Jorge A, Kebede A, Aseffa A. Risk map for cutaneous leishmaniasis in Ethiopia based on environmental factors as revealed by geographical information systems and statistics. Geospat Health 2014; 8:377-387. [PMID: 24893015 DOI: 10.4081/gh.2014.27] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Cutaneous leishmaniasis (CL) is a neglected tropical disease strongly associated with poverty. Treatment is problematic and no vaccine is available. Ethiopia has seen new outbreaks in areas previously not known to be endemic, often with co-infection by the human immunodeficiency virus (HIV) with rates reaching 5.6% of the cases. The present study concerns the development of a risk model based on environmental factors using geographical information systems (GIS), statistical analysis and modelling. Odds ratio (OR) of bivariate and multivariate logistic regression was used to evaluate the relative importance of environmental factors, accepting P ≤ 0.056 as the inclusion level for the model's environmental variables. When estimating risk from the viewpoint of geographical surface, slope, elevation and annual rainfall were found to be good predictors of CL presence based on both probabilistic and weighted overlay approaches. However, when considering Ethiopia as whole, a minor difference was observed between the two methods with the probabilistic technique giving a 22.5% estimate, while that of weighted overlay approach was 19.5%. Calculating the population according to the land surface estimated by the latter method, the total Ethiopian population at risk for CL was estimated at 28,955,035, mainly including people in the highlands of the regional states of Amhara, Oromia, Tigray and the Southern Nations, Nationalities and Peoples' Region, one of the nine ethnic divisions in Ethiopia. Our environmental risk model provided an overall prediction accuracy of 90.4%. The approach proposed here can be replicated for other diseases to facilitate implementation of evidence-based, integrated disease control activities.
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Tsegaw T, Gadisa E, Seid A, Abera A, Teshome A, Mulugeta A, Herrero M, Argaw D, Jorge A, Aseffa A. Identification of environmental parameters and risk mapping of visceral leishmaniasis in Ethiopia by using geographical information systems and a statistical approach. Geospat Health 2013; 7:299-308. [PMID: 23733292 DOI: 10.4081/gh.2013.88] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Visceral leishmaniasis (VL), a vector-borne disease strongly influenced by environmental factors, has (re)-emerged in Ethiopia during the last two decades and is currently of increasing public health concern. Based on VL incidence in each locality (kebele) documented from federal or regional health bureaus and/or hospital records in the country, geographical information systems (GIS), coupled with binary and multivariate logistic regression methods, were employed to develop a risk map for Ethiopia with respect to VL based on soil type, altitude, rainfall, slope and temperature. The risk model was subsequently validated in selected sites. This environmental VL risk model provided an overall prediction accuracy of 86% with mean land surface temperature and soil type found to be the best predictors of VL. The total population at risk was estimated at 3.2 million according to the national population census in 2007. The approach presented here should facilitate the identification of priority areas for intervention and the monitoring of trends as well as providing input for further epidemiological and applied research with regard to this disease in Ethiopia.
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Affiliation(s)
- Teshome Tsegaw
- Armauer Hansen Research Institute, All-Africa Leprosy and TB Rehabilitation and Training Center, Jimma Road, Addis Ababa, Ethiopia
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Mekasha Y, Tegegne A, Abera A, Rodriguez-Martinez H. Body size and testicular traits of tropically-adapted bucks raised under extensive husbandry in Ethiopia. Reprod Domest Anim 2008; 43:196-206. [PMID: 18325007 DOI: 10.1111/j.1439-0531.2007.00877.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Five tropically adapted buck breeds extensively managed in Ethiopia were studied to determine possible effects of breed and age on body size and testicular traits. In all, 177 bucks were selected following stratified random sampling, and evaluated in three age groups: <14 months (young), 14-19.5 months (intermediate) and 19.6-24 months (old). The breeds studied were Arsi-Bale (AB; N = 35), Central Highlands (CH; N = 33), Afar (N = 35), Boran (N = 36) and Woito-Guji (WG; N = 38). In all the three age groups, Boran and CH bucks were the heaviest (p < 0.05), Afar were the lightest, and AB and WG were in between. The highest body weight (BW) was achieved in the intermediate age group for Afar, but in the oldest age group for the other breeds. In the youngest age group, scrotal circumference (SC) was the widest (p < 0.05) for Boran and CH and the narrowest for Afar, AB and WG, while in the intermediate and the oldest age groups, Boran showed the widest SC. Boran, WG and CH had higher (p < 0.05) testicular weight (TW) than Afar and AB in the youngest age group. Boran retained the highest (p < 0.05) TW in the intermediate and the oldest age groups, while in the oldest age group WG and AB medium TW and Afar had the lowest TW. However, Afar had the highest TW expressed as percentage of BW. SC was well correlated with TW (p < 0.001; r = 0.74) and BW (p < 0.001; r = 0.61), indicating a linear, positive association between BW and TW (p < 0.001; r = 0.51). In conclusion, body size and testicular traits of Ethiopian bucks under an extensive management system are influenced differently by breed and age group.
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Affiliation(s)
- Y Mekasha
- Division of Reproduction, Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Science (SLU), Ullsväg, 14C Sweden.
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