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Shure W, Tayachew A, Berkessa T, Teka G, Biru M, Gebeyehu A, Woldeab A, Tadesse M, Gonta M, Agune A, Hailemariam A, Haile B, Addis B, Moges M, Lisanwork L, Gizachew L, Tigabu E, Mekuria Z, Yimer G, Dereje N, Aliy J, Lulseged S, Melaku Z, Abate E, Gebreyes W, Wossen M, Abayneh A. SARS-CoV-2 co-detection with influenza and human respiratory syncytial virus in Ethiopia: Findings from the severe acute respiratory illness (SARI) and influenza-like illness (ILI) sentinel surveillance, January 01, 2021, to June 30, 2022. PLOS Glob Public Health 2024; 4:e0003093. [PMID: 38635749 PMCID: PMC11025837 DOI: 10.1371/journal.pgph.0003093] [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] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 03/18/2024] [Indexed: 04/20/2024]
Abstract
SARS-CoV-2 co-infection with the influenza virus or human respiratory syncytial virus (RSV) may complicate its progress and clinical outcomes. However, data on the co-detection of SARS-CoV-2 with other respiratory viruses are limited in Ethiopia and other parts of Africa to inform evidence-based response and decision-making. We analyzed 4,989 patients' data captured from the national severe acute respiratory illness (SARI) and influenza-like illness (ILI) sentinel surveillance sites over 18 months period from January 01, 2021, to June 30, 2022. Laboratory specimens were collected from the patients and tested for viral respiratory pathogens by real-time, reverse transcription polymerase chain reaction (RT-PCR) at the national influenza center. The median age of the patients was 14 years (IQR: 1-35 years), with a slight preponderance of them being at the age of 15 to less than 50 years. SARS-CoV-2 was detected among 459 (9.2%, 95% CI: 8.4-10.0) patients, and 64 (1.3%, 95% CI: 1.0-1.6) of SARS-CoV-2 were co-detected either with Influenza virus (54.7%) or RSV (32.8%) and 12.5% were detected with both of the viruses. A substantial proportion (54.7%) of SARS-CoV-2 co-detection with other respiratory viruses was identified among patients in the age group from 15 to less than 50 years. The multivariable analysis found that the odds of SARS-CoV-2 co-detection was higher among individuals with the age category of 20 to 39 years as compared to those less than 20 years old (AOR: 1.98, 95%CI:1.15-3.42) while the odds of SARS-CoV-2 co-detection was lower among cases from other regions of the country as compared to those from Addis Ababa (AOR:0.16 95%CI:0.07-0.34). Although the SARS-CoV-2 co-detection with other respiratory viral pathogens was minimal, the findings of this study underscore that it is critical to continuously monitor the co-infections to reduce transmission and improve patient outcomes, particularly among the youth and patients with ILI.
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Affiliation(s)
- Wolde Shure
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adamu Tayachew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Gizaw Teka
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mengistu Biru
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ayele Gebeyehu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adane Woldeab
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Musse Tadesse
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melaku Gonta
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Admikew Agune
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Bizuwork Haile
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Beza Addis
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Muluken Moges
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Leuel Lisanwork
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Lehageru Gizachew
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Eyasu Tigabu
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Zelalem Mekuria
- The Ohio State University Global One Health initiative (GOHi), Columbus, OH, Unites States of America
| | - Getnet Yimer
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, Unites States of America
| | | | - Jemal Aliy
- ICAP at Columbia University, Addis Ababa, Ethiopia
| | | | | | - Ebba Abate
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Wondwossen Gebreyes
- The Ohio State University Global One Health initiative (GOHi), Columbus, OH, Unites States of America
- Department of Veterinary Preventive Medicine, Infectious Diseases, The Ohio State University, Columbus, OH, Unites States of America
| | - Mesfin Wossen
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Tayachew A, Teka G, Gebeyehu A, Shure W, Biru M, Chekol L, Berkessa T, Tigabu E, Gizachew L, Agune A, Gonta M, Hailemariam A, Gedefaw E, Woldeab A, Alemu A, Getaneh Y, Lisanwork L, Yibeltal K, Abate E, Abayneh A, Wossen M, Hailu M, Workineh F. Prevalence of respiratory syncytial virus infection and associated factors in children aged under five years with severe acute respiratory illness and influenza-like illness in Ethiopia. IJID Reg 2024; 10:191-196. [PMID: 38356999 PMCID: PMC10864198 DOI: 10.1016/j.ijregi.2024.01.004] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/16/2024]
Abstract
Objectives Acute respiratory infections because of respiratory syncytial viruses (RSVs) are among the major leading causes of morbidity and mortality in children worldwide. RSV prevalence and its contributing factors among children aged under 5 years in Ethiopia are not well studied. To assess the prevalence and associated factors of RSV infection in children aged under 5 years using influenza sentinel surveillance sites in Ethiopia. Methods A cross-sectional study design was used utilizing influenza-like illness/sever acute respiratory illness surveillance data from January 2021 to December 2022 at the Ethiopian Public Health Institute. Results In total, 2234 cases were included, with an overall RSV positivity rate of 16.2%. The RSV positivity rate was high in children aged under 1 year (22.8%) and during fall season (24.8%). The RSV positivity rate was significantly associated with ages under 1 year (adjusted odds ratio [AOR] 2.8, 95% confidence interval [CI]: 1.89-4.15) and 1-2 years (AOR 1.9, 95% CI: 1.26-2.73) and the fall season (AOR 1.67, 95% CI: 1.17-2.38). Conclusion The study revealed that a considerably high RSV positivity rate was detected in children aged under 5 years. The age of children and season have a significant association with RSV positivity rate. Further studies of RSV viral genotype, clinical characteristics, and disease outcome need to be conducted for a better understanding of the virus and disease outcome.
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Affiliation(s)
- Adamu Tayachew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Addis Continental Institute of Public Health, Addis Ababa
| | - Gizaw Teka
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ayele Gebeyehu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wolde Shure
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mengistu Biru
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Eyasu Tigabu
- The Ohio State University Global One Health, Addis Ababa, Ethiopia
| | | | - Admikew Agune
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melaku Gonta
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Ergetu Gedefaw
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adane Woldeab
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- The Ohio State University Global One Health, Addis Ababa, Ethiopia
| | - Ayinalem Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yimam Getaneh
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Leuel Lisanwork
- The Ohio State University Global One Health, Addis Ababa, Ethiopia
| | | | - Ebba Abate
- The Ohio State University Global One Health, Addis Ababa, Ethiopia
| | | | - Mesfin Wossen
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mesay Hailu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Tamire M, Abegaz T, Abaya SW, Lisanwork L, Gizachew L, Abate E, Wang SH, Gebreyes W, Kumie A. Exploring Community Perceptions of COVID-19 and Vaccine Hesitancy in Selected Cities of Ethiopia: A Qualitative Study. Vaccines (Basel) 2023; 11:1511. [PMID: 37896915 PMCID: PMC10610566 DOI: 10.3390/vaccines11101511] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/09/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
Even though the COVID-19 vaccine has been available and free of charge to the targeted population in Ethiopia, the vaccination rate was lower than needed to achieve herd immunity at community level. This study aimed to explore community perceptions of COVID-19 and vaccine hesitancy in selected cities of Ethiopia involving 70 in-depth interviews and 28 focused group discussions. The audio-taped data were transcribed verbatim, translated into English, and analyzed using a qualitative content analysis approach using the ATLAS.ti software version 8. The findings revealed that COVID-19 was perceived as evil and caused fear and frustration upon its emergence. The community initially used traditional remedies for its prevention but later transitioned to employing non-pharmaceutical interventions. The primary reasons for vaccine hesitancy were misinformation and misconceptions, such as connecting the vaccine with the mark of the beast, a lack of trust due to the multiple vaccine types, a shorter production timeline resulting in distrust of its effectiveness, and a fear of pain and side effects. Based on our findings, we recommend monitoring the use of social media and countering misinformation with the correct information and continuous public health campaigns. Further studies should be conducted to assess the types and magnitude of impacts from the myths and misconceptions on vaccination uptake.
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Affiliation(s)
- Mulugeta Tamire
- Department of Preventive Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia; (T.A.); (S.W.A.); (A.K.)
| | - Teferi Abegaz
- Department of Preventive Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia; (T.A.); (S.W.A.); (A.K.)
| | - Samson Wakuma Abaya
- Department of Preventive Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia; (T.A.); (S.W.A.); (A.K.)
| | - Leuel Lisanwork
- Ohio State Global One Health, Addis Ababa P.O. Box 9086, Ethiopia; (L.L.); (L.G.); (E.A.)
| | - Lehageru Gizachew
- Ohio State Global One Health, Addis Ababa P.O. Box 9086, Ethiopia; (L.L.); (L.G.); (E.A.)
| | - Ebba Abate
- Ohio State Global One Health, Addis Ababa P.O. Box 9086, Ethiopia; (L.L.); (L.G.); (E.A.)
| | - Shu-Hua Wang
- Global One Health Initiative, The Ohio State University, Columbus, OH 43210, USA; (S.-H.W.); (W.G.)
- Infectious Disease Division, Internal Medicine Department, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Wondwossen Gebreyes
- Global One Health Initiative, The Ohio State University, Columbus, OH 43210, USA; (S.-H.W.); (W.G.)
- Infectious Diseases Molecular Epidemiology Laboratory, Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Abera Kumie
- Department of Preventive Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia; (T.A.); (S.W.A.); (A.K.)
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Watare SH, Alemu MA, Tayachew A, Yohannes N, Gizachew L, Kebede A, Tessema A, Kassa W, Biru M, Teferi M, Wendrad N, Eshetu K, Teka G, Yimer H, Ebrahim F, Mulugeta D, Mirkuze A, Abdela S, Emmanuel M, Hassen A, Wosen M, Hussen M, Fufa Y, Tolera G, Assefa Z, Abayneh A, Abate E. An investigation of a hundred COVID-19 cases and close contacts in Ethiopia, May to June, 2020: A prospective case-ascertained study. PLoS One 2022; 17:e0275596. [PMID: 36240226 PMCID: PMC9565438 DOI: 10.1371/journal.pone.0275596] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 09/20/2022] [Indexed: 11/06/2022] Open
Abstract
Background Corona Virus Disease 2019 is a novel respiratory disease commonly transmitted through respiratory droplets. The disease has currently expanded all over the world with differing epidemiologic trajectories. This investigation was conducted to determine the basic clinical and epidemiological characteristics of the disease in Ethiopia. Methods A prospective case-ascertained study of laboratory-confirmed COVID-19 cases and their close contacts were conducted. The study included 100 COVID-19 laboratory-confirmed cases reported from May 15, 2020 to June 15, 2020 and 300 close contacts. Epidemiological and clinical information were collected using the WHO standard data collection tool developed first-few cases and contacts investigation. Nasopharyngeal and Oropharyngeal samples were collected by using polystyrene tipped swab and transported to the laboratory by viral transport media maintaining an optimal temperature. Clinical and epidemiological parameters were calculated in terms of ratios, proportions, and rates with 95% CI. Result A total of 400 participants were investigated, 100 confirmed COVID-19 cases and 300 close contacts of the cases. The symptomatic proportion of cases was 23% (23) (95% CI: 15.2%-32.5%), the proportion of cases required hospitalization were 8% (8) (95%CI: 3.5%-15.2%) and 2% (95%CI: 0.24% - 7.04%) required mechanical ventilation. The secondary infection rate, secondary clinical attack rate, median incubation period and median serial interval were 42% (126) (95% CI: 36.4%-47.8%), 11.7% (35) (95% CI: 8.3%-15.9%), 7 days (IQR: 4–13.8) and 11 days (IQR: 8–11.8) respectively. The basic reproduction number (RO) was 1.26 (95% CI: 1.0–1.5). Conclusion The proportion of asymptomatic infection, as well as secondary infection rate among close contacts, are higher compared to other studies. The long serial interval and low basic reproduction number might contribute to the observed slow progression of the pandemic, which gives a wide window of opportunities and time to control the spread. Testing, prevention, and control measures should be intensified.
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Affiliation(s)
| | | | - Adamu Tayachew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Adisu Kebede
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Wubayehu Kassa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mengistu Biru
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Kirubel Eshetu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Gizaw Teka
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Faiqa Ebrahim
- World Health Organization Country Office, Addis Ababa, Ethiopia
| | | | | | - Saro Abdela
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Musa Emmanuel
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | - Mesfin Wosen
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mukemil Hussen
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yaregal Fufa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Zewdu Assefa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Ebba Abate
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Gutu MA, Bekele A, Seid Y, Mohammed Y, Gemechu F, Woyessa AB, Tayachew A, Dugasa Y, Gizachew L, Idosa M, Tokarz RE, Sugerman D. Another dengue fever outbreak in Eastern Ethiopia-An emerging public health threat. PLoS Negl Trop Dis 2021; 15:e0008992. [PMID: 33465086 PMCID: PMC7845954 DOI: 10.1371/journal.pntd.0008992] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 01/29/2021] [Accepted: 11/17/2020] [Indexed: 12/15/2022] Open
Abstract
Background Dengue Fever (DF) is a viral disease primarily transmitted by Aedes (Ae.) aegypti mosquitoes. Outbreaks in Eastern Ethiopia were reported during 2014–2016. In May 2017, we investigated the first suspected DF outbreak from Kabridahar Town, Somali region (Eastern Ethiopia) to describe its magnitude, assess risk factors, and implement control measures. Methods Suspected DF cases were defined as acute febrile illness plus ≥2 symptoms (headache, fever, retro-orbital pain, myalgia, arthralgia, rash, or hemorrhage) in Kabridahar District residents. All reported cases were identified through medical record review and active searches. Severe dengue was defined as DF with severe organ impairment, severe hemorrhage, or severe plasma leakage. We conducted a neighborhood-matched case-control study using a subset of suspected cases and conveniently-selected asymptomatic community controls and interviewed participants to collect demographic and risk factor data. We tested sera by RT-PCR to detect dengue virus (DENV) and identify serotypes. Entomologists conducted mosquito surveys at community households to identify species and estimate larval density using the house index (HI), container index (CI) and Breteau index (BI), with BI≥20 indicating high density. Results We identified 101 total cases from May 12–31, 2017, including five with severe dengue (one death). The attack rate (AR) was 17/10,000. Of 21 tested samples, 15 (72%) were DENV serotype 2 (DENV 2). In the case-control study with 50 cases and 100 controls, a lack of formal education (AOR [Adjusted Odds Ratio] = 4.2, 95% CI [Confidence Interval] 1.6–11.2) and open water containers near the home (AOR = 3.0, 95% CI 1.2–7.5) were risk factors, while long-lasting insecticide treated-net (LLITN) usage (AOR = 0.21, 95% CI 0.05–0.79) was protective. HI and BI were 66/136 (49%) and 147 per 100 homes (147%) respectively, with 151/167 (90%) adult mosquitoes identified as Ae. aegypti. Conclusion The epidemiologic, entomologic, and laboratory investigation confirmed a DF outbreak. Mosquito indices were far above safe thresholds, indicating inadequate vector control. We recommended improved vector surveillance and control programs, including best practices in preserving water and disposal of open containers to reduce Aedes mosquito density. In 2017 an outbreak of Dengue fever (DF) was reported in Kabridahar Town, Ethiopia. This mosquito transmitted disease was recently detected in Ethiopia only four years prior, with this being the first time it was identified in the area. In response, our team was dispatched to confirm the presence of the disease, identify potential causes, and implement mitigation and control measures. We identified and compared suspected cases and suspected non-cases to identify the potential risk factors of infection. Laboratory confirmation of infection and disease-type was also performed. Due to the entomological nature of disease transmission, additional entomological investigations were conducted at the households of both groups to understand its influence at the household level. Through these measures, we were able to establish the presence of DF in Kabridahar Town and identify risk factors leading to infection. Risk factors included a lack of formal education and open water containers near the home, while the presence of long-lasting insecticide-treated nets were found to be protective. Mitigation and control measures were implemented to combat or promote the identified risk and protective factors respectively. Cases counts began to reduce five days after the onset of these measures. Recommendations were made based on our findings to prevent future outbreaks. The last case was recorded ten days after implementation of the mitigation and control measures.
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Affiliation(s)
- Mulugeta Asefa Gutu
- Ethiopian Field Epidemiology Training Program, Addis Ababa, Ethiopia
- * E-mail:
| | | | - Yimer Seid
- Addis Ababa University, Addis Ababa, Ethiopia
| | - Yusuf Mohammed
- World Health Organization Country Office for Ethiopia, Addis Ababa, Ethiopia
| | - Fekadu Gemechu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Adamu Tayachew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yohanis Dugasa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Lehageru Gizachew
- Ethiopian Field Epidemiology Training Program, Addis Ababa, Ethiopia
| | - Moti Idosa
- Ethiopian Field Epidemiology Training Program, Addis Ababa, Ethiopia
| | - Ryan E. Tokarz
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - David Sugerman
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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