Background: Diarrhoeal illness remains one of the leading causes of morbidity and mortality among children<5 years of age worldwide. In Ethiopia, about 230,000 deaths estimated to occur. Shigella and Salmonella are major causes of gastroenteritis in children and is associated with high resistance levels. Thus, the aims of this study was to isolate and determine susceptibility patterns of Shigella and Salmonella, isolated from under five children with diarrhoea attending at some selected health facilities in Addis Ababa, Ethiopia. Methods: A total of 253 children 115 males and 138 females with acute diarrhoea were enrolled. Stool samples were cultured and isolated Shigella and Salmonella species were run for antimicrobial susceptibility testing using disk diffusion method. Results: A total of 190 entropathogens were isolated. Sixty one (24.1%) was E. coli, (9.1%) was Shigella followed by (3.95%) Salmonella and Citrobacter species and 86 (34.0%) was parasites. The overall resistance rates of isolated Shigella and Salmonella spp were high for Ampicillin (95.7%, 80.0%) and Augmentin (91.4%, 80) respectively. However, high sensitivity was observed among both isolates for Ciprofloxacin (91.3%, 100%) and Ceftraxion (91.4%, 100%). More than 87% of Shigella species were multiple resistances (resistance for two or more antibiotics). Whereas, 70.0% for Salmonella species. The prevalence of Shigella species was significantly varied among children with different employment parent's status. Raw meat consumption was an independent predictor variable for exposures of Salmonella infection (P≤0.05). Conclusion: Isolation of high frequency of multidrug resistant Shigella and Salmonella spp. from children in the study area is an alarming for the present situation of emerging drug resistance. However, there is still a chance to use ciprofloxacin and ceftriaxone in area of no culture and sensitivity test performed.
Iron deficiency anemia among pregnant women is a widespread problem in developing countries including Ethiopia, though its influence on neonatal iron status was inconsistently reported in literature. This cross-sectional study was conducted to compare hematologic profiles and iron status of newborns from mothers with different anemia status and determine correlation between maternal and neonatal hematologic profiles and iron status in Ethiopian context. We included 89 mothers and their respective newborns and performed complete blood count and assessed serum ferritin and C-reactive protein levels from blood samples collected from study participants. Maternal median hemoglobin and serum ferritin levels were 12.2 g/dL and 47.0 ng/mL, respectively. The median hemoglobin and serum ferritin levels for the newborns were 16.2 g/dL and 187.6 ng/mL, respectively. The mothers were classified into two groups based on hemoglobin and serum ferritin levels as iron deficient anemic (IDA) and nonanemic (NA) and newborns of IDA mothers had significantly lower levels of serum ferritin (P = 0.017) and hemoglobin concentration (P = 0.024). Besides, newborns' ferritin and hemoglobin levels showed significant correlation with maternal hemoglobin (P = 0.018; P = 0.039) and ferritin (P = 0.000; P = 0.008) levels. We concluded that maternal IDA may have an effect on the iron stores of newborns.
BackgroundA rapid, sensitive and accurate laboratory diagnosis is of prime importance in suspected extrapulmonary tuberculosis (EPTB) cases. However, traditional techniques for the detection of acid-fast bacilli have limitations. The aim of the study was to evaluate the diagnostic value of immunocytochemical staining for detection of Mycobacterium tuberculosis complex specific antigen, MPT64, in aspirates from pleural effusions and lymph nodes, the most common presentations of EPTB.MethodA cross-sectional study was conducted by including patients at Tikur Anbessa Specialized Hospital and the United Vision Medical Services from December 2011 to June 2012. Lymph node aspirates and pleural fluid samples were collected and analyzed from a total of 51 cases (26 tuberculous (TB) pleuritis and 25 TB lymphadenitis) and 67 non-TB controls. Each specimen was subjected to Ziehl-Neelsen (ZN) staining, culture on Lowenstein– Jensen (LJ) medium, cytological examination, Polymerase Chain Reaction (PCR) using IS1081gene sequence as a primer and immunocytochemistry (ICC) with polyclonal anti-MPT64 antibody. All patients were screened for HIV.ResultICC was positive in 38 of 51 cases and in the 7 of 67 controls giving an overall sensitivity and specificity of 74.5% and 89.5%, respectively. Using IS1081-PCR as a reference method, the sensitivity and specificity, positive and negative predictive value of ICC was 88.1%, 89.5%, 82.2% and 93.2%, respectively. The case detection rate increased from 13.7% by ZN stain to 19.6% by LJ culture, to 66.7% by cytology and 74.5% by ICC.ConclusionImmunocytochemistry with anti-MPT64 antigen improved detection of TB in pleural effusion and lymph node aspirates. Further studies using monoclonal antibodies on samples from other sites of EPTB is recommended to validate this relatively simple diagnostic method for EPTB.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0585-1) contains supplementary material, which is available to authorized users.
BackgroundBoth podoconiosis and soil-transmitted helminth (STH) infections occur among barefoot people in areas of extreme poverty; however, their co-morbidity has not previously been investigated. We explored the overlap of STH infection and podoconiosis in Southern Ethiopia and quantified their separate and combined effects on prevalent anemia and hemoglobin levels in podoconiosis patients and health controls from the same area.Methods and Principal FindingsA two-part comparative cross-sectional study was conducted in Wolaita zone, southern Ethiopia. Data were collected from adult patients presenting with clinically confirmed podoconiosis, and unmatched adult neighborhood controls living in the same administrative area. Information on demographic and selected lifestyle factors was collected using interviewer-administered questionnaires. Stool samples were collected and examined qualitatively using the modified formalin-ether sedimentation method. Hemoglobin level was determined using two different methods: hemoglobinometer and automated hematology analyzer. A total of 913 study subjects (677 podoconiosis patients and 236 controls) participated. The prevalence of any STH infection was 47.6% among patients and 33.1% among controls (p<0.001). The prevalence of both hookworm and Trichuris trichiura infections was significantly higher in podoconiosis patients than in controls (AOR 1.74, 95% CI 1.25 to2.42, AOR 6.53, 95% CI 2.34 to 18.22, respectively). Not wearing shoes and being a farmer remained significant independent predictors of infection with any STH. There was a significant interaction between STH infection and podoconiosis on reduction of hemoglobin level (interaction p value = 0.002).ConclusionsPrevalence of any STH and hookworm infection was higher among podoconiosis patients than among controls. A significant reduction in hemoglobin level was observed among podoconiosis patients co-infected with hookworm and ‘non-hookworm STH’. Promotion of consistent shoe-wearing practices may have double advantages in controlling both podoconiosis and hookworm infection in the study area.
BackgroundThis study aimed to assess fetomaternal hemorrhage (FMH) among RhD negative pregnant mothers using two techniques, Kleihauer-Betke (KBT) and Flow cytometry (FCM). To determine if patient-specific doses of prophylactic anti-D warrant further investigation in Ethiopia and wider Africa.MethodsHospital- based cross-sectional study was conducted among 75 RhD negative pregnant mothers using convenient sampling technique.ResultFMH has been detected in 52% and 60% by KBT and FCM techniques, respectively. The volume of FMH quantified in the majority of the cases (92.5% and 87%) was <10 mL fetal blood while >30 mL in 1.3% (1/75) and 2.7% (2/75) as calculated by KBT and FCM, respectively. The FMH calculated by the two methods have good correlation; r = 0.828 (p = 0.000) for categorized and r = 0.897 (p = 0.000) for continuous values and the agreement between the FCM and KBT was moderate with kappa (κ) value of 0.53 (p = 0.000).ConclusionMost of FMH calculated (<10 mL) could have been neutralized by lower doses which might have lower costs than administering 300 μg dose which is currently in practice in our country for affording mothers. Besides, it also showed that the volume of FMH was >30 mL in 1.3% and 2.7% of the cases as calculated by KBT and FCM, respectively, which need more than 300 μg dose RhIG for neutralization. Further investigation into the cost- effectiveness and scalability of patient- specific dosing of prophylactic anti-D appears warranted.
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