BackgroundFood contamination may occur at any point during its journey through production, processing, distribution, and preparation. The risk of food getting contaminated depends largely on the health status of the food handlers, their personal hygiene, knowledge and practice of food hygiene. Food borne diseases are a public health problem in developed and developing countries like Ethiopia.MethodA cross sectional study was conducted among food handlers in Addis Ababa student’s cafeteria from January to May 2013. Structured questionnaire was used to collect socio demographic data and associated risk factors. Stool specimens were examined for bacteria and intestinal parasites following standard procedures. Biochemical tests were done to identify the species of bacterial isolates. Sensitivity testing was done using Kirby- Baur disk diffusion method.ResultA total of 172 food handlers were enrolled in the study. The majority of study participants were females 134 (77.9%). About 78 (45.3%) of food handlers were found to be positive for different intestinal parasites with the most abundant parasite of Entameoba histolytica/dispar 68 (70.8%) followed by Giardia lamblia 18 (18.8%), Taenia species 5 (5.2%), Ascaris lumbricoides 2 (2.1%), hookworm 2 (2.1%) and Trichuris trichiura 1 (1.1%). Stool cultures revealed 3.5% of Salmonella isolates (Sero-grouping on Salmonella isolate was not done), while Shigella species was not isolated from any of the stool samples obtained from Food handlers. All isolates of Salmonella were sensitive to ciprofloxacin, amikacin and gentamicin but resistant to ampicillin, clindamycin, and erythromycin.ConclusionThe present study revealed a high prevalence of intestinal parasite in asymptomatic (apparently health) food handlers. Such infected food handlers can contaminate food, drinks and could serve as source of infection to consumers via food chain.

Abstract. Tuberculosis (TB) is a major public health problem in Ethiopia and the Amhara region. Assessment of knowledge, attitude, and health-seeking practice in this region is essential to plan, implement, and evaluate advocacy, communication, and social mobilization work. This may improve the case detection rate. The aim of this study was to assess the knowledge, attitude, and practice of patients toward TB in the Eastern Amhara region of Ethiopia. A crosssectional survey was conducted among suspected and confirmed TB patients who were 18 years of age and older. For this purpose, 422 participants were enrolled. A structured and pre-validated questionnaire was used to collect data. In addition χ 2 and multivariate logistic regression analysis was used to see an association with different variables. The mean and median knowledge score of respondents about pulmonary TB was 6.81 and 7, respectively. The majority of respondents had several misconceptions in all aspects of the most infectious form of TB. About half of the respondents did not know the current free cost of TB diagnosis and treatment. The 69.9% of respondents claimed that cost is the main reason for not getting care. The majority of respondents had several misconceptions about TB. The TB control program needs to consider advocacy, communication, and social mobilization for addressing the gap in the study sites. BACKGROUND

BackgroundHepatitis B Virus is a major public health problem worldwide. In 2012 alone, over 350 million chronic carriers and 1. 2 million annual deaths were occurred. Hepatitis B Virus causes 60 to 80% of the world’s primary liver cancer and nearly 90% infants infected due to vertical transmission are at higher risk of developing chronic liver disease and cancer. Hence determining the burden of maternal and neonatal Hepatitis B Virus infection is a priority.MethodsA cross sectional study was conducted from July – September 2012 at St. Paul’s Hospital Millennium Medical College and Selam Health Center, Addis Ababa, Ethiopia. Blood samples from delivering mothers (n = 265) and their corresponding cords (n = 265) were collected. A pretested questionnaire was used to collect data. Hepatitis B Virus surface antigen was detected using Enzyme Linked Immunosorbent Assay. Frequency analysis and logistic regression test was used to identify the potential risk factors associated with Hepatitis B Virus positivity using SPSS Version -15.ResultsA total of 265 delivering women with the mean age of 25.8 years were enrolled in the study. Of these delivering women, 8 (3.0%) of mothers were positive for Hepatitis B Virus surface antigen, whereas 6 (2.3%) of cord bloods were positives with 75% concordance rate of exposed infants with sero-positive mothers. However, only one maternal positive case was observed for Hepatitis B e Ag test. Only 11% of the mothers know their Hepatitis B Virus status. Of the total mothers assessed for possible risk factors, 69 (26%) had only one type, while 161 (60.8%) had multiple exposure factors such as ear pricing, history of tribal marks, abortion, multiple-sexual partner and history of surgical procedures experienced from high to low frequency. The remaining 35 (13.2%) of the participants had not experienced possible risk factors.ConclusionThough the maternal positivity rate was low, the rate of positivity in cord bloods was almost equal to those infected mothers. Therefore, screening of pregnant mothers and vaccination of infants could help to reduce the transmission. To minimize the higher overall risk exposure status of mothers, increasing awareness and intensive public health education is also recommended.

We investigated the gastrointestinal colonization rate and antibiotic resistance patterns of Extended-Spectrum Beta-Lactamase (ESBL)- producing Escherichia coli and Klebsiella pneumoniae in hospitalized patients admitted at Ethiopia’s largest tertiary hospital. Fecal samples/swabs from 267 patients were cultured on chrome agar. ESBL. Bacterial species identification, verification of ESBL production and antibiotic susceptibility testing were done using Vitek 2 system (bioMérieux, France). Phenotype characterization of ESBL-E.coli and ESBL- K.pneumoniae was done using Neo-Sensitabs™. ESBL positivity rate was much higher in K. pneumoniae (76%) than E. coli (45%). The overall gastrointestinal colonization rate of ESBL producing Enterobacteriaceae (ESBL-E) in hospitalized patients was 52% (95%CI; 46%–58%) of which, ESBL-E. coli and K.pneumoniae accounted for 68% and 32% respectively. Fecal ESBL-E carriage rate in neonates, children and adults was 74%, 59% and 46% respectively. Gastrointestinal colonization rate of ESBL-E.coli in neonates, children and adults was 11%, 42% and 42% respectively. Of all E. coli strains isolated from adults, children and neonates, 44%, 49% and 22% were ESBL positive (p = 0.28). The prevalence of ESBL-K.pneumoniae carriage in neonates, children and adults was 68%, 22% and 7% respectively. All K. pneumoniae isolated from neonates (100%) and 88% of K. pneumoniae isolated from children were ESBL positive, but only 50% of K.pneumoniae isolated from adults were ESBL positive (p = 0.001). Thirteen patients (5%) were carriers of both ESBL-E.coli and ESBL-KP. The overall carrier rate of ESBL producing isolates resistant to carbapenem was 2% (5/267), all detected in children; three with E.coli HL cephalosporinase (AmpC), resistant to ertapenem and two with K. pneumoniae Carbapenemase (KPC) resistant to meropenem, ertapenem and impenem. We report a high gastrointestinal colonization rate with ESBL-E and the emergence of carbapenems-resistant K. pneumoniae in Ethiopia. Urgent implementation of infection control measures, and surveillance are urgently needed to limit the spread within healthcare facilities and further to the community.

BackgroundGroup B Streptococcus (GBS) is the leading cause of septicemia, meningitis, and pneumonia in neonates. Maternal colonization with GBS is the principal risk factor for early-onset disease in infants. Group B Streptococcus is now an important cause of maternal and neonatal morbidity and mortality in many parts of the world. In Ethiopia, few studies have been done on GBS colonization among pregnant women. The aim of this study was to determine the prevalence of GBS colonization, antimicrobial susceptibility patterns and assess risk factors among pregnant women.MethodsA prospective cross-sectional study was conducted from May to August 2014 at selected public antenatal care (ANC) centers in Addis Ababa, Ethiopia. Clinical and socio-demographical data were collected using structured questionnaire after obtaining written informed consent. A total of 281 lower vaginal swabs were collected and inoculated into 1 ml Todd Hewitt Broth supplemented with gentamicin and nalidixic acid to prevent the growth of contaminants. After overnight incubation, all broths were subcultured on 5% sheep blood agar for isolation of GBS. Antimicrobial susceptibility testing was performed according to the criteria of the Clinical and Laboratory Standard Institute (CLSI) guidelines 2013 by disk diffusion method. Data were entered and analysed using SPSS version 20.0 software. Chi-square test and binary logistic regression analysis were used. P-value < 0.05 was considered statistically significant.ResultsThe overall prevalence of GBS colonization among pregnant women was 14.6% (41/281). Group B Streptococcus colonization was significantly associated with health institutions (P < 0.05). All GBS isolates were susceptible to chloramphenicol. Resistance to tetracycline, cefotaxime, clindamycin, penicillin, vancomycin, ampicillin and erythromycin was 90.2%, 34.1, 26.8%, 19.5, 17%, 14.6 and 7.5% respectively. Multidrug resistance (MDR) (≥ 2 drugs) was detected in 43.9% (18/41) of the isolates.ConclusionThere was a high frequency of GBS colonization (14.6%) and resistance to the commonly used antibiotics which suggests the importance of the screening of GBS colonization in pregnant women at 35–37 weeks of gestation and testing their antimicrobial susceptibilities in order to provide antibiotic prophylaxis and minimize newborn infection and co-morbidity.