Background: Malaria is a major public health problem affecting humans, particularly in the tropics and subtropics. Children under 5 years old are the group most vulnerable to malaria infection because of less developed immune system. Countries have set targets that led to control and eliminate malaria with interventions of the at-risk groups, however malaria infection remained a major public health challenge in endemic areas. Objective: This study aimed at determining the magnitude of malaria and associated factors among febrile children under 5 years old in Arba Minch "Zuria" district. Methods: The study was conducted from April to May 2017. Blood samples were collected from 271 systematically selected febrile children under 5 years old. Thin and thick blood smears were prepared, stained with 10% Giemsa and examined under light microscope. Data of sociodemographic data, determinant factors, and knowledge and prevention practices of malaria were collected using a pretested structured questionnaire. Data were analyzed using binomial and multinomial regression model in SPSS ® Statistics program, version 25. Results: Among those febrile children, 22.1% (60/271) were positive for malaria; 50.0%, 48.33% and 1.66% of them were positive for Plasmodium falciparum, Plasmodium vivax and mixed infections of both parasites, respectively. Malaria infection was associated with nearby presence of stagnant water to resident areas (AOR=8.19; 95%CI: 3.62-18.5, P<0.0001). Children who slept under insecticide-treated mosquito nets (ITNs) were more likely to be protected from malaria infection than those did not sleep under an ITNs (AOR=9.65; 95%CI: 4.623-20.15, P<0.0001). Conclusion: Malaria infection is highly prevalent in children aged between 37 and 59 months old, in Arba Minch "Zuria" district. The proximity of residence to stagnant water and the use of ITNs are the most dominant risk factor for malaria infection. Improved access to all malaria interventions is needed to interrupt the transmission at the community level with a special focus on the risk groups.

BackgroundGiardia duodenalis is a species complex consisting of multiple genetically distinct assemblages. The species imposes a major public health crisis on developing countries. However, the molecular diversity, transmission dynamics and risk factors of the species in these countries are indeterminate. This study was conducted to determine the molecular epidemiology of G. duodenalis infection in asymptomatic individuals in Southern Ethiopia.MethodsFrom March to June 2014, fresh stool samples were collected from 590 randomly selected individuals. Socio-demographic data were gathered using a pre-tested structured questionnaire. The genotyping was done using triosephosphate isomerase gene-based nested polymerase chain reaction and DNA sequencing. The genetic identity and relatedness of isolates were determined using the basic local alignment search tool and phylogenetic analysis. Risk factors associated with G. duodenalis infection were analysed using binary and multinomial logistic regression models.ResultsThe results showed that 18.1% (92/509) of the study subjects were infected by G. duodenalis. Among the isolates, 35.9% (33/92) and 21.7% (20/92) were sub-typed into assemblages A and B, respectively, whereas 42.4% (39/92) showed mixed infections of A and B. Most of the assemblage A isolates (94%,31/33) were 100% identical to sequences registered in GenBank, of which the majority belonged to sub-assemblage AII. However, the high genetic variability and frequency of double peaks made sub-genotyping of assemblage B more problematic and only 20% (4/20) of the isolates matched 100% with the sequences. The risk factors of age (P = 0.032) and type of drinking water source (P = 0.003) both showed a significant association with the occurrence G. duodenalis infection.ConclusionsThis study established the endemicity of G. duodenalis in Southern Ethiopia. Infection with assemblage A was more frequent than with assemblage B, and the rate of infection was higher in children and in municipal/tap and open spring water consumers than the other groups. Sub-typing of assemblage B and determining the origin of double peaks were challenging. The present study confirms the need for further inclusive studies to be conducted focusing on sub-types of assemblage B and the origin of heterogeneity.Electronic supplementary materialThe online version of this article (10.1186/s40249-018-0397-4) contains supplementary material, which is available to authorized users.

Background: The concept of health is largely tied up with the quality of the ambient environment of human. There is a need to minimize the risks of environment to public health and comply with microbial contamination legislation stipulated by respective regulatory bodies. Though water borne protozoa are leading causes of diseases in socio-economically disadvantaged areas, less information is available about drinking water quality and its implication to the public. The present study aimed at characterizing the risks of Giardia and Cryptosporidium from water sources in southern Ethiopia.Methods: Twenty-one drinking water samples (10L per source) were collected from five different types of water sources. Sample analysis was performed using immunofluorescence assay (IFA) with fluorescein isothiocyanate–monoclonal antibodies and nested PCR with tpi, SSU-rRNA and gp60 loci of the parasites. Statistical analysis was performed using Spearman’s rho correlation and independent-samples nonparametric test.The risk was characterized using quantitative microbial risk assessment. Results: The IFA and genotyping assays overall showed that Giardia was detected in 81% (17/21) of the samples with a mean concentration of 64.6 cysts.10 L-1 and Cryptosporidium in 71% (15/21) with a mean concentration of 62.8 oocysts.10 L-1. Out of the 17 Giardia positive water sources, Giardia duodenalis (assemblage B) was detected in 29.4%, assemblage A in 17.6% and assemblages A+B in 52.9% of the sources. Likewise, Cryptosporidium genotype was detected in 57.1% (12/21) of the sources; C. parvum in 38.1% (8/21) and C. hominis in 14.3% (3/21) of the sources. The average probability of illness from the water sources was 0.06 for Giardia and 0.22 for Cryptosporidium.Conclusions: The present finding highlights the significance of water for transmission of Giardia and Cryptosporidium in southern Ethiopia. Genotypes detected in the water sources indicate that multiple sources likely contaminated the drinking water sources. The health risks that are inferred from the water sources to the public are significantly higher than most other reported findings. This study recommends the need of regular follow-up, improvement in water treatment facilities and setting appropriate legislation in areas where cycles of parasitic infection is linked to water sources.

Background: Giardia duodenalis and Cryptosporidium spp. are topmost causes of gastrointestinal diseases mainly in socio-economically disadvantaged regions. Understanding the molecular diversity and distribution of these parasites in water sources and the environmental variables that influence their prevalence is important to effectively control infections in at-risk populations, however, the state of knowledge about risks of these parasites associated with source water is little in Africa. This study aimed at characterizing risks of Giardia duodenalis and Cryptosporidium spp. from water sources in southern Ethiopia.Methods: Twenty-one water samples (10L per source) were collected from five different types of drinking water sources. Sample was analyzed using immunofluorescence assay with fluorescein isothiocyanate–monoclonal antibodies and nested PCR; tpi-PCR was used for genotyping purpose in Giardia duodenalis isolates and SSU-rRNA and gp60-PCR in Cryptosporidium spp. isolates. Statistical analysis was performed using Spearman’s rho correlation and independent-samples nonparametric test.The risk was characterized using quantitative microbial risk assessment.Results: The immunofluorescence assay showed that cyst was detected in 81% (17/21) and oocyst in 71% (15/21) of the samples with mean concentrations of 64.6 cysts.10 L-1 and 62.8 oocysts.10 L-1. Genotypic analysis showed that Giardia duodenalis assemblage B was genotyped in 29.4% (5/17), assemblage A in 17.6% (3/17) and assemblages A+B in 52.9% (9/17) of the samples. Cryptosporidium spp. genotype was detected in 57.1% (12/21) of the samples; Cryptosporidium parvum in 38.1% (8/21), Cryptosporidium hominis in 14.3% (3/21) and Cryptosporidium parvum and Cryptosporidium hominis in 4.7% (1/21) of the samples. The average probability of illness from the water sources was 0.06 for Giardia duodenalis and 0.22 for Cryptosporidium spp.Conclusions: The finding highlights the significance of water for transmission of Giardia spp. and Cryptosporidium spp. in southern Ethiopia. Genotypes detected in the samples indicate multiple sources likely contaminated the sources. Health risk that is inferred from the water sources to the public are significantly higher than most other reported findings. This study recommends the need of regular follow-up, improvement in water treatment facilities and setting appropriate legislation in areas where cycles of parasitic infection is linked to water sources.