Background. Hepatitis B virus (HBV) infection remains a serious public health concern worldwide. Mother-to-child transmission (MTCT) is the major mode in endemic areas, including Ethiopia, where little is known about pregnant women’s knowledge, attitudes, and practice towards HBV infection and MTCT. Therefore, the study is aimed at determining the knowledge, attitude, and practice towards HBV among pregnant women attending antenatal care. Method. A cross-sectional study was conducted from February to April 2018, at the University of Gondar Comprehensive Specialized Hospital. A total of 354 pregnant women were selected by systematic random sampling and included in this study. KAP of participants on HBV MTCT was assessed using a structured questionnaire. Data was analyzed using SPSS version 22 software. Result. The total response rate was 100% (354/354). Out of the 354 participants, 73.4% were within the poor knowledge. Only 18.9% of the respondents know HBV can be transmitted from mother to child during pregnancy. Less than half (43.8) of the participants think that they will never be infected with HBV, and 47.7% of them go to traditional healers when they have symptoms of HBV. Majority of the respondents (85.87%) had never screened for HBV, and only 28.5% of the participants believed that hepatitis B can cause liver cancer. In multivariable analysis, residence, income, and educational level were associated with mean score knowledge and attitude. Conclusions. Knowledge about HBV among pregnant women was found to be poor, and their attitude and practice were also limited. Therefore, extensive health education program should be given to the pregnant women to increase their awareness towards HBV infection. All pregnant women should be screened for HBV as part of ANC follow-up.

Immunologically, active visceral leishmaniasis (VL) is characterized by profound immunosuppression, severe systemic inflammatory responses, and an impaired capacity to control parasite replication. Neutrophils are highly versatile cells, which play a crucial role in the induction as well as the resolution of inflammation, the control of pathogen replication, and the regulation of immune responses. Neutrophil functions have been investigated in human cutaneous leishmaniasis; however, their role in human VL is poorly understood. In the present study we evaluated the activation status and effector functions of neutrophils in patients with active VL and after successful anti-leishmanial treatment. Our results show that neutrophils are highly activated and have degranulated; high levels of arginase, myeloperoxidase, and elastase, all contained in neutrophils’ granules, were found in the plasma of VL patients. In addition, we show that a large proportion of these cells are immature. We also analyzed effector functions of neutrophils that are essential for pathogen clearance and show that neutrophils have an impaired capacity to release neutrophil extracellular traps, produce reactive oxygen species, and phagocytose bacterial particles, but not Leishmania parasites. Our results suggest that impaired effector functions, increased activation, and immaturity of neutrophils play a key role in the pathogenesis of VL.

Malnutrition is commonly associated with increased infectious disease susceptibility and severity. Whereas malnutrition might enhance the incidence of disease as well as its severity, active infection can in turn exacerbate malnutrition. Therefore, in a malnourished individual suffering from a severe infection, it is not possible to determine the contribution of the pre-existing malnutrition and/or the infection itself to increased disease severity. In the current study we focussed on two groups of malnourished, but otherwise healthy individuals: moderately malnourished (BMI: 18.4–16.5) and severely malnourished (BMI <16.5) and compared several immune parameters with those of individuals with a normal BMI (≥18.5). Our results show a similar haematological profile in all three groups, as well as a similar ratio of CD4+ and CD8+ T cells. We found significant correlations between low BMI and increased levels of T helper (Th) 1 (Interferon (IFN)-γ, (interleukin (IL)-2, IL-12), Th2 (IL-4, IL-5, IL-13), as well as IL-10, IL-33 and tumor necrosis factor-α, but not IL-8 or C reactive protein. The activities of arginase, an enzyme associated with immunosuppression, were similar in plasma, peripheral blood mononuclear cells (PBMC) and neutrophils from all groups and no differences in the expression levels of CD3ζ, a marker of T cell activation, were observed in CD4+ and CD8+T cells. Furthermore, whereas the capacity of neutrophils from the malnourished groups to phagocytose particles was not impaired, their capacity to produce reactive oxygen species was impaired. Finally we evaluated the frequency of a subpopulation of low-density neutrophils and show that they are significantly increased in the malnourished individuals. These differences were more pronounced in the severely malnourished group. In summary, our results show that even in the absence of apparent infections, healthy malnourished individuals display dysfunctional immune responses that might contribute to increased susceptibility and severity to infectious diseases.

Acute undifferentiated febrile illness (AFI) is the most common reason for clinical presentation to health care services in developing countries. It can range from mild, self-limiting to progressive, life-threatening disease. AFI patients present with non-specific symptoms such as fever, headache and malaise, which can be caused by a wide range of pathogens [1].In the past decade, there has been a shift in importance of pathogens causing AFI. Studies on malaria showed that 80% of febrile illness, even in malaria-endemic regions, are caused by other pathogens, like Rickettsia, Borrelia, Leishmania and arboviruses [2][3][4][5]. Moreover, the decline of

Visceral leishmaniasis (VL) is a neglected tropical disease that affects the poorest communities and can cause substantial morbidity and mortality. Visceral leishmaniasis is characterized by the presence of Leishmania parasites in the spleen, liver and bone marrow, hepatosplenomegaly, pancytopenia, prolonged fever, systemic inflammation and low body mass index (BMI). The factors impacting on the severity of VL are poorly characterized. Here we performed a cross-sectional study to assess whether co-infection of VL patients with intestinal parasites influences disease severity, assessed with clinical and haematological data, inflammation, cytokine profiles and BMI. Data from VL patients was similar to VL patients co-infected with intestinal parasites, suggesting that co-infection of VL patients with intestinal parasites does not alter disease severity.