Visceral leishmaniasis (also known as kala-azar) is classified as one of the most neglected tropical diseases. It is becoming a growing health problem in Ethiopia, with endemic areas that are continually spreading. The annual burden of visceral leishmaniasis (VL) in Ethiopia is estimated to be between 4,500 and 5,000 cases, and the population at risk is more than 3.2 million. There has been a change in the epidemiology of VL in Ethiopia. Over the last decades, almost all cases and outbreaks of VL were reported from arid and semi-arid parts of the country; however, recent reports indicated the introduction of this disease into the highlands. Migration of labourers to and from endemic areas, climatic and environmental changes, and impaired immunity due to HIV/AIDS and malnutrition resulted in the change of VL epidemiology. HIV spurs the spread of VL by increasing the risk of progression from asymptomatic infection towards full VL. Conversely, VL accelerates the onset of AIDS. In Ethiopia, VL epidemiology remains complex because of the diversity of risk factors involved, and its control is becoming an increasing challenge. This paper reviews the changes in epidemiology of VL in Ethiopia and discusses some of the possible explanations for these changes. The prospects for novel approaches to VL control are discussed, as are the current and future challenges facing Ethiopia's public health development program.

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Summary Fasciolosis has emerged as an important zoonotic disease in many parts of the world. In recent years, an increasing number of human cases were reported in Vietnam. In this study, the 27‐kDa component protein from the excretory/secretory production of adult Fasciola gigantica, purified by high performance liquid chromatography, was assessed in an enzyme‐linked immunosorbent assay (ELISA) to detect antibodies against Fasciola spp. for diagnosis of human fasciolosis. The ELISA showed a high sensitivity (100%) and specificity (97.67%) when tested on patients with fasciolosis, other parasitic infections, cholangiocarcinoma and on healthy controls. The assay was applied for diagnosis on 143 patients in the Viet Duc‐Hanoi hospital who presented with clinical signs of liver disease and lesions in their livers as shown by imaging techniques. Antibodies were found in 37 (25.9%) of these patients, of whom only 3 shed Fasciola eggs in their stools (2.1%). The excellent response to triclabendazole treatment of 37 sero‐positive patients confirmed the diagnosis of fasciolosis. This study demonstrated the diagnostic potential for human fasciolosis of the 27‐kDa antigen ELISA. Fasciolosis should be considered in the differential diagnosis of hepatic disease in Vietnam.

Edema disease caused by Escherichia coli is one of the most common diseases in postweaning piglets throughout Vietnam. Verotoxigenic E. coli (VTEC) was isolated from 197 of 261 samples (75.5%). All isolates were confirmed by basic biochemical tests and carbohydrate fermentation characteristics. Of these, 70.1% of isolates are hemolytic, 45% isolates belonged to serotypes O149:K91, possessed the VT2e gene, and was the most predominant VTEC pathotype associated with edema disease in pigs. Serogroup O139 accounted for 30% of the isolates, followed by serogroup O138 and O141 (25%). In addition to VT2e gene, the ST (72.7%) and LT (52.7%) genes were also recognized. A total of 10 representative isolates were subjected to toxigenicity testing by intraperitoneal injection in mice and experimental infection in pigs. It was shown that 100% of the mice were killed 17-24 h post injection (p.i.). All pigs experimentally infected with challenge strains and developed typical symptoms of edema disease 36-72 h p.i. A multivalent killed whole-cells vaccine containing aluminum hydroxide was prepared from 5 VTEC strains. The vaccine was 100% safe when administered by the intramuscular route into the pigs. A field trial for over 100,000 pigs (21-90 days old) showed that vaccinated pigs were protected against edema disease at a level of 90% compared to 100% of pigs from unvaccinated groups.