Enteric pathogens and antimicrobial susceptibility profile among pediatric patients with diarrhea in Addis Ababa, Ethiopia

Background: Diarrheal disease remain a major public health problem in developing countries including Ethiopia. The current study was designed to isolate medically important bacterial enteric pathogens and assess the antimicrobial susceptibility pattern for prescribed drugs. Methods: A cross-sectional study was performed between November 2016 and May 2017 to determine bacterial enteric pathogens that cause diarrhea and assess their antimicrobial susceptibility profile. Stool specimens from pediatric patients aged 0-14 years were collected from two health centers and one specialized hospital to identify bacterial enteric pathogens. Antimicrobial susceptibility tests were performed on bacterial isolates using the Kirby-Bauer disc diffusion method. Results: Out of 290 study patients with diarrhea examined, the majority of bacterial enteropahogens isolated in the study were Shigella species 22(7.6%) followed by enterohemorrgic E.coli O157:H7 13(4.5%) and Salmonella species 7(2.4%). Among the Salmonella species 42.9% showed resistance to trimethoprim-sulphamethoxazole. Among the Shigella species, 77.3% were resistant to ampicillin and 68.2% to trimethoprim-sulphamethoxazole whereas E.coli O157:H7 strains were resistant mostly to ampicillin (69.2%), and trimethoprim-sulphamethoxazole (46.1%). The overall prevalence of multi-drug resistance (MDR) (to ≥3 classes of antibiotics) among the isolates was 26.2%. Conclusion: Salmonella species, enterohemorrhagic E.coli O157:H7and Shigella species were the most frequently isolated pathogens in children with diarrhea. A high proportion of the Salmonella and Shigella isolates identified in the study showed resistance to the most frequently prescribed drugs ampicillin and trimethoprim-sulphamethoxazole. Ciprofloxacin was found to be the best drug of choice for the treatment of diarrhea caused by Salmonella and Shigella. When antibiotics are indicated to treat diarrhea in children, clinicians should rely on stool culture and antimicrobial susceptibility testing before prescribing drugs

Determining seroprevalence of Hepatitis B and C virus infections and associated risk factors among apparently healthy mothers in Addis Ababa, Ethiopia

Introduction: Viral hepatitis is a global public health problem affecting millions of people every year, causing disability and death. Hepatitis B (HBV) and hepatitis C (HCV) viruses spread horizontally, mainly through sexual contact and contaminated needles, and vertically. Both cause considerable morbidity and mortality worldwide. Maternal infection is a risk factor for vertical transmission. Objective: To determine the sero-prevalence of HBsAg and anti-HCV antibody among non-pregnant, apparently healthy mothers and to identify potential risk factors associated with HBV or HCV infection. Methods: A community based cross sectional study was conducted on 454 apparently healthy women, in Addis Ababa, Ethiopia from May 2016 to June 2017. A systematic random sampling method was used to recruit participants. Result: A total of 454 mothers were enrolled. Sero-prevalence of HBsAg and HCV was found to be 3.7% and 2.0%, respectively. HBc antibody was detected in 36.3% of the mothers. None of the participants were co-infected with both viruses. Previous history of liver disease, history of jaundice, HIV infection, and family history of liver disease were significantly associated with HBV infection. Marital status, caring for hepatitis patients, and a history of liver disease were factors significantly associated with HCV infection. Conclusion: Apparently healthy mothers in Addis Ababa had intermediate level of endemicity for hepatitis B and C infections Routine screening and vaccination of high risk reproductive mothers against HBV is advisable. Emphasis should be given to health education and promotion of infection control practices. Population based studies are strongly recommended to help monitor disease transmission patterns and to design evidence-based interventions against the spread of hepatitis infections in Ethiopia

Antibody response against Hepatitis B virus after vaccination and seroprevalence of HBV in children in Addis Ababa, Ethiopia

Background: Around two billion people have been infected with HBV worldwide, and more than 240 million are chronic carriers. Vaccine introduction for HBV in children was officially launched by the WHO in 1980. Since then the vaccine response level has been determined in different countries. Since the introduction of the vaccine in Ethiopia in 2007, few studies have been conducted to assess the antibody response against the HBV vaccine. Objectives: The aim of this study is to determine antibody response against HBV after hepatitis B vaccination and assess the seroprevalence of HBV in children in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted using a multistage probability sampling technique. Four hundred and fifty children between the ages of 5 and 8 living in Addis Ababa were enrolled. Socio-demographic characteristics were obtained through a structured questionnaire and three to four ml of blood was collected from each child. ELISA was performed to determine antibody levels against HBV. Results:The mean age was 7+1 (SD) years. Anti-HBs were detected in 54.3% (208/450) of children with a slightly higher proportion of protective level in females 98 (54.7%) than males 110 (53.9%). The overall vaccine coverage in our study was 85.1 %. The proportion of children with a protective level (>10 mIU/ml anti-HBs antibody) declined as the age of the child increased: 52.6%, 60%, 43.5% and 37.1% at the age of 5, 6, 7 and 8 years, respectively. Seroprevalence of HBsAg was 0.4%, whereas seroprevalence of anti-HBc was 5.6%. Age was negatively correlated with the response level (p=0.001), whereas sex and history of HBV infection had no significant association. Age was also significantly associated with seroprevalence of anti-HBc (p=0.003). Conclusion: The HBV vaccine coverage in children was high but antibody response against the vaccine appears low. Seroprevalence of the virus was also low. The low response level to the vaccine should be a concern and revaccination or booster doses should be considered for non-responding children. Further studies should also be undertaken

Healthcare professionals' awareness, knowledge, attitudes, perceptions and beliefs about Ebola at Gondar University Hospital, Northwest Ethiopia: a cross-sectional study

A poor understanding of Ebola Virus Disease (EVD) among Health Care Professionals (HCPs) may put our lives at risk. We aimed to assess the awareness, knowledge, attitudes, perceptions, beliefs of HCPs towards Ebola at Gondar University Hospital (GUH) in Northwest Ethiopia. We conducted a hospital based, cross-sectional survey among 245 randomly selected HCPs working at GUH from August-October, 2015. A validated, self-administered questionnaire was used to collect the data. We calculated descriptive statistics with P0.05 being statistically significant. Of the 245 participants, 211 (86.1%) completed the study. The majority had heard about EVD and used news media (62%) as a source of information. Still, many were afraid of getting EVD (56.4%; P=0.001). A significant number of HCPs thought EVD can cause paralysis like polio (45%) and can be treated with antibiotics (28.4%). In addition, 46.4% of the HCPs felt anger or fear towards Ebola infected patients (P=0.006). We identified poor knowledge and negative incorrect beliefs among doctors and allied health professionals. There is a need for intensive training for all HCPs reduce EVD risk