Occupational exposures to blood and body fluids among healthcare workers in Ethiopia: a systematic review and meta-analysis

BACKGROUND@#Occupational exposure to blood and body fluids is a major risk factor for the transmission of blood-borne infections to healthcare workers. There are several primary studies in Ethiopia yet they might not be at the national level to quantify the extent of occupational blood and body fluid exposures (splash of blood or other body fluids into the eyes, nose, or mouth) or blood contact with non-intact skin among the healthcare workers. This systematic review and meta-analysis aimed to estimate the pooled prevalence of occupational blood and body fluid exposure of healthcare workers in Ethiopia.@*METHODS@#PubMed, Science Direct, Hinari, Google Scholar, and the Cochrane library were systematically searched; withal, the references of appended articles were also checked for further possible sources. The Cochrane Q test statistics and I tests were used to assess the heterogeneity of the included studies. A random-effects meta-analysis model was used to estimate the lifetime and 12-month prevalence of occupational exposure to blood and body fluids among healthcare workers in Ethiopia.@*RESULTS@#Of the 641 articles identified through the database search, 36 studies were included in the final analysis. The estimated pooled lifetime and 12-month prevalence on occupational exposure to blood and body fluids among healthcare workers were found to be at 54.95% (95% confidence interval (CI), 48.25-61.65) and 44.24% (95% CI, 36.98-51.51), respectively. The study identified a variation in healthcare workers who were exposed to blood and body fluids across Ethiopian regions.@*CONCLUSION@#The finding of the present study revealed that there was a high level of annual and lifetime exposures to blood and body fluids among healthcare workers in Ethiopia.

Response of drug resistant isolates of Schistosoma mansoni to antischistosomal agents

The susceptibility of four isolates of Schistosoma mansoni (BH, MAP, MPR-1 and K) to four multiple doses of anti-schistosomal agents (hycanthone, niridazole, oxamniquire, and praziquantel) were evaluated in infected female Swiss albino mice. These schistosomal isolates had been maintained in the laboratory without further drug pressure for 20 to 30 generations. Multiple dosage regimens were used for each drug against each isolate of S. mansoni to generate ED50 (effective dose 50%) values. Results demonstrated that the K isolate is resistant to niridazole, the MPR-1 isolate to oxamniquine, and the MAP isolate to both hycanthone and oxamniquine. The BH isolate was susceptible to all drugs and was used as the reference isolate. All isolates were susceptible to praziquantel. The significance of the difference in response of the MPR-1 and MAP isolates is discussed. These results confirm the resistance of these isolates of S. mansoni of three schistosomicides and demonstrate that the resistance of these isolates are stable over long periods of time without exposure to drugs

Efficacy of niclosamide as a potential antipenetrant (TAP) against cercariae of Schistosoma mansoni monkeys

A 1% (W/V) formulation of Niclosamide (2', 5-Dichloro-4-nitrosalicylanilide) (TAP) was tested on Cebus apella monkeys as a topical prophylatic against schistosomiasis mansoni. Two experiments were conducted using the same formulation. In the first experiment, the TAP provided complete protection against schistosomiasis for 3 days. Of the 4 monkeys treated with TAP 7 days before exposure to Schistosoma mansoni cercariae, 2 were completely protected. The remaining 2 monkeys of the 7 day treatment group had a 78% or greater reduction in adult worm buderns when compared to the placebo treated monkeys. The second experiment was designed determine the time between day 3 and 7 when the TAP no longer provided complete protection. However, all of the TAP treated monkeys in this experiment were completely protected, even the monkeys treated 7 days earlier. In both experiments, all monkeys used as infection controls and those receiving only the placebo became infected and showed typical experimental schistosomiasis. These results demonstrate that the TAP could provide fast acting, short-term protection to people who must enter cercariae infested water

Rate of action of Schistosomicides in mice infected with Schistosoma mansoni

Camundongos infectados experimentalmente com Schistosoma mansoni foram tratados por via oral com dose única de 125 ou 250 mg/Kg de oltipraz, 50 ou 100mg/Kg de oxamniquine, e 200 ou 400mg/Kg de praziquantel. O número de vermes e alteraçäo do oograma foram determinado entre a 1ª e a16ª semanas após o tratamento. O tempo necessário para observar o máximo de atividade da droga foi de 1 semana para o praziquantel, 2 semanas para o oxamniquine e 8 semanas para o olipraz. Alteraçöes do oograma persistiram durante o período de observaçäo, embora recidiva tenha sido detectada, já na 4ª semana, com as drogas utilizadas

Variation in response of Schistosoma mansoni strains to Schistosomicides

A cepa BH de S. mansoni foi suscetível ao hycanthone (1 X 80 mg/Kg), oxamniquine (1 X 100 mg/Kg), niridazole (5 X 100 mg/Kg), praziquantel (1 X 100 mg/Kg), oltipraz (5 X 125 mg/Kg) e amoscanato (1 X 300 mg/Kg). Assim, essa cepa do trematódeo é importante como referência nos estudos de quimioterapia experimental. Por outro lado, a cepa MPR-1 apresentou resistência ao oxamniquine e/ou hycanthone. Foi possível constatar em uma cepa resistência parcial ao oltipraz

Strain variation in the infectivity of Schistosoma mansoni for Biomphalaria glabrata

Com duas linhagens de Biomphalaria glabrata foi estudada a suscetibilidade de cinco cepas de Schistosoma mansoni resistentes e suscetíveis a esquistossomicidas. Três cepas do trematódeo oriundas de Porto Rico apresentaram desenvolvimento mais lento e menor índice de infecçäo em B. glabrata brasileira quando comparados com o comportamento de duas cepas de S. mansoni provenientes do Brasil. Por outro lado, as cepas brasileiras do parasita desenvolveram bem e infectaram mais de 90% dos exemplares de B. glabrata portorriquenhos. Entre os resultados, ressalta-se que cepas resistentes a esquistossomicidas poderäo ser utilizadas por pacientes em diferentes áreas geográficas como Brasil e Porto Rico

Drug resistance in Schistosomiasis: a review

Drug resistance associated with the treatment of human schistosomiasis appears to be an emerging problem requiring more attention from the scientific community than the subject currently receives. Drug-resistant strains of Schistosoma mansoni have been isolated by various investigators as a result of laboratory experimentation or from a combination of field and laboratory studies. Review of this data appears to indicate that the lack of susceptibility observed for some of the isolated strains cannot be ascribed solely to previous administration of antischistosome drugs and thus further studies are required to elucidate this phenomena. Strains of S. mansoni have now been identified from Brazil which are resistant to oxamniquine, hycanthone and niridazole; from Puerto Rico which are resistant to hycanthone and oxamniquine; and from Kenya which are resistant to niridazole and probably oxamniquine. Strains derived by in vitro selection and resistant to oxamniquine and possibly to oltipraz are also available. All of these strains are currently maintained in the laboratory in snails and mice, thus providing for the first time an opportunity for indepth comparative studies. Preliminary data indicates that S. haematobium strains resistant to metrifonate may be occurring in Kenya. This problem could poise great difficulty in the eventual development of antischistosomal agents. Biomphalaria glabrata from Puerto Rico and Brazil were found to be susceptible to drug-resistant S. mansoni from each country.