ABSTRACT
Background: Maternal red cell alloimmunization occurs when a woman's immune system becomes sensitive to unfamiliar red blood cell antigens. This leads to the production of alloantibodies, which can have serious implications for the fetus and newborn. However, there is a lack of comprehensive information about the extent of red cell alloimmunization in underdeveloped countries like Ethiopia. Therefore, this study aimed to determine the magnitude of red cell alloimmunization among pregnant women attending antenatal care at Wolaita Sodo University Comprehensive Specialized Hospital from September 01 to November 30, 2022. Methods: In this institutional-based cross-sectional study, 422 pregnant women were participated and recruited using a systematic random sampling technique. Data on sociodemographic characteristics, obstetric history, and other clinical information were collected using structured questionnaires through face-to-face interview. Blood grouping and indirect antihuman globulin tests were performed. The relationship between red cell alloimmunization and the independent variables was determined using the chi-square test. P-value <0.05 was considered statistical significance. Results: In this study, the blood group distributions among the participants were as follows: O, 177 (41.9%); A, 124 (29.4%); B, 76 (18%); and AB, 45 (3.86%). Among the pregnant women included in the study, a total of 51 (12.08%) were identified as RhD-negative. Out of these RhD-negative women, 5 (9.8%) were found to have developed alloimmunization with red blood cell antigens. Miscarriage and post-partum hemorrhage were found to be important factors associated with the occurrence of red cell alloimmunization in these women. Conclusion: This study showed that one out of ten pregnant women was alloimmunized. Therefore, antenatal blood grouping and indirect antihuman globulin screening should be performed routinely to manage and minimize the undesirable outcomes of alloimmunization during pregnancy.
ABSTRACT
Background: It is well documented that hospital environments are the niche/reservoir of many clinically important microorganisms, including multidrug-resistant air-borne and surface-borne pathogens. This problem is the most pressing public health concern, particularly in developing countries like Ethiopia, due to its poor infection management system. This study was planned to detect air-borne and surface-borne bacterial pathogens and their antimicrobial resistance patterns in Wolaita Sodo University Comprehensive Hospital, Southern Ethiopia. Method: A laboratory-based cross-sectional study was conducted from May to July 2021. Swabbing and open-plate sample collection methods were used to collect specimens. Standard bacteriological techniques were used to isolate and identify bacterial pathogens. The Mueller-Hinton agar was used to detect the drug susceptibility pattern of bacteria by using the Kirby-Bauer disc diffusion method. Result: From a total of 323 samples tested, 118 (36.5%) showed the growth of bacteria. The detection rate of bacterial pathogens in the intensive care unit (35.4%) was higher than in operation theater. From the total of 118 bacterial isolates, 39.8%, 27.9%, 20.3%, and 11.5% of S. aureus, P. aeruginosa, Klebsiella pneumoniae, and E. coli, respectively, were surface-borne. Whereas 37%, 25%, 20.83, and 16.6% of S. aureus, P. aeruginosa, Klebsiella species, and E. coli, respectively, were air-borne. S. aureus showed a 19.04 to 80.9% range of antimicrobial resistance to different classes of antibiotics from surface specimens. A 12.5-100% range of antibiotic resistance levels was detected for all Gram-negative surface-borne bacterial pathogens. P. aeruginosa was 66.7%, 73.3%, and 73.3% resistant to gentamicin, chloramphenicol, and ceftriaxone, respectively. K. pneumoniae showed 75% and 87.5% resistance to ceftriaxone and ciprofloxacin, respectively, and a completely ampicillin-resistant E. coli was detected. From a total of 48 bacterial pathogens identified from surfaces in the intensive care unit, 34 (70.8%) developed multidrug resistance. Conclusion: A significant prevalence of surface-borne bacterial pathogens was detected. This study revealed that S. aureus, P. aeruginosa, K. pneumoniae, and E. coli were nosocomial infection concerns of the hospital, and this could be the reason for different types of hospital acquired infections in the study area. A high prevalence of MDR was detected in the most surface-borne bacterial isolates.
ABSTRACT
BACKGROUND: In healthcare facilities, a gradual increase in methicillin-resistant Staphylococcus aureus (MRSA) infections has been seen over the past 2 decades. Similarly, it has been responsible for the most frequent and invasive pathogens associated with admitted patient infection. Currently, it is considered an urgent threat to public health and classified as one of the top-priority antimicrobial-resistant pathogens. This study aimed to determine the magnitude and associated risk factors of MRSA infection among admitted patients. METHODS: A facility-based cross-sectional examination was led on 413 patients admitted to Tikur Anbessa Specialized Hospital from January 2018 to January 2019. A convenient sampling technique was used. Clinical specimens of pus and blood were collected from admitted patients who developed the infection after 48 hours of admission. Gram stain, culture media preparations, and biochemical tests were conducted to identify and isolate the causative agent. Staphylococcus aureus (S. aureus) were identified as MRSA strains after having a zone of inhibition less than or equal to 21 mm to the cefoxitin (30 ug) disc. Bivariate and multivariable logistic regression analyses were computed. The odds ratio, along with 95% CI, was estimated to identify associated risk factors for MRSA infection. RESULTS: Out of 413 collected specimens, 38.7% had coagulase-positive S. aureus of which 35.6% (95% CI: 28.2%-43.0%) were MRSA. Being within the age group of 19-29 years and 30-39 years with AOR = 5.02 and 95% CI: 1.24-20.35 and AOR = 6.65 and 95% CI: 1.78-24.78, respectively, admitting in the hematology ward and the pediatric ward with AOR = 7.80 and 95% CI: 1.82-33.49 and AOR = 10.54 and 95% CI: 1.78-62.42, respectively, and experiencing poor prognosis with AOR = 10.97 and 95% CI: 4.57-26.36 were significantly associated with MRSA infection. Conclusion and Recommendation. The significant magnitude of MRSA was found among patients admitted to this hospital. Therefore, identified risk factors should be considered when executing hospital-acquired infection prevention programs. We also suggest that healthcare providers should consider the identified risk factors while prescribing the antibiotic.
ABSTRACT
BACKGROUND: Malaria rapid diagnostic tests (RDTs) are alternative diagnostic methods that have enabled reliable biological diagnostic testing in all situations where previously only clinical diagnosis was available. Varying diagnostic accuracy of malaria RDTs makes policymakers confused while choosing malaria test kits for their country. OBJECTIVE: The aim of this study was to evaluate the diagnostic performance of currently being used malaria RDT in Southern Ethiopia. METHODS: A cross-sectional study design was conducted from October 1 to December 15, 2016. A total of 160 patients were included in the study. Finger-prick blood sample was obtained from study subjects for the RDT test and microscopic examination. Collected data were entered and analyzed using SPSS version 20.0. RESULT: The test kit evaluated had an overall sensitivity, specificity, PPV, and NPV of 97.44%, 93.67%, 93.83%, and 97.37%, respectively, to detect the presence or absence of malaria. Sensitivity and specificity of the kit for P. falciparum detection were 63.27% and 94.3% and for P. vivax detection were 86.96% and 95.62%, respectively. The agreement between microscopy and RDT for specific identification of malaria species was moderate with a kappa value of 0.568. CONCLUSION: The overall performance of the kit was below the WHO standard. Further study on a large sample size is recommended to be carried out in the study area to use the test kit instead of microscopy for malaria diagnosis. Providing training on quality malaria laboratory diagnosis and availing necessary supplies for malaria diagnosis shall also be considered.
