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1.
PLoS One ; 19(7): e0289450, 2024.
Article in English | MEDLINE | ID: mdl-38980874

ABSTRACT

BACKGROUND: Second-line HIV treatment failure has become increasing worldwide, mainly in sub-Sahara Africa including Ethiopia. Even though the problem becomes increasing, inadequate information was available about its magnitude and associated factors in the current study area. OBJECTIVE: To assess the factors of second-line Anti-Retroviral Treatment virological failure among second-line ART users. METHOD AND MATERIALS: Institutional-based unmatched case-control study design was conducted from September to December 2021 at Felege Hiowt and University of Gondar Comprehensive Specialized Hospitals; Amhara region, Northwest Ethiopia. A total of 216 patients (60 cases and 156 controls) were recruited by a simple random sampling technique with a 1:3 cases-to-controls ratio. Patients who had two viral load results >1000 copies/ml within a 3-month interval after taking ART drugs for at least 6 months were cases and those who had ≤1,000 copies/ mL were controls. The sample size was calculated by using Epi-Info version 7.2.4. Structured questionnaires were used to gather the required information. SPSS version 26 was used to summarize the findings. In bivariate logistic regression model, Variables with two-tailed P-value ≤ 0.25 at 95% confidence interval were transferred into multivariate binary logistic regression model and P value at ≤ 0.05 was set as statistically significant. RESULTS: Out of 216 patients recruited, 212 have participated with a response rate of 98.2%. From these participants, 117(55.2%) were males and 187(88.2%) were urban dwellers. Among the total respondents, 208(98.1%) had age > 24 years, 200(94.3) were at HIV clinical stage I, 72(34%) had poor ART adherence and 112(52.8) did not disclose their HIV status. Likewise, most of the patients 147(69.37) didn't use condoms. The associated factors were not disclosing HIV status (AOR = 3.4, 95% CI: 1.52-7.79), medium adherence (AOR = 3.7, 95% CI = 1.3-10.7), poor adherence level (AOR = 5.27, 95% CI: 2.2-12.5), not using condoms (AOR = 4.47, 95% CI: 1.63-12.2) and Viral load (>150 copies/ml) when switched to second-line ART (AOR = 3.56, 95% CI: 1.5-8). CONCLUSION AND RECOMMENDATIONS: Non-disclosure, poor or medium adherence, not using condoms and high Viral load (>150 copes/ml) when switched to second-line ART were the main factors for second-line Anti-Retroviral Treatment virological failure. Disclosure about HIV status, using condoms and improving treatment adherence level are crucial to reduce second-line virological failure.


Subject(s)
HIV Infections , Treatment Failure , Viral Load , Humans , Ethiopia/epidemiology , Male , Female , HIV Infections/drug therapy , HIV Infections/virology , Adult , Case-Control Studies , Viral Load/drug effects , Middle Aged , Anti-HIV Agents/therapeutic use , Young Adult , Adolescent , Hospitals, Special
2.
Front Public Health ; 12: 1362086, 2024.
Article in English | MEDLINE | ID: mdl-38919920

ABSTRACT

Background: Intestinal parasitic infections pose significant global health challenges, particularly in developing countries. Asymptomatic infections often present a considerable burden with food handlers serving as potential carriers. In Ethiopia, the prevalence of these parasites varies across regions, and accurate data in the study area is lacking. Therefore, this study aimed to investigate the prevalence of intestinal parasites among food handlers working in hotels and restaurants in Gondar City, Northwest Ethiopia. Methods: A cross-sectional study collected stool samples from food handlers alongside a structured questionnaire gathering socio-demographic and hygiene practice information. Stool specimens were screened for intestinal parasites using direct wet mount and formol-ether concentration techniques. The collected data were checked for completeness, entered into EpiData software version 3.1, and exported to SPSS version 20 for analysis. A multivariable logistic regression analysis was deemed statistically significant if the p-value was less than 0.05. Results: A total of 257 food handlers working in hotels and restaurants in Gondar City participated in the study. Of these, 33.5% (86/257) were found positive for one or more intestinal parasites, with a 95% confidence interval (CI) of 28.0-39.5%. The study identified nine types of intestinal parasites, with E. histolytica/dispar (8.2%, 21/257) and Ascaris lumbricoides (6.6%, 17/257) being the predominant parasites, followed by hookworm (3.5%, 9/257) and S. mansoni (2.3%, 6/257). The prevalence of mixed infections was 9.3% (24/257). A significant association was observed between intestinal parasitic infection and the educational level of food handlers. Conclusion: In this study, a high prevalence of intestinal parasites was detected indicating poor hygiene practices of the food handlers at the study site. Even the prevalence of mixed infections was high. Regular training, strict adherence to personal hygiene and food-handling practices, and routine inspections and medical checkups for food handlers are crucial.


Subject(s)
Food Handling , Intestinal Diseases, Parasitic , Humans , Ethiopia/epidemiology , Intestinal Diseases, Parasitic/epidemiology , Cross-Sectional Studies , Male , Female , Adult , Food Handling/statistics & numerical data , Prevalence , Middle Aged , Feces/parasitology , Surveys and Questionnaires , Risk Factors , Young Adult , Adolescent , Restaurants/statistics & numerical data , Animals
3.
PLoS One ; 17(4): e0266878, 2022.
Article in English | MEDLINE | ID: mdl-35404978

ABSTRACT

Urinary tract infection and antimicrobial resistance remains the major problem, with significant health and socioeconomic burden, particularly in developing countries. This infection is commonly caused by Gram-negative bacteria, principally by Escherichia coli. So, this study aimed to determine bacterial isolates and antimicrobial resistance trend among patients with urinary tract infection at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. A retrospective study was conducted from January 1st to February 28th. A ten years (2010-2019) record of urine culture results, the biochemical test and antimicrobial susceptibility test results of isolates were collected from the medical microbiology laboratory register using a checklist. Data quality was checked, entered, and analyzed using SPSS version 23. We have presented results through descriptive tables and graphs. The overall prevalence of urinary tract infection among 4441 patients was 24.1%. Escherichia coli (37.7%), Klebsiella pneumoniae (11.4%), and Staphylococcus aureus (9.1%) were the predominant uropathogens. The infection rate was nearly similar across both sexes but highest in the age group above 60 years. Above 75% of Gram-negative isolates were resistant to ampicillin (92.5%), amoxicillin-clavulanate (80.1%), tetracycline (79.3%), cefuroxime (79.2%), and Trimethoprim-sulfamethoxazole (78.3%). Over 2/3 of Gram-positive isolates also showed increased resistance to tetracycline (84.8%) and penicillin (71.6%). Moreover, more than 44% of the isolates were multidrug-resistant (MDR). We have seen an inconsistent trend of antimicrobial resistance, with an overall resistance rate of above 50%. In conclusion, the overall prevalence of urinary tract infection was high and elderly patients were most affected. More than 70% of both Gram positive and gram-negative isolates were resistant to penicillin, ampicillin, amoxicillin-clavulanate, tetracycline, cefuroxime, Trimethoprim-sulfamethoxazole. Above than 44% of the isolates were multidrug-resistant (MDR). The increasing rate of antimicrobial resistance calls for routine diagnosis and antimicrobial susceptibility testing. A prospective multicenter study indicating the status of resistance should be encouraged.


Subject(s)
Anti-Bacterial Agents , Urinary Tract Infections , Aged , Amoxicillin-Potassium Clavulanate Combination , Ampicillin , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteria , Cefuroxime , Drug Resistance, Bacterial , Drug Resistance, Multiple, Bacterial , Escherichia coli , Ethiopia/epidemiology , Female , Hospitals , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Prospective Studies , Retrospective Studies , Tetracycline , Trimethoprim, Sulfamethoxazole Drug Combination , Urinary Tract Infections/drug therapy , Urinary Tract Infections/epidemiology , Urinary Tract Infections/microbiology
4.
Interdiscip Perspect Infect Dis ; 2022: 7905350, 2022.
Article in English | MEDLINE | ID: mdl-35309500

ABSTRACT

Background: Resistance among the commensal flora is a serious threat because they are highly populated ecosystems like the gut, maybe a source of extraintestinal infections. Infections due to extended-spectrum beta-lactamase (ESBL)- and carbapenemase (CPM)-producing Enterobacteriaceae family of bacteria impose a major global issue because they are usually resistant to multiple antimicrobial agents. Data on the fecal ESBL- and CPM-producing group of bacteria in developing countries including Ethiopia are limited mainly due to resource constraints. Thus, this study aimed to determine the prevalence of multidrug-resistant (MDR)-, ESBL-, and CPM-producing Enterobacteriaceae family of bacteria from diarrheal stool samples at the University Hospital, Northwest Ethiopia. Materials and Methods: A hospital-based cross-sectional study was conducted involving a total of 384 study participants having gastrointestinal complaints from January to April 2019. A diarrheal stool sample was aseptically collected and inoculated on a MacConkey agar plate. After getting pure colonies, biochemical and antimicrobial susceptibility testing was done following standard microbiological techniques. ESBL production was screened using ceftazidime and cefotaxime and confirmed using a combined disk diffusion test. Carbapenemases were screened by meropenem disk and confirmed by the modified carbapenem inactivation method. Data were checked, cleaned, and entered using Epi Info version 7.1 and transferred to SPSS version 20 for analysis. Result: A total of 404 Enterobacteriaceae groups of bacteria were isolated from 384 diarrheal stool samples. The overall prevalence of fecal MDR-, ESBL-, and CPM-producing group of Enterobacteriaceae was 196 (48.5%), 66 (16.3%), and 4 (1%), respectively. Of the total ESBL-producing Enterobacteriaceae, E. coli (41/66 (62.1%)) and K. pneumoniae (18/66 (27.3%)) were the most predominant isolates. One half of CPE has been observed in Citrobacter species and the rest in E. coli (25%) and P. vulgaris (25%). Conclusion and Recommendation. Finding the high rate of ESBL-producing Enterobacteriaceae and CPE requires strict infection control measures and careful selection of empirical therapy in the study area. Therefore, active surveillance with large sample size and better infection prevention control is needed.

5.
Article in English | MEDLINE | ID: mdl-31321030

ABSTRACT

Background: Enteric bacterial pathogens are the major causes of food-borne gastroenteritis in humans and remain important public health problems worldwide. The emergence of antimicrobial resistance is a global concern, particularly in developing countries. The aim of this study was to determine the prevalence of enteric bacteria pathogens and their antimicrobial susceptibility patterns among food handlers in Gondar town, Northwest Ethiopia. Methods: A cross-sectional study was conducted from February 4 to April 16, 2018. A total of 257 food handlers were selected using a multistage sampling technique. Data on socio-demographic characteristics were collected using a structured questionnaire. Stool samples were collected and inoculated into appropriate media. Enteric bacterial pathogens were identified using standard microbiological methods. Antimicrobial susceptibility tests were performed using the disk diffusion technique as per the standard Kirby-Bauer method. Data were entered and analyzed using SPSS version 20 software. Results: The overall prevalence of enteric bacteria was 34/257 (13. 2%, [95% CI, 8.9-17.5%]). Shigella species was the leading isolate that accounted for 26/257 (10.1%) followed by Enterohemorrhagic Escherichia coli (EHEC) O157: H7 5/257 (1.9%) and Salmonella species 3/257 (1.2%). Shigella spp. was susceptible to ciprofloxacin 26 (100%), ceftriaxone 25 (96.1%), chloramphenicol 24 (92.3%), nalidixic acid 24 (92.3%), and gentamicin 20 (76.9%). Escherichia coli O157: H7 and Salmonella spp. showed the maximum (100%) susceptibility results to ceftriaxone, chloramphenicol, ciprofloxacin, and gentamicin. The overall prevalence of Multidrug resistance (MDR) in the current study was 14/34 (41.2%). Conclusion: Our study showed high prevalence of enteric bacterial pathogens among food handlers. All isolates were susceptible to ciprofloxacin. However, a substential number of isolates were resistant to commonly prescribed antibiotics and the prevalence of MDR was high.


Subject(s)
Anti-Bacterial Agents/pharmacology , Ciprofloxacin/pharmacology , Drug Resistance, Multiple, Bacterial , Enterobacteriaceae Infections/epidemiology , Gastroenteritis/microbiology , Salmonella/isolation & purification , Shigella/isolation & purification , Adolescent , Adult , Cross-Sectional Studies , Disk Diffusion Antimicrobial Tests , Enterobacteriaceae Infections/microbiology , Ethiopia/epidemiology , Feces/microbiology , Female , Food Handling , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Prevalence , Salmonella/drug effects , Shigella/drug effects , Surveys and Questionnaires , Young Adult
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