Bacterial Etiology of Urinary Tract Infection and Antibiogram Profile in Children Attending Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia.

Background: Bacterial urinary tract infections are important public health problems in children. This study was conducted to identify the bacterial agents of urinary tract infections and antibiogram patterns in children. Methods: A hospital-based cross-sectional study including 220 children was carried out between November 15, 2021, and March 10, 2022. Simple random sampling was used to enroll participants. The sociodemographic and clinically pertinent information was gathered using a semi-structured questionnaire. Every participant in the study who was ≤15 years old gave clean-catch midstream urine. Urine samples were inoculated onto a cystine lactose electrolyte-deficient agar using a calibrated inoculating loop with a 0.001 ml capacity and then incubated aerobically for 24 hours at 37°C. Subculturing for significant bacteriuria was done on MacConkey and blood agar. Gram staining, biochemical assays, and colony characteristics were used for bacterial identification. The disc diffusion method developed by Kirby and Bauer was used for antimicrobial susceptibility testing. SPSS software version 25 was used for data entry and analysis. To find the risk factors, bivariate and multivariate logistic regression analyses were performed. An association was deemed statistically significant if the p value at the 95 percent confidence interval was less than 0.05. Results: In this study, the majority (50.5%) of the study participants were males. The mean age of the study participants was 6 ± 0.91 years. It was found that 31.8% of children had urinary tract infections. The most prevalent urinary pathogens among the isolates were E. coli (27.1%) and S. aureus (18.6%). Approximately 56% of the participants were infected with multidrug-resistant pathogens. Additionally, compared to children who have never had a urinary tract infection, children with a history of infection had 1.04 (95 percent confidence interval (CI): 0.39, 2.75) times higher risk of infection. Conclusion: This study has shown an alarming increase in the prevalence of pediatric urinary tract infections which warrants further investigation into multidrug-resistant bacterial infection.

Female adolescents' knowledge and acceptability of human papillomavirus vaccine in Debre Tabor Town, Ethiopia: a cross-sectional study.

OBJECTIVE: This study aimed to assess the knowledge and acceptability of the human papillomavirus (HPV) vaccine and associated factors among female adolescent students in Debre Tabor Town, Ethiopia, 2021. DESIGN: Cross-sectional study was done from 9 December 2020 to 28 February 2021. ANALYSIS: The data were entered into EpiData V.4.2 and analysed with SPSS V.23 software. The OR, 95% CI and p<0.05 were used to determine the bivariable and multivariable statistical association. SETTING: Three high schools (grades 9 and 10) and six primary schools (grades 7 and 8) were included in the study. PARTICIPANTS: Adolescent female students in Debre Tabor Town. RESULTS: The overall knowledge score in the questionnaire was six, and it was divided into two groups based on scoring level: poor (score <3) and good (score ≥3). More than half respondents (59.2%) scored good knowledge. The proportion of acceptability of the HPV vaccine was 61.9%. Age (adjusted OR, AOR 1.70, 95% CI 1.17 to 3.88), and having a source of information (AOR 1.94, 95% CI 1.06 to 3.22) were significantly associated with the knowledge of the HPV vaccine. Place of birth (AOR 1.55, 95% CI 1.15 to 1.95), fathers' educational status (AOR 2.80, 95% CI 1.18 to 5.65), having a source of information (AOR 2.14, 95% CI 1.05 to 4.32) and knowledge about the HPV vaccine (AOR 6.41, 95% CI 3.45 to 11.90) were significantly associated with the acceptance of the female adolescent HPV vaccine. CONCLUSION: In this study, the knowledge and acceptability of students of the HPV vaccine were low. Health authorities, through the mass media, should strengthen HPV vaccine promotion in schools, religious institutions and health facilities.

Diabetes mellitus among adults on highly active anti-retroviral therapy and its associated factors in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: Diabetes mellitus occurs as a comorbid illness among people living with HIV and, in particular those on Highly Active Anti-retroviral therapies (HAART). Previous studies have documented the prevalence of diabetes mellitus among adults on HAART; however, there is lack of comprehensive estimation. Hence, this study was aimed to estimate the pooled prevalence and associated factors of diabetes mellitus among adults on HAART in Ethiopia. METHODS: Primary studies were exhaustively searched using Cochrane, PubMed, Google Scholar, Scopus and Web of science databases until February 2021. Eligible studies were selected and critically appraised for quality using the Joanna Briggs Institute (JBI) quality appraisal checklist. The required data were extracted and exported to Stata version 16 for meta-analysis. The overall prevalence of diabetes mellitus among adults on HAART was estimated using a weighted inverse random effect model. Sensitivity and sub-group analysis were conducted for evidence of heterogeneity. Trim and fill analysis was performed after Egger's test and funnel plot were indicating the presence of publication bias. RESULTS: A total of 17 studies with 6,052 subjects on HAART were included. The pooled prevalence of diabetes mellitus among patients on HAART was 16.04% [95% Confidence Interval (CI); 11.6, 20.92]. Abnormal High Density Lipoprotein Cholesterol (HDL-C) [Adjusted Odd Ratio (AOR) = 4.68, 95% CI; 2.54, 6.82], Body Mass Index (BMI) ≥ 25 kg/m2 [AOR = 7.41, 95% CI; 2.75, 12.08], ≥6 years ART [AOR = 8.14, 95% CI; 5.85, 30.43], hypertension [AOR = 3.29, 95% CI; 2.13, 4.45], age 35-44 years [AOR = 6.28; 95% CI; 4.20, 8.37, BMI ≥ 30 kg/m2 [AOR = 7.81, 95% CI; 4.97, 10.64], educational status above diploma [AOR = 6.42, 95% CI; 1.28, 11.57] and age 45-55 years [AOR = 4.46, 95% CI; 2.81, 6.10] were positively associated with diabetes mellitus comorbidity among adults on HAART. CONCLUSION: The higher prevalence of diabetes mellitus was observed for adults on HAART. HDL-C, duration of ART, hypertension, overweight, obesity, age and educational status of participants increases the prevalence of diabetes mellitus. The study highlights the importance of timely screening of HDL-C level, blood pressure and BMI for adults on HAART.

Macrosomia and its predictors in pregnant women with diabetes in Ethiopia.

BACKGROUND: To estimate the prevalence of macrosomia and contributing factors among pregnant women with diabetes in Ethiopia. METHODS: The Cochrane, PubMed, Google Scholar, SCOPUS, Web of Science electronic databases and grey literature found in online university repositories were searched for primary studies reporting the prevalence of macrosomia (birth weight ≥4 kg, irrespective of gestational age) and/or at least one determinant factor using WHO diabetes diagnosis criteria were involved. Variations across the studies were checked using the I2  statistic; funnel plot and Egger's test were used to assess publication bias. A weighted inverse random effect model was used to estimate the overall prevalence of macrosomia. RESULTS: The overall prevalence of macrosomic newborns among pregnant women with diabetes [15.1% (95% CI: 9.0%, 21.2%)] was higher than the prevalence among non-diabetic mothers (3.9%). Maternal blood glucose level >100 mg/dl [AOR = 10.5: 95% CI: 5.9, 15.1] and >120 mg/dl [AOR = 8.8: 95% CI: 4.5, 13.0], lack of Antenatal Care (ANC) visit [AOR = 10.8: 95% CI: 6.0, 15.0], previous adverse birth outcomes and advanced maternal age [AOR = 3.5: 95% CI: 1.0, 5.9] were significantly associated with the prevalence of macrosomia at 95% CI. CONCLUSION: The pooled prevalence of macrosomia among pregnant women with diabetes was higher than the prevalence among non-diabetic pregnant women (3.9%). Advanced maternal age, previous adverse birth outcomes, lack of ANC and uncontrolled maternal plasma glucose level were independent predictors of macrosomia.

Coagulopathy in SARS-CoV-2 Infected Patients: Implication for the Management of COVID-19.

COVID-19 disease has led to an extraordinary inclusive health crisis globally. Elevation of D-dimer is the major remarkable abnormal coagulation test in seriously ill COVID-19 patients. In nearly 50% of COVID-19 patients, the value of D-dimer was significantly enhancing. Recent literature indicated that COVID-19 patients were at higher risk of developing disseminated intravascular coagulation. Pro-inflammatory cytokines and chemokines are some of the factors leading to these conditions. The majority of COVID-19 patients showed a higher profile of pro-inflammatory cytokines and chemokines in severe clinical conditions. Tumor necrosis factor-α (TNF-α) and interleukins (ILs) elevated in COVID-19 infected patients. TNF-α, IL-6, and IL-1 are major cytokines vital for the inhibition of intrinsic anticoagulant pathways. COVID-19 becomes a higher complication with a significant effect on blood cell production and hemostasis cascades. Deep vein thrombosis and arterial thrombosis are common complications. Changes in hematological parameters are also frequently observed in COVID-19 patients. Especially, thrombocytopenia is an indicator for poor prognosis of the disease and is highly expected and aggravates the likelihood of death of SARS-CoV-2 infected individuals. Thrombopoiesis reduction in COVID-19 patients might be due to viral abuse of the bone marrow/the viral load may affect thrombopoietin production and function. In other ways, immune-inflammation-mediated destruction and increased consumption of platelets are also the possible proposed mechanisms for thrombocytopenia. Therefore, the counting of platelet cells is an easily accessible biomarker for disease monitoring. All SARS-CoV-2 infected patients should be admitted and identifying potential higher-risk patients. It is also obligatory to provide appropriate treatments with intensive care and strict follow-up. In addition, considerations of chronic diseases are essential for better prognosis and recovery. The current review discusses coagulopathy among SARS-CoV-2 infected individuals and its complication for the management of the disease.

Prevalence and Determinants of Pre-Cancerous Cervical Lesion and Human Papillomavirus Among HIV-Infected and HIV-Uninfected Women in North-West Ethiopia: A Comparative Retrospective Cross-Sectional Study.

BACKGROUND: The poor socio-economic status, underdeveloped health care system, and the high HIV/AIDS burden have potentially increased the incidence of cervical cancer in sub-Saharan Africa (SSA) including Ethiopia. Studies on the magnitude of pre-cancerous cervical lesion and human papillomavirus (HPV) among HIV-infected women are still limited, particularly in the current study setting. Thus, we determined the prevalence of pre-cancerous cervical lesion and HPV among HIV-infected women in comparison with HIV-uninfected women at Debre Tabor Comprehensive Specialized Hospital (DTCSH), North-West Ethiopia. METHODS: Hospital-based comparative retrospective cross-sectional study was conducted among 546 women from July 2018 to January 2020 at DTCSH. All records during the study period were collected using a structured checklist. Epi data version 4.02 and SPSS version 25.0 were used for data entry and analysis, respectively. RESULTS: The overall prevalence of pre-cancerous cervical lesion among 546 women was 8.8%. The prevalence of pre-cancerous cervical lesion was comparable between HIV-infected (9.3%) and HIV-uninfected women (8.6%) (p = 0.859). Age >45 years old, widowed marital status, multiparous (women ≥ 5 childbirths), and educational status were independent contributing factors of a pre-cancerous cervical lesion. Regarding HPV prevalence, among 109 screened women, 7 (6.4%) were positive for both HPV 16 and 18 strains. CONCLUSION: HIV infection was not statistically correlated with the magnitude of pre-cancerous cervical lesion (p = 0.859). Women in the study setting developed pre-cancerous cervical lesions irrespective of their HIV status. Hence, we recommend routine screening of women for pre-cancerous cervical lesion and HPV infection regardless of their HIV status for early management and prevention of associated morbidity and/or mortality.

Neopterin: A Promising Candidate Biomarker for Severe COVID-19.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has rapidly spread across the world since its first emergence in China in late 2019. It is a major public health concern with no effective treatct 3ments. The immunopathology of SARS-CoV-2 is associated with an excessive inflammatory response. Macrophage activation syndrome (MAS) is also associated with the severity of the disease in SARS-CoV-2-infected patients. Neopterin is a macrophage activation marker produced by monocytes and macrophages upon activation by interferon-gamma (IFN-γ). Neopterin is a well-established marker in a variety of diseases, and recent evidence indicates that it could be helpful in early prediction of the severity of COVID-19 disease and serve as a prognostic marker. Here, we outline the role of macrophage activation syndrome in the pathogenesis of SARS-CoV-2 and suggest that neopterin could be used as a biomarker for progression of COVID-19.

COVID-19 pandemic: current knowledge about the role of pets and other animals in disease transmission.

On 11 March 2020, the World Health Organization (WHO) announced Corona Virus Disease (COVID-19), a disease caused by a pathogen called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a pandemic. This ongoing pandemic has now been reported in 215 countries with more than 23 million confirmed cases and more than 803 thousand deaths worldwide as of August 22, 2020. Although efforts are undergoing, there is no approved vaccine or any specific antiretroviral drug to treat COVID-19 so far. It is now known that SARS-CoV-2 can affect not only humans but also pets and other domestic and wild animals, making it a one health global problem. Several published scientific evidence has shown that bats are the initial reservoir hosts of SARS-CoV-2, and pangolins are suggested as an intermediate hosts. So far, little is known concerning the role of pets and other animals in the transmission of COVID-19. Therefore, updated knowledge about the potential role of pets in the current outbreak will be of paramount importance for effective prevention and control of the disease. This review summarized the current evidence about the role of pets and other animals in the transmission of COVID-19.

Immunoglobulin G2 Antibody as a Potential Target for COVID-19 Vaccine.

The global threat of COVID-19 is continued with no commercially available vaccine or drug yet. While the application of convalescent therapy is usually beneficial, for critically ill patients, the detrimental effect associated with some antibodies is also reported. The immunoglobulin G (IgG) antibody in response to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is described, albeit the lack of defining whether the difference in subclasses has a beneficial or detrimental role. IgG2 has limited ability to activate innate immune cells and complement-mediated inflammation, which have been inversely described in SARS-CoV-2 pathogenesis. The expansion of IgG2 is promoted by interferon γ (IFN-γ); however, there is a low level of IFN-γ in COVID-19 patients. Therefore, this review describes the importance of targeting IgG2, with IFN-γ in minimizing the SARS-CoV-2 associated inflammation, and may provide insight into the design of vaccine or antibody-based therapies to COVID-19 disease.

Hematological reference intervals among full-term newborns in Ethiopia: a cross-sectional study.

BACKGROUND: Hematological reference intervals are used for medical decision tools for interpretation of numerical test results. Establishing of hematological interval among newborn babies is very important for the diagnosis of malignancy, anemia, bleeding disorders, and various infections. There are no locally established hematological reference intervals in Ethiopia. Thus, the aim of this study is to establish locally determined hematological reference interval among full-term newborns. METHODS: A cross-sectional study was conducted from May 15 to July 30 2019 among 151 apparently healthy full-term newborns at Gondar University Hospital. About 3 ml of cord blood was obtained for analysis of Hematological parameters and determined by using Sysmex KX-21N (Sysmex Corporation Kobe, Japan) automated analyzer. Median, 2.5th and 97.5th percentile were computed. RESULT: Male to female ratio was almost equal. All hematological parameter had no statistically significant difference between males and females. The delivery types were not influenced its hematological values. The reference interval of white blood cells, red blood cells, platelets, hemoglobin, hematocrit, mean cell volume, and mean cell hemoglobin were (7.64-22.16) x109/l, (3.69-5.47)x1012/l, (132.74-413.4) x109/l, (13.32-19.64) g/dl and (39.42-58.06)%, (91.6-113.22)fl, and (30.48-38.02 pg), respectively. CONCLUSIONS: All hematological reference intervals were established from full-term newborns at University of Gondar hospital was different from other studies in Nigeria, Iraq, Pakistan, Nepal, Saudi Arabia and Iran. Therefore, own determined reference value is very important for the clinicians to correctly diagnosis the patients at health facility levels.

Assessment of hematological parameters of petrol filling workers at petrol stations in Gondar town, Northwest Ethiopia: a comparative cross-sectional study.

BACKGROUND: Petrol is the non-specific term for petroleum which is used for inside combustion of engines. Petrol filling workers are highly vulnerable to occupational exposure to these harmful substances which lead to hemato-toxicity and blood disorders such as leukemia, aplastic anemia, and dysplastic bone marrow. Thus, this study was aimed to assess hematological parameters of petrol filling workers in Gondar town, Northwest Ethiopia. METHODS: A comparative cross-sectional study was conducted from January to March 2019 in Gondar town, Northwest Ethiopia. A total of 110 study participants comprising 55 study groups and 55 controls group were recruited by a convenient sampling technique. Socio-demographic data were collected using a structured questionnaire, and 3 ml of venous blood was collected for the determination of hematological parameters. The data were entered into Epi info 7.2.0.1 and analyzed by SPSS version of 20. Mean, standard deviation, median, and interquartile ranges were used to present the data. Independent t test and Mann-Whitney U test were used to compare the mean or median difference between parametric and non-parametric hematological parameters, respectively. Moreover, Pearson product-moment and Spearman's rank-order bivariable correlations analyses were used to describe the correlation between hematological parameters and duration of exposure to petrol. A P value of ≤ 0.05 was considered statistically significant. RESULTS: The study revealed that mean red blood cell count and hemoglobin level as well as the median hematocrit, mean cell hemoglobin concentration, platelet count, absolute lymphocytes count, and red cell distribution width values of petrol filling workers showed a significant increment compared with the control group. On the other hand, the mean cell hemoglobin value of petrol filling workers showed a significant decrement compared with healthy controls. Moreover, the duration of exposure to petrol showed a significant positive correlation with red blood cell count and mean cell hemoglobin concentration; however, a significant negative correlation was observed with mean cell volume. CONCLUSION: This study showed that the majority of hematological parameters of petrol filling workers showed an increment compared with healthy controls which might be associated with exposure to petrol chemicals. However, further longitudinal study with a larger sample size should be conducted to explore the impact of petrol exposure on hematopoiesis.

Neonatal Iron: Factors Influencing its Level and Associated Complications - a Review Article.

BACKGROUND: Iron is an essential micronutrient which plays a significant role, particularly vital for early brain growth and function. Maternal iron condition influences the iron status of neonates since iron transferred from the mother is the only source for fetal iron. A depletion in iron as a result of rapid growth leads to iron deficiency which is common in neonates. Although there are inconsistencies with regard to the normal reference ranges for neonatal iron level, the current review summarized literature to provide compressive information about neonatal iron status and factors that influence its level. METHODS: This is a narrative review on the basis of relevant literatures mainly on neonatal iron from peer-reviewed journals. Electronic databases such as PubMed, PMC, Scopus, Science Direct, Google scholar, Google, and Yahoo were used to retrieve relevant literatures using key terms like "newborn iron, neonatal iron, iron overload, maternal factors, complication, iron level and neonates" separately and in combination. RESULTS: Several factors had been postulated as factors associated with neonatal iron status. The current review figured out that maternal obesity, gestational diabetes mellitus, preterm delivery, placental transferrin receptor, inappropriate iron supplementation, use of iron fortified formula, uses of recombinant erythropoietin therapy, smoking, maternal iron deficiency anemia, umbilical cord clamping, and transfusion are the major factors which can influence neonatal iron level. These factors may have either positive or negative effects on neonatal iron level. Both iron deficiency and iron overload at some stage in the fetal development or at early stage of neonatal development cause abnormal functions of multiple organ system of neonates and subsequently contributed to neonatal and childhood morbidity and mortality. CONCLUSIONS: By one and other means insufficient, late and extra maternal iron supplementation, early and delayed umbilical cord clamping have negative effects on the iron level of neonates. Therefore, careful prenatal and antenatal follow-up need to be strengthened with due emphasis for maternal iron assessment.