Occurrence of Methicillin-Resistant Staphylococcus aureus (MRSA) in Bovine Bulk Milk and Farm Workers in Smallholder Dairy Farming Systems in Northwestern Ethiopia.

Background and Purpose: Staphylococcus aureus is a common pathogen responsible for causing various human and animal infections and is well known for its ability to develop resistance to multiple antibiotics. This study aimed to evaluate the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) in bulk milk and dairy farms in northwestern Ethiopia and to determine their phenotypic and genotypic antimicrobial susceptibility patterns. Methods: We collected 50 bulk milk samples from 50 dairy farms and 50 hand swabs from dairy milkers. The cefoxitin disk diffusion test and PCR-based assays were used to identify MRSA isolates. In addition, cefoxitin-resistant isolates were tested for susceptibility to other antibiotics using the Kirby-Bauer disk diffusion method. Results: The results showed that MRSA was detected in 8 samples: 6 from bulk milk samples (12%) and 2 from hand swabs (4%). All MRSA isolates exhibited a high resistance rate to penicillin (100%), followed by tetracycline (75%), ciprofloxacin (25%), chloramphenicol (25%), erythromycin (25%), gentamycin (12.5%), and trimethoprim-sulfamethoxazole (12.5%). Moreover, 72% of the isolates showed resistance to three or more antibiotic classes and were classified as multidrug-resistant. Conclusion: This study identified methicillin-resistant Staphylococcus aureus and multidrug-resistant MRSA in bulk milk and dairy farms in northwestern Ethiopia. These findings highlight the potential risk of transmission of these antibiotic-resistant bacteria to humans and the need for improved antibiotic stewardship in the dairy sector using the One Health approach.

Characteristics of Pathogenic Escherichia coli Associated with Diarrhea in Children under Five Years in Northwestern Ethiopia.

Diarrheagenic Escherichia coli (DEC) are the leading cause of infectious diarrhea and pose a significant global, regional, and national burden of disease. This study aimed to investigate the prevalence of six DEC pathotypes in children with diarrhea and determine their antibiotic resistance patterns. Samples from 107 diarrheagenic children were collected and processed for Escherichia coli (E. coli). Single-plex PCR was used to detect target virulence genes as well as characterize and categorize DEC pathotypes. Antibiotic resistance patterns were determined by the Kirby-Bauer disk diffusion method. E. coli was detected in 79 diarrheal stool samples, accounting for 73.8% of the samples collected. Additionally, 49.4% (39 out of 79) of the isolates harbored various typical virulence factors. Results revealed six pathotypes of virulence: enterotoxigenic E. coli (ETEC) (53.8%), enteropathogenic E. coli (EPEC) (12.8%), enteroaggregative E. coli (EAEC) (10.3%), Heteropathotypes (7.8%), Shiga toxin-producing E. coli (STEC), and enterohemorrhagic E. coli (EHEC) (7.7% each). The isolates exhibited high antibiotic resistance against trimethoprim/sulfamethoxazole (82.1%), amoxicillin (79.5%), ampicillin (74.4%), gentamicin (69.2%), and streptomycin (64.1%). An overall occurrence of 84.6% of multiple-drug resistance was observed in the isolates, with resistance ranging from three to four antibiotic classes. Our findings revealed a high level of pathogenic E. coli that were highly resistant to multiple categories of antibiotics among children in the Awi zone. These findings highlight the potential role of pathogenic E. coli in childhood diarrhea in tropical low-resource settings and underscore the need for continued research on the characteristics of pathogenic and antibiotic-resistant strains.

Sexual and reproductive health issues and associated factors among female night school students in Amhara Region, Ethiopia: an institution-based cross-sectional study.

OBJECTIVE: This study aimed to assess the prevalence of sexual and reproductive health (SRH) issues and associated factors among female night school students in the Amhara Region, Ethiopia. DESIGN: Institution-based cross-sectional study. SETTING: 16 night schools were selected from 4 zones in the Amhara Region. The data were collected between 1 January and 28 February 2019. PARTICIPANTS: 1428 female night school students aged 15-24 years. OUTCOMES: Prevalence of SRH issues, defined as those who had experienced at least one SRH issue during their lifetime (including sexual violence, sexually transmitted diseases, teenage pregnancy, unwanted pregnancy, early marriage and abortion). Bivariable and multivariable logistic regression models were used in the analysis. RESULTS: The prevalence of SRH issues was 32.7% (95% CI 29.5% to 35.9%). Having secondary education (adjusted (OR) AOR = 1.49, 95% CI 1.19 to 1.86), being single in marital status (AOR = 1.33, 95% CI 1.01 to 1.74), not discussing SRH issues with their families (AOR = 2.69, 95% CI 2.13 to 3.40) and poor knowledge of SRH services (AOR = 2.63, 95% CI 2.08 to 3.32) were significantly associated with SRH issues. CONCLUSION: The lifetime prevalence of SRH issues among female night school students was high. Being single, having a secondary education, not discussing SRH issues with family, and having a poor understanding of SRH services were associated with SRH issues. Qualitative studies should be conducted to explore students' feelings and intentions about SRH issues.

COVID-19 vaccine hesitancy in Ethiopia in 2021: a multicenter cross-sectional study.

Introduction: Worldwide, hesitancy to be immunized against SARS-CoV-2 is the most common barrier to reducing COVID-19 incidence. Our study investigated determinants for hesitancy and will be helpful to community mobilizers, health professionals and policymakers. Objective: To assess the prevalence and determinants of hesitancy to COVID-19 vaccination among patients attending public hospitals in South Gondar zone, Ethiopia. Methods: A multicenter facility-based cross-sectional study was conducted from 1 November to 30 December 2021 to assess the prevalence and determinants of hesitancy to COVID-19 vaccination. Chi-square test and multivariable logistic regression methods were employed using SPSS 23. Significance level was examined using an odds ratio at 95% CI. Multi-collinearity and model fitness were also checked. Results: A total of 415 participants were included in the study, with a questionnaire response rate of 100%. The prevalence of hesitancy to COVID-19 vaccination was 46.02%. Age of >49 years, rural residency, fear of the adverse effects of the vaccines, myths about vaccine ineffectiveness and poor practices in COVID-19 prevention were the most common determinants of hesitancy. Conclusions: Despite increased global morbidity and mortality due to COVID-19, the prevalence of vaccine hesitancy is still high. Therefore, it is important to create awareness in highly hesitant groups.

Levels of Escherichia coli as Bio-Indicator of Contamination of Fish Food and Antibiotic Resistance Pattern Along the Value Chain in Northwest Ethiopia.

Introduction: Microbiological contamination in fish origin foods is the leading risk for public health. Among the range of pathogenic bacterial species that cause fish food borne diseases is Escherichia coli. The pathogenic strains of Escherichia coli cause diarrhea by producing and releasing toxins and can also be the cause of food spoilage in fish. Methods: A cross-sectional study was conducted to assess hygienic practices of fish handlers, to evaluate bacterial load and antimicrobial resistance patterns of Escherichia coli along the fish value chain in Northwest Ethiopia. Systematic and purposive sampling techniques were used for uncooked and cooked fish samples respectively. Results: From a total of 180 fish samples, 36 (20%) were positive for Escherichia coli. From 115 uncooked and 65 cooked fish samples examined, 27 (23.5%) and 9 (13.8%) had E. coli respectively. The highest mean bacterial count was observed in raw fish samples (6.13 × 105 cfu/g), followed by cooked fish samples (2.81 × 104 cfu/g). Among the interviewed fish handlers, 83.3%, 76.7% and 80% of respondents had good knowledge and attitude towards using a clean cutting-and-filleting board, storing raw and cooked foods separately and using an apron for reducing the risk of fish contamination, respectively. All 36 isolates were 100% sensitive to ciprofloxacin and gentamycin. Of the Escherichia coli isolates subjected to tetracycline, 55.6% were resistant, 8.3% were intermediate and 36.1% were susceptible. Conclusion and Recommendation: This study revealed that there was a lack hygienic practice and high Escherichia coli profiles were observed. Hence, it could be wise to advise the fish harvesters, fish traders, hotels and restaurants about fish food safety practices from harvesting to consumption to improve fish food safety practices and quality standards of fish harvested and sold in northwest Ethiopia.

Availability, Utilization, and Quality of Basic Emergency Obstetric and Newborn Care Services in Farta District, Rural Health Centers, Ethiopia.

BACKGROUND: Emergency obstetric and neonatal care (EmONC) is a cost-effective priority intervention to reduce maternal and neonatal morbidity and mortality in poorresource settings. In most sub-Saharan African countries, all signal functions perform below the appropriate United Nations standard. OBJECTIVE: This study aims to assess the availability, utilization, and quality of basic emergency obstetric and newborn care services in Farta District, Ethiopia primary health care centers. METHODS: A cross-sectional descriptive study was conducted in primary health care centers in Farta District, South Gondar zone, Ethiopia. RESULTS: Out of ten rural health centers, 50% administered parenteral antibiotics, 50% administered parenteral anticonvulsants, 30% performed assisted vaginal delivery, 40% performed manual placenta removal, and 70% administered oxytocin for treatment of postpartum hemorrhage and 60% performed neonatal resuscitation with bag and mask. CONCLUSION: All of the health centers in the study area were not fully implementing the BEmONC signal functions.

Outbreak Investigation and Molecular Detection of Pox Virus Circulating in Sheep and Goats in Selected Districts of West Gojjam and Awi Zones Northwest, Ethiopia.

INTRODUCTION: Sheep and goat pox virus (SGPV) is a systemic contagious disease causing extreme illness and death in small ruminants. METHODS: A cross-sectional study was conducted in West Gojjam and Awi zone of Amhara national regional state Northwest Ethiopia, from November 2018 to May 2019 with the objective of pox virus outbreak investigation and molecular detections in sheep and goats (shoats). The study included clinical examinations of lesions, laboratory analysis, and questionnaire survey. Study locations were selected randomly when an active outbreak was reported and observed. RESULTS: A total of 485 small ruminants (303 sheep and 182 goats) suspected of shoat pox were examined for the presence of specific skin lesions, 71 (14.64%) showed pox lesions, 35 (11.55%) sheep and 36 (19.78%) goats, and 24 (4.95%) had died. The study revealed highest morbidity rate in Jawie (31.25%) and Gunagua (14.89%) districts in goats and sheep, respectively. Lowest morbidity rate was recorded in Dega Damot district in sheep (6.45%) and goats (7.14%), respectively. The mortality rate was >1% in all districts except Dega Damot for both species. From a total of 38 tissue samples, 19 samples were selected based on the geographical distribution. All 19 samples (6 sheep and 13 goats) were found to be positive for goat pox virus based on polymerase chain reaction results. The significant risk factors were free animal movements, age, flock size and composition, body condition, vaccination status, and season. The study showed that in the absence of free movement of animals, the disease was less likely to occur (OR = 0.05, CI 95%; 0.02, 0.15). CONCLUSION: The disease was found in higher rate during the dry and short rainy season. Sheep were also found to be infected by goat pox virus. The study indicated that there was widespread sheep and goat pox in Northwest Ethiopia.

Magnitude of Gender-Based Violence and Its Associated Factors among Female Night Students in Bahir Dar City, Amhara Region, Ethiopia.

BACKGROUND: Gender-based violence (GBV) is a major public health issue that affects the health and well-being of millions of young people worldwide each year. Gender-based violence was prevalent throughout Sub-Saharan Africa. However, research in Africa is extremely diverse. OBJECTIVE: The purpose of this study is to determine the extent and risk factors of gender-based violence among night female students in Bahir Dar, Ethiopia. METHODS: This cross-sectional study was conducted among 788 elementary and high school night female students in Bahir Dar from October 15 to November 15, 2019. Data was gathered using self-administered questionnaires. A binary and multiple logistic regression model was used to identify factors associated with gender-based and sexual violence. An adjusted odds ratio (AOR) with a 95 percent confidence interval (CI) was calculated to determine the level of significance. RESULTS: The overall lifetime prevalence of gender-based violence (sexual, physical, and emotional violence) was 71.1% with a 95% CI of 67.8%-74.1%. The lifetime prevalence of sexual violence, physical violence, and emotional violence was 49.1%, 57.5%, and 41.6%, respectively. Rural childhood residence (AOR: 3.37, 95% CI: (2.17-5.54)), low school performance (AOR: 3.44, 95% CI: (2.13-5.56)), lack of sexual and reproductive health conversation experience (AOR: 3.68, 95% CI: (2.07-6.54)), poor family control (AOR: 5.62, 95% CI: (3.25-9.71)), and being sexually active (AOR: 3.79, 95% CI: (2.35-6.12)) increased significantly the risk of gender-based violence. The risk factors for sexual violence were young people living with both parents (AOR: 0.28, 95% CI: (0.19-0.41)), peer pressure (AOR: 5.73, 95% CI: (4.11-7.98)), and family support (AOR: 0.31, 95% CI: (0.22-0.43)). CONCLUSION: In the study area, the lifetime prevalence of sexual violence, physical violence, and emotional violence was high. As a result, it is recommended that policymakers, district officials, schools, and other stakeholders pay attention to and act on gender-based values.

Neonatal near Miss and Its Predictors among Neonates Delivered at Debretabor General Hospital, Northern Ethiopia; A Retrospective Analysis.

BACKGROUND: In many low-resource countries, the progress of neonatal mortality reduction is very slow. The scenario is notably true in sub-Saharan Africa including Ethiopia. For every neonatal death, there are lots of near missed neonates. Generating evidences on the extent and predictors of neonatal near miss is a key step in neonatal mortality reduction efforts. However, there is limited evidence in this aspect in Ethiopia. OBJECTIVE: This study is aimed at assessing the proportion of neonatal near miss and associated factors among neonates delivered at Debretabor General Hospital, Northern Ethiopia, 2019. METHODS: An institution-based cross-sectional study was conducted on 422 neonates delivered at Debretabor General Hospital from July 1st, 2018, to June 30th, 2019. Both pragmatic and management criteria of definition of neonatal near miss were utilized. A systematic random sampling technique was used to select the cards of the study participants. Data were extracted with structured and pretested checklist, entered in the EpiData, and then exported to SPSS version 20. Both descriptive and analytical procedures have been done. Descriptive statistics such as frequencies and cross tabulations were carried out. The binary logistic regression model was fitted and variables with p value < 0.20 were entered in the multivariable logistic regression model. Both crude and adjusted odds ratios with the corresponding 95% CI were computed. The level of significance has been claimed based on the adjusted odds ratio with 95% CI and its p value of ≤0.05. RESULTS: The proportion of neonates experiencing near miss was obtained to be 32.2% with 95% CI (28, 36). Rural residence (AOR = 4.41; 95% CI: 2.57,7.55), incomplete ANC visit (AOR = 3.16; 95% CI: 1.90,5.25), primiparous (AOR = 2.55; 95% CI: 1.59,4.12), pregnancy-induced hypertension (AOR = 3.23; 95% CI: 1.19,8.78), premature rupture of membrane (AOR = 4.65; 95% CI: 1.70,12,73), cephalic-pelvic disproportion (AOR = 3.05; 95% CI: 1.32,7.01), and antepartum hemorrhage (AOR = 4.95; 95% CI: 1.89,12.96) were the independent predictors of neonatal near-miss. Conclusion and Recommendations. The proportion of neonatal near miss was found to be high in the study setting. Most of the determinants of near miss are modifiable obstetric-related factors. Hence, stakeholders need to consider the aforesaid factors while they design interventions.