Pathogenic Bacteria and Their Antibiotic Resistance Patterns in Milk, Yoghurt and Milk Contact Surfaces in Debre Berhan Town, Ethiopia.

Background: Bacterial contamination of milk is a primary culprit for causing foodborne illnesses, presenting a significant health hazard for millions of individuals around the globe. The level and variety of microorganisms present in raw milk determine its degree of contamination and the potential health risks it poses. Methods: A cross-sectional survey was conducted from February to August. A questionnaire was used to collect data on socio-demographic characteristics and hygiene practices from milk distributors and traders. Raw milk, yoghurt, swabs from milk containers and drinking cups were collected and processed for bacterial isolation and identification, antibiotic susceptibility testing, MDR screening and confirmation, ESBL screening and confirmation. Finally, all data were pooled and analyzed using SPSS software version 25. Results: A total of 120 samples of fresh milk, yogurt and cotton swabs from milk containers and cups were collected. A total of 80 bacterial isolates were isolated from 120 samples. Among the bacteria isolated, S. aureus 17 (21.3%), E. coli 17 (21.3%), S. epidermidis 14 (17.5%), Klebsiella spp. 9 (11.3%) and Salmonella spp. 7 (8.8%) were detected most often. High rate of contamination was observed in fresh milk 23 (28.8%) and yogurt 23 (28.8%). All isolates were resistant to at least one antibiotic tested. Comparatively, high rates of resistance were observed in all isolates to the most commonly prescribed antibiotics in Ethiopia. However, lower rates of resistance have been observed for recently introduced antibiotics in Ethiopia. Of the isolates, 20 (25.0%) were resistant to eight or more antibiotics. While 16 (20.0%), 12 (15.0%), 9 (11.3%) isolates were resistant to two, three and five antibiotics, respectively. Of the bacteria isolated, 52/80 (65.0%) were MDR, 25/49 (51.0%) were screened for ESBL production, and 20/49 (40.8%) isolates were confirmed as ESBL producer. Conclusion: This study showed a high rate of bacterial isolates along with MDR and ESBL-producing strains in raw milk, yoghurt, milk container swabs and drinking cup swab samples, associated with poor hygiene and sanitation practices.

High Levels of Multidrug-Resistant and Beta-Lactamase-Producing Bacteria in Meat and Meat Contact Surfaces, Debre Berhan Town, Ethiopia.

Background: Over the years, microbial contamination caused by foodborne bacteria has led to a significant number of food recalls, particularly for meat items that have been related to outbreaks of deadly diseases. Animals often carry Salmonella and Escherichia coli bacteria in their intestines, and these bacteria contaminate raw meat during slaughter. In addition, pathogens such as Staphylococcus aureus can contaminate meat processing equipment and utensils and spread to raw meat. Methods: A cross-sectional study was undertaken between 30 February and 15 March 2022. Sanitary conditions of abattoir and butchers and food handlers' hygienic practices were assessed using a structured questionnaire. An equal number of meat, swabs from carcasses, knife, weighing balance and cutting board samples (24 each, 120 total) were collected from abattoir and butcher shops. The collected samples were processed for bacterial isolation, antimicrobial susceptibility testing, MDR screening and confirmation, and ESBL screening and confirmation. Finally, SPSS software version 25 was used to compile and analyze the data. Descriptive data from surveys and laboratory procedures were cross-tabulated and summarized using statistical tables and figure. Results: A total of 76 bacteria were isolated from 120 samples. Of all bacteria isolated, S. aureus 16 (21.1%). E. coli 13 (17.1%), and S. epidermidis 12 (15.8%) were the most prevalent. The rate of bacterial contamination was high in meat 18 (23.7%), carcasses 15 (19.7%) and weighing balance 15 (19.7%), respectively. Among the isolates, 18 (23.7%) were resistant for eight and more antibiotics. While, 17 (22.4%), 7(9.2%) and 4(5.3%) of the isolates were resistant for two and three, four and five, and six and seven antibiotics, respectively. Of bacteria isolated, 51/76 (67.1%) were MDR, 23/48 (47.9%) were screened for ESBL production and 13/48 (27.1%) isolates were confirmed as ESBL producer. Conclusion: Multidrug-resistant bacterial contamination was common in meat and meat contact surfaces, which was exacerbated by inadequate sanitation and hygiene practices.

Parasitic Contamination and Microbiological Quality of Commonly Consumed Fresh Vegetables Marketed in Debre Berhan Town, Ethiopia.

Parasitic and microbial contamination and the pattern of occurrence of the parasite species depends on weather conditions, socio-cultural conditions, sampling season, analyzed vegetable products, and other factors. Therefore, local assessment of vegetable contamination is crucial for targeted and effective interventions. A cross-sectional study was conducted from February to August 2022. A questionnaire was used to assess factors associated with parasite contamination of vegetables during the marketing period. The selected vegetables were purchased and processed for parasite and microbial analysis using standard methods. Finally, all data were summarized and analyzed using SPSS software version 25. A total of 180 vegetable samples were purchased from 180 vendors. This study identified a total of 129 parasites from 180 vegetable samples, with an overall contamination rate of (75; 41.7%). Both protozoa (41; 31.8%) and helminthes (88; 68.2%) were identified from vegetables. Contamination with more than one parasite species was (38; 21.1%). The kind of produce, finger nail status of vendors/sellers, the medium of the display, the type of market and not washed prior to display were significantly associated with parasite contamination. The results also showed that vegetable microbial load for total heterotrophic count, total coliform count, fecal coliform count, yeast count, and mold count was higher in the afternoon than in the morning. To decrease risks to public health, local health authorities and/or market inspectors should establish and implement strategies to reduce contamination such as encouraging specific display medium and washing of vegetables prior to display.

Acute and Subacute Toxicity Study of Essential Oil of Cymbopogon Martini in Mice.

Background: Local Ethiopians regularly use Cymbopogon martini for cosmetic purposes. The plant's safety, however, is not supported by any solid facts. This investigation aimed to evaluate the acute and subacute toxicities of C. martini essential oil in mice. Methods: The essential oil was analyzed using GC-MS. The approach outlined by Chinedu et al., 2013 has been used to calculate the median lethal dose. According to organization for economic cooperation and development (OECD) 407 standard, a 28-day repeated dose oral toxicity study was carried out on female mice. Three groups of ten experimental mice each were distributed at random. Group I received the same saline volume and was considered the control. Groups II and III were treated with doses of C. martini of 500 mg/kg and 1000 mg/kg, respectively, of body weight. Hematological and biochemical markers were assessed. The liver and kidney were taken out after the sacrifice using sodium pentobarbital for pathological analysis. Results: Geraniol (40.89%) was the predominant component in the essential oil composition of C. martini with cyclofenchene (13.91%), myrcene (9.34%), 2, 4, 6, octatriene, 2, 6, dimethyl (8.20%), and ocimene (5.93%) being present in small amounts. The LD50 of C. martini essential oil was discovered to be greater than 5000 mg/kg body weight. During a 4-week follow-up period, mice treated with C. martini, the essential oil, at doses of 500 mg/kg or 1000 mg/kg body weight showed no evidence of toxicity or mortality. Biochemical and hematological parameters were not significantly altered in mice treated with the essential oil of C. martini compared with the control group. Histopathological evaluation of the liver and kidney did not exhibit any adverse results. Conclusions: The essential oil of C. martini from Ethiopia is considered relatively safe and nontoxic.

Antidiabetic Activity of Mung Bean or Vigna radiata (L.) Wilczek Seeds in Alloxan-Induced Diabetic Mice.

Introduction: Despite the development of oral hypoglycemic medications, diabetes and its associated complications continue to be significant clinical issues. The purpose of this study was to examine the antidiabetic effects of Vigna radiata (L.) Wilczek seeds in mice that had been given alloxan to cause diabetes. Methods: In Swiss albino mice, diabetes was brought on by a single intraperitoneal injection of the drug alloxan (150 mg/kg). For 14 days, glibenclamide (5 mg/kg) and methanol extract of V. radiata seeds (100, 200, and 400 mg/kg) were given orally. Following oral administration of V. radiata to mice, the blood glucose levels (BGL) and body weight were measured at 7 and 14 days. The mice were sacrificed at the end of the trial, and blood samples were taken for the evaluation of insulin, glycated hemoglobin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), high-density lipoprotein (HDL), total cholesterol (TC), and triglyceride (TG) levels. It was determined how much glycogen was present in the liver. Additionally, the total phenolic and flavonoid contents of V. radiata were determined, along with the in vitro DPPH (2, 2 diphenyl-1-picrylhrazyl) free radical-scavenging activity. P < 0.05 was chosen as the cutoff for statistical significance. Results: Following oral administration of V. radiata for 14 days, diabetic mice's BGL and bad cholesterol (TC and TG) levels significantly decreased, while HDL levels increased. Treatment with V. radiata significantly decreased the levels of AST, ALT, and glycated hemoglobin when compared with diabetes control. On the other hand, it raised insulin levels and the amount of liver glycogen. V. radiata underwent phytochemical analysis, which identified the presence of tannins, saponins, phenols, alkaloids, terpenoids, steroids, flavonoids, and glycosides. Per gram of V. radiata seed extract, the total phenolic content was 43.12 ± 3.14 mg of gallic acid equivalents, while the total flavonoid content was 38.35 ± 2.6 mg of quercetin equivalents. Ascorbic acid was shown to have an IC50 value of 18.64 µg/ml during a DPPH-scavenging assay, while V. radiata had an IC50 value of 73.35 µg/ml. Conclusion: According to the findings of the current study, the methanolic extract of the seeds from the plant V. radiata possesses significant antidiabetic characteristics that are on par with those of the commonly used drug glibenclamide. Hence, V. radiata seems to be effective as a natural antidiabetic.

Foodborne Pathogens and Antimicrobial Resistance in Ethiopia: An Urgent Call for Action on "One Health".

Foodborne pathogens are the most common cause of foodborne disease worldwide. They contaminate food at all stages of the food chain, at the agricultural production level (soil and irrigation), from animal sources or at the time of preparation by food handlers. Therefore, food security is a critical issue that affects everyone in the world. Current studies indicate that the problem is more severe in low-income countries like Ethiopia. The majority of studies in Ethiopia have been conducted partially on human, animal or environmental samples with conventional culture-based diagnostic methods. Therefore, this review was conducted to gather information on the main foodborne pathogens and identify gaps in their traceability. Clinically important foodborne pathogens in Ethiopia include (A. lubmbricoids, Toxocara spp., H. nana. E. histolytica/dispar, G. intestinalis, H. diminuta and C. belli), bacteria (Salmonella spp, E. coli O157:H7, B. anthracis, Yersinia, C. perfringens, Klebsiella spp. M. paratuberculosis, and L. monocytogenes), and viruses like (rotaviruses, enteroviruses and astroviruses, hepatitis E virus). In Ethiopia, all isolated foodborne bacterial pathogens showed high rates of antimicrobial resistance (AMR). In particular, the most studied foodborne pathogens, Staphylococcus spp., Salmonella spp., and E. coli from specific sources, showing high levels of resistance to most of the antibiotics prescribed in Ethiopia. The occurrence and persistence of AMR in food is one of the main factors causing the spread of antimicrobial resistance in different compartments, humans, animals and the environment. Therefore, strategies of coordination and struggle from a One Health perspective is an urgent strategy to control antibiotic resistance in order to achieve better outcomes for human and animal health.

Determinants of Opportunistic Infections Among HIV-Positive Patients on HAART in Debre Berhan Referral Hospital, North Shoa Zone, Ethiopia, 2020: A Case-Control Study.

INTRODUCTION: Opportunistic infections are an illness that exists more frequently and is more severe in people with HIV. In HIV/AIDS patients, opportunistic infections still cause morbidity and mortality even after the era of highly active antiretroviral therapy (HAART) and most patients die as direct or indirect complications of opportunistic infections. This study was aimed to identify the determinants for the occurrence of opportunistic infections in HIV-positive patients having HAART follow-up in DBRH, Debre Berhan, Ethiopia. METHODS: A total of 339 study subjects were involved under institution-based unmatched case-control study design and simple random sampling technique. A pre-tested structured questionnaire was used for data collection. Data were entered using Epidata version 3.1 and analyzed for descriptive and logistic regression models by SPSS version 21. A P-value of less than 0.05 was considered as statistically significant. RESULTS: After adjusting potential confounders, drinking alcohol (AOR=3.12, 95% CI: 1.07-9.06), BMI <18.5 (AOR= 3.36, 95% CI: 1.49-7.55), previous history of opportunistic infections (AOR= 2.96, 95% CI: 1.51-5.8) were independent predictors of opportunistic infections in people living with HIV/AIDS on HAART. CONCLUSION: In this study, the poor clinical and biochemical status, and behavioral factors were being the predictors of the occurrence of opportunistic infections. HIV/AIDS patients must be assessed and screened for opportunistic infections.

Newborn Birth Weight and Associated Factors Among Mother-Neonate Pairs in Public Hospitals, North Wollo, Ethiopia.

BACKGROUND: Birth weight or size at birth is an important indicator of the child's vulnerability to the risk of childhood illnesses and diseases. Low birth weight is closely associated with fetal and neonatal morbidity, inhibited growth and cognitive development, and chronic diseases in life. The study was aimed to assess the birth weight of neonates and associated factors among mothers who gave birth at a public hospital in North Wollo, 2020. METHODS: A hospital-based cross-sectional study was conducted among 337 mothers who gave birth in public hospitals of North Wollo, Ethiopia from January 1st to June 30, 2020. A systematic sampling technique was used to reach the study participants. Data were entered using Epi data 3.1 software and analysis will be done using SPSS 20. Adjusted beta coefficient with 95% confidence interval and p-value ≤ 0.05 was used to declare statistical significance. RESULTS: A total of 337 mothers were included with a response rate of 100%. The mean ± SD weight of the child was 2.94 ± 0.65 kilograms. The prevalence of low birth weight was 24% (95% CI= 19.6, 28.8). Maternal nutritional factors correlate with newborn weight. Age of the mother, family average monthly income, being single, alcohol use, education, female sex, had no abortion history and multigravida became statistically significant predictors of birth weight. CONCLUSION: Almost one-fourth of the newborn child had low birth weight. It will be better to give special attention to mothers with associated factors.

Methanolic Extract of Myrsine africana Leaf Ameliorates Hyperglycemia and Dyslipidemia in Alloxan-Induced Diabetic Albino Mice.

BACKGROUND: Diabetes mellitus is one of the leading public health problems globally, and its prevalence is increasing in Ethiopia. The current drugs for people with diabetes are costly, less effective, and less safe with a challenging administration method. Thus, globally, the need for alternative herbal antidiabetic medicines is increasing. In the previous studies, antioxidant activities have been seen in crude extracts of M. africana leaves, which is an auspicious sign of antidiabetic property. Accordingly, this study has evaluated the antidiabetic and antidyslipidemic activities of methanolic extract of M. africana leaves. METHODS: Hypoglycemic and antihyperglycemic activities of the three doses (250 mg/kg, 500 mg/kg, and 1000 mg/kg) of crude methanolic extract of M. africana leaf were studied on normoglycemic, oral glucose-loaded, and alloxan-induced diabetic mice models. The effect of the extract on diabetic dyslipidemia, insulin and glycated hemoglobin levels, carbohydrate-metabolizing enzymes, and body weight was also studied in alloxan-induced diabetic mice. Glibenclamide (5 mg/kg) was used as a standard drug in all cases. Data analysis was carried out using mixed-design ANOVA. A P value of ≤0.05 was considered a statistically significant difference. RESULTS: The methanolic extract of M. africana leaf did not show acute toxicity up to the dose of 5000 mg/kg and showed better glucose utilization in the oral glucose tolerance test. After 14 days of treatment, M. africana leaf extract decreased the blood glucose level, glycated hemoglobin, glucose-6-phosphatase, and fructose-1-6-bisphosphatase in diabetic mice. In contrast, it increased hexokinase and insulin levels in diabetic mice. Moreover, weight loss and dyslipidemia profiles have been corrected significantly in diabetic mice. CONCLUSION: M. africana leaves showed antihyperglycemic and antidyslipidemic effects in alloxan-induced diabetic mice. That suggests M. africana may be a potential treatment option for diabetes in the future. However, further molecular studies are required to analyze the mechanisms.

Evaluation of Pulmonary Function Tests Among Pregnant Women of Different Trimesters in Debre Berhan Referral Hospital, Shoa, Ethiopia.

INTRODUCTION: Pregnancy is characterized by a sequence of dynamic physiological changes that impact multiple organ system functions and is associated with various changes in pulmonary anatomy and physiology. Precise knowledge of the pulmonary function test parameters helps to understand and manage the course and outcome of pregnancy leading to safe delivery. It also helps to avoid misdiagnosis and unnecessary interventions. The aim of this study was to evaluate the effect of normal pregnancy on pulmonary function tests among pregnant women in Debre Berhan Referral Hospital, Ethiopia. METHODS: A total of 176 study participants (first, second, and third trimester; and control) were involved under a comparative cross-sectional study design and convenience sampling technique. Anthropometric data, oxygen saturation of arterial blood, and pulmonary function tests were measured. Data were tabulated and statistically analyzed using SPSS version 20.0 statistical software. Means of all parameters were compared using one-way ANOVA followed by Tukey's post hoc multiple comparison test. Statistical significance was preset at a p-value of less than 0.05. RESULTS: Mean of FVC for the controls, first, second, and third trimesters was 2.59 ± 0.26, 2.13 ± 0.15, 1.93 ± 0.27, and 1.90 ± 0.11 liters, respectively. Except for FEV1%, the mean values of FVC, FEV1, PEFR, and FEF 25-75% in the pregnant group (all the three trimesters) were significantly decreased from the controls (P<0.05). Strong negative correlation was seen between SaO2 and RR (r= -0.865; P <0.01). As the pregnancy progressed from first to the third trimester, dynamic pulmonary function tests (FVC, FEV1, FEF25-75%, and PEFR) were dropped and the respiratory rate increased. CONCLUSION: The results had shown the tendency of obstructive pattern while pregnancy becoming advanced. We have observed also a remarkable decline of SaO2 in pregnant women that might be counterbalanced by raised respiratory rate.

Prevalence of hospital-acquired infections (HAIs) and associated factors in Ethiopia: a systematic review and meta-analysis protocol.

INTRODUCTION: Hospital-acquired infections (HAIs) are public health problems of global concern and are notably prevalent in developing countries. The prevalence of HAI and its associated factors are not well described in the context of Ethiopia. Currently, the nationwide prevalence of HAI and its corresponding associated factors have not been formally reported in Ethiopia. This review will provide an estimate of the prevalence of HAI and its associated factors. METHODS: Scholarly articles will be selected from the Embase, PubMed, Cochrane library, Hinary, Scopus, Web of Science and Google Scholar databases. Articles within the timeline of January 2000 to December 2020 will be included for review. Observational studies, randomised trials, surveys, surveillance reports, published and grey literature that reported the prevalence of HAI or factors associated with HAI reported as OR (95% CI) with no language restriction will be included in the analysis. Screening and selection of articles will be done using web-based Covidence software. The article's quality and risk of bias will be critically appraised using Johanna Briggs Institute quality appraisal checklist. Random effects model using the inverse variance method will be conducted to estimate the prevalence of HAI. To examine heterogeneity, the Q statistics and I2 statistics will be conducted. Publication bias will be investigated using Begg's correlation method and Egger's weighted regression test. All analyses will be performed with STATA (V.14) software. ETHICS AND DISSEMINATION: Ethical approval is not required for meta-analysis reviews as participants are not included. The review will be submitted for publication in peer-reviewed journals.