Risk Factors and Spatio-Temporal Patterns of Human Rabies Exposure in Northwestern Tigray, Ethiopia.

BACKGROUND: Rabies is a neglected tropical disease, which is economically important with great public health concerns in developing countries including Ethiopia. Epidemiological information can play an important role in the control and prevention of rabies, though little is known about the status of the disease in many settings of Ethiopia. The present study aimed to investigate the risk factors and spatio-temporal patterns of human rabies exposure in Northwestern Tigray, Ethiopia. METHODS: A prospective study was conducted from 01 January 2016 to 31 December 2016 (lapsed for one year) at Suhul general hospital, Northern Ethiopia. Data of human rabies exposure cases were collected using a pretested questionnaire that was prepared for individuals dog bite victims. Moreover, GPS coordinate of each exposure site was collected for spatio-temporal analysis using hand-held Garmin 64 GPS apparatus. Later, cluster of human rabies exposures were identified using Getis-Ord Gi* statistics. RESULTS: In total, 368 human rabies exposure cases were collected during the study year. Age group of 5 to 14 years old were highly exposed (43.2%; 95% CI, 38.2-48.3). Greater number of human rabies exposures was registered in males (63%; 95% CI, 58.0-67.8) than females (37%; 95% CI, 32.1-42.0). Residents of rural (85.6%; 95% CI, 81.6-88.8) areas were at greater risk to rabies than urban residents (14.4%; 95% CI, 11.2-18.4). Higher proportion of human rabies exposures were caused by unprovoked (96.5%; 95% CI, 94.0-98.0) and unvaccinated (85.9%; 95% CI, 81.9-89.1) dogs. All rabies exposures were exclusively caused by dog bites and the majority of them (80.4%; 95% CI, 76.0-84.2) were caused by stray dogs. Results of spatio-temporal analysis showed that Asgede Tsimbla, Endaselassie and Laelay Adiyabo districts experienced the highest burden of rabies exposure; identified as hot spots. Strong peaks of human rabies exposure occurred between March and July months. CONCLUSION: The present study provided basic epidemiological information on the potential risk factors associated with human rabies exposure. Moreover, our findings provided basis for understanding the spatio-temporal patterns of human rabies in Northwestern Tigray districts for the first time.

Epidemiology of Mycobacterium bovis and Mycobacterium tuberculosis in animals: Transmission dynamics and control challenges of zoonotic TB in Ethiopia.

Mycobacterium tuberculosis complex is the cause of tuberculosis (TB) in humans and other animals. Specifically, Mycobacterium bovis (M. bovis) and Mycobacterium tuberculosis (M. tuberculosis) are highly pathogenic mycobacteria that may infect different animal species and are the sources of TB in humans. The objective of this paper was to review the epidemiology of M. bovis and M. tuberculosis in animals. The review also highlighted the transmission dynamics of M. bovis and M. tuberculosis in humans and animals and control challenges of zoonotic TB in Ethiopia. The literature review focused on scientific peer-reviewed articles from studies exclusively conducted in Ethiopia that were published from 1998 to 2017. Husbandry system, breed and herd size have significant role in the epidemiology of bovine tuberculosis (BTB) in Ethiopia. The information presented reveals that different strains of M. bovis are widely distributed in domestic animals predominantly in the Ethiopian cattle and the main strain was found to be SB1176. In addition, the isolation of M. tuberculosis from domestic animals in different settings signifies the circulation of the agent between humans and animals in Ethiopia. The life styles of the Ethiopian communities, close contact with domestic animals and/or the habit of consuming raw animal products, are suggested as the main factors for transmission of M. bovis and M. tuberculosis between human and animal which may have impact on the TB control program in human. In Ethiopia, a human TB control program has been widely implemented, however, the role of animal in the transmission of the causative agent has been neglected which could be one of the challenges for an effective control program. This warrants the need for incorporating animal TB control programs using "One Health" approach for effective TB control for both human and animal.

Antibacterial Activities of Five Medicinal Plants in Ethiopia against Some Human and Animal Pathogens.

OBJECTIVE: To evaluate the in vitro antibacterial activities of five plant extracts which have been used as traditional medicines by local healers against three multidrug resistant bacteria, namely, Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. RESULTS: The highest mean zone of inhibition (4.66 mm) was recorded from methanol extract of Calpurnia aurea (Ait.) Benth. at a concentration of 200 mg/ml against S. aureus, followed by Croton macrostachyus Del. (4.43 mm) at the same dose and solvent for the same bacterial species, while methanol and chloroform extracts of E. brucei Schwein. did not inhibit growth of any bacterial species. The lowest value (100 µg/ml) of minimum inhibitory concentration (MIC) was observed from both methanol and chloroform extracts of C. aurea (Ait.) Benth. against all the three bacteria. The results of the positive control had no statistically significant difference (P > 0.05) when compared with crude extracts of C. aurea (Ait.) Benth. at concentration of 200 mg/ml against S. aureus. CONCLUSION: The results of the present study support the traditional uses of these medicinal plants by the local healers. Except Erythrina brucei Schwein., all the plants investigated in this study exhibited antibacterial activities against the test bacterial species. Further researches are needed to be conducted to evaluate efficacy of these medicinal plant species on other microbes in different agroecological settings and their safety levels as well as their phytochemical compositions.

Single locus genotyping to track Leishmania donovani in the Indian subcontinent: Application in Nepal.

BACKGROUND: We designed a straightforward method for discriminating circulating Leishmania populations in the Indian subcontinent (ISC). Research on transmission dynamics of visceral leishmaniasis (VL, or Kala-azar) was recently identified as one of the key research priorities for elimination of the disease in the ISC. VL in Bangladesh, India, and Nepal is caused by genetically homogeneous populations of Leishmania donovani parasites, transmitted by female sandflies. Classical methods to study diversity of these protozoa in other regions of the world, such as microsatellite typing, have proven of little use in the area, as they are not able to discriminate most genotypes. Recently, whole genome sequencing (WGS) so far identified 10 different populations termed ISC001-ISC010. METHODOLOGY / PRINCIPLE FINDINGS: As an alternative to WGS for epidemiological or clinical studies, we designed assays based on PCR amplification followed by dideoxynucleotide sequencing for identification of the non-recombinant genotypes ISC001 up to ISC007. These assays were applied on 106 parasite isolates collected in Nepal between 2011 and 2014. Combined with data from WGS on strains collected in the period 2002-2011, we provide a proof-of-principle for the application of genotyping to study treatment outcome, and differential geographic distribution. CONCLUSIONS / SIGNIFICANCE: Our method can aid in epidemiological follow-up of visceral leishmaniasis in the Indian subcontinent, a necessity in the frame of the Kala-azar elimination initiative in the region.