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Seroprevalence and risk factors for Toxoplasmosis in HIV infected and non-infected individuals in Bahir Dar, Northwest Ethiopia
Walle Fisseha,Kebede Nigatu,Tsegaye Aster,Kassa Tesfu
Parasites & Vectors , 2013, DOI: 10.1186/1756-3305-6-15
Abstract: Background Toxoplasmosis, a zoonotic disease distributed worldwide, is an infection caused by the ubiquitous obligatory intracellular coccidian protozoan organism, Toxoplasma gondii. It is a major public health concern because the disease is serious in terms of mortality or physical and /or psychological sequellae in patients with HIV disease. The aim of the study was to assess the seroprevalence of Toxoplasma gondii IgG and IgM antibodies and associated risk factors in HIV infected and non-infected individuals attending Felege Hiwot referral hospital, Bahir Dar, Northwest Ethiopia. Methods A cross sectional study was conducted at Felege Hiwot referral hospital, Bahir Dar, Amhara National Regional State. Venous blood samples were collected from 103 HIV infected pre anti-retroviral therapy patients at Felege Hiwot referral hospital and 101 HIV negative apparently healthy voluntary blood donors at the blood bank. Serum samples were analyzed for anti-Toxoplasma gondii IgG and IgM antibodies using a commercially available ELISA kit. Socio-demographic and associated risk factors for Toxoplasmosis from each individual were also obtained and the data was analyzed using SPSS version 18. Results Of the examined HIV seropositive individuals, 87.4% (90/103) and 10.7% (11/103) were positive for anti-T. gondii IgG and IgM antibodies, respectively. Multivariate analysis using logistic regression showed that anti-T. gondii seropositivity was independently significantly associated with undercooked or raw meat consumption (adjusted OR=5.73, 95% CI=1.35-24.39; P=0.02) and having contact with cat (adjusted OR= 4.29, 95% CI=1.08-16.94; P=0.04) in HIV positive individuals. In HIV negative apparently healthy blood donors, prevalence of anti-T. gondii antibodies were 70.29% and 2.97% for IgG and IgM, respectively. Multivariate analysis showed that undercooked or raw meat consumption (adjusted OR=6.45, 95% CI=2.16-19.28; p=0.001) and sex (OR=6.79, 95% CI=2.14-21.60; p=0.001) were independently significantly associated with anti-T. gondii IgG seropositivity, with a significantly higher number of males affected than females. Conclusion The present findings showed a high sero-prevalence of anti-T. gondii antibodies in HIV infected pre-ART and HIV non-infected apparently healthy blood donors in Bahir Dar. Consumption of undercooked or raw meat might greatly contribute towards acquiring T. gondii infection in HIV infected pre-ART and HIV non-infected apparently healthy blood donors. It may be appropriate to include routine serological screening test for determination of an
Prevalence of Pulmonary tuberculosis and immunological profile of HIV co-infected patients in Northwest Ethiopia
Yitayih Wondimeneh, Dagnachew Muluye, Yeshambel Belyhun
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-331
Abstract: A cross sectional study was conducted among adult HIV-positive patients attending HIV/AIDS clinic of Gondar University Hospital. Clinical and laboratory investigations including chest x-ray and acid fast staining were used to identify tuberculosis cases. Blood samples were collected to determine CD4+ lymphocyte count. A structured questionnaire was used to collect socio-demographic characteristics of study subjects. The data was entered and analyzed using SPSS version 16 software.A total of 400 HIV positive study participants were enrolled. Thirty (7.5%, 95%CI: 5.2-10.6%) of the study participants were found to have pulmonary tuberculosis. In multivariate analysis, only CD4+ lymphocyte count (AOR?=?2.9; 95% CI: 1.002-8.368) was found to be independently associated with tuberculosis-HIV co-infection. Individuals who had advanced WHO clinical stage were also statistically significant for co-infection. The mean CD4+ lymphocyte count of HIV mono-infected participants were 296?±?192 Cells/mm3 and tuberculosis-HIV co-infected patients had mean CD4+ lymphocyte count of 199?±?149 Cells/mm3 with p value of 0.007.We found high prevalence of tuberculosis-HIV co-infection. Lower CD4+ lymphocyte count was found to be the only predicting factor for co-infection. Early detection of co-infection is very necessary to prolong their ART initiation time and by then strengthening their immune status.Tuberculosis (TB) and human immune deficiency virus (HIV) infections are two major public health problems in many parts of the world. The prevalence of TB-HIV Co-infection is higher worldwide and 90% of these co-infected cases live in developing nations [1-3]. Tuberculosis is the most common opportunistic disease and cause of the death for those infected with HIV [3]. Similarly, HIV infection is one of the most important risk factors associated with an increased risk of latent TB infection progressing to active TB disease [4,5]. In persons infected with TB only, the lifetime risk of developi
Birth outcome and correlates of low birth weight and preterm delivery among infants born to HIV-infected women in public hospitals of Northwest Ethiopia  [PDF]
Bekana Kebede, Gashaw Andargie, Abebaw Gebeyehu
Health (Health) , 2013, DOI: 10.4236/health.2013.57A4004
Abstract:

Background: HIV-positive pregnant women are at an increased risk of adverse pregnancy outcomes. However, data on birth outcome among HIV-infected women are limited in Ethiopia. This study was conducted to identify the adverse birth outcomes and associated factors of low birth weight (LBW) and preterm delivery (PD) among HIV-infected women. Methods: A hospital based retrospective cohort study was conducted. All deliveries from HIV-infected women from September 1, 2009 to April 30, 2012 were included in the study. Multivariate logistic regression was performed to explore the potential risk factors for LBW and PD. Result: Out of 416 singleton infants born to HIV-infected mothers, the prevalence of LBW and PD was 89 (21.4%) and 69 (16.6%), respectively. The baseline maternal CD4 counts below 200 cells/mm3, maternal body mass index (BMI) below 18.5, maternal anemia and maternal exposure to Highly Active Antiretroviral Treatment (HAART) were factors significantly associated with LBW. On the other hand, a baseline maternal CD4 level below 200/ mm3, having no Prevention of Mother-to-Child Transmission (PMTCT) intervention during pregnancy, maternal BMI less than 18.5, maternal Eclamsia during pregnancy, and mothers being on HAART before pregnancy were factors associated with preterm delivery. Conclusion: There was a significant prevalence of low birth weight and preterm delivery among infants born to HIV-positive mothers. The programme for PMTCT services should maximize the need for an early identification of those mothers with predicted complications.

Total Lymphocyte Count as surrogate marker for CD4 Cell Count in HIV-Infected Individuals in Gondar University Hospital, Northwest Ethiopia
Yitayih A Wondimeneh, Getachew E Ferede, Gizachew W Yismaw, Dagnachew F Muluye
AIDS Research and Therapy , 2012, DOI: 10.1186/1742-6405-9-21
Abstract: To evaluate utility of total lymphocyte count (TLC) as surrogate marker for CD4 count in HIV-infected patients.In this cross sectional study, 400 ART-naive HIV-positive patients enrolled in Gondar University Hospital, from March 2011 to May 2011, were tested for CD4 count & TLC. The cutoffs were determined as: 200 cells/μL for CD4 count and 1200 cells/μL for TLC by using BD FACS count and CELL DYN 1800 Flow Cytometrys respectively. Spearman correlation between TLC and CD4 cell count were assessed. Sensitivity, specificity, positive and negative predictive values for different age a group, TLC ≤1200 was computed for CD4 count ≤200 cells/cu.mm.Among 400 ART naive HIV infected patients, 278 (69.5%) were females. The mean age of the study participants was 33.7. TLC and CD4 count were positively correlated (r?=?0.33, p?=?0.001). A TLC of ≤1200 cells/m?m3 was found to have a sensitivity (32.86%), specificity (95.33%), PPV (79.7%), and NPV (71.9%) for predicting a CD4 count of <200 cells/mm3.This study showed that low sensitivity and specificity of TLC as a surrogate measure for CD4 count. Moreover, CD4 cell counts of?<?200 cells/mm3 were found in 96 cases (24%) with TLCs of ≤1200 cells/mm3. Thus, 1 in 4 individuals would have been deprived of needed treatment. Therefore, we recommend keep on expansion of access to CD4 counter.
Prevalence of vitamin A deficiency in children aged 6-9 years in Wukro, northern Ethiopia
Kassaye,Tarik; Receveur,Olivier; Johns,Timothy; Becklake,Margaret R.;
Bulletin of the World Health Organization , 2001, DOI: 10.1590/S0042-96862001000500008
Abstract: objective: to determine the prevalence of vitamin a deficiency in children aged 6-9 years in northern ethiopia. methods:a cross-sectional study was carried out and the data were analysed for 824 (61.5%) of 1339 eligible children for whom there was complete information on biochemical vitamin a status, dietary vitamin a intake, ocular examination for xerophthalmia, and anthropometry. findings: the prevalence of xerophthalmia was 5.8%; serum retinol levels were below 0.35 mmol/l and between 0.35 and 0.70 mmol/l in 8.4% and 51.1% of the children respectively. the liver vitamin a reserve (modified relative dose response ratio > 0.06) was low in 41.0% of the children. conclusion: the high prevalence of severe vitamin a deficiency in children aged 6-9 years indicates the need to re-evaluate the practice of targeting vitamin a supplementation programmes on children under 6 years of age in areas where vitamin a deficiency is endemic.
Prevalence of vitamin A deficiency in children aged 6-9 years in Wukro, northern Ethiopia  [cached]
Kassaye Tarik,Receveur Olivier,Johns Timothy,Becklake Margaret R.
Bulletin of the World Health Organization , 2001,
Abstract: OBJECTIVE: To determine the prevalence of vitamin A deficiency in children aged 6-9 years in northern Ethiopia. METHODS:A cross-sectional study was carried out and the data were analysed for 824 (61.5%) of 1339 eligible children for whom there was complete information on biochemical vitamin A status, dietary vitamin A intake, ocular examination for xerophthalmia, and anthropometry. FINDINGS: The prevalence of xerophthalmia was 5.8%; serum retinol levels were below 0.35 mumol/l and between 0.35 and 0.70 mumol/l in 8.4% and 51.1% of the children respectively. The liver vitamin A reserve (modified relative dose response ratio > 0.06) was low in 41.0% of the children. CONCLUSION: The high prevalence of severe vitamin A deficiency in children aged 6-9 years indicates the need to re-evaluate the practice of targeting vitamin A supplementation programmes on children under 6 years of age in areas where vitamin A deficiency is endemic.
Micronutrient levels and nutritional status of school children living in Northwest Ethiopia  [cached]
Amare Bemnet,Moges Beyene,Fantahun Bereket,Tafess Ketema
Nutrition Journal , 2012, DOI: 10.1186/1475-2891-11-108
Abstract: Background Several micronutrients are essential for adequate growth of children. However, little information is available on multiple micronutrient status of school children in Ethiopia. The present study was designed to evaluate the relationship between multiple micronutrient levels and nutritional status among school children. Method In this cross-sectional study, anthropometric data, blood and stool samples were collected from 100 children at Meseret Elementary School in Gondar town, Northwest Ethiopia. Serum concentration of magnesium, calcium, iron, copper, zinc, selenium and molybdenum were measured by inductively coupled plasma mass spectrometer. Anthropometric indices of weight-for-age, height-for-age and BMI-for-age were used to estimate the children's nutritional status. Stool samples were examined by standard microscopic methods for intestinal parasites. Results The prevalence of stunting, underweight, wasting and intestinal parasitoses among school children was 23%, 21%, 11% and18%, respectively. The mean serum levels of magnesium, calcium, iron, copper, zinc, selenium and molybdenum were 2.42±0.32 (mg/dl), 15.31±2.14 (mg/dl), 328.19±148.91 (μg/dl), 191.30±50.17 (μg/dl), 86.40±42.40 (μg/dl), 6.32±2.59 (μg/dl), and 0.23±0.15 (μg/dl), respectively. Selenium deficiency, zinc deficiency and magnesium deficiency occurred in 62%, 47%, and 2% of the school children, respectively. Height-for-age showed significant positive correlation with the levels of copper and molybdenum (p = 0.01) and with the levels of magnesium (p = 0.05). Conclusion Deficiencies of selenium and zinc were high among the school children although the deficiencies were not significantly related with their nutritional status. The prevalence of both malnutrition and intestinal parasitism was not negligible. These calls for the need to undertake multicentre studies in various parts of the country to substantiate the data obtained in the present study so that appropriate and beneficial strategies for micronutrient supplementation and interventions on nutritional deficiencies can be planned.
Risk Factors for Vitamin D Deficiency among HIV-Infected and Uninfected Injection Drug Users  [PDF]
Allison A. Lambert, M. Bradley Drummond, Shruti H. Mehta, Todd T. Brown, Gregory M. Lucas, Gregory D. Kirk, Michelle M. Estrella
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0095802
Abstract: Introduction Vitamin D deficiency is highly prevalent and is associated with bone disease, cardiovascular disease, metabolic syndrome and malignancy. Injection drug users (IDUs), with or without HIV infection, are at risk for these conditions; however, limited data on vitamin D deficiency exist in this population. We determined the prevalence and correlates of vitamin D deficiency among urban IDUs in the AIDS Linked to the IntraVenous Experience (ALIVE) Study cohort. Methods For this cross-sectional sub-study, vitamin D deficiency was defined as a serum 25(OH)-vitamin D level <20 ng/mL. Multivariable logistic regression was used to identify factors independently associated with vitamin D deficiency. Results Of 950 individuals analyzed, 29% were HIV-infected. The median age was 49 years; 65% were male, and 91% were black. The median vitamin D level was 13.5 ng/mL (IQR, 9.0–20.3); 74% were deficient (68% in HIV-infected vs. 76% in HIV-uninfected, p = 0.01). Non-black race, fall/winter season, multivitamin intake, higher serum albumin, HCV seropositivity and HIV-infection were associated with significantly lower odds of vitamin D deficiency. Conclusions Vitamin D deficiency is prevalent among IDUs. Notably, HIV-infected IDUs were less likely to be vitamin D deficient. Higher vitamin D levels were associated with multivitamin intake and with higher albumin levels, suggesting that nutritional status contributes substantially to deficiency. The association between HCV serostatus and vitamin D level remains unclear. Further investigation is needed to define the clinical implications of the heavy burden of vitamin D deficiency in this high-risk, aging population with significant co-morbidities.
Prevalence of vitamin D deficiency in human immunodeficiency virus-infected patients  [cached]
V Fridman,N Bello,E Godoy,D Stecher
Journal of the International AIDS Society , 2012, DOI: 10.7448/ias.15.6.18324
Abstract: Purpose of the study: Vitamin D deficiency in the adults could produce osteomalacia, secondary hyperparathyroidism with bone loss and increased risk of fractures. An increased prevalence of osteopenia, osteoporosis, decreased bone density, vitamin D deficiency and increased risk of fracture was found in HIV-positive patients. A study performed in Buenos Aires, Argentina that included non-HIV-infected adult patients showed 15% prevalence of vitamin D deficiency in winter and 0% prevalence in summer. There is no local data published of vitamin D deficiency in HIV-positive populations. The aim of the study is to determinate the prevalence of vitamin deficiency in our HIV-positive population receiving HAART. Methods: An observational, retrospective study was performed. We reviewed the clinical charts of the HIV-positive adult patients attending the infectious disease clinic. We collected data of vitamin D, parathormone and beta cross laps value; we recorded if the test was performed in winter or summer. We considered vitamin D deficiency if<10 ng/ml. We recorded age, sex, comorbidities (diabetes mellitus, renal failure, hepatic failure, HBV and/or HCV coinfection, menopause, malignancy and metabolic syndrome), months since HIV diagnosis, CD4 count, viral load and HAART. Summary of results: 60 patients were included, 49 (65%) of whom were male. Mean age was 49.15 years. Mean time from diagnosis was 112 months. Mean CD4 count was 548 cells/mm3 and 6.6% presented CD4 <200; 83.3% had viral load <50 copies/mm3. All patients were on HAART; 50% received efavirenz, 65% received tenofovir and 11.6% recived atazanavir. Mean vitamin D value was 23.58 ng/ml (5–66.5 ng/ml). In winter, 15.3% of the patients had <10 ng/ml of vitamin D and mean value was 24.16 ng/ml (10–40 ng/ml). Although the mean value in summer was 25.8 ng/ml (11.6–66 ng/ml) 10% of the patients had vitamin D deficiency. PTH value was abnormal in 31.6% of patients and beta cross laps was abnormal in 10% of patients. Conclusions: Although the small number of patient included, we observed a high prevalence of vitamin D deficiency even in summer. A systematic assessment of vitamin D must be included in HIV positive patient care.
Vitamin B12 Deficiency in Helicobacter pylori Infected Patients
Gufran Kadhim, Mashitah Shikh, Hishamuddin Omar, Ahmad Ismail
Open Access Library Journal (OALib Journal) , 2018, DOI: 10.4236/oalib.1104172
Abstract:
Background: H. pylori infection is strongly related with chronic gastritis of the antrum of the stomach, which causes impairment in gastric acid and pepsin secretion, and is thus linked to malabsorption of food-vitamin B12. H. pylori can cause an individual to have a vitamin B12 deficiency. It is also a known contributor to gastritis ulcers and it can prevent the stomach from being able to absorb the vitamin B12 you consume and leads to a deficiency of vitamin B12. The purpose of this study is to determine the frequency of vitamin B12 deficiency in Helicobacter pylori infected patients. Methods: All patients aged 17 - 65 years, of either gender were evaluated for urine vitamin B12 level by human vitamin B12 ElSA kit. The data were analyzed in statistical software (SPSS) and the P-value = 0.05 was considered as statistically significant. Results: Of one hundred subjects, 65 (65%) were males, while 35 (35%) were females. 31 (36.0%) H. pylori infected patients had normal vitamin B12 level and 55 (64%) were Vitamin B12 deficiency in 86 (86%). H. pylori infected patients with a significant difference (P value < 0.05). Conclusions: Vitamin B12 deficiency is more prevalent in Helicobacter pylori infected patients.
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