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Search Results: 1 - 10 of 2574 matches for " Abraham Aseffa "
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Risk Factors for Multidrug-Resistant Tuberculosis and Characteristics of Cases: A Case-Control Study of Patients Attending ALERT General Hospital in Addis Ababa, Ethiopia  [PDF]
Ezra Shimeles, Fikre Enquselassie, Melaku Tilahun, Alemayehu Mekonnen, Getachew Wondimagegn, Tsegaye Hailu, Abraham Aseffa
Open Journal of Respiratory Diseases (OJRD) , 2019, DOI: 10.4236/ojrd.2019.91001
Abstract: Background:Tuberculosis remains a major public-health problem in the world, despite several efforts to improve case identification and treatment. Particularly multidrug-resistant tuberculosis is becoming a major threat to tuberculosis control programs in Ethiopia which seriously threatens the control and prevention efforts and is associated with both high death rates and treatment costs. Methods: A case-control study was conducted to assess risk factors and characteristics of MDR-TB cases at ALERT Hospital, Addis Ababa, Ethiopia, where cases were 167 MDR-TB patients, while controls were newly diagnosed and bacteriologically confirmed pulmonary TB cases of similar number, who were matched by sex and age of 5-years interval. Results: The socio-demographic characteristics of the participants indicated that majority (53.3%) were males and 46.7% females; a little over half of cases (55.1%) were in the age group 26 - 45 years, whereas 46.7% of controls were in this age group. According to the multivariable logistic regression analysis, previous history of hospital admission was the only factor that was identified as predictor which increased risk to develop MDR-TB by almost twenty times (AOR = 19.5; 95% CI: 9.17 - 41.62) and P-value of <0.05. All other studied factor such as being unemployed, family size, having member of household member with TB, and history of visiting hospital in past 12 months etc., didn’t show any statistically significant association. Conclusion: The study identified previous history of hospital admission as independent predictors for the occurrence of MDR-TB, while other studied variables didn’t show any strong association. The findings added to the pool of knowledge emphasizing the need for instituting strong infection control practice at health care facilities to prevent nosocomial transmission of MDR-TB.
Comparison of acid-fast stain and culture for Mycobacterium tuberculosis in pre- and post-bronchoscopy sputum and bronchoalveolar lavage in HIV-infected patients with atypical chest X-ray in Ethiopia
Aderaye Getachew,G/Egziabher Haimanot,Aseffa Abraham,Worku Alemayehu
Annals of Thoracic Medicine , 2007,
Abstract: Background : Smear-negative tuberculosis occurs more frequently in human immunodeficiency virus (HIV)-infected patients than in non-HIV-infected patients. Besides, there are substantial numbers of patients who cannot produce sputum, making the diagnosis of pulmonary tuberculosis (PTB) difficult. Aims : To evaluate the relative yield of pre- and post-bronchoscopy sputum and bronchoalveolar lavage (BAL) in ′sputum smear′-negative, HIV-positive patients. Settings : A tertiary care referral hospital in Addis Ababa. Materials and Methods : Acid-fast stain (AFS) using the concentration technique was done on 85 pre-bronchoscopy sputum and 120 BAL samples. Direct AFS was done on all BAL and 117 post-bronchoscopy sputum samples. Culture for Mycobacterium tuberculosis (MTB) was done for all sputa and BAL. Results : MTB was isolated from 26 (21.7%), 23 (19.7%) and 13 (15.3%) of BAL, post- and pre-bronchoscopy sputum cultures respectively. AFS on pre-bronchoscopy sputum using concentration technique and direct AFS on BAL together detected 11 (41%) of the 27 culture-positive cases. In patients who could produce sputum, the sensitivity of pre-bronchoscopy sputum culture (13/85, 15.3%) was comparable to BAL (12/85, 14%) and post-bronchoscopy sputum (12/85, 14%). In patients who could not produce sputum, however, both BAL (12/35, 40%) and post-bronchoscopy sputum (12/32, 31.4%) detected significantly more patients than those who could produce sputum ( P =0.002, P =0.028 respectively). Conclusion: In HIV-infected patients, AFS by concentration method on pre-bronchoscopy sputum and direct AFS on BAL in patients who cannot produce sputum are the preferred methods of making a rapid diagnosis. BAL culture seems to add little value in patients who can produce sputum; therefore, bronchoscopy should be deferred under such circumstances.
Plasma Level of IL-4 Differs in Patients Infected with Different Modern Lineages of M. tuberculosis
Adane Mihret,Yonas Bekele,Andre G. Loxton,Abraham Aseffa,Rawleigh Howe,Gerhard Walzl
Journal of Tropical Medicine , 2012, DOI: 10.1155/2012/518564
Abstract: Epidemiological evidence from tuberculosis outbreaks revealed that some genotypes of M. tuberculosis are more transmissible and capable of causing disease than others. We analysed the plasma cytokine levels of pulmonary tuberculosis patients infected with different strains of M. tuberculosis to test the hypothesis that immune responses would be linked to the bacterial genotype. Spoligotyping was carried out for genotyping, and we used Luminex technology to measure 17 cytokines (EGF, fractalkine, GM-CSF, IFN-γ, IL-1, IL-10, IL-12, IL-17, IL-4, IL-7, IL-9, IP-10, MCP-1, MCP-3, MIP-1β, TNF, and VEGF) from plasma samples of tuberculosis patients. The levels of IL-12 (p40), IL-4, IL-7, and MIP-1beta were higher in patients infected with lineage 3, however, it was only IL-4 which showed statistically significant difference ( ) between lineage 3 and lineage 4. We further grouped the lineages into families (CAS, H and T families), and we found that the plasma level of IL-4 was significantly higher in patients infected with the CAS family ( ) in comparison with T and H families. However, there was no difference between T and H families. Therefore, the higher level of IL-4 in lineage 3 families might indicate that possible differences in the response elicited from host depend on strain lineages in the studied population. 1. Introduction Tuberculosis remains a significant public health problem, and it is estimated that one-third of the world’s population is infected with Mycobacterium tuberculosis, although the majority will never develop active disease [1]. The factors that lead to the considerable variability in the outcome of M. tuberculosis infection are complex and incompletely understood. Host genetics and environmental factors such as prior exposure to nonpathogenic mycobacteria, HIV infection, advanced age, malnutrition, alcohol abuse, diabetes, and use of corticosteroids have been associated with tuberculosis disease [2]. Moreover, as tuberculosis disease results from the interactions between host and bacteria, there is growing evidence that the genetic diversity of Mycobacterium tuberculosis may have important clinical consequences [3, 4]. The global population structure of M. tuberculosis is defined by six phylogeographical lineages: Indo-Oceanic lineage, East Asian lineage, East African Indian lineage, Euro-American lineage, West African lineage I and West African lineage II [5]. The Indo-Oceanic lineage (lineage I), West African lineage I (lineage 5), and West African lineage II (lineage 6) are belonging to ancient lineages whereas the East Asian
Evaluation of collaborative TB/HIV activities in a general hospital in Addis Ababa, Ethiopia
Aragie Kassa, Degu Jerene, Yibeltal Assefa, Azmera Teka, Abraham Aseffa, Amare Deribew
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-67
Abstract: From register review, it was determined that the HIV testing acceptance rate was 95%, and that 70% of patients received post-test counseling. A review of the patient chart revealed that of 51 patients with a complaint of cough, duration for cough was recorded in 35 (68.6%) cases and cough > 2 weeks was recorded in 25 (49.0%) cases. Seventy two percent (18 of 25) were linked for sputum microscopy. Linkage to cotrimoxazole prophylactic treatment was 81%, but only 47% of eligible patients were linked to isoniazid preventive therapy (IPT). Correct diagnosis was accomplished at a rate of 100% for smear positive pulmonary TB, 23% for smear negative pulmonary TB and 88% for extra pulmonary TB patients. Both chart review and exit interviews indicated that history of TB contact and cough > 2 weeks predicted TB disease.The rates of HIV testing and linkage to cotrimoxazole prophylactic therapy were high. Improvement is needed in the areas of recording patient information, screening HIV positives for TB, initiation of IPT, referral, linkages, and TB diagnostic capacity.Tuberculosis (TB) is the leading killer of human immunodeficiency virus (HIV) infected individuals, and the overlapping epidemics have had a devastating impact on TB and HIV morbidity, mortality and control worldwide [1]. These TB and HIV co-epidemics require urgent and effective attention and demand a collaborative effort between TB and HIV programs employing different but complementary strategies. Both programs should be able to identify and manage both diseases [2,3].However, the two programs are often separate at the level of patient care contributing to delayed diagnosis and linkage to care. TB and HIV programs must establish linkages to better utilize resources, avoid missed opportunities, and accelerate universal access to comprehensive TB and HIV prevention, treatment and care services [4].In Ethiopia, 24% HIV sero prevalence is reported in TB patients from health facilities implementing TB/HIV services [
Anti-mycobacterial recall responses differentiate female patients with genital tuberculosis from patients with other gynecological problems
Markos Abebe, Abraham Aseffa, Morten Harboe, Zufan Lakew, Lukman Yusuf, Joseph Olobo, Mekuria Lakew
Ethiopian Journal of Health Development , 2005,
Abstract: Background: Female Genital Tuberculosis (FGTB) is one form of extra pulmonary tuberculosis affecting the female reproductive organs, most commonly the fallopian tubes and the endometrium. It affects young women aged between 20 and 40 years of age and is an important cause of infertility. It often occurs as a secondary complication following pulmonary tuberculosis. Diagnosis depends mainly on clinical suspicion in countries where facilities for mycobacterial culture and histopathology are unavailable. Even in places where these facilities exist, diagnosis still remains difficult because of the lower sensitivity and specificity of the methods as well as the invasive procedure of acquiring biopsy specimens. Objective: To explore the immunological profiles of female genital tuberculosis (FGTB) patients in response to mycobacterial antigens. Methods: Twenty-five clinically suspected cases of FGTB and 12 control subjects who came to the Black Lion hospital for unrelated gynecological problems were included in the study. Peripheral blood samples were collected from each subject. Plasma was separated by centrifugation and PBMC were isolated over ficoll-hypaque and stimulated in vitro with mycobacterial antigens to examine their proliferative response as incorporation of tritiated thymidine using a β-counter. HIV status and total IgG-, IgA- and IgM- antibody levels were determined by ELISA tests. Results: In vitro recall responses to M. tuberculosis antigens (PPD and BCG sonicate) as well as plasma levels of IgGIgA- and IgM-antibodies to MPT59 showed statistically significant differences between the patients and the controls (p<0.05). Conclusion: The results show that PBMC of FGTB patients recognize M. tuberculosis antigens more strongly than PBMC of patients with other gynecological problems. Ethiopian Journal of Health Development Vol. 19(3) 2005: 219-24
Evaluation of a direct colorimetric assay for rapid detection of rifampicin resistant Mycobacterium tuberculosis
Dawit Wolde Meskel, Getahun Abate, Mekuria Lakew, Solomon Goshu, Alemayehu Selassie, Hakan Miorner, Abraham Aseffa
Ethiopian Journal of Health Development , 2005,
Diversity of Mycobacterium tuberculosis Isolates from New Pulmonary Tuberculosis Cases in Addis Ababa, Ethiopia
Adane Mihret,Yonas Bekele,Andre G. Loxton,Annemie M. Jordan,Lawrence Yamuah,Abraham Aseffa,Rawleigh Howe,Gerhard Walzl
Tuberculosis Research and Treatment , 2012, DOI: 10.1155/2012/892079
Abstract: Understanding the genetic diversity of Mycobacterium tuberculosis is needed for a better understanding of the epidemiology of TB and could have implications for the development of new diagnostics, drugs, and vaccines. M. tuberculosis isolates were characterized using spoligotyping and were compared with the SpoIDB4 database of the Pasteur Institute of Guadeloupe. A total of 53 different patterns were identified among 192 isolates examined. 169 of the isolates were classified into one of the 33 shared SITs, whereas the remaining 23 corresponded to 20 orphan patterns. 54% of the isolates were ascribed to the T family, a family which has not been well defined to date. Other prominent families were CAS, Haarlem, LAM, Beijing, and Unknown comprising 26%, 13%, 2.6%, 0.5%, and 2.1%, respectively. Among HIV-positive patients, 10 patterns were observed among 25 isolates. The T (38.5%), H (26.9%), and CAS (23.1%) families were the most common among HIV-positive individuals. The diversity of the M. tuberculosis strains found in this study is very high, and there was no difference in the distribution of families in HIV-positive and HIV-negative TB patients except the H family. Tuberculosis transmission in Addis Ababa is due to only the modern M. tuberculosis families (CAS, LAM, T, Beijing, Haarlem, and U). 1. Introduction Tuberculosis (TB) continues to be a major public health problem in Ethiopia. Currently Ethiopia is rated seventh among the 22 high-TB-burdened nations of the world, with a prevalence of 394 per 100,000 population in the year 2010 [1]. This situation has been worsened by the country’s HIV/AIDS epidemic and emerging Multidrug-Resistant (MDR) TB. HIV prevalence was 3.5% in 2009 and among TB patients 15% were coinfected with HIV and the rate of MDR is 1.6 in new cases and 12% in retreatment cases [2]. Despite the high-TB burden in the country, very limited information is available on the genetic diversity of M. tuberculosis strains and the impact of HIV disease on this diversity. Molecular typing techniques have been extensively used to speciate strains of M. tuberculosis involved in TB infections, studying molecular epidemiology of M. tuberculosis, providing insights into dissemination dynamics, evolutionary genetics, and detection of suspected outbreaks and person-to-person transmission [3]. Although recent studies are recommending the use of robust markers such as single nucleotide polymorphisms (SNP) or large sequence polymorphisms (LSP) for a better understanding of strain lineages [4], Insertion sequence (IS) 6110 restriction fragment length
Prediction of HLA Class II Alleles Using SNPs in an African Population
Fasil Tekola Ayele, Elena Hailu, Chris Finan, Abraham Aseffa, Gail Davey, Melanie J. Newport, Charles N. Rotimi, Adebowale Adeyemo
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0040206
Abstract: Background Despite the importance of the human leukocyte antigen (HLA) gene locus in research and clinical practice, direct HLA typing is laborious and expensive. Furthermore, the analysis requires specialized software and expertise which are unavailable in most developing country settings. Recently, in silico methods have been developed for predicting HLA alleles using single nucleotide polymorphisms (SNPs). However, the utility of these methods in African populations has not been systematically evaluated. Methodology/Principal Findings In the present study, we investigate prediction of HLA class II (HLA-DRB1 and HLA-DQB1) alleles using SNPs in the Wolaita population, southern Ethiopia. The subjects comprised 297 Ethiopians with genome-wide SNP data, of whom 188 had also been HLA typed and were used for training and testing the model. The 109 subjects with SNP data alone were used for empirical prediction using the multi-allelic gene prediction method. We evaluated accuracy of the prediction, agreement between predicted and HLA typed alleles, and discriminative ability of the prediction probability supplied by the model. We found that the model predicted intermediate (two-digit) resolution for HLA-DRB1 and HLA-DQB1 alleles at accuracy levels of 96% and 87%, respectively. All measures of performance showed high accuracy and reliability for prediction. The distribution of the majority of HLA alleles in the study was similar to that previously reported for the Oromo and Amhara ethnic groups from Ethiopia. Conclusions/Significance We demonstrate that HLA class II alleles can be predicted from SNP genotype data with a high level of accuracy at intermediate (two-digit) resolution in an African population. This finding offers new opportunities for HLA studies of disease epidemiology and population genetics in developing countries.
Anti-Tuberculosis Therapy-Induced Hepatotoxicity among Ethiopian HIV-Positive and Negative Patients
Getnet Yimer, Getachew Aderaye, Wondwossen Amogne, Eyasu Makonnen, Eleni Aklillu, Lars Lindquist, Lawrence Yamuah, Beniyam Feleke, Abraham Aseffa
PLOS ONE , 2008, DOI: 10.1371/journal.pone.0001809
Abstract: Background To assess and compare the prevalence, severity and prognosis of anti-TB drug induced hepatotoxicity (DIH) in HIV positive and HIV negative tuberculosis (TB) patients in Ethiopia. Methodology/Principal Findings In this study, 103 HIV positive and 94 HIV negative TB patients were enrolled. All patients were evaluated for different risk factors and monitored biochemically and clinically for development of DIH. Sub-clinical hepatotoxicity was observed in 17.3% of the patients and 8 out of the 197 (4.1%) developed clinical hepatotoxicity. Seven of the 8 were HIV positive and 2 were positive for HBsAg. Conclusions/Significance Sub-clinical hepatotoxicity was significantly associated with HIV co-infection (p = 0.002), concomitant drug intake (p = 0.008), and decrease in CD4 count (p = 0.001). Stepwise restarting of anti TB treatment was also successful in almost all the patients who developed clinical DIH. We therefore conclude that anti-TB DIH is a major problem in HIV-associated TB with a decline in immune status and that there is a need for a regular biochemical and clinical follow up for those patients who are at risk.
Bovine Tuberculosis at the Wildlife-Livestock-Human Interface in Hamer Woreda, South Omo, Southern Ethiopia
Rea Tschopp,Abraham Aseffa,Esther Schelling,Stefan Berg,Elena Hailu,Endalamaw Gadisa,Meseret Habtamu,Kifle Argaw,Jakob Zinsstag
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0012205
Abstract: Bovine tuberculosis (BTB) is endemic in cattle in the Ethiopian Highlands but no studies have been done so far in pastoralists in South Omo. This study assessed the prevalence of bovine tuberculosis (BTB) at an intensive interface of livestock, wildlife and pastoralists in Hamer Woreda (South Omo), Ethiopia. A cross-sectional survey including a comparative intradermal skin testing (CIDT) was conducted in 499 zebu cattle and 186 goats in 12 settlements. Sputum samples from 26 symptomatic livestock owners were cultured for TB. Fifty-one wildlife samples from 13 different species were also collected in the same area and tested with serological (lateral flow assay) and bacteriological (culture of lymph nodes) techniques. Individual BTB prevalence in cattle was 0.8% (CI: 0.3%–2%) with the >4 mm cut-off and 3.4% (CI: 2.1%–5.4%) with the >2 mm cut-off. Herd prevalence was 33.3% and 83% when using the >4 and the >2 mm cut-off respectively. There was no correlation between age, sex, body condition and positive reactors upon univariate analysis. None of the goats were reactors for BTB. Acid fast bacilli (AFB) were detected in 50% of the wildlife cultures, 79.2% of which were identified as Mycobacterium terrae complex. No M. bovis was detected. Twenty-seven percent of tested wildlife were sero-positive. Four sputum cultures (15.4%) yielded AFB positive colonies among which one was M. tuberculosis and 3 non-tuberculous mycobacteria (NTM). The prevalence of M. avium-complex (MAC) was 4.2% in wildlife, 2.5% in cattle and 0.5% in goats. In conclusion, individual BTB prevalence was low, but herd prevalence high in cattle and BTB was not detected in goats, wildlife and humans despite an intensive contact interface. On the contrary, NTMs were highly prevalent and some Mycobacterium spp were more prevalent in specific species. The role of NTMs in livestock and co-infection with BTB need further research.
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