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Tuberculosis Lymphadenitis in Northwest Ethiopia: Implications for Public Health  [PDF]
Fantahun Biadglegne, Berhanu Anagaw, Belay Anagaw, Weghata Tesfaye, Belay Tessema, Ulrich Sack, Arne C. Rodloff
Open Journal of Medical Microbiology (OJMM) , 2013, DOI: 10.4236/ojmm.2013.31004
Abstract: Objective: In Ethiopia where there are limited diagnostic facilities, the actual burden of tuberculosis (TB) lymphadenitis is not well known. Therefore, we conducted this study to determine the proportion of TB lymphadenitis (TBL) in childhood and adults in Northwest Ethiopia. Materials and Methods: A prospective cross sectional study was conducted from April to May 2012. Fine needle aspiration cytology (FNAC) for cytological diagnosis of TBL was used. The diagnosis of TBL was established when cytological features from lymph node aspirates are strongly suggestive of TB. Descriptive and multivariate analysis was done using SPSS version 16. Results: Out of 1070 patients attending the cytological diagnosis in the study sites 437 (41%) were positive for TBL. Of the 437 registered TBL, 59 (13.5%) were pediatric patients and 378 (86.5%) were adults. There were more females than males with a male to female ratio of 0.8:1. The cervical region had the most common group of TBL with 321 (73.2%) patients. Most of all these patients 314 (75.3%), were matted with a majority of (250/314) being in the cervical region. Individuals who had contact history with TB patients (P = 0.046) were more likely to have TBL. Conclusions: In the studied region high prevalence of TBL was documented. Screening of TBL particularly for those who had contact with TB patients is recommended. Most patients in our study presented with matted lymph nodes, indicating that late arrival of patients to health institutions. Thus continuous and intensified public health strategies on health education and early referral system have to be done in order to link them to health institutions earlier than at present.
Smear positive extra pulmonary tuberculosis disease at University of Gondar Hospital, Northwest Ethiopia
Yohannes Zenebe, Belay Anagaw, Wogahta Tesfay, Tewodros Debebe, Baye Gelaw
BMC Research Notes , 2013, DOI: 10.1186/1756-0500-6-21
Abstract: A cross-sectional study on extra pulmonary tuberculosis suspected patients was conducted at University of Gondar Hospital from January 2012 to April, 2012. Specimens of patients suspected of extra pulmonary tuberculosis were obtained from fine needle aspiration and body fluid samples collected by pathologist. Demographic characteristics and other variables were collected using a pretested semi-structured questionnaire. Smears were prepared from each sample and stained by Ziehel Neelson and Wright stain. The result of the study was analyzed with bivariate and multivariate logistic regression.A total of 344 extra pulmonary tuberculosis suspected clients were included in the study and specimens were taken from lymph node aspirates and body fluids. The overall prevalence of smear positive extra pulmonary tuberculosis was 34 (9.9%). Of these cases of extra pulmonary tuberculosis, lymph node tuberculosis constituted the largest proportion (82.4%). Among the 34 extra pulmonary tuberculosis patients, over half of them (52.9%) were positive for human immunodeficiency virus. The largest proportion of tuberculosis and human immunodeficiency virus cases occurred among persons with in the age group of 31–40 years. Previous history of tuberculosis (OR?=?4.77, 95% CI 1.86-12.24), contact to a known tuberculosis cases (OR?=?6.67 95% CI 2.78-16.90), history of underlying diseases (OR?=?2.79 95% CI 1.15-6.78) and income (OR?=?12.9 95% CI 2.25-68.02) were significantly associated with extra pulmonary tuberculosis infection.The prevalence of smear positive extra pulmonary tuberculosis infection in Gondar is high. Screening of lymph node and other body fluid specimens for extra pulmonary tuberculosis could help for treatment, control and prevention of the disease.Tuberculosis (TB) is one of the leading causes of death in the world. Globally around 8.8 million people develop tuberculosis and 1.45 million people die every year due to TB [1]. An increased incidence of tuberculosis occurs m
Frequent detection of ‘azole’ resistant Candida species among late presenting AIDS patients in northwest Ethiopia
Mulu Andargachew,Kassu Afework,Anagaw Belay,Moges Beyene
BMC Infectious Diseases , 2013, DOI: 10.1186/1471-2334-13-82
Abstract: Background The chronic use of antifungal agents in the treatment of fungal infection in general and oropharyngeal candidiasis mainly in AIDS patient’s leads to the selection of strain resistant to these therapies and a shift in the spectrum of Candida species. This study determines the species diversity and in vitro susceptibility of Candida isolates from late presenting AIDS patients in northwest Ethiopia. Methods Two hundred and twenty one HIV/AIDS patients were assessed with a standardized evaluation form at enrolment. Oral rinses were cultured on CHROMagar plates at 37°C for 48 hours and Candida species identification were made following standard microbiological techniques. In vitro drug susceptibility tests were made using broth microdilution method. Results The colonization rate of Candida species was found to be 82.3% (177/215). C. albicans was the predominant species isolated from 139 (81%) patients but there was a diversity of other species. C. glabrata was the most frequent non-albicans species isolated in 22.5% (40/177) of the patients followed by C. tropicalis 14.1% (27/177), C. krusei 5.6% (10) and other unidentifiable Candida species 4% (7/177). Recurrent episodes of oropharyngeal candidiasis and previous exposure to antifungal drugs were found to be predisposing factors for colonization by non-albicans species. Irrespective of the Candida species identified 12.2% (11/90), 7.7% (7/90) and 4.7% (4) of the isolates were resistant to fluconazole, ketoconazole and itraconazole, respectively. In contrast, resistance to micafungin, amphotericin B and 5-Fluorocytosine was infrequent. Conclusion HIV/AIDS patients are orally colonized by single or multiple albicans and non- albicans Candida species that are frequently resistant to azoles and occasionally to amphotericin B, 5-Fluorocytosine and micafungin. These highlight the need for national surveillance for examining Candida epidemiology and resistance to antifungal drugs.
Seroprevalence of hepatitis B and C viruses among medical waste handlers at Gondar town Health institutions, Northwest Ethiopia
Belay Anagaw, Yitayal Shiferaw, Berhanu Anagaw, Yeshambel Belyhun, Woldearegay Erku, Fantahun Biadgelegn, Beyene Moges, Agersew Alemu, Feleke Moges, Andargachew Mulu
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-55
Abstract: A cross-sectional study was conducted from April, 2011 to June, 2011 in government health institutions at Gondar town. Socio-demographic and possible risk factors data from medical waste handlers were collected using pre-tested and well structured questionnaires. Venous bloods were collected and the serums were tested for hepatitis B surface antigen and anti-hepatitis C antibody using rapid Immunochromatography assay. Data was entered and analyzed using SPSS software package (version16). Chi-square and Fisher exact tests were used to assess risk of association. A p-value of < 0.05 was considered statistical significance.A total of 100 medical waste handlers and 100 non-clinical waste handlers were examined for HBV and HCV viruses. HBV was detected in 6 (6.0%) and 1 (1.0%) and HCV in 1 (1.0%) and 0 (0.0%) of medical waste handlers and non-clinical waste handlers, respectively. Significant differences were observed in the detection rates of HBV (OR = 6.3; X2 = 4.1; P = 0.04) and overall infection rate (HBV + HCV) (OR = 7.5; X2 = 5.2; P: 0.02) in medical waste handlers when compared with non-clinical waste handlers. It was found that none of the observed risk factors significantly associated with rate of hepatitis infection compared to others.Prevalence of HBV and HCV were significantly higher in medical waste in relation to non-clinical waste handlers. There were poor waste management system which contributed for occurrence of higher degree of sharps injury and blood and body fluids splash.Viral hepatitis is an inflammation of the liver due to viral infections and there are groups of viruses that affects the liver [1,2]. The most common types are hepatitis B virus (HBV) and hepatitis C virus (HCV) [2]. Viral hepatitis is a major health problem worldwide and cause acute and/or chronic hepatitis which can leads to the development of extensive liver scarring (cirrhosis), liver failure, liver cancer and death. Viral hepatitis is the tenth leading cause of death and the le
Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women at University of Gondar Teaching Hospital, Northwest Ethiopia
Agersew Alemu, Feleke Moges, Yitayal Shiferaw, Ketema Tafess, Afework Kassu, Belay Anagaw, Abebe Agegn
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-197
Abstract: A cross-sectional study was conducted at University of Gondar Teaching Hospital from March 22 to April 30, 2011. Mid stream urine samples were collected and inoculated into Cystine Lactose Electrolyte Deficient medium (CLED). Colony counts yielding bacterial growth of 105/ml of urine or more of pure isolates were regarded as significant bacteriuria for infection. Colony from CLED was sub cultured onto MacConkey agar and blood agar plates. Identification was done using cultural characteristics and a series of biochemical tests. A standard method of agar disc diffusion susceptibility testing method was used to determine susceptibility patterns of the isolates.The overall prevalence of UTI in pregnant women was 10.4?%. The predominant bacterial pathogens were Escherichia coli 47.5?% followed by coagulase-negative staphylococci 22.5?%, Staphylococcus aureus 10?%, and Klebsiella pneumoniae 10?%. Gram negative isolates were resulted low susceptibility to co-trimoxazole (51.9?%) and tetracycline (40.7?%) whereas Gram positive showed susceptibility to ceftriaxon (84.6?%) and amoxicillin–clavulanic acid (92.3?%). Multiple drug resistance (resistance to two or more drugs) was observed in 95?% of the isolates.Significant bacteriuria was observed in asymptomatic pregnant women. Periodic studies are recommended to check the outcome of asymptomatic bacteriuria and also monitor any changes in the susceptibility patterns of urinary tract pathogens in pregnant women.In the female human subject, the urinary tract has an important relationship with the reproductive organs because of its proximity. In the non-pregnant state, the uterus lies just behind and partly over the bladder while in the pregnant state the enlarging uterus affects all the tissues of the urinary tract at various times [1]. Urinary Tract Infection (UTI) has become the most common hospital-acquired infection, accounting for as many as 35?% of nosocomial infections, and it is the second most common cause of bacteraemi
Impacts of Chromium from Tannery Effluent and Evaluation of Alternative Treatment Options  [PDF]
Alebel Abebe Belay
Journal of Environmental Protection (JEP) , 2010, DOI: 10.4236/jep.2010.11007
Abstract: The paper has focused on the challenges/impacts of tannery effluent and evaluates the alternative treatment options used to treat, recover or recycle chromium from the waste water. The paper was done entirely on secondary data by consulting literature sources including scientific journals, chapters of books, conference report papers and websites. The results of this review paper indicated that chromium is highly toxic and carcinogenic to human beings, animals, plants and the general environment (soil and water sediment). It is found out that chrome is the primary threat when ever tanning industry comes in to practice. Though many treatment options were evaluated to prevent its consequence on the environment, neither of them could achieve to treat or recover chrome 100%. Treatment options are either; inef-ficient, complicated, energy demanding, costly or applicable to a certain parts of the world due to technology or skilled man power demand. Therefore, to tackle this serious challenge stringent environmental regulation with law enforce-ment has to be exercised to use better treatment system which is widely applicable. Polluters must also know the envi-ronmental cost of their industry and treated according to polluter pay or precautionary principles. Moreover, the gen-eral public has to be aware of it and all concerned organizations and governments has to work hand in hand to reach zero discharge level or at least to attain the EPA chrome discharge limit
Stability of Accretion Discs around Magnetized Stars  [PDF]
Solomon Belay Tessema
International Journal of Astronomy and Astrophysics (IJAA) , 2014, DOI: 10.4236/ijaa.2014.42026
We study the stability of accretion disc around magnetised stars. Starting from the equations of magnetohydrodynamics we derive equations for linearized perturbation of geometrically thin, optically thick axisymmetric accretion disc with an internal dynamo around magnetized stars. The structure and evolution of such discs are governed by an evolution equation for matter surface density ∑(R,T). Using the time-dependent equations for an accretion disc we do a linear stability analysis of our steady disc solutions in the presence of the magnetic field generated due to an internal dynamo.
Climate Change Induced Vulnerability of Smallholder Farmers: Agroecology-Based Analysis in the Muger Sub-Basin of the Upper Blue-Nile Basin of Ethiopia  [PDF]
Abayineh Amare, Belay Simane
American Journal of Climate Change (AJCC) , 2017, DOI: 10.4236/ajcc.2017.64034
Abstract: Ethiopia is also frequently identified as a country that is highly vulnerable to climate variability and change. The potential adverse effects of climate change on Ethiopia’s agricultural sector are a major concern, particularly given the country’s dependence on agricultural production, which is sensitive to climate change and variability. This problem calls the need to understand agroecology based vulnerability to climate change and variability to better adapt to climate risks and promote strategies for local communities so as to enhance food security. The objective of this study is to estimate and compare the level of vulnerability of smallholder farmers’ to climate change and variability from three agroecology representing Muger River sub-Basin of the upper Blue Nile basin using Livelihood Vulnerability Index. The research used quantitative and qualitative data collected through Focussed Group Discussions, key informant interviews and a questionnaire survey of 442 sampled households across three different agro-ecologies in the sub-basin. The results reveal that along with the different agro-ecological zone, households and communities experienced different degrees of climate vulnerability. These differences are largely explained by differences in exposure, sensitivity and adaptive capacity of smallholder farmers. The livelihood vulnerability analysis reveals that Kolla agroecology exhibits relatively low adaptive capacity, higher sensitivity and higher exposure to climate change and variability that is deemed to be the most vulnerable agroecology. These contributing factors to a vulnerability in Kolla agroecology are largely influenced by assets, livelihood diversification, innovation, infrastructure, socio-demographic factors, social capital, agriculture, food security, and natural disasters and climate variability. The result furthermore shows that Dega agroecology has least vulnerable owing to its higher adaptive capacity. These results suggest that designing agroecology based resilience-building adaptation strategies is crucial to reduce the vulnerability of smallholder farmers to climate change and variability.
Characterizing Vulnerability of Crop-Based Rural Systems to Climate Change and Variability: Agro-Ecology Specific Empirical Evidence from the Dabus Watershed, North-West Ethiopia  [PDF]
Paulos Asrat, Belay Simane
American Journal of Climate Change (AJCC) , 2017, DOI: 10.4236/ajcc.2017.64033
Abstract: Climate change is impacting climate sensitive rural livelihood systems. Exposure, sensitivity, and adaptive capacity of agricultural livelihoods to climate variability and change differ across agro-ecologies and these pose a challenge to climate resilient development strategy. This study assesses agro-ecology specific vulnerability of smallholder farmers to climate change and variability in the Dabus Watershed (North-west Ethiopia), based on a survey of 734 farm households complemented with focus group discussion and key informant interviews. Recognizing the physiographic and climatic diversity that exists across agro-ecologies in the study area, Livelihood Vulnerability Index (LVI) framed within the United Nations Intergovernmental Panel on Climate Change (IPCC) vulnerability framework (LVI-IPCC) is adapted to assess agro-ecology specific vulnerability in two local agro-ecologies, namely wet lowland and dry lowland. For each agro-ecology, exposure, sensitivity and adaptive capacity indices as well as LVI-IPCC vulnerability score was calculated. The result shows that the dry lowland agro-ecology has a relatively higher exposure and sensitivity to climate stresses with a comparatively limited adaptive capability. On the other hand, the wet lowland agro-ecology exhibits intermediate vulnerability with a relatively lower perceived exposure and higher adaptive capacity. Higher exposure relative to adaptive capacity resulted in a positive LVI-IPCC score in the dry lowland agro-ecology and positioned it in more vulnerable level than the wet lowland. A higher adaptive capacity relative to exposure unveils a negative LVI-IPCC score for the wet lowland agro-ecology and positioned it in a moderate vulnerability category. In line with the findings, there is a need to set agro-ecology specific priorities for intervention that is most needed to cop up with the effects of climate variability and change in each agro-ecology. Climate risk exposure levels can be reduced through timely provision of climate specific information and early warning systems aimed at enhancing preparedness of farm households to extreme events. It is also crucial to expand availability of infrastructural facilities such as market, health services, and veterinary services so as to enhance adaptive capacity. Supporting alternative livelihood options and enhancing water harvesting practices for supplementary irrigation also call policy attention.
Intestinal parasitosis and shigellosis among diarrheal patients in Gondar teaching hospital, northwest Ethiopia
Kahsay Huruy, Afework Kassu, Andargachew Mulu, Netsanet Worku, Teshome Fetene, Simon Gebretsadik, Fantahun Biadglegne, Yeshambel Belyhun, Abebe Muche, Aschalew Gelaw, Belay Anagaw, Sisay Yifru, Yemataw Wondie, Assegedech Bekele, Moges Tiruneh, Dieter Reissig, Feleke Moges
BMC Research Notes , 2011, DOI: 10.1186/1756-0500-4-472
Abstract: A cross-sectional study involving 384 consecutive diarrheal patients who visited Gondar teaching hospital, Gondar, Ethiopia from October 2006 to March 2007 was conducted. Stool specimens were collected and examined for intestinal parasites and enteropathogenic bacteria following standard parasitological and microbiological procedures.Intestinal parasites were diagnosed in 36.5% of the patients. The most frequently encountered protozoan parasite was Entamoeba histolytica/dispar (7.3%) followed by Giardia lamblia (5.0%), Cryptosporidium parvum (1.8%) and Isospora belli (1.3%). The dominant helminthic parasite identified was Ascaris lumbricoides (5.5%) followed by Strongyloides stercoralis and Schistosoma mansoni (3.1% each), hookworm infection (1.8%), and Hymenolepis species (1.3%). Multiple infections of intestinal parasites were also observed in 6.3% of the patients. Among the enteropathogenic bacteria Shigella and Salmonella species were isolated from 15.6% and 1.6%, respectively, of the patients. Escherichia coli O57:H7 was not found in any of the stool samples tested. Eighty eight percent and 83.3% of the Shigella and Salmonella isolates were resistant to one or more commonly used antibiotics, respectively.Intestinal parasitosis was higher in patients who live in rural area, in patients who were washing their hands after visiting toilet either irregularly with soap and without soap or not at all, in patients who used well and spring water for household consumption, and in patients who had nausea (P < 0.05). Statistically significant associations were also observed between Shigella infections and patients who were using well and spring water for household consumption, and patients who had dysentery and mucoid stool (P < 0.05).The high prevalence of intestinal parasites and Shigella species in diarrheic patients calls for institution of appropriate public health intervention measures to reduce morbidity and mortality associated with these diseases. The rational use
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