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Bacteriological Safety of Blood Collected for Transfusion at University of Gondar Hospital Blood Bank, Northwest Ethiopia
Hailegebriel Wondimu,Zelalem Addis,Feleke Moges,Yitayal Shiferaw
ISRN Hematology , 2013, DOI: 10.1155/2013/308204
Abstract: Background. Transfusion associated bacterial infection has remained more frequent with a sever risk of morbidity and mortality. This study assessed the bacteriological safety of blood collected for transfusion. Method. A cross-sectional study was conducted at University of Gondar hospital blood bank from December 2011 to June 2012. Bacterial isolation, identification, and antimicrobial susceptibility tests were done as per the standard procedure. Chi-square test and value were used to assess associations between risk factors and the bacterial isolation rate. Results. Twenty-one (15.33%) blood units were found contaminated with bacteria, and 95.24% contamination was due to external sources. The commonly isolated bacteria were Staphylococcus aureus, Coagulase negative Staphylococci, Escherichia coli, Klebsiella species, Streptococci species, Enterobacter species, and Citrobacter species. All of the bacteria isolated were 100% sensitive to Gentamicin, Chloramphenicol, Amoxicillin, and Doxycycline. Multiple antimicrobial resistances were observed in 66.7% of the isolates. Not using glove by phlebotomist, touching disinfected phlebotomy site and double puncture at the same hand or both hands of a donor were found to be risk factors for bacterial contamination. Conclusion. Bacterial contamination of blood to be transfused is a common problem in the hospital. So attention should be given to activities performed at the blood bank for safe transfusion practices. 1. Introduction The development of modern blood transfusion medicine represents one of the greatest achievements of medicine in the 20th century with about 75 million blood units being collected and transfused yearly [1, 2]. Although millions of lives are saved by blood transfusion, limited access to transfusion and the provision of unsafe blood is putting millions of people at risk of transfusion transmissible infections (TTI) [1, 3, 4]. Due to stringent donor selection, improved mandatory tests, and close surveillance of new emerging infections, the risk of TTI in developed countries is very low [5], but blood safety remains an important public health concern in Africa where lack of availability and provision of unsafe blood adversely impacts morbidity and mortality in the region [6, 7]. Transfusion associated bacterial infection (TABI) has remained more frequent than viral infections and is associated with high mortality due to rapid occurrence of septic shock [8–11]. Contaminated blood units may contain a numbers of virulent bacteria as well as endotoxins that are considered to be fatal to the
Changing Trends in Prevalence and Antibiotics Resistance of Uropathogens in Patients Attending the Gondar University Hospital, Northwest Ethiopia
Moges Tiruneh,Sisay Yifru,Mucheye Gizachew,Kassie Molla,Yeshambel Belyhun,Feleke Moges,Mengistu Endris
International Journal of Bacteriology , 2014, DOI: 10.1155/2014/629424
Abstract: Background. In most hospitals of developing countries, urinary tract infections are treated empirically because of lack of culture facilities. This leads to emergence of multiresistant uropathogens. Culturing and drug susceptibility testing are essential to guide therapy. Objectives. To assess changing prevalence and resistance pattern of uropathogens to commonly used antibiotics in a two-year study period. Methods. Urine specimens were collected and cultured. Uropathogens were identified by standard methods and tested for antibiotics resistance. Data were analyzed using SPSS version 16 statistical sofware. P value < 0.05 was considered statistically significant. Results. The commonest isolates in both the previous and present studies were E. coli, Klebsiella, CoNS, S. aureus, Proteus, and Citrobacter species. Previous isolates of Enterobacteriaceae were 100% sensitive to ciprofloxacin, whereas present isolates developed 31% to 60% resistance to it. Previous isolates were less resistant to gentamycin than the present ones. Multiresistance isolates were predominant in present study than previous ones. Conclusion. E. coli was predominant in the two study periods. Present isolates were more resistant than previous ones. Some previous isolates were 100% sensitive to ciprofloxacin, whereas present isolates were increasingly resistant. Ciprofloxacin and gentamicin have been recommended for empiric treatment of urinary tract infections. 1. Background Urinary tract infection is one of the commonest bacterial infections encountered in daily clinical practice [1]. It has been estimated that worldwide about 150 million people suffer from asymptomatic and symptomatic UTIs each year [2]. In most parts of the sub-Saharan Africa, as well as in other developing parts of the world, UTI is among the most common health problems occurring both in the community and hospitalized patients [3]. Since the last two to three decades, just as many community and hospital acquired bacterial infections, UTIs due to multidrug resistant uropathogens have caused a growing concern worldwide [1, 4–6]. Investigators [1, 7, 8] explained that the drug resistance problem in Africa stems from factors like indiscriminate use of antibiotics, inappropriate advertisement, and erratic prescription by unqualified drug sellers. Since the previous two decades, the problem of UTIs due to uropathogens resistant to the commonly used antibiotics was reported by many authors in Ethiopia in general and in Gondar region in particular [1, 9–12]. Consequently, the prevalence of urinary tract pathogens and
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
Prevalence of Toxoplasma gondii and Associated Risk Factors among People Living with HIV at Gondar University Hospital, Northwest Ethiopia
Dagnachew Muluye,Yitayih Wondimeneh,Yeshambel Belyhun,Feleke Moges,Mengistu Endris,Getachew Ferede,Gashaw Yitayew,Digsu Negese
ISRN Tropical Medicine , 2013, DOI: 10.1155/2013/123858
Abstract: Background. Toxoplasma gondii is an obligate intracellular protozoan parasite and is a major opportunistic pathogen in immune-compromised hosts. This study assessed the prevalence of T. gondii and associated risk factors among people living with HIV. Methods and Materials. A cross-sectional study was carried out among people living with HIV attending Gondar University Hospital. A structured and pretested questionnaire was used to collect sociodemographic factors, and 10mL of venous blood was collected for anti-Toxoplasma antibody test and determination of CD4 levels. Serum was tested in duplicate for anti-Toxoplasma antibody using rapid slide agglutination test. Results. A total of 170 study subjects were enrolled in the study. Seroprevalence of T. gondii among the study participants was 76.5% (95% CI: 69.0–82.8). High proportions of seropositive individuals (64.7%) were found under the child bearing age groups. The mean CD4+ lymphocyte count of HIV monoinfected participants was cells/mm3 while coinfected study participants had mean CD4+ lymphocyte count of cells/mm3 with value of 0.01. Conclusion. The seroprevalence of T. gondii among people living with HIV was high. Cautious followup of HIV-positive patients is needed to prevent development of toxoplasmic encephalitis and other related complications. 1. Introduction Toxoplasma gondii??is an obligate intracellular protozoan of worldwide distribution and is a major opportunistic pathogen in immunocompromised hosts. Infection is mainly acquired by ingestion of food, water or soil that is contaminated with oocysts shed by cats or by eating undercooked or raw meat containing tissue cysts [1]. Toxoplasmosis in patients with AIDS is usually the result of reactivation of latent infection. In HIV-positive people, without previous exposure to T. gondii, the acute infection could not be well controlled and in these susceptible hosts a wide range of infections is expected [2]. Toxoplasmosis occurs mostly in brain that is the frequent clinical finding [3, 4] even in patients with latent toxoplasmosis. Seroprevalence varies greatly in geographical regions within a country and within different ethnic groups according to different environments, social customs, and habits of different populations [5, 6]. There is wide geographic variation in the prevalence of latent Toxoplasma infection. Studies from Latin America, Europe, Asia, and Africa have reported a range of prevalence estimates of 30%–75% and prevalence estimates from US studies have had a range of 3%–42% [7, 8]. Worldwide prevalence rate of latent Toxoplasma
Zoonosis Due to Bruella suis with Special Reference to Infection in Dogs (Carnivores): A Brief Review  [PDF]
Moges Woldemeskel
Open Journal of Veterinary Medicine (OJVM) , 2013, DOI: 10.4236/ojvm.2013.33034
Abstract:

Brucella suis (B. suis) is the major cause of porcine brucellosis. Zoonosis due to B. suis infection associated with transmission by various animal species is reported. Recently an increase in brucellosis associated with feral swine transmitted B. suis infection in humans and hunting dogs is emerging. Reports on B. suis infection in carnivores including dogs is scant. This report gives a brief review of B. suis zoonosis with particular reference to B. suis infection in dogs (carnivores).

The Practice of US Execution of Juvenile Delinquents in Dated Times Vis-à-Vis International Human Rights Laws and Case Laws  [PDF]
Nuruye Beyan Feleke
Beijing Law Review (BLR) , 2015, DOI: 10.4236/blr.2015.64029
Abstract: The prohibition against the death penalty as applied to juveniles is widely practiced across the globe. The United Nations treaties have prescribed age requirements for extreme sentences such as the juvenile death penalty. Despite these requirements very few countries continue to sentence juveniles to the death penalty that ignore the age of the offender. The United States leads the world in state-sanctioned juvenile executions. However, recently the United States came into compliance with international norms and heralded a major shift by banning the death penalty as applied to juveniles in the Supreme Court case of Roper v. Simmons in 2005. Due to that, the overwhelming majority of states do not sentence juveniles to the death penalty and the prohibition against sentencing children to die has become accepted. On the contrary, for over three centuries, the United States executed juvenile delinquents and the Supreme Court, for a long time, held there was no national consensus rejecting juvenile executions and not a violation of the Eighth Amendment. The US is already a party to a number of fundamental human rights treaties that impact capital punishment. To some extent, the US has isolated itself from the most direct effects of these treaties through reservations or by invoking domestic law. But the US is committed to the underlying human rights principles of these treaties and these instruments can serve as a starting point for reforming and restricting the death penalty from a human rights perspective.
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
Determinates of Regain in Body Mass Index among Malnourished Aids Patients on Therapeutic Food in Amhara National Regional State, Northwest Ethiopia: A Retrospective Cohort Study  [PDF]
Molla Gedefaw, Moges Tariku
Open Journal of Epidemiology (OJEpi) , 2015, DOI: 10.4236/ojepi.2015.52016
Abstract: Although its utilization is greatly disputed, ready-to-use therapeutic food has been started as clinical nutrition care and treatment for malnourished adult AIDS patients since 2011 in Amhara National Regional State. However, factors determining the intended outcome (weight gain) have not been properly investigated. The main objective of the study was to assess improvement in body mass index and to identify its determinant factors. A retrospective cohort study design was conducted. Cluster sampling was employed to select health facilities in which the service was provided in the region. Of the 44 health facilities, nine were selected using lottery method, and all patients receiving the care in these health institutions were included in the study. Using tailored structured checklist, data were collected, organized and cleaned. Using paired T-test existence of difference between the mean of body mass index at admission and at 3rd visit was measured. Finally analysis of association between some selected independent variables with the outcome variable was done using logistic regression model at 95% CI and p < 0.05. Of 431 study participants, 175 (40.6%) study participants’ body mass index was improved (≥18.5 kg/m2). Paired T-test revealed that there was a statistically significant difference between mean of body mass index at admission and at the 3rd visit. Good ready-to-use therapeutic food treatment adherence (AOR 11.145; 95% CI 6.556, 18.946), moderate acute malnutrition at admission (AOR 6.71; 95% CI 2.618, 17.195), good ART adherence (AOR 2.136; 95% CI, 1.269, 3.595) and being male (AOR 1.73; 95% CI 1.052, 2.850) have a statistically significant contribution for body mass index improvement. The study identifies factors that determine gain in body mass index among AIDS patients on ready-to-use therapeutic food. However, although the study revealed a statistically significant difference between body mass index during enrolment, and after three months, we disagreed with the right and left utilization of imported food because of lack of sustainability, and aid dependency. We rather recommend interventions that encourage households to produce food with similar outcomes from locally available food staff.
Contributing Factors to Long Working Hours: Case Study of Waiters in Dire Dawa Administration  [PDF]
Gizachew Girma, Tadesse Moges
Beijing Law Review (BLR) , 2015, DOI: 10.4236/blr.2015.63017
Abstract: The need to create and maintain industrial peace, in one hand, protect the fragile interest of workers on the other side to boost economic development have been critical issues which have attained significant consideration from states. To that end, they introduced at international and national levels different set of legislations regulating employment relations. Among other things, working time limit has meticulously been introduced to safeguard the rights of workers, who are generally with the lesser bargaining power, and make the labor more productive. Ethiopia has accepted this notion of delimitating working hours, and adopted legislations. However, it has become a public secret that such rules have not been maintained in practice and that the enforcement mechanism appeared meager. Though researches have been made in different part of the world; in Ethiopia, particularly in Dire Dawa, the factors contributing for long working hours have not been addressed. There are, however, indicators that particularly waiters are working for longer hours than what the law stipulates. In a town dubbed as industrial corner, this factor should not be left unconsidered if the aspired objective of the labour regulation is really to be met. This research, hence, took the first step in studying the existence of this violation, and investigating the contributing factors. The data were collected through structured questionnaires and interviews, and samples were taken using stratified systematic sampling method. Data were analyzed through quantitative (descriptive analysis and logistic regression model) and qualitative techniques. Then, job insecurity, lack of legal awareness, culture of the work, salary, tips, dependents, and level of education have been found out to be contributing factors, and their level of significance has also been established. It has also revealed that the absence of strong enforcement mechanisms contributed for the apparent non-adherence to the rules so delimiting working hours.
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