Increased resistance of Streptococcus pneumoniae isolates to antimicrobial drugs, at a referral hospital in north-west Ethiopia

Beta lactam antibiotics were very effective against Streptococcus pneumoniae. However, resistance to this class of antibiotics has become an increasing problem. Reports of penicillin resistant and multidrug resistant strains are being made in many parts of the world. We examined the drug sensitivity pattern of S. pneumoniae isolates in a retrospective analysis of laboratory records of S. pneumoniae isolates between March 2001 and April 2005 at Gondar University Hospital, Ethiopia. A significant proportion of the isolates were found to be resistant to one or more of the commonly used antibiotics. Furthermore, the isolates appear to be acquiring an increasing resistance to crystalline penicillin, cotrimoxazole and ampicillin. This situation needs immediate attention.     

Pridominant isolates of urinary tract pathogens and their antimicrobial susceptiblity patterns in Gondar University Teaching Hospital, nothwest Ethiopia

BACKGROUND: Urinary tract infection (UTI) is one of the most common bacterial infections encountered by clinicians in developing countries. Although UTI seldom leads to complications, it can cause significant morbidity and mortality. OBJECTIVE: To identify the etiologic agents of UTIs and to assess their antimicrobial susceptibility pattern. METHODS: A retrospective analysis of 1420 mid-stream urine specimens processed fobr culture and antimicrobial susceptibility testing in the bacteriology laboratory of Gondar University Teaching Hospital between September 2002 and August 2003 was conducted RESULTS: Significant bacteriuria (cultures with > 10(5) colony forming units of bacteria per ml of urine) was observed in 399 (28.1%) of the specimens. Two bacteria each were isolated from 14 specimens, making the number of bacteria isolated to be 413 with the isolation rate of 29.1%. The most commonly isolated bacteria were Escherichia coli 166 (40.2%), Staphylococcus aureus 60 (14.5%), Klebisella species 42 (10.2%) and Citrobacter species 34 (8.2%). Among Gram-positive organisms S. aureus showed high level qf drug resistance for tetracycline 48 (80%), corimoxazole 32 (53.3%), chloramphenicol 32 (53.3%), amnpicillin 26 (43.3%) and penicillin 22 (36.7%). Of the Gram-negative bacteria, extremely high resistance patterns were found in Salmonella species for ampicillin 5 (100%), erythromycin 5 (100%), penicillin 5 (100%), co-trimoxazole 3 (60%), tetracycline 3 (60%) and 3 chloramphenicol (60%). Multiple drug resistance was observed in 85.7% of the isolates. Only 5.1% of the isolates were found to be sensitive to all antibiotics tested. CONCLUSION: Resistance to the commonly used antibiotics was found to be very high among the isolates leaving clinicians with very few choices of drugs or the treatment of UTIs. It is therefore, critical that the use of antimicrobial agents with in a hospital and all other responsible institutions he reviewed     

Immune restoration disease and changes in CD4+ T-cell count in HIV- infected patients during highly active antiretroviral therapy at Zewditu memorial hospital,Addis Ababa,Ethiopia

Background  

Highly active antiretroviral therapy (HAART) improves the immune function and decreases morbidity, mortality and opportunistic infections (OIs) in HIV-infected patients. However, since the use of HAART, immune restoration disease (IRD) has been described in association with many OIs. Our objective was to determine the proportion of IRD, changes in CD4+ T-cell count and possible risk factors of IRD in HIV-infected patients.     

Magnitude and determinants of nonadherence and nonreadiness to highly active antiretroviral therapy among people living with HIV/AIDS in Northwest Ethiopia: a cross - sectional study

Background  

Adequate antiretroviral drug potency is essential for obtaining therapeutic benefit, however, the behavioral aspects of proper adherence and readiness to medication, often determine therapeutic outcome. Therefore, this study aimed to assess the level and determinants of nonadherence and nonreadiness to highly active antiretroviral therapy (HAART) among people living with HIV/AIDS (PLWHA) at Gondar University Teaching Hospital and Felege Hiwot Hospital in Northwest Ethiopia.     

The invitro assessment of antibacterial effect of papaya seed extract against bacterial pathogens isolated from urine, wound and stool

BACKGROUND: Carica papaya family Caricaceacae is one of the herbal remedies, which has recently become a subject of research focus. It is used in traditional medicine for variety of purposes in treating infectious and noninfectious diseases. OBJECTIVE: The objective of this study was to assess the antibacterial effect of papaya seed extract against bacterial pathogens isolated from wound, urine and stool. METHODS: This analytical experimental study was conducted in Jimma University, School of Medical Laboratory Technology, Microbiology laboratory between February to March 2005. The antibacterial activity of methanol extract of papaya seed was investigated against specific pathogenic bacteria isolated from wound, urine and stool by an agar dilution technique and the crude preparation was assessed by an agar diffusion technique. The growth or inhibition of control strains of Escherichia coli, Staphylococcus aureus, Salmonella typhi, and Pseudomonas aeruginosa as well as the clinical isolates of these bacteria were determined in growth media. RESULTS: Results obtained in this study indicate that the minimum inhibitory concentration of papaya seed extract for 50% of the test bacteria was 18.38mg/ml and for S. typhi the MIC was at 11.8 mg/ml of extract. However, the growth inhibitory effect of papaya seed extract was not observed for P. aeruginosa up to 26.25 mg /ml of extract. Even though, the minimum bactericidal concentration is higher than the minimum inhibitory concentration of papaya seed extract (13.13 mg/ml, 11.8 mg/ml respectively) against S. typhi control and clinical isolates, the minimum bactericidal concentration for 50% of the tested bacteria was found to be similar with the minimum inhibitory concentration of the test bacteria, CONCLUSION: Papaya seed could be used as an effective antibacterial agent for the tested organisms. Nevertheless, preclinical studies including invivo animal models and clinical trial on the effect of the seed are essential before advocating large-scale therapy.     

Determination of urinary iodine excretion to assess iodine deficiency level and iodine intake in primary school children, Bahir Dar, northwest Ethiopia

BACKGROUND: Iodine deficiency is a major public health problem all over the world, particularly among preschool children and pregnant women in low-income countries like Ethiopia and it is known to be the most common cause of preventable brain damage. OBJECTIVES: to determine urinary iodine concentration and to assess the level of iodine deficiency disorders. METHODS: A cross-sectional study was conducted in 386 randomly selected primary school children to determine urinary iodine concentrations as to assess level of iodine deficiency and iodine in take in Bahir Dar town. RESULTS: Median urinary iodine excretion was 58.8 mg/L (12.89 mg/L to 564.5 mg/L) which indicated the presence of mild iodine deficiency. Eighty seven percent of the children had urinary iodine excretion of below 100 mg/L and the intake of iodine was below 150 mg/day. CONCLUSIONS: Mild iodine deficiency disorder was found in Bahir Dar primary school children, Iodine intake was also found insufficient. Therefore, use of salt ionization should be advocated and strengthened.     

Potential risk of HIV transmission in barbering practice in Ethiopia: from public health and microbiological perspectives

ABSTRACT: BACKGROUND: HIV and other blood borne infections can be transmitted through the use of improperly sterilized and disinfected sharp equipments. METHODS: A cross sectional study was conducted from January to June, 2010 to assess the potential risk of HIV transmission in barbering practice in Ethiopia from public health and microbiological perspectives. Barbers in barbershop were interviewed using pre-designed questionnaires and check lists were used to evaluate barbering practice. Microbiological data from tips of the sharpener before and after the barbering was collected and processed as per the standard procedure. RESULTS: One hundred and twenty three barbering sessions and barbers were observed in which 106 (86.2%) were males. Ninety six (78%) of the respondents knew that HIV could be transmitted by sharing non-sterile sharp instruments. Among the total participants 59 (48%) had the correct knowledge of what sterilization mean and 111 (94.1%) of them believed its importance in their work place. Barbers had a mean knowledge score of 6 [PLUS-MINUS SIGN] 1.5 out of a score of 10 regarding sterilization and disinfection as well as in the transmission of HIV in their work place. Three (2.5%) barbers were disagreed that unsterilized blade can transmit skin diseases and 26 (21.3%) of them believed disinfection is enough to avoid microbes from sharp objects. Ninety two (76.7%) barbers were using sterilization in their establishment. According to Likert scaling almost all sterilization and disinfection procedures were riskily practiced and respondents had poor level of knowledge. No significant association was found to influence the decontamination and sterilization of barbering equipments except monthly income, pre and post colony count of microbes identified. The isolation of normal skin flora in the pre-and post- sterilization and disinfectant procedures and less average percent colony reduction showed that sterilization and disinfectant practices in barbershop were generally. CONCLUSION: This study has revealed the presence of potential risk of HIV and other blood borne disease transmission among the barbers of the study areas. Thus continuous and intensified public health strategies on health education, training, supervision and monitoring are needed to facilitate the adoption of effective methods of sterilization and /or disinfection.     

Seroprevalence of syphilis and HIV-1 during pregnancy in a teaching hospital in northwest Ethiopia

Ethiopia is one of the countries in which sexually transmitted infections are highly prevalent. However, the data needed to present a realistic picture of the infections are lacking. This study was therefore designed to determine the seroprevalence of syphilis and HIV-1 among pregnant women at the University of Gondar Teaching Hospital. A prospective cross-sectional hospital-based study was conducted between March and June, 2005. Blood samples were collected from 480 pregnant women attending the antenatal clinic of the hospital. Sera were tested for syphilis using the Rapid Plasma Regain (RPR) and Treponema pallidum hemagglutination (TPHA) kits, and serostatus for HIV infection was checked using rapid HIV diagnostic test kits following the manufacturers' instructions. The mean (+/-SD) age of the study participants was 26.1 (+/-7.2) years. The seroprevalence of syphilis was 1%. Antibodies against HIV-1 were detected in 9.6% of the pregnant women. A higher HIV-1 prevalence (13%) was observed in the 25- to 29-year-old age group followed by the 30- to 34-year-old age group (10.2%). Only one subject (2.2%) was found to be positive for both HIV-1 and syphilis. The data indicated a relatively declined prevalence of syphilis and HIV-1 among pregnant women in an urban antenatal clinic. However, incidence and behavioral studies are required to substantiate the findings.