Prevalence and characterization of antimicrobial resistance among gram-negative bacteria isolated from febrile hospitalized patients in central Ethiopia

Background Infectious diseases are among the leading causes of death in many low-income countries, such as Ethiopia. Without reliable local data concerning causative pathogens and antimicrobial resistance, empiric treatment is suboptimal. The objective of this study was to characterize gram-negative bacteria (GNB) as pathogens and their resistance pattern in hospitalized patients with infections in central Ethiopia. Methods Patients ≥ 1 year of age with fever admitted to the Asella Referral and Teaching Hospital from April 2016 to June 2018 were included. Blood and other appropriate clinical specimens were collected and cultured on appropriate media. Antibiotic susceptibility testing (AST) was performed using the Kirby–Bauer method and VITEK® 2. Species identification and detection of resistance genes were conducted using MALDI-ToF MS (VITEK® MS) and PCR, respectively. Results Among the 684 study participants, 54.2% were male, and the median age was 22.0 (IQR: 14–35) years. Blood cultures were positive in 5.4% (n = 37) of cases. Among other clinical samples, 60.6% (20/33), 20.8% (5/24), and 37.5% (3/8) of swabs/pus, urine and other body fluid cultures, respectively, were positive. Among 66 pathogenic isolates, 57.6% (n = 38) were GNB, 39.4% (n = 26) were gram-positive, and 3.0% (n = 2) were Candida species. Among the isolated GNB, 42.1% (16/38) were Escherichia coli, 23.7% (9/38) Klebsiella pneumoniae and 10.5% (4/38) Pseudomonas aeruginosa. In total, 27/38 gram-negative isolates were available for further analysis. Resistance rates were as follows: ampicillin/sulbactam, 92.6% (n = 25); cefotaxime, 88.9% (n = 24); ceftazidime, 74.1% (n = 20); cefepime, 74.1% (n = 20); gentamicin, 55.6% (n = 15); piperacillin/tazobactam, 48.1% (n = 13); meropenem, 7.4% (n = 2); and amikacin, 3.7% (n = 1). The blaNDM-1 gene was detected in one K. pneumoniae and one Acinetobacter baumannii isolate, which carried an additional blaOXA-51 gene. The ESBL enzymes were detected in 81.5% (n = 22) of isolates as follows: TEM, 77.2% (n = 17); CTX-M-1 group, 68.2% (n = 15); SHV group, 27.3% (n = 6); and CTX-M-9 group, 9.1% (n = 2). Based on the in vitro antimicrobial susceptibility results, empiric treatment initiated in 13 of 18 (72.2%) patients was likely ineffective. Conclusion We report a high prevalence of ESBL-producing bacteria (81.5%) and carbapenem resistance (7.4%), with more than half of GNB carrying two or more ESBL enzymes resulting in suboptimal empiric antibiotic therapy. These findings indicate a need for local and national antimicrobial resistance surveillance and the strengthening of antimicrobial stewardship programs.

Factors Associated With Minimum Dietary Diversity Among Children Aged 6 to 23 Months in Debre Berhan Town, Central Ethiopia: Community-based Cross-sectional Study

Background: Minimum dietary diversity (MDD) is the consumption of four or more food groups from the seven food groups. Poor infant and young child feeding (IYCF) practices in the first 2 years of age are among major causes of childhood undernutrition, illness, and mortality. Therefore, this study aimed at investigating MDD and its associated factors among IYC aged 6–23 months in Debre Berhan town, central Ethiopia.Methods: A community-based cross-sectional study was undertaken from January 1 to 30, 2017. A simple random sampling technique was used to sample 377 IYC aged 6-23 months with mothers/caregivers. An interviewer-administered structured and pretested questionnaire was used to collect data through a face-to-face interview. Data were cleaned and entered into Epidata 3.1, exported to SPSS software version 20. Logistic regression was fitted and an odds ratio with a 95% confidence interval (CI) and p-value less than 0.05 was used to identify factors associated with MDD. Results: A total of 377 IYC aged 6-23 months with mothers/caregivers were participated in the study. The proportion of children who met the MDD practice was 58.4%. Mother’s education [(AOR = 0.15; 95% CI = 0.02-0.88), (AOR = 0.21; 95% CI = 0.05-0.97)], mother’s occupation (AOR = 0.28; 95% CI = 0.15-0.54), father’s occupation (AOR = 3.45; 95% CI = 1.40-8.54), and number of antenatal care visit by mothers (AOR = 0.54; 95% CI = 0.30-0.97) were factors associated with MDD among IYC.Conclusion: Even though the study showed better progress as compared to the national prevalence of the consumption of MDD, it is substandard in the study area. Thus, more efforts need to be done to achieve the recommended MDD intake for all children aged between 6 and 23 months. Increasing mothers’ level of education, creating employment opportunities for both mothers and fathers’, and increasing the frequency of ANC service use are vital interventions to improve IYCF practices in Debre Berhan town.

Seroprevalence of major infectious causes of dairy cattle reproductive problems in central Ethiopia

Background Reproductive problem is one of the main constraints of livestock genetic improvement efforts in tropical countries. The aim of this study was to determine the prevalence of major infectious causes of reproductive problems of dairy cattle in selected dairy farms in central Ethiopia. Overall 86 serum samples were collected from October 2018 to February 2019 from animals with history of reproductive problems. The collected serum was tested for antibody titer against Brucella species, Neospora caninum, Bovine Viral Diarrhea (BVD), Infectious Bovine Rhinotracheitis (IBR) and Q-fever using rose-bengal and enzyme-linked immunosorbent assay (ELISA) tests. Result Among the animals with the history of reproductive disordered; abortion, still birth and repeat breeding cases were found in 61.6%, 19.8% and 18.6%, respectively. The prevalence of IBR, BVD, Neospora caninum and Coxiella brunetti was found to be 79.1%, 38.4%, 3.5% and 1.2%, respectively. The combined infection of both BVD and IBR were detected in 21% of animals. Out of the total animals examined in this study, 95.9% of Jersey breeds were found seropositive to IBR than Boran-Friesian crosses (57.7%). The incidence of BVD was significantly higher in Boran-Friesian crossbred cattle than in Jersey which was found to be 69.3% and 14.3, respectively. The prevalence of IBR and BVD was directly proportional with age of the animal and parity. Conclusion Vaccination against IBR and BVD is not practiced in Ethiopia, the rising level of those diseases in dairy sector needs regular surveillance and control program.

Estimation of genetic erosion on Ethiopian tetraploid wheat landraces using different approaches

The demand and use of improved crop varieties by farmers has increased in the central highlands of Ethiopia, where continuous loss of local traditional varieties has been occurring in the last two to three decades. The objectives of the study were to assess the extent of genetic erosion and perception of farmers and associated causes for the reduction of traditional farmers' varieties. Direct field assessment covering 56 wheat farms and a survey in which 149 farmers participated were carried out in three districts of central Ethiopia. Based on data collected during direct farm assessment, the loss of genotypes was found to be 88% in Ada followed by 80% and 60% in Lume and Gimbichu districts, respectively. The farmer survey indicated an even greater loss of diversity of100% in Ada followed by Lume (93%) and Gimbichu (67%). Diseases and pests as well as shorter growing seasons associated with climate change were identified as main causes for farmers to switch to modern varieties. The expansion of high yielding improved bread and durum wheat varieties also contributed to gradually replace local durum wheat varieties by local farmers of these districts. Overall, genetic erosion of tetraploid wheat varied among the three districts of central Ethiopia. Reductions in the number of farmers and area coverage in the study districts could be used as good indicators for the existence of genetic erosion.

Evaluation of health-related quality of life of Covid-19 patients: a hospital-based study in South Central Ethiopia

Background Covid-19 causes a wide range of symptoms in patients, ranging from mild manifestations to severe disease and death. This study assessed the health-related quality of life (HRQOL) and associated factors of Covid-19 patients using primary data from confirmed cases in South Central Ethiopia. Methods We employed a facility-based, cross-sectional study design and conducted the study at the Bokoji Hospital Covid-19 treatment centre. A structured questionnaire and the EQ-5D-3L scale were used to collect the data for analysis. The HRQOL results measured by the EQ-5D-3L tool were converted to a health state utility (HSU) using the Zimbabwe tariff. The average health utility index and HSU–visual analogue scale across diverse sociodemographic and clinical characteristics were compared using the Mann–Whitney U test or Kruskal–Wallis test. We employed a multiple linear regression to examine factors associated with HSU values simultaneously. The data were analysed using STATA version 15. Results The overall mean HSU score from the EQ-5D was 0.688 (SD: 0.285), and the median was 0.787 (IQR 0.596, 0.833). The mean HSU from the visual analogue scale score was 0.69 (SD: 0.129), with a median of 0.70 (IQR 0.60, 0.80). Those who received dexamethasone and intranasal oxygen supplement, those with comorbidity, those older than 55 years and those with a hospital stay of more than 15 days had significantly lower HSU scores than their counterparts (p < .001). Conclusion Covid-19 substantially impaired the HRQOL of patients in Ethiopia, especially among elderly patients and those with comorbidity. Therefore, clinical follow-up and psychological treatment should be encouraged for these groups. Moreover, the health utility values from this study can be used to evaluate quality adjusted life years for future cost-effectiveness analyses of prevention and treatment interventions against Covid-19.