Dataset Information

Serological investigation of visceral Leishmania infection in human and its associated risk factors in Welkait District, Western Tigray, Ethiopia.

ABSTRACT: Visceral leishmaniasis (VL) is major neglected public health problem in terms of geographical spread and incidence in Ethiopia. Magnitude, public health impact and dynamics of VL were not well studied in Welkait District, Western Tigray, though the area is known for VL. Hence, this study aimed to determine sero-prevalence of human VL and associated risk factors in Welkait as new foci. A cross sectional study design was employed in this study. Two stage stratified random sampling method was used to select study participants. Hence, a total of 329 human study participants were included for serological survey using ITleish and leishmanin skin tests. Semi structured questionnaire was also used to identify VL associated risk factors. Univariate and multivariate logistic regression statistical methods were used to determine the degree of association. The overall sero-prevalence of human VL in the study area was found to be 8.81%. Statistical significant difference in the prevalence of the disease was found among Sub-districts, sex, re-settlement, sleeping outdoor and dog ownership (P < 0.05). Participants who resettled from their original place were found 2 times (AOR = 2.143; 95% CI = 1.02, 14.20) more vulnerable to VL infection. Those who had an experience of sleeping outdoor were found almost 4 times (AOR = 4.29; 95% CI = 1.58, 11.69) more likely to be at risk of acquiring VL infection than those sleep indoor. Furthermore, individuals who owned dogs were 3 times more prone to the VL infection than their counterparts (AOR = 3.37; 95% CI = 1.29, 8.76). Alarming sero-positivity of human VL was recorded from new foci. Hence, it is recommended to improve the VL health services in the study area. The investigation also invites further study on VL dynamics in the study area.

SUBMITTER: Bsrat A

PROVIDER: S-EPMC5952676 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Serological investigation of visceral <i>Leishmania</i> infection in human and its associated risk factors in Welkait District, Western Tigray, Ethiopia.

Bsrat Abrha A Berhe Mebrahtu M Gadissa Endalemaw E Taddele Habtamu H Tekle Yohannes Y Hagos Yohannes Y Abera Adugna A G/Micael Messele M Alemayhu Tehetna T Gugsa Getachew G Aseffa Abraham A

Parasite epidemiology and control 20171104 1

Visceral leishmaniasis (VL) is major neglected public health problem in terms of geographical spread and incidence in Ethiopia. Magnitude, public health impact and dynamics of VL were not well studied in Welkait District, Western Tigray, though the area is known for VL. Hence, this study aimed to determine sero-prevalence of human VL and associated risk factors in Welkait as new foci. A cross sectional study design was employed in this study. Two stage stratified random sampling method was used ...[more]

PMID: 29774295

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Project description:BackgroundEthiopia bears a high burden of visceral leishmaniasis (VL). Early access to VL diagnosis and care improves clinical prognosis and reduces transmission from infected humans; however, significant obstacles exist. The approximate 250,000 seasonal mobile workers (MW) employed annually in northwestern Ethiopia may be particularly disadvantaged and at risk of VL acquisition and death. Our study aimed to assess barriers, and recommend interventions to increase access, to VL diagnosis and care among MWs.Methodology/principal findingsIn 2017, 50 interviews and 11 focus group discussions were conducted with MWs, mobile residents, VL patients and caretakers, community leaders and healthcare workers in Kafta Humera District, Tigray. Participants reported high vulnerability to VL among MWs and residents engaged in transitory work. Multiple visits to health facilities were consistently needed to access VL diagnosis. Inadequate healthcare worker training, diagnostic test kit unavailability at the primary healthcare level, lack of VL awareness, insufficient finances for care-seeking and prioritization of income-generating activities were significant barriers to diagnosis and care. Social (decision-making and financial) support strongly and positively influenced care-seeking; workers unable to receive salary advances, compensation for partial work, or peer assistance for contract completion were particularly disadvantaged. Participants recommended the government/stakeholders intervene to ensure: MWs access to bed-nets, food, shelter, water, and healthcare at farms or sick leave; decentralization of diagnostic tests to primary healthcare facilities; surplus medications/staff during the peak season; improved referral/feedback/reporting/training within the health system; free comprehensive healthcare for all VL-related services; and community health education.Conclusions/significanceContrary to what health policy for VL dictates in this endemic setting, study participants reported very poor access to diagnosis and, consequently, significantly delayed access to treatment. Interventions tailored to the socio-economic and health needs of MWs (and other persons suffering from VL) are urgently needed to reduce health disparities and the VL burden.

Project description:BACKGROUND:Canine leishmaniasis (CanL) is endemic in western China, resulting in important public health problem. It is essential to evaluate the prevalence of canine Leishmania infantum infection for designing control policy. In the present study we report for the first time prevalence of Leishmania infection in dogs living in Jiuzhaigou County (Sichuan Provence, China), which is not only an important endemic area of CanL but also a tourism scenic spot, detected by PCR, ELISA and dipstick test. The results could provide key information for designing control programs against canine and human leishmaniasis. In addition, the complete sequence of the Leishmania isolate from Sichuan Province has not been reported to date and we present the sequences of 116 base-pair (bp) fragment of the conserved region in the minicircle kinetoplast DNA (kDNA) and the results of phylogenetic analyses based on the sequence of the amplified fragment. RESULTS:The proportion of dogs infected with Leishmania in Jiuzhaigou County was 36.79%, 9.43%, and 51.88% detected by ELISA, dipstick test, and PCR, respectively. The ELISA and PCR tests were more sensitive than dipstick test. The PCR method is the most sensitive way to detect dogs infected with Leishmania parasites. The total positive rate for infected dogs in the area was 59.43% by the three methods. The PCR products of 116-bp fragment amplified from the kDNA conserved region of dog blood samples and laboratory maintained L. infantum were DNA sequenced and the variation of the sequences was observed. The phylogenetic tree based on the sequences of 116-bp fragment reveals that L. infantum is more genetically related to visceralizing species L. donovani than to the Leishmania species associated with cutaneous disease. CONCLUSIONS:More than half of dogs living in the endemic Jiuzhaigou County were infected by L. infantum. Control measures, such as treatment or eradication of infected dogs, or prohibition of maintaining dogs, must be taken against these infected dogs due to their role in the transmission of the infection to vectors. The phylogenetic tree based on the sequences of conserved region in kDNA of Leishmania can effectively distinguish species of Leishmania.

Project description:BACKGROUND:Starting from the ancient time, the people of Ethiopia use medicinal plants as traditional medicine to heal different human and livestock ailments. This ethnobotanical study of medicinal plants was carried out in Ganta Afeshum District, Eastern Zone of Tigray, Northern Ethiopia, to identify medicinal plant species used by the local community to treat various human and livestock ailments. METHODS:A total of 78 informants (54 men and 24 women) were selected to collect ethnobotanical information from four study sites. Among the 78 informants, 20 key informants were selected purposefully; the other 58 informants were selected randomly by lottery method. Ethnobotanical data were collected using semi-structured interviews, field observations, guided field walks, and group discussions and were analyzed by preference ranking, paired comparison, direct matrix ranking, informant consensus factor, fidelity level (FL), use-value, independent samples t test, and Pearson correlation coefficients. RESULTS:A total of 173 medicinal plants were collected and identified that were distributed across 77 families and 156 genera. The family Fabaceae stood first by contributing 17 (9.8%) species followed by Lamiaceae and Solanaceae with 9 (5.2%) species each. Rhamnus prinoides was reported for the treatment of many of the described diseases. One hundred sixteen (67.1%) medicinal plant species were collected from natural vegetation, 34 (19.7) were from home gardens, 13 (7.5%) from farmland, and 10 (5.8%) were from natural vegetation and home gardens. The most widely used life form was herbs (69 species, 39.9%) followed by shrubs (58 species, 33.5%). The most commonly used part of the medicinal plants was the leaves followed by roots. The plants were prepared by grinding, powdering, squeezing, roasting, and burning and were administered through oral, dermal, nasal, anal, ocular, and vaginal, and on the surface of the teeth. The most commonly used applications were by drinking, smearing, eating, fumigation, and chewing. There was no difference between men and women informants, showing that the two sexes had similar knowledge in the use of traditional medicinal plants. Educational level and medicinal plant knowledge of informants were negatively correlated; whereas age and medicinal plant knowledge of informants were positively correlated. CONCLUSIONS:Ganta Afeshum District is relatively rich in diversity of medicinal plant resources accompanied with a rich indigenous knowledge within the local communities to harvest and effectively use to prevent different human and livestock ailments. However, nowadays, deforestation, agricultural expansion, overgrazing, drought, and overexploitation are threatening these properties. Therefore, people of the study area should apply complementary conservation approaches (in situ and ex situ) for sustainable use of these resources and to prevent species extinction.

Project description:BackgroundDrug use evaluation is a systematic approach to determining the appropriateness of drug use, identifying drug therapy problems, and proposing interventions. Ceftriaxone is one of the most widely used drugs in hospitals, requiring the performance of drug use evaluation. This study was aimed at evaluating the appropriateness of ceftriaxone use at Kahsay Abera and Mearg hospitals in the Western zone of Tigray, Ethiopia.MethodsAn institution-based retrospective cross-sectional study design was conducted in both hospitals from December 2015 to August 2016 using standardized and pretested data collection formats. Systematic random sampling was used, and a total of 800 patients' medication records (patients who took ceftriaxone) from both hospitals (400 each) were assessed in this study. Statistical analysis was performed by using the statistical package for social sciences (version 20).ResultsThe overall appropriateness of ceftriaxone use in Kahsay Abera and Mearg hospitals was 247 (61.75%) and 252 (63.0%), respectively. The majority of inappropriate use of ceftriaxone was noted in indication errors at both Kahsay Abera (71.2%) and Mearg hospitals (52.0%). The treatment duration in Kahsay Abera (69%) and Mearg hospitals (88%) was in the range of 2-7 days. Mostly, a 2-gram ceftriaxone daily dose was prescribed in both Kahsay Abera and Mearg hospitals, accounting for 285 (71.25%) and 318 (79.5%), respectively. In this study, the top three diseases, indicated for ceftriaxone in both hospitals, were typhoid fever, urinary tract infection, and pneumonia in descending order. Among the medications coadministered with ceftriaxone, the top three coprescribed drugs with ceftriaxone in Kahsay Abera Hospital were metronidazole (17.25%), tramadol 68 (11.28%), and diclofenac (8.96%), but in Mearg Hospital, next to metronidazole, drugs like paracetamol and doxycycline were the most common coprescribed medicines along with ceftriaxone.ConclusionThe appropriateness of ceftriaxone use in Kahsay Abera and Mearg hospitals was 247 (61.8%) and 252 (63%), respectively, in which about one-third of patients' charts were not compliant with the standard treatment guidelines of Ethiopia for general hospitals. In Kahsay Abera and Mearg hospitals, the empiric use of ceftriaxone was 262 (65.5%) and 375 (93.8%), respectively.

Dataset Information

Serological investigation of visceral Leishmania infection in human and its associated risk factors in Welkait District, Western Tigray, Ethiopia.

Publications

Serological investigation of visceral <i>Leishmania</i> infection in human and its associated risk factors in Welkait District, Western Tigray, Ethiopia.

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