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Garedew L.,St Pauls Hospital Millennium Medical College | Taddese A.,Max Planck Institute for Heart and Lung Research | Biru T.,University of Gondar | Nigatu S.,University of Gondar | And 4 more authors.
BMC Microbiology | Year: 2015

Background: Listeriosis, mostly caused by Listeria monocytogenes species, has become a major concern to public health authorities due to its clinical severity and high mortality rate, particularly in high risk groups. Currently, there is limited information regarding the prevalence and antimicrobial susceptibility profiles of listeria species in ready-to-eat foods of animal origin in Gondar town, Ethiopia. The aim of this study was to determine the prevalence and antimicrobial susceptibility pattern of Listeria species isolated from ready-to-eat food of animal origin from public dinning places in Gondar town, Ethiopia. A cross sectional study on ready-toeat foods of animal origin sampled from major supermarkets, butcher shops, pastry shops, restaurants and hotels was carried out. Culture, biochemical and sugar tests were conducted for listeria species identification and disc diffusion test was performed to study the antimicrobial susceptibility profiles of the isolates. Results: Out of 384 food samples examined, 96 (25%) were positive for Listeria species. Listeria monocytogenes was detected in 24 (6.25%) of the samples. Listeria monocytogenes was isolated from cake, raw meat, ice cream, minced beef, fish, unpasteurized milk and pizza in that order from higher to lower rate. Assessment of antimicrobial susceptibility profile of L. monocytogenes revealed the presence of four multi-drug resistant isolates. The higher resistance rate was recorded for penicillin, nalidixic acid, tetracycline and chloramphenicol, in decreasing order. All L. monocytogenes identified in the current study were sensitive to amoxicillin, cephalothin, cloxacillin, sulfamethoxazole, gentamicin and vancomycin. Conclusions: The presence of L. monocytogenes including drug resistant and multidrug resistant isolates in some ready-to-eat food items is an indicator of the presence of public health hazards to the consumer, particularly to the high-risk groups. Hence awareness creation on food safety and implementation of regulations about the use of drugs in humans and animals is strongly recommended. © 2015 Garedew et al.; licensee BioMed Central.

Kebede M.A.,St Pauls Hospital Millennium Medical College | Haidar J.,Addis Ababa Institute of Technology
Infectious Diseases of Poverty | Year: 2014

Background: One way of addressing malnutrition among HIV/AIDS patients is through the Food by Prescription program (FBP) and many studies have explained the treatment outcomes after therapeutic food supplementation, though available evidences on adherence levels and factors associated with these sorts of programs are limited. The findings of this study would therefore contribute to the existing knowledge on adherence to Ready-to-Use Therapeutic/Supplementary Food (RUF) in Ethiopia.Methods: A facility-based, cross-sectional study supplemented with qualitative methods was conducted among 630 adult HIV + patients. Their level of adherence to RUF was measured using the Morisky 8-item Medication Adherence Scale (MMAS-8). The total score on the MMAS-8 ranges from 0 to 8, with scores of <6, 6 to <8, and 8 reflecting low, medium, and high adherence, respectively. Patients who had a low or a moderate rate of adherence were considered non-adherent.Results: The level of adherence was found to be 36.3% with a 95.0% response rate. With the exception of the educational status, other socio-demographic variables had no significant effect on adherence. Those who knew the benefits of the FBP program were 1.78 times more likely to adhere to the therapy than the referent groups. On the other hand, patients who were not informed on the duration of the treatment, those prescribed with more than 2 sachets/day and had been taking RUF for more than 4 month were less likely to adhere. The main reasons for non-adherence were not liking the way the food tasted and missing follow-up appointments. Stigma and sharing and selling food were the other reasons, as deduced from the focus group discussion (FGD) findings.Conclusion: The observed level of adherence to the FBP program among respondents enrolled in the intervention program was low. The major factors identified with a low adherence were a low level of education, poor knowledge on the benefits of RUF, the longer duration of the program, consuming more than two prescribed sachets of RUF per day, and not being informed about the duration of the treatment. Therefore, counseling patients on the program's benefits, including the treatment plans, would likely contribute to improved adherence. © 2014 Kebede and Haidar; licensee BioMed Central Ltd.

Moyer C.A.,University of Michigan | Tadesse L.,St Pauls Hospital Millennium Medical College | Fisseha S.,University of Michigan
International Journal of Gynecology and Obstetrics | Year: 2013

Objective To determine whether facility delivery is related to compliance with recommended infant immunizations, particularly those that occur weeks or months after delivery. Methods In a retrospective analysis, multivariate logistic regression was used to assess data from the 2011 Ethiopia Demographic and Health Survey (EDHS) to determine the strongest correlates of facility delivery. These correlates were then used, along with facility delivery itself, to determine the relationship between facility delivery and infant immunization. Results In total, 3334 women delivered a newborn 12-24 months before the 2011 EDHS: 90.2% (3007) delivered at home, and 9.8% (327) delivered in a facility. Education, wealth status, urban residence, and number of children under 5 years living in the household were the factors most strongly associated with facility delivery. When facility delivery and its strongest correlates were entered into multivariate logistic regression models with infant immunizations as the outcome, facility delivery was significantly associated with increased likelihood of DPT-HepB-Hib, polio, and measles vaccination, and increased likelihood of being fully immunized (all P < 0.01). Facility delivery was the strongest single factor associated with infants being immunized, doubling the odds of full immunization. Conclusion The impact of facility delivery on health outcomes transcends the immediate delivery and postpartum period. © 2013 International Federation of Gynecology and Obstetrics.

Garedew L.,St Pauls Hospital Millennium Medical College | Hagos Z.,University of Gondar | Zegeye B.,University of Gondar | Addis Z.,University of Gondar
Journal of Infection and Public Health | Year: 2016

Food borne pathogens are major causes of deaths, illnesses and billions of dollars of expenses. The burden of food borne illness is worsened by the ever increasing rate of antimicrobial resistance microbes. Shigella, a bacterial pathogen associated with food, is reported to account for higher prevalence rates of food borne illness in different settings. A cross-sectional study was conducted from February 10 to June 30, 2013, at the butcher houses of Gondar town in the Northwest of Ethiopia to assess the prevalence and antimicrobial susceptibility pattern of Shigella. Cattle raw meat and swab samples from selected critical control points, including knives, chopping boards, and the hands and noses of butchers, were collected and analyzed. The identification of Shigella was carried out using colony characteristics, the Gram reaction, and biochemical tests. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method. The overall hygienic status of the butcher shops was also assessed using a checklist. An observational analysis revealed that the sanitary condition of the butcher shops and their premises was poor. Of 306 samples screened, 10.5% were positive for Shigella. Approximately 7.4% of meat samples and 10.2% of swab samples were contaminated with Shigella. Out of the total Shigella isolates, 90.6%, 46.9%, 18.8% and 9.4% were resistant to ampicillin, amoxicillin, ceftriaxone and tetracycline, respectively. A multidrug resistance pattern was recorded in 27.8% of the isolates. In conclusion, the safety of meat sold at Gondar butchers houses was poor. The identified Shigella isolates showed high levels of drug resistance and multidrug resistance patterns for commonly used antimicrobials in veterinary and human medicine. Practicing wise use of antimicrobials and strict sanitary interventions at different critical control points is strongly recommended, in addition to further in-depth studies to prevent unprecedented consequences from shigellosis. © 2015 King Saud Bin Abdulaziz University for Health Sciences.

Digafe R.T.,Addis Ababa Institute of Technology | Kifelew L.G.,St Pauls Hospital Millennium Medical College | Mechesso A.F.,Hawassa University
BMC Research Notes | Year: 2015

Background: Rabies is a fatal animal disease of significant public health importance. Domestic dogs are the main reservoir and transmitter of this disease particularly in developing countries. Even though rabies is a highly fatal disease, it is a preventable disease. Community awareness about rabies is one of the key components for prevention. This study describes the knowledge, attitudes and practices of a rural community in Gondar Zuria District, Ethiopia. Methods: A cross sectional study was conducted from March to June, 2013. A structured questionnaire was used to collect the data through face to face interviews among 400 respondents. The data were then analyzed using SPSS statistical software version 20. Results: The current study indicated that almost all (99.3 %) of the surveyed individuals were aware of the disease rabies. Rabies is considered to be a fatal disease in humans by 67.8 % of the respondents while 27.8 % believe that it is a treatable disease. Dogs were indicated as source of infection for humans by all respondents followed by equines (27.2 %) and cats (12.1 %). Bite was known as mode of rabies transmission by majority of the respondents (94 %) while other means were given less weight. Aggression was described as a major clinical sign of rabies in animals. Consumption of cooked or boiled meat from rabid animals was considered as safe by 67.0 % of the respondents and about 19 % replied even raw meat is safe for human consumption. The need for immediate treatment after exposure was mentioned by less than half (47.4 %) of the respondents and only 38.8 % of the respondents considered modern medicine as appropriate treatment after exposure to rabid animals. Nearly 42 % of respondents had experienced a dog bite. Following the dog bites, only 30.7 % practiced washing of the wounds with water as first aid. Conclusion: Rabies was found to be well known in the study area. However, knowledge and practices in prevention of rabies were limited. Education of rabies about possible sources of infection, mode of transmission and measures to be taken after exposure is very important in the study area. © 2015 Digafe et al.

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