Francisco Reyes

Approximately 50 million people (60 %) live in malaria risk areas in Ethiopia, at altitudes below 2000 m. According to official data, 60–70 % of malaria cases are due to Plasmodium falciparum, and 40–30 % by Plasmodium vivax. The species Plasmodium ovale was detected in 2013 in the northwest of the country, being the first report of the presence of this species in Ethiopia since the 60 s. The aim of this study was to assess the diagnosis by microscopy and PCR, and demonstrate the presence of other Plasmodium species in the country. The survey was conducted in Bulbula, situated in the Rift Valley (West Arsi Province, Oromia Region). From December 2010 to October 2011, 3060 samples were collected from patients with symptoms of malaria; the diagnosis of malaria was done by microscopy and confirmation by PCR. 736 samples were positive for malaria by microscopy. After removing the 260 samples (109 positives and 151 negatives) for which it was not possible to do PCR, there were a total of 2800 samples, 1209 are used for its confirmation by PCR and quality control (627 are positives and 582 negatives by microscopy). From the 627 positive samples, 604 were confirmed as positive by PCR, 23 false positives were detected, and the group of 582 negative samples, 184 were positive by PCR (false negatives), which added to the previous positive samples is a total of 788, positive samples for some species of Plasmodium sp. 13.3 % more positives were detected with the PCR than the microscopy. Importantly, 23 samples were detected by PCR as P. ovale, after the sequencing of these samples was determined as P. ovale curtisi. The PCR detected more positive samples than the microscopy; in addition, P. ovale and P. ovale/P. vivax were detected that had not been detected by microscopy, which can affect in the infection control.

The objective of this study was to determine the epidemiological and clinical features of rotavirus infection among children aged less than 5 years in rural southern Ethiopia. We conducted a hospital-based, prospective study among children aged less than 5 years with acute diarrhea and moderate to severe dehydration attending the outpatient department of Gambo Rural Hospital, Ethiopia during September-November 2012. Three hundred fourteen children were included in the study, of whom 137 (43.6%) had rotavirus infection. The average age of children with rotavirus infection was lower than those without it [odds ratio (OR): 0.94]. Finding severe dehydration on skin pinch test (adjusted OR: 3.76) and having diarrhea for !3 days (adjusted OR: 2.50) were associated with rotavirus infection. The mortality rate was 4.4% among rotavirus infection children and 0% among non-rotavirus diarrhea cases (p=0.006). Rotavirus infection should be suspected in children with severe dehydration on a skin pinch test and among those presenting with diarrhea for 3 days in rural southern Ethiopia.

The aim of this study was to analyze the association of intestinal parasitic diseases with age and gender in patients with diarrhea attending a rural hospital in southern Ethiopia in the period 2007-2012. A total of 32,191 stool examination was performed in patients who presented with diarrhea. The overall prevalence of intestinal parasites in the present study was 26.5%. Predominant parasites detected were Giardia lamblia (15.0%), Entamoeba histolytica/dispar (5.4%), and Ascaris lumbricoides (5.0%). The median of age of diarrheal patients with Hymenolepis species, Schistosoma mansoni and G. lamblia was significantly lower (5 y., 10.5 y., and 18 y., respectively; p<0.001). The median age of diarrheal patients with Taenia species, S. stercoralis, and E. histolytica/dispar was significantly higher (24 y., 24 y., and 20 y., respectively; p<0.01). In conclusion, Giardia lamblia was the most prevalent intestinal parasite and the profile of intestinal parasitic infections is influenced by age.

Childhood leprosy has an important bearing on the epidemiology of disease and reflects the level of control in a community. There is limited information about this disease in rural Ethiopia. Data were collected retrospectively from leprosy patient records and treatment cards in a rural mission hospital in southern Ethiopia from 1999 to 2011. Over the 13-year period, 298 patients with leprosy were registered for treatment. Of these, 22 (7.4%) were children (under 15 years) and 66 (21.1%) were adolescents (from 15 to 18 years). The male:female ratio was 2.6:1 in children and 1.7:1 in adolescents. Slit skin examination was positive in eight of 15 (36.4%) child patients and in 26 of 53 (41.3%) adolescents. Multibacillary leprosy was the most common type in both age groups, encountered in 95.5% of children and in 84.1% of adolescents. Six (27.3%) children and 18 (28.6%) adolescents had deformities of the hand, feet or eyes (WHO grade II), detected either at the time of diagnosis or during follow-up. Sixty-one per cent of children were transferred to their health institutions for treatment and follow-up; seven children (38.9%) completed the treatment and one (5.9%) defaulted while on therapy. Of 63 adolescent patients, 31 (49.2%) completed the recommended therapy, 28 (44.4%) were transferred out, and four (6.3%) defaulted on therapy. Childhood leprosy continues to be a common problem in rural southern Ethiopia. Multibacillary disease and disabilities remain common in children. Early detection and treatment of cases including the study of contacts should reduce the burden of leprosy in the community.

Knowledge of appropriate reference intervals is critical not only to provide optimal clinical care, but also to enrol populations in medical research. The aim of this study was to generate normal ranges of laboratory values for haemoglobin among healthy Ethiopian adults and children and to determine if anaemia is a possible indicator of malaria in women and children in this area of Ethiopia.

Malaria is a leading public health problem in Ethiopia. Accurate diagnosis of Plasmodium infections is crucial for the reduction of malaria in tropical areas and for epidemiological studies. The role of light microscopy (LM) as gold standard has been questioned and, therefore, new molecular methods have been developed for the detection of Plasmodium species. The aim of the present work was to compare different malaria diagnostic methods in order to detect the most common species of Plasmodium and to broaden the knowledge of malaria prevalence in a hospital in a rural area in Ethiopia.

In previous studies, women are less aware of causation and symptoms of leprosy and have less access to health care coverage than men, thus contributing to their delay in seeking for treatment. We assess the gender differences in leprosy cases admitted to a rural referral hospital in Ethiopia for 7 and a half years.

In Ethiopia, malaria is caused by Plasmodium falciparum and Plasmodium vivax, and anti-malarial drug resistance is the most pressing problem confronting control of the disease. Since co-infection by both species of parasite is common and sulphadoxine-pyrimethamine (SP) has been intensively used, resistance to these drugs has appeared in both P. falciparum and P. vivax populations. This study was conducted to assess the prevalence of anti-malarial drug resistance in P. falciparum and P. vivax isolates collected at a rural hospital in southern Ethiopia.

To assess the clinical features and histological diagnoses of patients with lymphadenopathy in a rural general hospital. Gambo Rural General Hospital, located between the Arsi and East Shoa regions, 250 km south of Addis Ababa (Ethiopia), and the Department of Pathology, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia for the pathology examination carried out between December 2003 and July 2005. Retrospective cross-sectional survey. 308 patients with enlarged superficial lymph nodes with surgical lymph node excision. The most common diagnoses were tuberculosis lymphadenitis (TB-L) (74.4%), followed by non-specific reactive lymphadenitis (10.2%), malignant secondary lymphadenopathy (7.5%), and lymphomas (7.1%). In the multivariate analysis, TB-L was significantly associated with previous antibiotic treatment for more than 20 days (adjusted odds ratio (aOR): 3.70; 95% CI: 1.43-9.59) (p = 0.007), and female sex (OR: 2.07; 95% CI: 1.09-3.9). Non-specific reactive lymphadenitis was significantly associated with paediatric cases (aOR: 4.42; 95% CI: 1.78-10.87) (p = 0.001). These results show that tuberculosis is a major problem in this area.