Hassen Mamo

Malaria remains a significant public health concern in Ethiopia, affecting both rural and urban populations. In urban settings, rapid unplanned expansion, poor drainage, and population movement are increasingly creating aquatic habitats that support vectors such as Anopheles stephensi, thereby leading to complex and underestimated transmission patterns. Serology-based risk factor analyses offer a sensitive indicator of recent and past exposure, helping to reveal underlying transmission patterns and more tailored interventions. This study assessed malaria seroprevalence and associated risk factors among residents of three towns in Ethiopia: Adama, Metehara, and Awash Sebat Kilo to better characterize transmission dynamics and identify context-specific vulnerabilities. A community-based cross-sectional survey was conducted from January 30 to March 14, 2020, involving 912 individuals from randomly selected 196 households. Malaria infection was diagnosed using rapid diagnostic tests (RDTs) and quantitative polymerase-chain reaction (qPCR). Serological analyses were performed to determine exposure to Plasmodium falciparum and Plasmodium vivax . The study found a low malaria prevalence of 0.78% by RDT and 4% by qPCR, with 1.7% of cases due to P. falciparum and 2.3% due to P. vivax . The overall seroprevalence was 19.4% (149/767) for P. falciparum and 18% (139/767) for P. vivax using combined short-lived response markers. Seroprevalence rates varied among towns, with Awash Sebat Kilo showing the highest exposure for recent markers (36.5% for P. falciparum ; 28% for P. vivax ) compared to lower rates in Adama (2.8% and 2.8%, respectively). Proximity to breeding sites (OR = 2.8, 95% CI: 1.1–7.4; p = 0.037) and being older than 15 years (OR = 4.0 95% CI: 2.1–7.6; p < 0.001) were significant risk factors for P. falciparum and P. vivax malaria exposure, respectively. This study demonstrates marked heterogeneity in malaria exposure across urban settings, with the lowest seroprevalence observed in Adama and higher levels in Awash Sebat Kilo. The findings emphasize the importance of incorporating serological surveillance into routine monitoring and highlight the need for targeted, locally tailored control strategies. Such tailored approaches will be increasingly critical, particularly in the context of emerging urban transmission risks driven by the expansion of An. stephensi in the region.

Schistosomiasis remains a significant public health burden in many developing countries. Plant‐based molluscicides have gained considerable attention as alternatives for snail control, owing to their relatively lower toxicity and favorable environmental profile. However, prior to large‐scale application, plant‐based molluscicides require rigorous small‐scale field trials and comprehensive toxicity assessments under natural conditions to confirm their efficacy and evaluate their potential impact on nontarget organisms, particularly fish. This study evaluated the molluscicidal activity of 70% ethanol and chloroform fractions of Hagenia abyssinica flowers against Biomphalaria species and assessed the acute toxicity of the 70% ethanol extract on Nile tilapia ( Oreochromis niloticus ) through a small‐scale trial. Female flowers of H. abyssinica were collected in Addis Ababa, Ethiopia. Adult Biomphalaria species were exposed to 70% ethanol and chloroform fractions of H. abyssinica for 24, 48, and 72 h. Fish toxicity was assessed following the Organisation for Economic Co‐operation and Development guidelines at the National Fish and Other Aquatic Lives Research Center in Sebeta. Lethal concentration values (LC ₅₀ and LC ₉₀ ) were calculated from mortality data using probit regression analysis in IBM SPSS software. In fish toxicity assessments, the LC ₅₀ and LC ₉₀ for the 70% ethanol extract were 38.71 and 57.14 mg/L, respectively. Fish fingerlings showed no significant difference in survival at concentrations up to 16 mg/L, establishing this level as the no observed adverse effect concentration (NOAEC). The study found that both the 70% ethanol extract and chloroform fraction of H. abyssinica flowers displayed significant molluscicidal activity against Biomphalaria species, with LC ₅₀ values of 78.77 and 36.49 mg/L, respectively, after 24 h. The LC ₅₀ of the 70% ethanol extract for molluscicidal activity was about twice that needed for fish, showing that fish were more sensitive than Biomphalaria snails. This differential toxicity raises important ecological concerns.

Background: Hagenia abyssinica (Bruce) J.F. Gmel (Family: Rosaceae) and Rumex abyssinicus Jacq (Family: Polygonaceae) are valuable medicinal plants traditionally used in Ethiopia to treat various diseases. Recent studies have also demonstrated that solvent extracts of these plants exhibit molluscicidal activities under laboratory conditions, highlighting their potential for snail control. However, limited information is available regarding their safety profiles. Objective: This study aimed to evaluate acute, and sub-acute toxicity of 70% ethanol extracts of H. abyssinica and R. abyssinicus flowers in Swiss albino mice, following the Organization for Economic Co-operation and Development guidelines 423 and 407. Methods: In the acute toxicity study, both extracts were administered orally to experimental groups at varying concentrations (mg/kg bodyweight): 5, 50, 300, and 2000. For the sub-acute toxicity study, both extracts were given to the experimental groups at doses (mg/kg) of 125, 250, and 500 daily for 28 days. Blood samples were collected from each mouse and analyzed for hematological and biochemical parameters. Additionally, the heart, liver, and kidneys were excised, stained, and examined for potential histopathological effects. Results: The acute toxicity study revealed no noticeable changes in behavior at the highest oral dosage of 2000 mg/kg. In the sub-acute toxicity study, no statistically significant changes were observed in hematological and biochemical parameters compared to the control group. Similarly, no abnormal histological findings were noted in the examined organs in comparison to the control group. Conclusion: These findings indicate that flower extracts of both plants did not show significant toxicity to laboratory mammals at an oral dosage of 2000 mg/kg.

The spread of multidrug-resistant tuberculosis (MDR-TB) poses a significant challenge to TB control efforts. This study evaluated the treatment outcomes and associated factors among patients receiving treatment for MDR-TB in southern Ethiopia. A retrospective follow-up study covering ten years, from 2014 to 2023, analyzed the records of confirmed cases of pulmonary TB admitted to Yirgalem General Hospital, an MDR-TB treatment initiation center in the Sidama Region. To compare the successful treatment outcomes across the years, a chi-square test of independence was conducted. Bivariate and multivariable logistic regression models were used to identify factors associated with treatment outcomes for MDR-TB. Out of 276 confirmed MDR-TB cases, 4(1.4%) were diagnosed with resistance to second-line drugs (SLDs). Overall, 138 patients achieved favourable treatment outcomes, resulting in a treatment success rate of 50.0% [95% CI 44.1–55.9%]. Among these 138 patients, 105(76.1%, 95 CI 68.7–83.5%) were cured, while 33(23.9%, 95 CI 16.5–31.3%) completed their treatment. The successful treatment outcomes varied significantly across the years, ranging from 3.6% in 2020 to 90% in 2021. The analysis indicated a statistically significant difference in treatment outcomes when considering data from 2014 to 2023 (χ2 = 44.539, p = 0.001). The proportion of patients with deaths, lost-to-follow-up (LTFU), treatment failures and not evaluated were 7.9% [95% CI 4.8–11.2%], 10.9% [95% CI 7.2–14.6%), 2.2% [95% CI 1.1–3.3%), and 28.9% [95% CI 23.7–34.2%] respectively. Individuals with a positive HIV status had significantly lower odds of a favorable treatment outcome [AOR = 0.628, 95% CI (0.479–0.824), p = 0.018]. Similarly, patients with a BMI of less than 18 are more likely to have unfavorable treatment outcomes compared to those with a BMI of 18 or higher [AOR = 2.353, 95% CI 1.404–3.942, p < 0.001]. The study revealed a concerning 1.4% prevalence of additional resistance to SLDs. The 50% rate of unfavorable treatment among MDR-TB cases exceeds the target set by the WHO. A significant number of patients (10.9%) were LTFU, and the 28.9% categorized as ‘not evaluated’ is also concerning. Enhanced strategic interventions are needed to reduce such cases, and factors associated with poor treatment outcomes should receive greater attention. Future prospective studies can further explore the factors influencing improved treatment success.

: Ethiopia has a plan to eliminate malaria in selected low-transmission districts by 2025. However, complex factors such as seasonality, focal heterogeneity, and coendemicity of Plasmodium vivax and Plasmodium falciparum, and asymptomatic cases, along with other factors, pose challenges. This longitudinal study assessed these dynamics and associated factors in three elimination-targeted settings in southern Ethiopia. The study included rural districts (Wonago and Yirgacheffe) and an urban setting (Dilla town) with 504 participants from 168 households per season. The study covered the peak and minor malaria transmission seasons and the dry season. Finger-prick blood was collected for microscopy, rapid diagnostic tests, and 18S-rRNA-based quantitative polymerase chain reaction (qPCR). During the dry season, P. vivax accounted for most infections (64.5%, 71/110) and symptomatic malaria (50.9%, 29/57), whereas P. falciparum dominated during the peak transmission season (45.7%, 42/92 infections and 58.1%, 25/43 of symptomatic cases). Treatment-seeking behavior was low, with 65.3% (143/219) of symptomatic individuals not seeking treatment. Dilla town had significantly higher infection prevalence (29.6%, 149/504, P <0.001) in all seasons compared with the rural sites. The incidence rate was 12/1,000 person-seasons by qPCR and 5/1,000 person-seasons by microscopy. Urban residents, those with low hemoglobin levels, nonuse of mosquito nets, and proximity to stagnant water had a significantly higher risk of infection (P <0.001). Tailored approaches are needed in elimination-targeted areas, focusing on urban settings, Plasmodium species, and strengthening community-level interventions for behavioral change and active case detection.

Background: Malaria remains a major global health problem although there was a remarkable achievement between 2000 and 2015. Malaria drug resistance, along with several other factors, presents a significant challenge to malaria control and elimination efforts. Numerous countries in sub-Saharan Africa have documented the presence of confirmed or potential markers of partial resistance against artemisinin, the drug of choice for the treatment of uncomplicated Plasmodium falciparum malaria. The World Health Organization (WHO) recommends regular surveillance of artemisinin therapeutic efficacy to inform policy decisions. Methods: This study aimed to evaluate the therapeutic efficacy of artemether-lumefantrine (AL), which is the first-line treatment for uncomplicated P. falciparum malaria in Ethiopia since 2004. Using a single-arm prospective evaluation design, the study assessed the clinical and parasitological responses of patients with uncomplicated P. falciparum malaria in Metehara Health Centre, central-east Ethiopia. Out of 2332 malaria suspects (1187 males, 1145 females) screened, 80 (50 males, 30 females) were enrolled, followed up for 28 days, and 73 (44 males, 29 females) completed the follow up. The study was conducted and data was analysed by employing the per-protocol and Kaplan–Meier analyses following the WHO Malaria Therapeutic Efficacy Evaluation Guidelines 2009. Results: The results indicated rapid parasite clearance and resolution of clinical symptoms, with all patients achieving complete recovery from asexual parasitaemia and fever by day (D) 3. The prevalence of gametocytes decreased from 6.3% on D0 to 2.5% on D2, D3, D7, and ultimately achieving complete clearance afterward. Conclusion: The overall cure rate for AL treatment was 100%, demonstrating its high efficacy in effectively eliminating malaria parasites in patients. No serious adverse events related to AL treatment were reported during the study, suggesting its safety and tolerability among the participants. These findings confirm that AL remains a highly efficacious treatment for uncomplicated P. falciparum malaria in the study site after 20 years of its introduction in Ethiopia.

Malaria drug resistance presents a significant challenge to malaria control and elimination efforts. Therefore, it is crucial to conduct regular surveillance to assess the therapeutic efficacy of first-line antimalarial drugs, which informs policy decisions to manage this threat. This study aimed to evaluate the therapeutic efficacy of artemether-lumefantrine (AL), which is the first-line treatment for uncomplicated malaria in Ethiopia since 2004, for uncomplicated Plasmodium falciparum malaria in Metehara, central-east Ethiopia. Using a one-arm prospective evaluation design, the study assessed the clinical and parasitological responses of patients with uncomplicated P. falciparum malaria. Initially, 80 patients (50 males and 30 females) were screened, and a total of 73 participants (44 males, 29 females) successfully completed the follow-up. The results indicated rapid parasite clearance and resolution of clinical symptoms, with all patients achieving complete recovery from asexual parasitemia and fever by day 3. The prevalence of gametocytes decreased from 6.3% on day zero to 2.5% on days two, three, seven, and ultimately achieving complete clearance afterwards. The overall cure rate for AL treatment, without a polymerase chain reaction correction, was 100%, demonstrating its high efficacy in effectively eliminating the malaria parasite in patients. Importantly, no serious adverse events related to AL treatment were reported during the study, suggesting its safety and tolerability among the participants. These findings confirm that, even 20 years after its introduction in Ethiopia, AL remains an effective treatment for uncomplicated P. falciparum malaria in the study site.

The spread of drug-resistant tuberculosis (DR-TB) poses a significant challenge to TB control efforts. This study assessed the prevalence of drug resistance and identified predictors among patients undergoing treatment for MDR-TB in south Ethiopia. A retrospective study spanning ten years, 2014–2023, was conducted, analyzing the records of confirmed cases of pulmonary DR-TB admitted to Yirgalem General Hospital. Out of 276 patients with confirmed multidrug-resistant (MDR-TB), 4(1.4%) cases were diagnosed with resistance to second-line drugs (SLDs) upon enrollment. The treatment success rate was 70.4%, with 53.6% cured and 16.8% completing the treatment which varied significantly (p-value?), ranging from 90% in 2021 to 4% in 2020. The proportion of deaths, lost-to-follow-up, and treatment failures were 11.2%, 15.3%, and 3.1%, respectively. Unsuccessful treatment outcomes were significantly associated with HIV positivity (adjusted odds ratio [AOR]: 3.200; 95% confidence interval (CI): 1.206, 8.493; p = 0.018), the presence of comorbid diseases other than HIV (AOR: 2.062; 95% CI: 0.875, 4.858; p = 0.040) and baseline body-mass-index of patients below 18kg/m² (AOR: 2.353; 95% CI: 1.404, 3.942; p = 0.001). The study revealed a concerning 1.4% prevalence of additional resistance to SLDs. The 29.6% rate of unsuccessful treatment among MDR-TB cases exceeds the target set by the WHO. A significant number of patients (15.3%) were LTFU. Enhanced strategic interventions are needed to reduce such cases, and factors associated with poor treatment outcomes should receive greater attention. Future prospective studies can further explore the factors influencing improved treatment success.

This study aimed to investigate the association between disease severity and demographic characteristics, clinical features, and prevalence of intestinal parasite carriage among patients with COVID-19 in Addis Ababa, Ethiopia. A cross-sectional study was conducted at St. Paul's Hospital Millennium Medical College, involving 337 COVID-19 patients. Patient data were collected during hospitalization to assess clinical outcomes, including demographic information, clinical features, and associated factors. Blood and stool samples were collected and analyzed for hematological and biochemical tests, as well as the presence of intestinal parasites. Statistical analysis was performed using the Statistical Packages for Social Sciences v. 26, employing descriptive statistics, chi-square tests, and logistic regression. A p-value of < 0.05 was considered statistically significant. Among the 337 patients with confirmed SARS-CoV-2 infection through PCR testing, 96(28.5%) were found to have co-infections with one or more intestinal parasites. Multivariate analysis revealed that patients aged ≥ 60 years [Adjusted Odds Ratio (AOR) 3.943 (95% CI: 1.792–8.673), p < 0.001], elevated creatinine levels [AOR 2.254 (95% CI: 1.041–4.881), p = 0.039], increased glutamate oxaloacetate transaminase levels [AOR 2.219 (95% CI: 1.234–3.991), p = 0.008], decreased hematocrit levels [AOR 8.839 (95% CI: 4.914–15.900), p < 0.001], and co-infection with intestinal parasites [AOR 2.419 (95% CI: 1.278–4.579), p = 0.007] were significantly associated with increased disease severity in COVID-19 patients. These findings suggest a potential link between co-infection with intestinal parasites and a more severe form of COVID-19, indicating that parasite-induced immunomodulatory responses may hinder the essential immune response against SARS-CoV-2.