Smear positive pulmonary tuberculosis and associated factors among homeless individuals in Dessie and Debre Birhan towns,Northeast Ethiopia

Background

Tuberculosis (TB) remains one of the globe’s deadliest communicable diseases. The homeless individuals are at high risk to acquire TB and multi-drug resistant TB (MDR-TB), because of their poor living conditions and risky behaviors. Tuberculosis and MDR-TB in the homeless individuals can pose a risk to entire communities. However, the magnitude of the problem is not known in Ethiopia. Therefore, the aim of this study was to determine the prevalence and associated factors of smear positive pulmonary TB (PTB) and MDR-TB among homeless individuals in Dessie and Debre Birhan towns, Northeast Ethiopia.

Methods

A community based cross-sectional study design was conducted from September 2014 to June 2015. Using an active screening with cough of ≥2 weeks, 351 TB suspects homeless individuals were participated in this study. Data were collected by using pre-tested and structured questionnaire. Spot-morning-spot sputum sample was collected and examined for acid-fast bacilli (AFB) using fluorescence microscopy by Auramine O staining technique. All AFB positive sputum was further analyzed by GeneXpert for detection of Mycobacterium tuberculosis complex and rifampicin resistant gene. Univariate and multivariate logistic regressions were applied to identify factors associated with smear positive PTB and P value <0.05 was considered as statistically significant.

Results

The prevalence of smear positive PTB was 2.6 % (95 % CI 1.3–5) among TB suspect homeless individuals. Extrapolation of this study finding implies that there were 505 smear positive PTB per 100,000 homeless individuals. All smear positive PTB sputum specimens were further analyzed by GeneXpert assay, the assay confirmed that all were positive for MTBC but none were resistant to RIF or MDR. Smoking cigarette regularly for greater than 5 years (AOR 10.1, 95 % CI 1.1, 97.7), body mass index lower than 18.5 (AOR 6.9, 95 % CI 1.12, 41.1) and HIV infection (AOR 6.8, 95 % CI 1.1, 40.1) were significantly associated with smear positive PTB.

Conclusion

The prevalence of smear positive PTB among TB suspect homeless individuals was 2.6 %. Among smear positive PTB, prevalence of HIV co-infection was very high 5 (55.5 %). Smoking cigarette regularly for greater than 5 years, BMI lower than 18.5 and HIV infection were factors associated with smear positive PTB. Special emphasis is needed for homeless individuals to exert intensive effort to identify undetected TB cases to limit the circulation of the disease into the community.

     

The shape of things to come? household dependency ratio and adolescent nutritional status in rural and urban Ethiopia

Several related demographic trends are occurring in developing countries: youth comprise a large portion of populations, fertility rates are declining, and urban dwellers are increasing. As fertility rates decline and populations age, the decline in the ratio of young dependents to working age adults is expected to free up household resources, which can be invested in human capital, including youth nutritional wellbeing. We test this hypothesis in a sample of youth (n = 1,934) in Southwestern Ethiopia. Multiple measures of achieved growth and nutritional status are explored (weight, height, mid-upper arm circumference (MUAC), body mass index (BMI) and body mass index for age z-score (BMIZ), weight for age z-score (WAZ), and height for age z-score (HAZ)). In multivariable models controlling for the effects of income, age, gender, and youth workloads, youth living in rural settings had significantly lower weight (1.24 kg lighter), MUAC (0.67 cm lower), BMI (0.45 BMI lower), BMIZ (0.27 lower), HAZ (0.14 HAZ lower), and WAZ (0.3 WAZ lower) than urban youth (all P < 0.01). Compared with youth in the lowest dependency ratio households, results show that youth in households with the highest dependency ratios were estimated to be 1.3 kg lighter, have 0.67 cm smaller MUAC, and BMI that was 0.59 lower (all P<0.01). Similar results were found for WAZ (0.21 lower) and BMIZ (0.36 lower). Youth height and HAZ were not associated with household dependency. These results may point toward increasing levels of human capital investments in Ethiopian youth as fertility levels decline and populations urbanize.     

Growth and essential oil responses of <Emphasis Type="Italic">Nepeta</Emphasis> species to potassium humate and harvest time

Nepeta is a perennial herbal plant that belongs to the Lamiaceae mint family. Nepta has different species that are widely used in the agriculture, medicine, and pharmaceutical industries. A field experiment was conducted in 2015 and 2016 to determine the effects of potassium humate foliar application [0 (control) and 400 ppm] on growth, essential oil and constituents of three Nepta species [Nepeta cataria (catnip), Nepeta cataria var. citriodora (lemon catnip), and Nepeta grandiflora (giant catmint)] under Egyptian conditions. In all three species, the application of potassium humate increased growth indicators, essential oil content (%) and yield (mL/plant), and flavonoids in each of the two harvests. However, the height of giant catmint was significantly higher than that of lemon catnip, which was higher than that of catnip. Lemon catnip that received potassium humate and harvested second gave the highest essential oil content and yield. The major constituents were geraniol and nepetalactone in catnip; citronellol and geraniol in lemon catnip; and o-cymene, c-terpinene, p-cymene and carvacrol in giant catmint. The highest p-cymene in giant catmint, citronellol in lemon catnip, and geraniol in catnip were obtained from the application of potassium humate, while the highest o-cymene, c-terpinene and carvacrol in giant catmint, geraniol in lemon catnip, and nepetalactone in catnip were obtained from control plants. This study demonstrated the variations among species of nepeta, and how they respond to the application of potassium humate. The findings of this study can guide the customization of potassium humate applications to the three species for achieving desired growth and essential oil production outcomes.     

Trematode metacercariae from the cranial cavity of African catfish Clarias gariepinus (Burchell, 1822) from Lake Tana,Ethiopia

Metacercariae of two species of trematodes from the fam. Diplostomidae from the cranial cavity of the African catfish Clarias gariepinus are described. The metacercaria Tylodelphys grandis n. sp. is described for the first time. Data are presented on the infection rate of catfishes in Lake Tana.     

Adding Content to Contacts: Measurement of High Quality Contacts for Maternal and Newborn Health in Ethiopia,North East Nigeria,and Uttar Pradesh,India

BackgroundFamilies in high mortality settings need regular contact with high quality services, but existing population-based measurements of contacts do not reflect quality. To address this, in 2012, we designed linked household and frontline worker surveys for Gombe State, Nigeria, Ethiopia, and Uttar Pradesh, India. Using reported frequency and content of contacts, we present a method for estimating the population level coverage of high quality contacts.ConclusionsMeasuring content of care to reflect the quality of contacts can reveal missed opportunities to deliver best possible health care.