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Infectious diseases are considered a major cause of death globally, accounting for one-third of all deaths. Traditionally, microbiological approaches to diagnose infectious diseases have been labor-intensive and time-consuming; molecular methods significantly improve on these constraints. DNA microarray is a novel and advanced diagnostic test for infectious disease that is designed for specific identification of a wide variety of organisms simultaneously. Microarray has various advanced applications in infectious disease diagnostics, including the 2019 pandemic COVID 19, detection of food-borne infectious agents, and detection of Neisseria meningitidis. The aim of this review is to provide updated application of DNA microarray techniques for the diagnosis of infectious diseases and to explore the development of new DNA microarray methods. In conclusion, DNA microarray techniques are the future rapid and accurate diagnostic tool for infectious disease diagnosis and detection of antimicrobial resistance. Keywords: DNA microarray, infectious disease diagnostics, molecular techniques

Background The high levels of antimicrobial consumption in hospitals contribute to the occurrence of antimicrobial resistant bacteria. Antimicrobial resistant bacteria and sub-lethal concentrations of antimicrobial metabolites can end up in hospital wastewater which can spread to the environment and to the community. However, information on the resistance profile of bacteria isolated from environments is not well studied. Thus, the main aim of this study was to determine the antibiotic resistance profile of bacteria from hospital wastewater in Bahir Dar City, Northwest Ethiopia. Method A total of 70 hospital wastewater samples were collected from two comprehensive specialized hospitals using a grab-sampling technique. Bacteria were identified using colony morphology, Gram staining, and biochemical tests. The drug susceptibility test was performed using the Kirby-Bauer disc diffusion method on Muller-Hinton agar. Result The most dominant bacterial isolates from hospital wastewater were Staphylococcus aureus ( S. aureus ), Escherichia coli ( E. coli ), Citrobacter spp., Acinetobacter spp., Enterobacter spp., Klebsiella pneumoniae ( K. pneumoniae ), and Pseudomonas aeruginosa ( P. aeruginosa ). All K. pneumoniae and 52.4% (11/21) E. coli were resistant to ceftazidime (third-generation cephalosporin), while Citrobacter spp., Acinetobacter spp., and Enterobacter spp., were susceptible to ceftazidime. Likewise, S. aureus revealed 64% (16/25) resistance to erythromycin. Overall, 22.2% of bacterial isolates were multidrug resistant bacteria to the commonly prescribed antimicrobials. Conclusion Hospital waste waters contain high prevalence of multiple drug-resistant bacteria, particularly the third-generation cephalosporin resistant K. pneumoniae and E. coli would be a big concern. Infection prevention and control practices with proper treatment of hospital wastewater before discharging should be in practice to contain the spread of drug-resistant bacteria from hospital to external environment.

Antimicrobial-resistant (AMR) bacterial infection is a significant global threat to the healthcare systems. Pseudomonas aeruginosa, the leading infectious agent in the healthcare setting is now one of the major threats due to AMR. A comprehensive understanding of the magnitude of AMR, particularly highly public health important pathogens such as P. aeruginosa, is necessary for the management of infections based on local information. This systematic review and meta-analysis aimed to determine the country-wide AMR of P. aeruginosa. Systematic searches were performed to retrieve articles from PubMed, Scopus, Web of Science, ScienceDirect electronic databases, Google Scholar search engine, and repository registrars from 2015 to 31st December 2023. Twenty-three studies that provided important data on AMR in P. aeruginosa were systematically reviewed and analyzed to determine the country-wide magnitude of P. aeruginosa AMR profile from healthcare-associated infections. AMR of P. aeruginosa to 10 different antibiotics were extracted separately into Microsoft Excel and analyzed using STATA 17.0. Cohen's kappa was computed to determine the agreement between reviewers, the Inverse of variance (I2) was used to evaluate heterogeneity across studies, and Egger's test to identify publication bias. A random effect model was used to determine the pooled resistance to each antibiotic. Subgroup analysis was performed by infection type and year of publication. This systematic review and meta-analysis revealed that the pooled prevalence of P. aeruginosa in clinical specimens associated with HAI was 4.38%(95%CI: 3.00-5.76). The pooled prevalence of AMR in P. aeruginosa for different antibiotics varies, ranging from 20.9% (95%CI: 6.2-35.8) for amikacin to 98.72% (95%CI: 96.39-101.4) for ceftriaxone. The pooled resistance was higher for ceftriaxone (98.72%), Trimethoprim-sulfamethoxazole (75.41), and amoxicillin-clavulanic acid (91.2). In contrast relatively lower AMR were observed for amikacin (20.9%) and meropenem (28.64%). The pooled multi-drug resistance (MDR) in P. aeruginosa was 80.5% (95%CI: 66.25-93.84). Upon subgroup analysis by infection types and year of publication, P. aeruginosa isolated from healthcare-associated infections exhibited higher resistance to ceftazidime (94.72%) compared to isolates from mixed types of healthcare-associated infections (70.84%) and surgical site infections (57.84%). Antimicrobial resistance in gentamicin was higher during the periods of 2018-2020 (73.96%), while comparatively lower during 2021-2023 (42.69%) and 2015-2017 (29.82%). Significantly high AMR and MDR were observed from this systematic review and meta-analysis. AMR obtained from this systematic review and meta-analysis urges the need for improved infection control, antimicrobial stewardship practices, and strengthened surveillance systems to control the spread of AMR and ensure effective treatment of P. aeruginosa infections. This systematic review and meta-analysis was registered on PROSPERO (Registration ID: CRD42024518145).

Background Coronavirus disease 2019 is caused by the severe acute respiratory syndrome coronavirus 2, which has become a pandemic. Severe acute respiratory syndrome coronavirus 2 is an enveloped, unsegmented, positive‐sense, single‐stranded RNA virus that belongs to the family Coronaviridae. Aim The objective of this review is to conduct a qualitative analysis of the current updates on epidemiology, evolution, and vaccine variants for SARS‐CoV‐2. Method The search strategy was done from the database based on the PRISMA criteria for qualitative analysis of this review. Literature on variants of severe acute respiratory syndrome coronavirus 2, published in English in the last 5 years (2019–2023), were included. From 179 a total of 105 articles were reviewed, searched, and retrieved from the electronic databases PubMed. The search was done using keywords like COVID‐19, SARS‐CoV‐2, variants, mutations, and vaccines, and articles were managed using EndNote X8 software. The scope of view for this review was the course of the pandemic by emerging variants and how man is struggling to overcome this sudden pandemic through vaccines. The narrative skeleton was constructed based on the article's scope of view. Result From the parent severe acute respiratory syndrome coronavirus 2, many variants emerged during the course of this pandemic. They are mainly categorized into two variants: variants of interest and variants of concern based on the impact on public health. The World Health Organization leveled five variants: Alpha (strain B.1.1.7), Beta (strain B.1.351), Gamma (strain P.1), Delta (strain B.1.617.2), and Omicron (B.1.1.529). Conclusions It is crucial to stay informed about the latest developments in the understanding of SARS‐CoV‐2 variants, as new variants can emerge and impact the course of the pandemic. Health authorities and researchers continuously have to monitor and study these variants to assess their characteristics, transmissibility, severity, and the effectiveness of vaccines against them. One has to always refer to the latest information from reputable health journals or organizations for the most up‐to‐date and accurate details on COVID‐19 variants.

Malaria and schistosomiasis are infectious diseases that cause coagulation disorders, biochemical abnormalities, and thrombocytopenia. Malaria and Schistosoma mansoni co-infection cause exacerbations of health consequences and co-morbidities.This study aimed to compare the effect of malaria and Schistosoma mansoni co-infection and malaria infection on selected biochemical and coagulation profiles, and platelet count. An institutional-based comparative cross-sectional study was conducted from March 30 to August 10, 2022. A total of 70 individuals were enrolled in the study using a convenient sampling technique. Wet mount and Kato Katz techniques were conducted to detect Schistosoma mansoni in a stool sample. Blood films were prepared for the detection of plasmodium . The data was coded and entered into EpiData version 3.1 before being analyzed with SPSS version 25. An independent t test was used during data analysis. A P-value of less than 0.05 was considered statistically significant. The mean [SD] of alanine aminotransferase, aspartate aminotransferase, creatinine, total bilirubin, and direct bilirubin in the co-infected was higher than in malaria infected participants. However, the mean of total protein and glucose in co-infected was lower than in the malaria infected participants. The mean of prothrombin time, international normalization ratio, and activated partial thromboplastin time in co-infected was significantly higher, while the platelet count was lower compared to malaria infected participants. Biochemical and coagulation profiles, and platelet count status in co-infection were changed compared to malaria infected participants. Therefore, biochemical and coagulation profiles and platelet count tests should be used to monitor and manage co-infection related complications and to reduce co-infection associated morbidity and mortality.

Background Antimicrobial resistance (AMR) is a growing global health threat. Acinetobacter baumannii ( A. baumannii ) emerged as one of the most concerning critical priority pathogens due to its ability to develop resistance to multiple antimicrobial agents. In Ethiopia, the public health impact of AMR is increasingly significant, with A. baumannii responsible for a variety of infections. Although A. baumannii causes a range of infections in Ethiopian patients, the drug resistance status of the clinical isolates has not been thoroughly assessed. Therefore, this systematic review and meta-analysis aimed to determine the country-wide AMR of A. baumannii. Methods This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted a search of articles on PubMed, Web of Science, Science Direct, Scopes electronic databases, Google Scholar search engine, and institutional repositories/libraries for studies published between 2015 and 2024. Eligible studies on A. baumannii -related infections and AMR in Ethiopia were assessed for quality using the Joanna Briggs Institute (JBI) criteria. Data on study characteristics were extracted, and statistical analyses, including heterogeneity (Invers of variance), publication bias (Eggers test), and subgroup analyses, were performed using STATA 17.0. A random effect model was used to compute the pooled prevalence of AMR. Results This systematic review and meta-analysis of 26 Ethiopian studies (26,539 participants) found an A. baumannii prevalence of 3.99% (95% CI: 3.01–4.98%) and 9.13% of all bacterial infections (95% CI: 6.73–11.54%). The most common infections were surgical site infections, urinary tract infections, pneumonia, and sepsis. Pooled resistance to antibiotics varied, with amikacin showing the lowest resistance (20.27%) (95% CI: 11.51–29.03) and cefotaxime the highest (83.18) (95% CI: 71.87–94.48). A pooled multi-drug resistant (MDR) A. baumannii was found in 88.22% (95% CI: 82.28–94.15) of isolates, with regional and infection-type variations, particularly in higher prevalence in Oromia and Amhara regions and sepsis cases. Conclusion This systematic review underscores the alarming rise of antimicrobial resistance in A. baumannii , particularly against carbapenems. The findings highlight a high prevalence of MDR A. baumannii and widespread extended-spectrum beta-lactamase production, with notable regional variations in resistance patterns. These high resistance rates reinforce A. baumannii as a critical global health threat, necessitating urgent interventions such as enhanced antimicrobial stewardship programs, improved infection control measures, and the development of alternative treatment strategies. Healthcare professionals, policymakers, and researchers must collaborate to mitigate the clinical and public health impact of this pathogen. Protocol registration This systematic review and meta-analysis was registered on PROSPERO (Registration ID: CRD42024623927).

Background Catheter-associated urinary tract infections (CAUTIs) due to multidrug-resistant Gram-negative bacilli (GNB) is a common concern globally. Investigating the incidence of CAUTI and associated antibiotic resistance has paramount importance from the health care associated infections perspective. This study therefore assessed the incidence of CAUTIs due to GNB and the production of extended-spectrum beta-lactamase (ESBL) and carbapenemase among inpatients in specialized hospitals of Northwest, Ethiopia. Methods A total of 363 patients with indwelling urinary catheters who were admitted in the hospital for > 48 h were consecutively enrolled and followed from 3 to 18 days. Data were collected through interviewing and review of medical records. Patients who developed at least one of the following: fever (> 38 O C), suprapubic tenderness, or costovertebral angle pain, coupled with a GNB positive urine culture of ≥ 10 3 CFU/mL with no more than two bacterial species were defined as CAUTI. The ESBL and carbapenemase production were detected and identified by chromogenic medium. Logistic regression analysis was done to identify associated factors. Results From 363 patients followed, the incidence rate of CAUTI was 27.8 per 1000 catheter days. Catheterization for ≥ 8 days (AOR = 10.6, 95%CI:1.8–62.1) and hospitalization for > 10 days (AOR = 8.1, 95%CI: 2.4–27.2) were the factors significantly associated with CAUTIs. E. coli ( n  = 18, 34.6%), Proteus species ( n  = 7, 13.5%), and P. aeruginosa ( n  = 6, 11.5%) were the most frequent GNB. Isolates revealed high rates of resistance to amoxicillin-clavulanic acid (100%), cefazolin ( n  = 51, 98%), ceftazidime ( n  = 47, 90%) and cefotaxime ( n  = 46, 88%). Most of the GNB isolates (86.5%) were multidrug-resistant. Overall, 19.2% and 5.8% of GNB isolates were ESBL and carbapenemase producers, respectively. Conclusions Incidence of CAUTI with Gram-negative bacilli is high. As most of the GNB isolates are MDR and showed a super high rate of resistance to amoxicillin-clavulanic and third-generation cephalosporins, empirical treatment with these substances is virtually ineffective in patients with suspected GNB infection in Ethiopia. The expression of ESBL and carbapenemase among GNB isolates is also a concern. Therefore, improved infection prevention and control measures, careful use of catheters and third generation of cephalosporins are needed to improve patient outcomes and reduce the burden of CAUTIs and the spreading of antimicrobial resistance.

Background Anopheles stephensi has been a primary cause of malaria spread in urban areas. The World Health Organization announced a threat alert in 2019 that highlighted the An. stephensi outbreak in the Horn of Africa. Currently, there is insufficient information on the prevalence of An. stephensi . Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of An. stephensi in Horn of Africa. Methods Systematic search was performed to retrieve articles from PubMed, Scopus, Science Direct databases, and Google Scholar search engine. Fourteen potential studies that provided important data on An. stephensi were systematically reviewed and analyzed. The prevalence of An. stephensi was extracted separately into Microsoft Excel and analyzed using STATA 17.0. The Inverse of variance was done to evaluate heterogeneity across studies. A funnel plot and an Egger’s test were used to evaluate the potential publication bias. A trim-and-fill-meta-analysis was carried out to generate a bias-adjusted effect estimate. A random effect model was used to determine the pooled prevalence of An. stephensi . Subgroup analysis was performed based on year of publication and country. Results A total of 14 studies were included for this systematic review and meta-analysis. From this meta-analysis, the pooled prevalence of An. stephensi was 41.26%. The subgroup analysis based on year of publication showed that the pooled prevalence of An. stephensi in studies conducted 2014–2018 was 99%, while it was 36.82% in studies conducted 2019–2024. On the other hand, country-based analysis showed that the pooled prevalence of An. stephensi in Djibouti, Eritrea, Ethiopia, Kenya, Somaliland, and Sudan was 10.5%, 17.3%, 55.30%, 9.90%, 48.70%, and 24.63%, respectively. Conclusions This systematic review and meta-analysis reveal a high prevalence of An. stephensi across the Horn of Africa region. This underscores the significant challenges in managing malaria infections transmitted by An. stephensi in the region. Health officials must adjust current vector control measures to incorporate An. stephensi with the local malaria vector species. Also, regular identification and limiting of An. stephensi must be sustained to ensure the effectiveness of malaria prevention.

Despite the decline in tuberculosis (TB) incidence across many regions worldwide, including Ethiopia, the disease remains highly concentrated among vulnerable or socially marginalized populations and in high-risk settings. This systematic review and meta-analysis aims to estimate the pooled prevalence of pulmonary tuberculosis (PTB) among key and vulnerable populations (KVPs) residing in hotspot settings in Ethiopia. Potential papers were searched systematically in PubMed, Scopus, ScienceDirect databases, Google Scholar search engine, and institutional electronic repositories/registrars. A total of 34 potential articles that provide necessary information on the prevalence of PTB were reviewed and data were analyzed to determine the pooled prevalence of PTB among KVPs. The relevant data were recorded and analyzed using STATA 17.0. Cohen's kappa was computed to determine the agreement between reviewers, the Inverse of variance (I2) to evaluate heterogeneity across studies, and Egger's test to identify publication bias. A random effect model was used to determine the pooled prevalence of PTB, subgroup analysis was computed by types of hotspot settings and year of publication. This meta-analysis demonstrates that the pooled prevalence of PTB among populations residing in hotspot settings in Ethiopia was 11.7% (95% confidence interval (95CI): 7.97-15.43) with an I2 of 99.91% and a p< 0.001. Furthermore, the subgroup analysis unveiled the pooled prevalence of PTB among KVPs residing in different hotspot settings as follows: Prison inmates 8.8% (95CI: 5.00-12.55%), University students 23.1% (95CI: 15.81-30.37%), Refugees 28.4% (95CI: -1.27-58.15%), Homeless peoples 5.8% (95CI: -0.67-12.35%), Healthcare settings 11.1% (95CI: 0.58-21.63%), Spiritual holy water sites attendees 12.3% (95CI: -6.26-30.80%), and other high-risk settings 4.3% (95CI: 0.47-8.09%). Besides, the subgroup analysis revealed that the pooled prevalence of PTB post-2015 was 10.79% (95CI: 5.94-15.64%), whereas it stood at 14.04% (95CI: 10.27-17.82%) before 2015. The prevalence of PTB among KVPs residing in the hotspot settings in Ethiopia remains significant, with a weighted pooled prevalence of 11.7%. Thus, the national TB control programs should give due attention and appropriate control measures should be instituted that include regular systematic TB screening, compulsory TB testing for presumptive TB cases among KVPs, and tightened infection control at hotspot settings.