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Introduction Above 80% of urinary tract infections are caused by enteric bacteria, which are known for years by their drug-resistant ability. Though the prevalence of drug-resistant strains is increasing in the world, it is not well known in low-income countries. The aim of this study was to assess the prevalence of Multi-drug resistance, Extended-spectrum β-lactamases production, and associated risk factors among pregnant women in Northwest Ethiopia. Methods A hospital-based cross-sectional study was conducted among pregnant women from March to May 2017. A total of 384 clean-catch midstream urine sample was collected from study participants. Bacterial identification and drug susceptibility testing were done following standard microbiological techniques; Extended-spectrum β-lactamase production was screened using a disc diffusion test and confirmed by a combination disc test. The data were entered and analyzed by using SPSS version 20, and a p-value of less than 0.05 was considered as statistically significant. Result The overall prevalence of urinary tract infection was 15.9% (95% CI 12.8–20.1%). E. coli (49.2%), CoNS (27.9%), and S. aureus (18%) were the main uropathogens. The prevalence of MDR uropathogens was 60.65%. The prevalence of ESBLs production among cases caused by Enterobacteriaceae was 18.2%. The drug resistance rate of Gram-negative isolates was higher for ampicillin (90.9%), cephalothin (84.8%), and augmentin (57.6%). The drug nitrofurantoin showed the highest activity (100%) against Gram-negative isolates. Gram-positive isolates were showed low susceptibility to penicillin (89.3%) and cotrimoxazole (75%); however highest susceptibility rate for gentamicin (100%), amikacin (100%), and nitrofurantoin (98.36%) was recorded. Prior antibiotic therapy (AOR = 5.46, 95% CI 1.38–21.65) was a risk factor for the presence of multi-drug resistant bacteria. Conclusion and recommendation The multi-drug resistance prevalence was high among uropathogen, thus treatment of urinary tract infection during pregnancy; should be based on the antibacterial susceptibility testing result. The isolation of drug-resistant strains like Extended-spectrum β-lactamases in this study calls for the need of periodic and continuous follow-up of antibiotic usage among pregnant women. Nitrofurantoin, gentamicin, amikacin, and ciprofloxacin/norfloxacin showed higher activity against bacterial uropathogen.

Background Measles is a highly contagious, vaccine-preventable viral disease that remains a major public health concern in low-income countries like Ethiopia, particularly in the Amhara Region. Despite ongoing vaccination efforts, periodic outbreaks continue to occur. In this regard, data on the recent epidemiological patterns, temporal trends, and spatial distribution of measles cases in the region are limited. Therefore, this study was conducted to assess the incidence, temporal trends, and spatial clustering of measles cases in Amhara region from 2019 - 2024 to inform targeted interventions and outbreak responses. Methods A retrospective analysis of regional measles surveillance data from 2019-2024 was conducted in Amhara region, Ethiopia. Enzyme linked immunosorbent assay method employed for measles confirmation using anti-measles specific immunoglobulin M using EUROIMMUN test kit. Descriptive statistics and trend analysis was conducted using SPSS version 26. Spatial analysis to determine the spatial distribution, case distribution pattern (autocorrelation), and hot spot analysis was performed through ArcGIS tool. SaTScan statistics tool was used to identify the significant primary and secondary measles case clusters in the Amhara region. Results Out of a total of 18,468 reported measles suspected cases, 11354 (61%) were classified as clinically compatible, 3657 (20%) were epidemiologically linked, 1886 (10%) were discarded cases, and 1571 (9%) were laboratory-confirmed. The highest proportion of cases (36.5%) occurred among children aged 5–14 years, followed by adults aged ≥15 years (26%). Males accounted for the majority of cases (54%). Among all cases, 4.7% were ineligible for vaccination due to being under 9 months of age. Geographically, the highest number of cases were reported from Waghimra zone (16.6%), followed by Central Gondar (12.4%), Oromo Special zone (9.6%), and East Gojjam (9%). The crude incidence rate per 100,000 population increased from 0.53 to 2.13, peaking in 2023. Measles cases showed clear seasonal trends, with peaks occurring during the spring (March-May) and autumn (September-November) seasons. Spatial autocorrelation analysis indicated clustering of measles cases. Hotspots were identified at the woreda level in Waghimra, Oromo Special zone, South Gondar, and North Shoa zones. Significant primary clusters were also detected in the same zones. Conclusion Measles transmission persists in Amhara Regional State, with increasing incidence and distinct spatial and temporal patterns. Immunity gaps in older children and geographically clustered outbreaks highlight the need for enhanced vaccination strategies. Strengthening measles surveillance, prioritizing catch-up vaccination for older children, and implementing targeted immunization campaigns in hotspot areas during peak transmission seasons are recommended. Clinical trial Not applicable.

Antimicrobial resistance is a major public health problem worldwide, particularly in developing countries. The effectiveness of currently available antimicrobial is decreasing due to the increasing prevalence of resistant strains among bacterial isolates. This study aims to determine the antimicrobial resistance profile of bacterial isolates from different clinical specimens at Amhara Public Health Institute. A retrospective analysis was conducted using data extracted from the WHONET 2024 database from July 1, 2022, to December 31, 2024, at the Amhara Public Health Institute bacteriology and mycology reference laboratory. The age range of the patients included in this study was 1-96 years, and the mean age of the patients was 33.44 ± 17.36 years. The data included demographic characteristics of patients, types of bacterial isolates and antimicrobial resistance profiles, which were analyzed using SPSS version 20 statistical software. The descriptive statistics were displayed as percentages and frequencies. The chi-square test was used to determine the prevalence of bacterial isolates from patients by age and sex. P-values below 0.05 were seen as a sign of a statistically significant difference. A total of 1165 specimens were processed, resulting in a culture-positive rate of 41% (478/1165) for bacterial pathogens isolated from clinical specimens. The majority of bacterial isolates were from stool (55%; 263/478), urine (20%; 96/478), wound (12.9%; 62/478), and blood (9.8%; 45/478), respectively. Of these, Gram-negative bacteria accounted for 89.1% (426/478) and Gram-positive bacteria accounted for 10.8% (52/478). The predominant bacterial isolates were Vibrio cholerae 54.6% (261/478), E. coli 16.1% (77/478), Klebsiella spp 6% (29/478), S. aureus 4.6% (22/478) and Enterococcus spp 2.9% (14/478). In this study Proteus spp 67.6% (46/68), A. baumannii 58.4% (31/53), and Klebsiella spp 64.1% (136/212) were identified as the most resistant bacteria to the tested antimicrobial. S. aureus shows resistance to tobramycin 100% (1) and penicillin 100% (17), oxacillin 84.6% (11/13) and tetracycline 63.6% (7/11). Enterococcus spp resistance to vancomycin 85.7% (6/7), penicillin 72.7% (8/11) and ampicillin 62.5% (5/8). In total, 53.1% (254/478) of the bacterial isolates were classified as multidrug-resistant (MDR), with 93.7% (238/ 254) being Gram-negative bacteria. Both Gram-negative and Gram-positive isolates showed high levels of resistance to commonly used antimicrobial. To address the problem of antimicrobial resistance, healthcare providers should focus on responsible antimicrobial prescribing practices based on local antibiogram data.

Background Hepatitis B virus (HBV) is one of the most common causes of chronic liver disease and is a growing concern in low-income countries, including Ethiopia. Different studies have been conducted on the prevalence of HBV infection among Ethiopian regions and population segments. Therefore, this systematic review was commenced to summarize these findings, deliver representative pooled data on the prevalence of HBV infection among Ethiopian administrative regions and population segments, and identify possible factors associated with HBV infection. Methods Electronic databases such as PubMed, African Journals Online, and Google Scholar were searched for published articles from July 9, 2019, to February 30, 2024. The data were exported to STATA version 15.1 for meta-analyses. The heterogeneity between the results of the primary studies was accessed using Cochran’s Q chi-square test and quantified with I 2 statistics. A random effect model was used to pool the prevalence of HBV infection. Results The overall pooled prevalence of HBV infection was 6.9% (95% CI: 6.1, 7.7). Among the subgroup analyses, the highest pooled prevalence of HBV infection was obtained from Harar city 9.6% (95% CI: 5.6, 13.5), followed by South Nations and Nationalities People Regions (SNNPR) 8.5% (95% CI: 7.4, 9.7). On the other hand, the pooled prevalence of HBV infection among waste handlers was high 12.6% (95% CI: 2.4, 27.6) followed by female commercial sex workers (FCSW) 10.9% (95% CI: 7.7, 15.2) and human immune deficiency virus (HIV) positive individuals 9.9% (95% CI: 7.2, 12.8). HBV infection was significantly linked to the following factors: those with multiple sexual partners, a family history of chronic liver disease, exposure to bodily fluids, HIV seropositivity, and sharp needle injury had Adjusted Odd Ratio (AOR):3.9 (95% CI: 2.62, 5.76), (AOR: 6.9 (95% CI:3.46, 10.53), (AOR:3.1 (95% CI: 2.01, 3.05), (AOR:7.7 (95% CI: 2.99, 19.93), (AOR:2.1 (95% CI: 1.58, 2.66) times a greater chance of infection, respectively. Conclusions The high pooled prevalence of HBV infection in Ethiopia indicates that the burden of HBV infection continues to be a public health concern. The Ethiopian Ministry of Health should develop a strategic plan for prevention and control of HBV infection transmission including awareness creation, scale-up screening programs, diagnosis, treatment, and care services to reduce the burden of HBV infection and eliminate it as a public health threat.

Background Malaria in pregnancy remains a major public health problem in the globe, especially in sub-Saharan Africa. In malaria endemic areas, most pregnant women remain asymptomatic, but malaria could still cause complications on the mother and her offspring; as well as serve as reservoirs to transmit infection. Despite these effects, no attention is given to the diagnosis of asymptomatic Plasmodium infections (APIs) using highly sensitive and specific laboratory diagnostic tools in Ethiopia. Therefore, the goal of this study was to compare the performance of Rapid Diagnostic Test (RDT), microscopy and real-time polymerase chain reaction (RT-PCR) to detect APIs among pregnant women. Methods A health facility based cross -sectional study was conducted among pregnant women attending antenatal care at Fendeka town health facilities Jawi district, northwest Ethiopia from February to March, 2019. A total of 166 participants were enrolled by using convenient sampling technique. Socio-demographic features were collected using a semi structured questionnaire. Dried blood spot (DBS) samples were collected for molecular analysis. Asymptomatic Plasmodium infection on pregnant women was diagnosed using RDT, microscopy and RT-PCR. Descriptive statistics were used to determine the prevalence of APIs. Method comparison was performed, and Cohen’s kappa coefficient (k) was used to determine the degree of agreement among the diagnostic methods. Parasite densities were also calculated. Results The prevalence of API was 9.6%, 11.4% and 18.7% using RDT, microscopy and RT-PCR, respectively. The overall proportion of API was 19.3%. Sensitivity of the RDT was 83.3% as compared with microscopy. Rapid Diagnostic Test and microscopy also showed sensitivity of 50% and 60%, respectively, as compared with RT-PCR. The mean parasite density was 3213 parasites/µl for P falciparum and 1140 parasites/µl of blood for P. vivax . Conclusion Prevalence of API in the study area was high. Both RDT and microscopy had lower sensitivity when compared with RT-PCR. Therefore, routine laboratory diagnosis of API among pregnant women should be given attention and done with better sensitive and specific laboratory diagnostic tools.

Introduction Measles is an extremely contagious viral disease that can be prevented through vaccination. It is caused by the measles virus and presents with symptoms such as high fever, cough, runny nose, conjunctivitis, and a distinctive rash. Complications may include pneumonia, diarrhoea, and neurological issues. The disease spreads through respiratory droplets and continues to pose a significant public health challenge, especially in Africa, despite vaccination efforts. Objective This systematic review and meta-analysis aim to estimate the pooled vaccine effectiveness of measles vaccines among African children, providing insights into immunization program success and informing policy decisions on vaccine distribution and resource allocation. Methods Following PRISMA guidelines, search was conducted in databases including PubMed/Medline, Science Direct, HINARI, Cochrane/Wiley library, Europe PMC, and grey literatures like Google Scholar up to March 2024. Cross-sectional studies assessed measles vaccine effectiveness in African children aged nine months and above were included. Data was extracted using JBI extraction tool and entered into microsoft excel and analysed via STATA version 20.1 using random effect model. Results From 5295 identified articles, 18 met the inclusion criteria, encompassing 26,470 children from 13 African countries. The pooled measles vaccine effectiveness was 68.58%, with significant heterogeneity (I2 = 99.66%, p  < 0.001). Subgroup analysis showed variability in vaccine effectiveness by study period, with higher effectiveness in studies conducted after the Global Vaccine Action Plan (GVAP) in 2012. Conclusion Measles vaccine effectiveness varies in African regions, ranging from 98.4% in Nigeria to 36.5% in Mozambique, with an overall effectiveness of 68.58% and high heterogeneity among studies. Optimizing vaccine distribution, increasing coverage, and prompt administration are important for enhancing effectiveness. Continued support for GVAP strategies and further research is needed to understand factors affecting vaccine performance and improve immunization efforts in Africa.

Background Human immunodeficiency virus (HIV) infected children represent a very vulnerable population for anti-retroviral therapy (ART) drug resistance. As a global target, 90% of patients receiving ART should have HIV-RNA viral suppression. A threshold of >  1000 RNA copies/ml is used to define non-suppressed viral load. If it is confirmed in the laboratory, adherence should be addressed and should be followed by the switch to second-line ART. Therefore, the aim of this study was to assess the rate of viral load suppression among children tested at the Amhara Public Health Institute (APHI), Bahir Dar. Methods Institutional based cross-sectional study design was conducted from July 01, 2017 to June 30, 2018, in children under the age of 15 years. Socio-demographic, clinical and HIV1RNA viral load data were collected from the excel database. The data were analyzed in SPSS 20.0 statistical software. Results A total of 1567 children, age ranged from one to 14 years, were tested for HIV viral load. Of which, about 54% were males. Children were treated using nevirapine-based (76.7%), efavirenz-based (21.8%) and protease inhibitor-based (1.5%) anti-retroviral drugs. Non-suppressed HIV viral load was found in 28.3% of the participants. High viral load (> 1000 cp/ml) were found in 24% of the children below the age of five years. Children on nevirapine-based treatment had about two times more non-suppressed viral load (Adjusted odds ratio [AOR]: 1.90; 95%CI: 1.41–2.56; P  < 0.001) compared to those who had efavirenz-based treatment. However, adherence (P: 0.204) was not associated with non-suppressed viral load. Conclusions There was a high rate of non-suppressed HIV viral load among children tested at APHI. Specifically, the odds of having a non-suppressed viral load was higher in NVP based treatment users. Hence, comprehensive management and follow up of children on ART, and testing for resistance as well as viral load could help to reduce the problem in advance.

ObjectivesTo determine uptake of the COVID-19 vaccine and identify the associated factors among health professionals in major cities of the Amhara region in Ethiopia.DesignInstitution-based, cross-sectional study.SettingThe study was conducted from July to September 2022 across 40 health centres and 13 hospitals, representing 10 major cities within the Amhara region.Participants1251 participants, all of whom were vaccine-eligible health professionals, were selected using a systematic random sampling procedure.Outcome measuresThe level of vaccine uptake in the study was determined by the proportion of health professionals who had received at least one dose of a COVID-19 vaccine.Results1251 health professionals participated, with 848 (67.8%) reporting that they had received at least one dose of a COVID-19 vaccine. Key findings from the multivariable logistic regression analysis revealed that health professionals aged 46 years and older were four times more likely to be vaccinated (95% CI, 1.656 to 9.510), married participants were 1.4 times more likely to take the vaccine (95% CI, 1.010 to 1.933) and those with good knowledge of COVID-19 vaccines were 1.75 times more likely to get vaccinated (95% CI, 1.307 to 2.331). Additionally, participants with a positive attitude towards vaccination were 3.65 times more likely to have received a vaccine (95% CI, 2.753 to 4.732).ConclusionsThe study reveals a commendable level of COVID-19 vaccine uptake among health professionals, emphasising their critical role in public health initiatives. However, the observed disparities in vaccination rates indicate the need for targeted interventions to improve vaccine coverage, particularly among younger professionals and those with limited knowledge of the vaccine. Addressing these gaps requires the implementation of tailored educational programmes that enhance understanding of COVID-19 vaccines. Furthermore, fostering positive attitudes through targeted campaigns, workplace-based initiatives and peer influence, particularly among younger and unmarried professionals, will be crucial. Encouraging vaccinated professionals to share their experiences and establishing regular follow-ups will also be essential strategies to improve vaccine acceptance and coverage in the region.

The genetic analysis of the Dengue virus circulating in Ethiopia's Afar region, in 2023, identified three distinct introductions with spatiotemporal clustering linked to genomes from Asia and Italy. These findings are crucial for enhancing prevention and control strategies, reinforcing the necessity to provide sustainable tools for genomic epidemiology in Africa.

Globally, approximately 35 million people are infected with HIV infection. Sub-Saharan countries contributed 71% of global burden. Women are the most affected groups accounting for 51% of global infection and 90% of HIV infections in children (<15 years) are a result of mother to child transmission. In the absence of any intervention, mother-to-child transmission has been estimated to 30-40% that could occur at various periods like during pregnancy, delivery, and post-partum, via breastfeeding. For future generations to be born HIV-free, evidences on the level of viremia and contributing factors in pregnant mothers is important. The objective of this study is to determine the magnitude of viral non-suppression rate among pregnant women and identify the risk factors associated with viral non-suppression. A cross-sectional study was conducted from July 01, 2021 to June 30, 2022, in pregnant women who are on antiretroviral treatment and attending HIV viral load testing in Amhara region viral load testing sites, North West Ethiopia. Socio-demographic, clinical, and HIV-1 RNA viral load data were collected from the excel database. The data were analyzed in SPSS 23.0 statistical software. Overall viral non-suppression rate was 9.1%. In other words, the viral suppression rate was 90.9%. Pregnant women being at AIDS stages III and IV and with fair treatment adherence and suspected testers were statistically associated with increased viral non-suppression rate. Relatively low viral non-suppression rate among pregnant mothers that had almost met the third 90 of UNAIDS target. But, still, some mothers received a non-suppressed viral replication specifically the odds of having a non-suppressed viral load was higher in pregnant women with poor treatment adherence and WHO Stage III and IV and suspected testers.