Explore the vast range of titles available.

Background The existing seroepidemiological data on viral hepatitis in Ethiopia showed a wide variation in prevalence pattern and the clinical and public health burden have been underestimated. The aim of this systematic review and meta-analysis was to provide a clear and comprehensive estimation of viral hepatitis epidemiology and the potential clinical burdens in Ethiopia. Methods A comprehensive literature search was carried out from five decades (1968–2015) published studies from biomedical databases; PubMed, Google scholar, Medline and Web of Science. Results The overall pooled prevalence of hepatitis B virus (HBV) was 7.4% (95%CI: 6.5–8.4). The pooled prevalence among subgroups showed 5.2% (95%CI: 3.7–7.4) in human immunodeficiency virus (HIV) infected individuals, 8.0% (95%CI: 5.9–10.7) in community based studies, 8.4% (95%CI: 5.4–12.7) in blood donors, 11.0% (95%CI: 7.5–15.9) in immigrants and 6.9% (95%CI: 5.6–8.5) in other groups. Among study parameters considered during meta-regression analysis, only study years were associated with a decreasing HBV prevalence rate over time. The overall pooled prevalence of anti-hepatitis C virus antibody (anti-HCV) was 3.1% (95%CI: 2.2–4.4). Unlike HBV, the anti-HCV prevalence in HIV infected individuals was higher (5.5%, 95%CI: 3.8–7.8%, p  = 0.01) than the prevalence observed in the other subgroup of study population. Although relatively few data were available, hepatitis virus A (HAV), D (HDV) and E (HEV) were also circulated in Ethiopia. Conclusions This review indicates that all types of viral hepatitis origins are endemic in Ethiopia. Adapting a recommended diagnostic and treatment algorithm of viral hepatitis in the routine healthcare systems and implementing prevention and control policies in the general population needs an urgent attention.

Historically, mother-to-child transmission (MTCT) of hepatitis B virus (HBV) was considered uncommon in Africa, leading to a reluctant attitude to birth-dose HBV vaccination on the continent. As a randomized trial would be unethical, real-life data are needed to assess the effect of HBV birth-dose vaccine in Africa. A multicenter, prospective, observational study of hepatitis B surface antigen (HBsAg)-positive pregnant women and their infants was carried out in Ethiopia, from January 2019 to May 2021. Pregnant women were screened for HBsAg and HIV as part of routine antenatal care and/or delivery, and HBsAg-positive HIV-negative pregnant women were included in the study. HBV birth-dose vaccine and hepatitis B immunoglobulin (HBIg) were recommended but not all newborns received it as it was not national policy. All infants, however, received the pentavalent HBV vaccine at 6, 10, and 14 weeks of age. Vaccination status was confirmed from delivery ward charts and infant vaccination certificates. Infants were tested for HBsAg at 9 months of age and a positive result was taken as evidence of MTCT. Of 290 HBsAg-positive pregnant women, 168 mother/infant pairs returned for their 9-month follow-up visit and were included in this analysis. Two of 112 (1.8 %) infants who received birth-dose vaccine with HBIg, and 2 of 23 (8.7 %) who received birth-dose vaccine alone were HBsAg positive at nine months of age, compared to 8 of 33 (24.2 %) who received neither vaccine nor HBIg at birth (p = 0.002). High maternal viral load (>200,000 IU/ml; adjusted odds ratio [AOR] 10.4; 95 % confidence interval [CI] 1.2–92.1) and not receiving HBV birth-dose vaccine nor HBIg (AOR 29.2; 95 % CI 4.0–211.3) were independent predictors of MTCT. Birth-dose HBV vaccine with or without HBIg significantly reduced the risk of MTCT of HBV in Ethiopia. Improved coverage of birth-dose HBV vaccine should be an urgent priority. •It is uncertain if MTCT of HBV is a major driver of new infections in Africa.•We conducted a real-life study of pregnant women and their offspring in Ethiopia.•The overall rate of MTCT of HBV was high (7∙1 %).•Birth-dose vaccine with/without HBIg significantly reduced MTCT of HBV.

Hepatitis B vaccination is recommended for all children at birth within 24 hours or during childhood. This study was aimed to evaluate protective efficacy of hepatitis B vaccine and estimate the sero-prevalence of hepatitis B virus infection among vaccinated children. A community-based cross-sectional study was conducted from March, 2021 to October, 2021 in Debre Markos town. A simple random sampling technique was used to select 165 fully vaccinated children aged 5-12 years old. A serum sample was used to determine hepatitis B surface antigen (HBsAg), anti-hepatitis B core antibody (anti-HBc), anti-hepatitis B surface antibody titer (anti-HBs) using ELISA. The seroprevalence of HBsAg and anti-HBc anti-body was found to be 4.2% and 4.8% respectively. Of 165 fully vaccinated children, 129 (78.2%) had anti-HBs titer ≥ 10 mIU/ml. Among 129 sero-protected children, 76 (58.9%) were hypo-responders whereas the rest 53 (41.1%) were good responders. Those children within the age group of 5-7 years were 2.9 times (AOR: 2.873, 95% CI: 1.156, 7.141) (P<0.023) more likely to respond to HBV vaccine. Multivariate logistic regression revealed that children who were born from HBV positive mothers (AOR 3.917, 95% CI: 1.456, 5.365, P<0.027) and those who had history of injectable medications (AOR 9.232, 95% CI: 1.503, 11.697, P<0.016) were more likely to be HBsAg positive. Children who had history of hospital admission (AOR 6.973, 95% CI: 1.495, 8.530, P<0.013) were more likely to be anti-HBcAb positive. There was an intermediate prevalence of childhood HBV infection despite being vaccinated suggesting low protective efficacy of hepatitis B vaccine in the study area.

Scaling up of diagnostic capacity is needed to mitigate the global pandemic of SARS-CoV2. However, there are challenges including shortage of sample collection swabs and transport medium. Saliva has been recommended as a simple, low-cost, non-invasive option. However, data from different populations and settings are limited. Here, we showed that saliva could be a good alternative sample to diagnose COVID-19 patients. Pair of NPS-saliva samples was collected from 152 symptomatic; confirmed COVID-19 patients, and compared their positivity rate, viral load, and duration of viral shedding. From 152 patients, 80 (52.63%) tested positive and 72 (47.37%) were negative for SARSA-CoV2 in NPS sample. In saliva, 129 (92.14%) were tested positive and 11 (7.86%) were negative on the day of admission to hospital. The overall percent agreement of RT-PCR result of Saliva to NPS was 70% (196/280). A comparison of viral load from 72 NPS-saliva pair samples on day of admission shows saliva contains significantly higher viral load ( P  < 0.001). In conclusion, saliva has higher yield in detecting SARS-CoV2, and COVID-19 patients show higher viral load and prolonged period of viral shedding in saliva. Therefore, we recommend saliva as a better alternative sample to NPS to diagnose COVID-19 patients.

Background Although a universal vaccine is available and Ethiopia is working outstandingly towards measles elimination, a recurrent measles outbreak has occurred each year in different parts of the country. Therefore, understanding the epidemiology of measles cases, the incidence of confirmed measles virus cases and related risk factors is crucial. Here, we conducted a systematic review and meta-analysis to summarize information regarding the epidemiology, measles incidence rate and risk factors for national measles infections occurring in the past two decades, from 2000 to 2023. Methods Data from electronic databases, including PubMed, African Journal Online, WHO databases and Google Scholars, were searched to identify studies describing measles outbreaks, incidence rates and associated factors in Ethiopia that occurred between 2000 and 2023. Important basic information was extracted in an Excel spreadsheet and imported into Comprehensive Meta-analysis Software version 3 to evaluate the associations between measles outbreaks and different risk factors. We pooled the odds ratios (ORs) and 95% confidence intervals (CIs) for every included risk factor to evaluate the associations with measles outbreaks. Results We included 36 studies involving 132,502 patients with confirmed measles cases in Ethiopia. The results of this systematic review and meta-analysis revealed that measles outbreaks were more frequently reported in the Oromia region (73,310 (33.1%)), followed by the Southern Nation Nationalities of Ethiopia region (29,057 (13.4%)). The overall pooled analysis indicated that the prevalence of measles susceptibility was 67.5% (95% CI: 67.3–67.8%), with an I 2 of 99.86% and a p value for heterogeneity < 0.0001. The non-vaccinated status of the children, their contact history with measles cases, their travel history, the presence of cases in family or neighbors, and malnourished patients were identified as factors associated with the high prevalence and recurrent measles infections in Ethiopia. Conclusion The results of this systematic review and meta-analysis indicated that the pooled prevalence of measles infection was high, which is a public health concern in Ethiopia. Thus, strengthening healthcare services, regular vaccination campaigns, and the integration of health education activities with other services may decrease the incidence rate.

Background Virological failure, drug resistance, toxicities, and other issues make it difficult for ART to maintain long-term sustainability. These issues would force a modification in the patient's treatment plan. The aim of this research was to determine whether first-line antiretroviral therapy is durable and to identify the factors that lead to patients on HAART changing their first highly active antiretroviral therapy regimen. Methods A retrospective cohort study was conducted from October, 2019—March, 2020 across all regional states including Addis Ababa and Dire Dawa administrative cities. The target population is from all health facilities that have been providing ART service for at least the past 6 months as of October 2019. Multi-stage clustered sampling method was used to select study facilities and participants. Simple random selected ART medical records of patients ever enrolled in ART treatment services. We adopted a multi-state survival modelling (msm) approach assuming each treatment regimen as state. We estimate the transition probability of patients to move from one regimen to another for time to treatment change/switch. We estimated the transition probability, prediction probabilities and length of stay and factor associated with treatment modification of patients to move from one regimen to another. Results Any of the six therapy combinations (14.4%) altered their treatment at least once during the follow-up period for a variety of reasons. Of the patients, 4,834 (13.26%) changed their treatments just once, while 371 (1.1%) changed it more than once. For 38.6% of the time, a treatment change was undertaken due to toxicity, another infection or comorbidity, or another factor, followed by New drugs were then made accessible and other factors 18.3% of the time, a drug was out of supply; 2.6% of those instances involved pregnancy; and 43.1% involved something else. Highly active anti-retroviral therapy (HAART) combinations TDF + 3TC + NVP, d4T + 3TC + NVP, and TDF + 3TC + EFV were high to treatment alterations in all reasons of treatment modifications, with 29.74%, 26.52%, and 19.52% treatment changes, respectively. Early treatment modification or regime change is one of the treatment combinations that include the d4T medication that creates major concern. The likelihood of staying and moving at the the start of s = 0 and 30-month transitions increased, but the likelihood of staying were declined. For this cohort dataset, the presence of opportunistic disease, low body weight, baseline CD4 count, and baseline TB positive were risk factors for therapy adjustment. Conclusion Given that the current study took into account a national dataset, it provides a solid basis for ART drug status and management. The patient had a higher likelihood of adjusting their treatment at some point during the follow-up period due to drug toxicity, comorbidity, drug not being available, and other factors, according to the prediction probability once more. Baseline TB positivity, low CD4 count, opportunistic disease, and low body weight were risk factors for therapy adjustment in this cohort dataset.

Globally, rabies is found in several geographical areas, with tens of thousands of deaths annually, mainly in developing countries. However, though Ethiopia is highly endemic for rabies, the overall risk of rabies has not yet been estimated. Hence, this systematic review and meta-analysis aimed at estimating a pooled incidence rate of human exposure to suspected rabid animals as well as the incidence rates of rabies in humans and other domestic animals. Published articles search was systematically performed through PubMed, Scopus, Embase, and Web of Science databases to identify the available studies on rabies until October 2023. The Joanna Brigg's Institute (JBI) critical appraisal checklists were used for assessing the quality of the studies. The PRISMA 2020 guideline was followed. A qualitative synthesis was made describing the characteristics of the included studies. The quantitative synthesis was performed with a random effects model using Comprehensive Meta-Analysis (CMA) version 3.0 software. The Q statistic quantified by I2 was used to check for heterogeneity among the included studies. To explain the source of heterogeneity, subgroup analysis was performed. Egger's regression test was used to evaluate publication biases. This study is registered with PROSPERO, CRD42023468791. For this study, a total of 439 articles were retrieved; of which fifteen studies were included in the final review. The annual pooled incidence rate of human exposure to suspected rabid animals was 33.65 (95% CI: 31.82 to 35.49) per 100,000 humans. The suspected rabies deaths in humans were also estimated to be 4.57 (95% CI: 2.93 to 6.21) per one million humans annually. In both cases, considerable heterogeneities were presented across the included studies, and obvious publication biases were detected using Egger's regression test. Among animals, the highest combined estimate per 100,000 population was recorded in dogs, 120.99 (95% CI: 46.29 to 195.69), followed by equines and cattle, with pooled incidence rates of 19.57 (95% CI: -1.85 to 40.98) and 18.08 (95% CI: 1 to 35.15), respectively. It was also described that human exposure to rabid animals and human rabies deaths were more common among children. The current study showed a high pooled incidence rate of human exposure to rabid animals. Significant overall incidence rates of rabies in humans and animals were also indicated. Therefore, strengthening intersectoral and transdisciplinary collaborations through one health approach are key components for rabies prevention and control.

HIV co-infection with hepatitis B (HIV-HBV) and hepatitis C (HIV-HCV) is known to affect treatment outcomes of antiretroviral therapy (ART); however, its magnitude is not well documented. We aimed to determine the magnitude of HIV-HBV and HIV-HCV co-infections simultaneously in people living with HIV (PLHIV) enrolled in ART care in Addis Ababa. We reviewed the medical records of adults ≥15 years who were receiving ART care in three high burden hospitals in Addis Ababa. Baseline clinical and laboratory test results were extracted from medical records. Co-infection was determined based on hepatitis B surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV) tests obtained from the medical records. A multivariable logistic regression model was used to identify the risk factors for hepatitis B and C co-infections. A total of 873 HIV-positive participants were included in this study. The median age of the participants was 37.5 years, and 55.7% were women. Overall, HIV-HBV co-infection was 5.96% (95% CI: 4.56-7.74), and HIV-HCV co-infection was 1.72% (95% CI: 1.03-2.83). The multivariable logistic regression showed that the male sex was the most independent predictor for viral hepatitis B co-infection with an odds ratio of 2.42(95% CI:1.27-4.63). However, HIV-HCV co-infection did not show a significant association in any of the sociodemographic data of the participants. HIV co-infection with hepatitis B was moderately high in individuals enrolled in ART care in Addis Ababa. Men had significantly higher HIV-HBV co-infection. HIV co-infection with hepatitis C was relatively low. Strengthening integrated viral hepatitis services with HIV care and treatment services should be emphasized to improve patient care in health facilities.

Introduction Tuberculosis (TB) remains the most common opportunistic infection and leading cause of death among individuals living with HIV/AIDS in Ethiopia. Its significant impact on morbidity and mortality underscores the crucial link between these two diseases. While the advent of antiretroviral therapy (ART) has led to a dramatic decline in mortality rates among HIV/AIDS patients, TB continues to pose a substantial threat. This study aims to estimate the probability of death due to TB among HIV/AIDS patients on ART, considering the presence of various competing risks, including diarrhea, other infections, and unknown/unspecified causes. Also we have assessed the effects of prognostic factors on HIV/AIDS cause specific deaths, compared with the death from other competing risks, and exploring leading cause of death among HIV/AIDS patients on Antiretroviral Therapy. Methods Data from a retrospective research examining the effectiveness of antiretroviral therapy (ART) in Ethiopia were used in this investigation. The data came from medical records of patients who were part of the national ART program. A total of 39,590 records were gathered between October 2019 and March 2020 from all regions of Ethiopia as well as the administration cities of Addis Ababa and Dire Dawa. The study facilities were grouped using a multi-stage sample technique and simple random selection was used to select health facility and a person record from medical records. In the presence of the competing causes of death, Cause specific hazard, subdistribution hazard model and flexible parametric proportional hazard model have been used to assess the effect of covariates on the risk of death, with the cmprisk package in R4.3.2 software. Results Out of the total 1212 deaths, 542(44.7%) died competing with other opportunistic infection (TE-Esophageal Candidiasis, TO-oral, CT-CNS Toxoplasmosis, CM-Crypotococcal Meningitis…), 421 (34.7%) died due to tuberculosis and the remaining death were unknown/Not specified infection 222(18.3%) and diarrhea 27(2.2%). Rates of mortality caused by tuberculosis, competing with other opportunistic infection, diarrhea and unknown/Not specified were 3.5, 4.5, 0.2 and 1.8 per 1000 person-months, respectively. Having a higher CD4 count at diagnosis, responding to combination antiretroviral treatment (cART) six months after start, and having prophylactic treatment for pneumocystis pneumonia (PCP) decreased the risk of tuberculosis, other opportunistic infections, and unidentified and diarrheal causes of death. However, older age, late HIV.AIDS diagnosis, and the last HIV/AIDS WHO clinical stages increased the hazard of tuberculosis and other opportunistic disease mortality. Additionally, male gender, older age and last HIV clinical stages increased the mortality HIV/AIDS patients. Conclusion The findings of this study demonstrated that TB, an opportunistic infection, was the primary cause of death in HIV/AIDS patients, despite the presence of several competing risks, such as diarrhea, other infections, and an undetermined or unclear cause. It's important to use effective techniques to quickly detect those who have HIV or AIDS and provide them with care and treatment to increase their chances of surviving.

Cervical cancer is a significant public health concern in Ethiopia. It is mainly caused by persistent infection with the human papillomaviruses. The aim of this study was to assess the relationship between carcinogenic risk of probable, possible and low risk HPV infection and those of cervical intraepithelial neoplasia (CIN) and cervical cancer. A cross sectional study nested from prospective cohort study was conducted in Bahir Dar, northwest Ethiopia. Statistical analyses were performed using SPSSversion 26.0. HPV-16 was associated with a relatively higher risk of CIN II + , (AOR = 15.42; 95% CI 6.81–34.91). In addition, HPV-52, -18, -53 and -58, were significantly associated with an increased risk of CIN II + , (AOR = 7.38 (1.73–31.54), 5.42 (1.61–18.31), 4.08 (1.53–10.87), and 3.17 (1.00–10.03)), respectively. The current study shows high rate of HPV with predominance of HPV-16, -53, -58, -18, -35, and -52. The quadrivalent and nonavalent vaccine had only covered 27.1% and 45% of the circulating HPV genotypes. Ethiopia may need to consider introduction of nonavalent vaccine into the national public health strategy. Polyvalent vaccine which includes the genotypes not covered by existing approved vaccines should be considered.