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Diabetes mellitus is associated with increased mortality during tuberculosis treatment:a prospective cohort study among tuberculosis patients in SouthEastern Amahra Region,Ethiopia

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Infectious Diseases of Poverty 2016年第1期5卷 198-207页

作者： Mahteme Haile Workneh Gunnar Aksel Bjune solomon abebe yimer Institute of Health and Society Faculty of MedicineUniversity of OsloOsloNorway Amhara Regional State Health Bureau Bahir-DarEthiopia Department of Microbiology Oslo University HospitalOsloNorway Department of Bacteriology and Immunology Norwegian Institute of Public HealthOsloNorway

Background:There is growing evidence suggesting that diabetes mellitus(DM)affects disease presentation and treatment outcome in tuberculosis(TB)*** study aimed at investigating the role of DM on clinical presentations and treatment outcomes among newly diagnosed TB ***:A prospective cohort study was conducted in South-Eastern Amhara Region,Ethiopia from September 2013 till March *** subjects were consecutively recruited from 44 randomly selected health facilities in the study *** were categorized into two patient groups,namely,patients with TB and DM(TBDM)and TB patients without DM(TBNDM).Findings on clinical presentations and treatment outcomes were compared between the two patient *** proportional hazard regression analysis was applied to identify factors associated with ***:Out of 1314 TB patients enrolled in the study,109(8.3%)had coexisting *** comorbidity[adjusted hazard ratio(AHR)3.96;95%confidence interval(C.I.)(1.76–8.89)],and TB coinfection with human immunodeficiency virus(HIV)[AHR 2.59;95%C.I.(1.21–5.59)]were associated with increased *** and TBNDM patients did not show significant difference in clinical symptoms at baseline and during anti-TB treatment ***,at the 2nd month of treatment,TBDM patients were more symptomatic compared to patients in the TBNDM ***:The study showed that DM is associated with increased death during TB *** has no association with clinical presentation of TB except at the end of the intensive phase *** screening of TB patients for DM is recommended for early diagnosis and treatment of patients with TBDM comorbidity.

关键词： Tuberculosis Diabetes mellitus Association Symptoms Treatment outcome Amhara Region Ethiopia

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The burden of and risk factors for active trachoma in the North and South Wollo Zones of Amhara Region,Ethiopia:a crosssectional study

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Infectious Diseases of Poverty 2017年第1期6卷 1270-1281页

作者： Beselam Tadesse Alemayehu Worku Abera Kumie solomon abebe yimer Ethiopian Institute of Water Resources(EIWR) Addis Ababa UniversityAddis AbabaEthiopia School of Public Health College of Health SciencesAddis Ababa UniversityAddis AbabaEthiopia Department of Microbiology Oslo University HospitalOsloNorway

Background:Trachoma is a disease of the eye,caused by the bacteria Chlamydia trachomatis,which can lead to blindness if left *** is one of the most trachoma-affected countries in the *** objective of this study was to determine the prevalence of and associated risk factors for active trachoma among children in selected woredas of North and South Wollo Zones in Amhara Region,***:This study was a community-based,cross-sectional study,which was conducted from October to December 2014 among children aged 1-8.A four-stage random cluster sampling technique was employed to select the study areas and *** each selected household,one child was clinically assessed for active trachoma.A structured questionnaire was used to collect sociodemographic,behavioral,and clinical *** logistic regression analysis was used to analyze the association between predictor variables and active ***:The overall prevalence of active trachoma among 1358 children was found to be 21.6%(95%CI:19.4-23.8%).When analyzed by the presence or absence of individual WHO simplified system signs of active trachoma,trachomatous inflammation-follicular cases constituted18%(95%CI:15.9-20.2%),while 4.7%(95%CI:3.6-5.8%)were trachomatous inflammation-intense *** discharge(aOR=5.2;95%CI:3.3-8.2),nasal discharge(aOR=1.8;95%CI:1.2-2.7),time taken to fetch water(aOR=0.02;95%CI:0.01-0.05),frequency of hand and face washing(aOR=4.4;95%CI:1.1-17.8),and access to a latrine(aOR=0.006;95%CI:0.001-0.030)were found to be independently associated with the presence of active ***:There is a high burden of active trachoma among children in the study *** of personal hygiene and limited access to a safe water supply and latrines were associated with increased prevalence of active *** order to reduce the burden of active trachoma,facial cleanliness and environmental improvement components of the SAFE strategy should be up

关键词： North Wollo South Wollo Amhara region Ethiopia Trachoma Prevalence SAFE strategy Wash

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Applying tuberculosis management time to measure the tuberculosis infectious pool at a local level in Ethiopia

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Infectious Diseases of Poverty 2017年第1期6卷 1392-1400页

作者： Senedu Bekele Gebreegziabher Gunnar Aksel Bjune solomon abebe yimer Amhara Regional State Health Bureau Bahir DarEthiopia Department of Community Medicine Institute of Health and SocietyUniversity of OsloOsloNorway Oslo University Hospital OsloNorway Department of Bacteriology and Immunology Division of Infectious Disease ControlNorwegian Institute of Public HealthOsloNorway

Background:Measuring the size of the infectious pool of tuberculosis(TB)is essential to understand the burden and monitor trends of TB control program *** study applied the concept of TB management time to estimate and compare the size of the TB infectious pool between 2009 and 2014 in West Gojjam Zone of Amhara Region,***:New sputum smear-positive and smear-negative pulmonary TB(PTB)and retreatment cases who attended 30 randomly selected public health facilities in West Gojjam Zone from October 2013 to October 2014 were consecutively enrolled in the *** order to determine the infectious period,the TB management time(number of days from the onset of cough until start of anti-TB treatment)was computed for each patient *** number of undiagnosed TB cases was estimated and hence the TB management time for the undiagnosed category was *** total size of the TB infectious pool during the study period for the study zone was estimated as the annual number of infectious person ***:New smear-positive and smear-negative PTB cases contributed 25,050 and 12,931 infectious person days per year to the TB infectious pool,*** retreatment and presently undiagnosed cases contributed 8840 and 34,310 infectious person days per year,*** total size of the TB infectious pool in West Gojjam Zone during the study period was estimated at 81,131 infectious person days per year or 3405 infectious person days per 100,000 population per *** to a similar study done in 2009 in the study area,the current study showed reduction of the TB infectious pool by 244,279 infectious person ***:TB management time is a simple and practical tool that may help to estimate and compare the changes in the size of the TB infectious pool at local *** may also be used as an indicator to monitor the changes in TB control program performance.

关键词： Tuberculosis TB management time Infectious pool West Gojjam zone Ethiopia

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