Israel Tareke - Academia.edu (original) (raw)
Papers by Israel Tareke
Online Journal of Public Health Informatics, 2013
Objective To describe the results of the evaluation of the PAILD active surveillance system and l... more Objective To describe the results of the evaluation of the PAILD active surveillance system and lessons learned for similar surveillance efforts in a resource-limited setting.
BMC Infectious Diseases, May 15, 2017
Background: Yellow Fever (YF) is a viral hemorrhagic disease transmitted by aedes mosquito specie... more Background: Yellow Fever (YF) is a viral hemorrhagic disease transmitted by aedes mosquito species. Approximately, 200,000 cases and 30,000 deaths occur worldwide every year. In Ethiopia, the last outbreak was reported in 1966 with 2200 cases and 450 deaths. A number of cases with deaths from unknown febrile illness reported from South Ari district starting from November 2012. This investigation was conducted to identify the causative agent, source of the outbreak and recommend appropriate interventions. Methods: Medical records were reviewed and Patients and clinicians involved in managing the case were interviewed. Descriptive data analysis was done by time, person and place. Serum samples were collected for serological analysis it was done using Enzyme-linked Immunosorbent Assay for initial screening and confirmatory tests were done using Plaque Reduction and Neutralization Test. Breteau and container indices were used for the entomological investigation to determine the risk of epidemic. Results: A total of 141 Suspected YF cases with 43 deaths (CFR = 30.5%) were reported from November 2012 to October 2013 from South Omo Zone. All age groups were affected (mean 27.5, Range 1-75 Years). Of the total cases, 85.1% cases had jaundice and 56.7% cases had fever. Seven of the 21 samples were IgM positive for YF virus. Aedes bromeliae and Aedes aegypti were identified as responsible vectors of YF in affected area. The Breteau indices of Arkisha and Aykamer Kebeles were 44.4% and 33.3%, whereas the container indices were 12.9% and 22. 2%, respectively. Conclusion: The investigation revealed that YF outbreak was reemerged after 50 years in Ethiopia. Vaccination should be given for the affected and neighboring districts and Case based surveillance should be initiated to detect every case.
Background: Influenza is an acute viral disease of the respiratory tract which is characterized b... more Background: Influenza is an acute viral disease of the respiratory tract which is characterized by fever, headache, myalgia, prostration, coryza, sore throat and cough. Globally, an estimated 3 to 5 million cases of severe influenza illness and 291 243-645 832 seasonal influenza-associated respiratory deaths occur annually. Although recent efforts from some African countries to describe burden of influenza disease and seasonality, these data are missing for the vast majority, including Ethiopia. Ethiopia established influenza sentinel surveillance in 2008 aiming to determine influenza strains circulating in the country and know characteristics, trend and burden of influenza viruses. Methods: We used influenza data from sentinel surveillance sites and respiratory disease outbreak investigations from 2009 to 2015 for this analysis. We obtained the data by monitoring patients with influenza-like illness (ILI) at three health-centers, severe acute respiratory infection (SARI) at five hospitals and investigating patients during different respiratory infection outbreaks. Throat-swab specimens in viral transport media were transported to the national reference laboratory within 72 h of collection using a cold-chain system. We extracted viral RNA from throat-swabs and subjected to real-time PCR amplification. We further subtyped and characterized Influenza Apositive specimens using CDC real-time reverse transcription PCR protocol. Results: A total of 4962 throat-swab samples were collected and 4799 (96.7%) of them were tested. Among them 988 (20.6%) were influenza-positive and of which 349 (35.3%) were seasonal influenza A(H3N2), 321 (32.5%) influenza A(H1N1)pdm2009 and 318 (32.0%) influenza B. Positivity rate was 29.5% in persons 5-14 years followed by 26.4% in 15-44 years, 21.2% in > 44 years and 6.4% in under five children. The highest positivity rate observed in November (37.5%) followed by March (27.6%), December (26.4%), October (24.4%) and January (24.3%) while the lowest positivity rate was in August (7.7%). Conclusion: In Ethiopia, seasonal Influenza A(H3N2), Influenza A(H1N1)pdm2009 and Influenza B viruses were circulating during 2009-2015. Positivity rate and number of cases peaked in November and December. Influenza is one of public health problems in Ethiopia and the need to introduce influenza vaccine and antivirus is important to prevent and treat the disease in future.
BMC public health, Jan 14, 2018
Yellow fever (YF) is a viral hemorrhagic fever, endemic in the tropical forests of Africa and Cen... more Yellow fever (YF) is a viral hemorrhagic fever, endemic in the tropical forests of Africa and Central and South America. The disease is transmitted by mosquitoes infected with the yellow fever virus (YFV). Ethiopia was affected by the largest YF outbreak since the vaccination era during 1960-1962. The recent YF outbreak occurred in 2013 in Southern part of the country. The current survey of was carried out to determine the YF seroprevalence so as to make recommendations from YF prevention and control in Ethiopia. A multistage cluster design was utilized. Consequently, the country was divided into 5 ecological zones and two sampling towns were picked per zone randomly. A total of 1643 serum samples were collected from human participants. The serum samples were tested for IgG antibody against YFV using ELISA. Any serum sample testing positive by ELISA was confirmed by plaque reduction neutralization test (PRNT). In addition, differential testing was performed for other flaviviruses, n...
Ethiopian medical journal, 2016
An outbreak of a chronic liver disease of unidentified cause, known as "Unidentified Liver D... more An outbreak of a chronic liver disease of unidentified cause, known as "Unidentified Liver Disease (ULD)" by local communities was first observed in a rural village in Tigray, northern-Ethiopia in 2001. Little was known about the geographical extent, trend, and epidemiology of the disease. The Ethiopian Public Health Institute (EPHI) by then Ethiopian Health and Nutrition Research Institute (EHNRI), Centers for Disease Control and Prevention, World Health Organization, and Tigray Regional Health Bureaue established the ULD surveillance system in 2009 to characterize and monitor trends for this emerging disease and to identify cases for treatment and follow up. A large-scale official training was provided to the surveillance staff on case identification, management and reporting. In absence of a confirmatory test, the system used simple case definitions that could be applied by frontline staff with varying clinical training. To maximize resources, health extension workers a...
Ethiopian Journal of Health Development, 2006
Background: We planned to raise public awareness and decentralize directly observed tuberculosis ... more Background: We planned to raise public awareness and decentralize directly observed tuberculosis treatment at village level using volunteer community members in order to reduce prolonged delays in seeking care and improve compliance to tuberculosis treatment. We do not know the magnitude of tuberculosis knowledge gap and preferred modality of tuberculosis treatment supervision among the public in Tigray. Objectives: To assess knowledge of pulmonary tuberculosis and to determine level of acceptance regarding village-based tuberculosis treatment using volunteers among the general public. Method: A cross sectional survey was conducted among 838 adults (≥15 years) in 8 districts of Tigray region. Respondents selected from 70 villages using a multistage cluster sampling technique were interviewed using a pre-tested questionnaire in July 2002. Result: The mean and median knowledge score of respondents about pulmonary tuberculosis (PTB) was 5.24 and 6.67 (maximum score of 10) respectively. Female respondents (Adjusted Odds Ratio (AOR)=1.86; 95% Confidence interval (CI)=1.39-2.47), illiterates (AOR=1.64; 95% CI=1.1-2.47) and rural residents (AOR=1.95; 95% CI=1.37-2.76) were more likely to have a low level of knowledge score. Among respondents who had prior knowledge of PTB (n=717), 599 (83.5%) accepted the idea of tuberculosis (TB) treatment by volunteer community members. Illiterates, rural residents, married and respondents with large family size were more likely to support supervised TB-treatment using volunteers. Respondents' preferred treatment supervisors were: volunteer community health workers (60%), public health staff (16.5%) and family members (12.7%). Conclusion: There is a wide knowledge gap among the public regarding PTB. The idea of organizing directly observed TB treatment using volunteers appears to be accepted.
Background: Poor treatment adherence to tuberculosis treatment is a problem among rural patients ... more Background: Poor treatment adherence to tuberculosis treatment is a problem among rural patients in Ethiopia. We aimed to decentralize directly observed treatment of tuberculosis at village level using volunteer Community Health Workers (CHWs) in order to improve treatment adherence. However, we need to determine their training needs and willingness to supervise treatment of patients with tuberculosis in their respective villages.
Ethiopian Journal of Health Development, 2006
Ethiopian Journal of Health Development, 2006
Background: Delayed initiation of treatment among tuberculosis patients is a common problem which... more Background: Delayed initiation of treatment among tuberculosis patients is a common problem which might contribute to the high burden of tuberculosis in Ethiopia. There is paucity of evidence on the magnitude of delay and why patients fail to seek modern care early in Tigray. Objectives: To assess patient and health service delays and factors for delay among tuberculosis patients. Methods: Adult tuberculosis patients who began treatment (12/10/2001-15/05/2002) in 47 public health institutions were interviewed using a pre-tested questionnaire to gather information about their health seeking behaviour. Patient charts were also reviewed to determine the magnitude of delays. Result: The median patient delay for 42 pulmonary smear positive, 101 pulmonary smear negative and 94 extra-pulmonary tuberculosis patients was 90 days, 60 days and 90 days respectively, while the overall median health service delay was 9 days. Delayed first consultation (>21 days since onset of illness) was significantly higher among patients with no formal education (Adjusted Odds Ratio (AOR)=2.46; 95%Confidence Interval (CI)=1.21-5.01), among those treated first by a private and/or traditional practitioner (AOR=2.9; 95% CI=1.42-6.08), among those who thought their illness not serious (AOR=2.39; 95% CI= 1.52-3.78) and among those who suspected they had tuberculosis (AOR=2.5; 95% CI=1.18-5.29). Conclusion: This unacceptably long patient delay calls for identification and inclusion of feasible strategies to promote early treatment in the national tuberculosis control program. 19:7-12]
Ophthalmic Epidemiology, 2006
Aim: Trachoma is a public health problem in Ethiopia accounting for 35-50% of cases of blindness.... more Aim: Trachoma is a public health problem in Ethiopia accounting for 35-50% of cases of blindness. This study aims to determine the prevalence of trachoma in Tigray and to evaluate whether common risk factors are also risk factors in this region. Method: A cross sectional community-based survey was conducted. From six districts, a total of 48 villages were selected by a multistage cluster random sampling technique. A total of 3900 people who were selected randomly from 1200 households were assessed for signs of trachoma. Ophthalmic nurses used a simplified clinical grading system to assess stages of trachoma while environmentalists assessed risk factors for trachoma. Results: Of the 3900 people examined, 13% had trachomatous follicles (TF), 27% intense trachomatous inflammation (TI), 17.7% trachomatous scarring (TS), 3.4% trachomatous trichiasis (TT) and 0.3% had corneal opacity (CO). The presence of a kitchen with chimney had a protective effect on TS (Adjusted Odds Ratio [AOR] = 0.82; 95% Confidence Interval [CI]: 0.65-0.96) and TT (AOR = 0.80; 95% CI: 0.53; 0.97). Active trachoma was more prevalent among children (AOR = 0.97; 95% CI: 0.96-0.97), illiterates (AOR = 1.38; 95% CI: 1.13-1.69) and those who infrequently wash their face (AOR = 1.35; 95% CI: 1.18-1.54). Conclusions: Trachoma is hyperendemic in the Tigray region. Mass chemotherapy, the expansion of primary eye care services, and promotion of a regular face washing habit are recommended. We recommend further investigations on the effect of domestic use of biomass energy on trachoma.
BMC Public Health, 2010
Background: Delays seeking care worsen the burden of tuberculosis and cost of care for patients, ... more Background: Delays seeking care worsen the burden of tuberculosis and cost of care for patients, families and the public health system. This study investigates costs of tuberculosis diagnosis incurred by patients, escorts and the public health system in 10 districts of Ethiopia.
Online Journal of Public Health Informatics, 2013
Online Journal of Public Health Informatics, 2013
Objective To describe the results of the evaluation of the PAILD active surveillance system and l... more Objective To describe the results of the evaluation of the PAILD active surveillance system and lessons learned for similar surveillance efforts in a resource-limited setting.
BMC Infectious Diseases, May 15, 2017
Background: Yellow Fever (YF) is a viral hemorrhagic disease transmitted by aedes mosquito specie... more Background: Yellow Fever (YF) is a viral hemorrhagic disease transmitted by aedes mosquito species. Approximately, 200,000 cases and 30,000 deaths occur worldwide every year. In Ethiopia, the last outbreak was reported in 1966 with 2200 cases and 450 deaths. A number of cases with deaths from unknown febrile illness reported from South Ari district starting from November 2012. This investigation was conducted to identify the causative agent, source of the outbreak and recommend appropriate interventions. Methods: Medical records were reviewed and Patients and clinicians involved in managing the case were interviewed. Descriptive data analysis was done by time, person and place. Serum samples were collected for serological analysis it was done using Enzyme-linked Immunosorbent Assay for initial screening and confirmatory tests were done using Plaque Reduction and Neutralization Test. Breteau and container indices were used for the entomological investigation to determine the risk of epidemic. Results: A total of 141 Suspected YF cases with 43 deaths (CFR = 30.5%) were reported from November 2012 to October 2013 from South Omo Zone. All age groups were affected (mean 27.5, Range 1-75 Years). Of the total cases, 85.1% cases had jaundice and 56.7% cases had fever. Seven of the 21 samples were IgM positive for YF virus. Aedes bromeliae and Aedes aegypti were identified as responsible vectors of YF in affected area. The Breteau indices of Arkisha and Aykamer Kebeles were 44.4% and 33.3%, whereas the container indices were 12.9% and 22. 2%, respectively. Conclusion: The investigation revealed that YF outbreak was reemerged after 50 years in Ethiopia. Vaccination should be given for the affected and neighboring districts and Case based surveillance should be initiated to detect every case.
Background: Influenza is an acute viral disease of the respiratory tract which is characterized b... more Background: Influenza is an acute viral disease of the respiratory tract which is characterized by fever, headache, myalgia, prostration, coryza, sore throat and cough. Globally, an estimated 3 to 5 million cases of severe influenza illness and 291 243-645 832 seasonal influenza-associated respiratory deaths occur annually. Although recent efforts from some African countries to describe burden of influenza disease and seasonality, these data are missing for the vast majority, including Ethiopia. Ethiopia established influenza sentinel surveillance in 2008 aiming to determine influenza strains circulating in the country and know characteristics, trend and burden of influenza viruses. Methods: We used influenza data from sentinel surveillance sites and respiratory disease outbreak investigations from 2009 to 2015 for this analysis. We obtained the data by monitoring patients with influenza-like illness (ILI) at three health-centers, severe acute respiratory infection (SARI) at five hospitals and investigating patients during different respiratory infection outbreaks. Throat-swab specimens in viral transport media were transported to the national reference laboratory within 72 h of collection using a cold-chain system. We extracted viral RNA from throat-swabs and subjected to real-time PCR amplification. We further subtyped and characterized Influenza Apositive specimens using CDC real-time reverse transcription PCR protocol. Results: A total of 4962 throat-swab samples were collected and 4799 (96.7%) of them were tested. Among them 988 (20.6%) were influenza-positive and of which 349 (35.3%) were seasonal influenza A(H3N2), 321 (32.5%) influenza A(H1N1)pdm2009 and 318 (32.0%) influenza B. Positivity rate was 29.5% in persons 5-14 years followed by 26.4% in 15-44 years, 21.2% in > 44 years and 6.4% in under five children. The highest positivity rate observed in November (37.5%) followed by March (27.6%), December (26.4%), October (24.4%) and January (24.3%) while the lowest positivity rate was in August (7.7%). Conclusion: In Ethiopia, seasonal Influenza A(H3N2), Influenza A(H1N1)pdm2009 and Influenza B viruses were circulating during 2009-2015. Positivity rate and number of cases peaked in November and December. Influenza is one of public health problems in Ethiopia and the need to introduce influenza vaccine and antivirus is important to prevent and treat the disease in future.
BMC public health, Jan 14, 2018
Yellow fever (YF) is a viral hemorrhagic fever, endemic in the tropical forests of Africa and Cen... more Yellow fever (YF) is a viral hemorrhagic fever, endemic in the tropical forests of Africa and Central and South America. The disease is transmitted by mosquitoes infected with the yellow fever virus (YFV). Ethiopia was affected by the largest YF outbreak since the vaccination era during 1960-1962. The recent YF outbreak occurred in 2013 in Southern part of the country. The current survey of was carried out to determine the YF seroprevalence so as to make recommendations from YF prevention and control in Ethiopia. A multistage cluster design was utilized. Consequently, the country was divided into 5 ecological zones and two sampling towns were picked per zone randomly. A total of 1643 serum samples were collected from human participants. The serum samples were tested for IgG antibody against YFV using ELISA. Any serum sample testing positive by ELISA was confirmed by plaque reduction neutralization test (PRNT). In addition, differential testing was performed for other flaviviruses, n...
Ethiopian medical journal, 2016
An outbreak of a chronic liver disease of unidentified cause, known as "Unidentified Liver D... more An outbreak of a chronic liver disease of unidentified cause, known as "Unidentified Liver Disease (ULD)" by local communities was first observed in a rural village in Tigray, northern-Ethiopia in 2001. Little was known about the geographical extent, trend, and epidemiology of the disease. The Ethiopian Public Health Institute (EPHI) by then Ethiopian Health and Nutrition Research Institute (EHNRI), Centers for Disease Control and Prevention, World Health Organization, and Tigray Regional Health Bureaue established the ULD surveillance system in 2009 to characterize and monitor trends for this emerging disease and to identify cases for treatment and follow up. A large-scale official training was provided to the surveillance staff on case identification, management and reporting. In absence of a confirmatory test, the system used simple case definitions that could be applied by frontline staff with varying clinical training. To maximize resources, health extension workers a...
Ethiopian Journal of Health Development, 2006
Background: We planned to raise public awareness and decentralize directly observed tuberculosis ... more Background: We planned to raise public awareness and decentralize directly observed tuberculosis treatment at village level using volunteer community members in order to reduce prolonged delays in seeking care and improve compliance to tuberculosis treatment. We do not know the magnitude of tuberculosis knowledge gap and preferred modality of tuberculosis treatment supervision among the public in Tigray. Objectives: To assess knowledge of pulmonary tuberculosis and to determine level of acceptance regarding village-based tuberculosis treatment using volunteers among the general public. Method: A cross sectional survey was conducted among 838 adults (≥15 years) in 8 districts of Tigray region. Respondents selected from 70 villages using a multistage cluster sampling technique were interviewed using a pre-tested questionnaire in July 2002. Result: The mean and median knowledge score of respondents about pulmonary tuberculosis (PTB) was 5.24 and 6.67 (maximum score of 10) respectively. Female respondents (Adjusted Odds Ratio (AOR)=1.86; 95% Confidence interval (CI)=1.39-2.47), illiterates (AOR=1.64; 95% CI=1.1-2.47) and rural residents (AOR=1.95; 95% CI=1.37-2.76) were more likely to have a low level of knowledge score. Among respondents who had prior knowledge of PTB (n=717), 599 (83.5%) accepted the idea of tuberculosis (TB) treatment by volunteer community members. Illiterates, rural residents, married and respondents with large family size were more likely to support supervised TB-treatment using volunteers. Respondents' preferred treatment supervisors were: volunteer community health workers (60%), public health staff (16.5%) and family members (12.7%). Conclusion: There is a wide knowledge gap among the public regarding PTB. The idea of organizing directly observed TB treatment using volunteers appears to be accepted.
Background: Poor treatment adherence to tuberculosis treatment is a problem among rural patients ... more Background: Poor treatment adherence to tuberculosis treatment is a problem among rural patients in Ethiopia. We aimed to decentralize directly observed treatment of tuberculosis at village level using volunteer Community Health Workers (CHWs) in order to improve treatment adherence. However, we need to determine their training needs and willingness to supervise treatment of patients with tuberculosis in their respective villages.
Ethiopian Journal of Health Development, 2006
Ethiopian Journal of Health Development, 2006
Background: Delayed initiation of treatment among tuberculosis patients is a common problem which... more Background: Delayed initiation of treatment among tuberculosis patients is a common problem which might contribute to the high burden of tuberculosis in Ethiopia. There is paucity of evidence on the magnitude of delay and why patients fail to seek modern care early in Tigray. Objectives: To assess patient and health service delays and factors for delay among tuberculosis patients. Methods: Adult tuberculosis patients who began treatment (12/10/2001-15/05/2002) in 47 public health institutions were interviewed using a pre-tested questionnaire to gather information about their health seeking behaviour. Patient charts were also reviewed to determine the magnitude of delays. Result: The median patient delay for 42 pulmonary smear positive, 101 pulmonary smear negative and 94 extra-pulmonary tuberculosis patients was 90 days, 60 days and 90 days respectively, while the overall median health service delay was 9 days. Delayed first consultation (>21 days since onset of illness) was significantly higher among patients with no formal education (Adjusted Odds Ratio (AOR)=2.46; 95%Confidence Interval (CI)=1.21-5.01), among those treated first by a private and/or traditional practitioner (AOR=2.9; 95% CI=1.42-6.08), among those who thought their illness not serious (AOR=2.39; 95% CI= 1.52-3.78) and among those who suspected they had tuberculosis (AOR=2.5; 95% CI=1.18-5.29). Conclusion: This unacceptably long patient delay calls for identification and inclusion of feasible strategies to promote early treatment in the national tuberculosis control program. 19:7-12]
Ophthalmic Epidemiology, 2006
Aim: Trachoma is a public health problem in Ethiopia accounting for 35-50% of cases of blindness.... more Aim: Trachoma is a public health problem in Ethiopia accounting for 35-50% of cases of blindness. This study aims to determine the prevalence of trachoma in Tigray and to evaluate whether common risk factors are also risk factors in this region. Method: A cross sectional community-based survey was conducted. From six districts, a total of 48 villages were selected by a multistage cluster random sampling technique. A total of 3900 people who were selected randomly from 1200 households were assessed for signs of trachoma. Ophthalmic nurses used a simplified clinical grading system to assess stages of trachoma while environmentalists assessed risk factors for trachoma. Results: Of the 3900 people examined, 13% had trachomatous follicles (TF), 27% intense trachomatous inflammation (TI), 17.7% trachomatous scarring (TS), 3.4% trachomatous trichiasis (TT) and 0.3% had corneal opacity (CO). The presence of a kitchen with chimney had a protective effect on TS (Adjusted Odds Ratio [AOR] = 0.82; 95% Confidence Interval [CI]: 0.65-0.96) and TT (AOR = 0.80; 95% CI: 0.53; 0.97). Active trachoma was more prevalent among children (AOR = 0.97; 95% CI: 0.96-0.97), illiterates (AOR = 1.38; 95% CI: 1.13-1.69) and those who infrequently wash their face (AOR = 1.35; 95% CI: 1.18-1.54). Conclusions: Trachoma is hyperendemic in the Tigray region. Mass chemotherapy, the expansion of primary eye care services, and promotion of a regular face washing habit are recommended. We recommend further investigations on the effect of domestic use of biomass energy on trachoma.
BMC Public Health, 2010
Background: Delays seeking care worsen the burden of tuberculosis and cost of care for patients, ... more Background: Delays seeking care worsen the burden of tuberculosis and cost of care for patients, families and the public health system. This study investigates costs of tuberculosis diagnosis incurred by patients, escorts and the public health system in 10 districts of Ethiopia.
Online Journal of Public Health Informatics, 2013