LaPolt Devin, Moges Azmeraye Binyam, Kuang Zhanpeng, Degefaw Desalegne, Mihret Teshale Amete, Alonso Silvia, Dessie Yadeta, Lopez Melanie, Abrha Kalayu Alem, Andargie Gashaw, Kowalcyk Barbara
Department of Food Science and Technology, The Ohio State University, Columbus, Ohio, United States of America.
The Ohio State University Global One Health Initiative, Eastern Africa Regional Office, Addis Ababa, Ethiopia.
PLOS Glob Public Health. 2025 Aug 11;5(8):e0005021. doi: 10.1371/journal.pgph.0005021. eCollection 2025.
Enteric diseases are major contributors to morbidity and mortality worldwide; however, in Ethiopia, information on the prevalence of enteric infections and associated trends is limited. Understanding the epidemiology of enteric infections is necessary for determining disease burden and allocating resources. The objective of this study was to estimate the prevalence of laboratory-confirmed infections associated with select parasitic and bacterial pathogens in three Ethiopian hospitals, assess trends, and identify associated factors. Laboratory and patient metadata for stool samples tested at clinical laboratories in Addis Ababa, Gondar, and Harar in Ethiopia from 2018 through 2022 were collected and digitized. Descriptive statistics were used to summarize laboratory results and assess trends in sample submission and infection. Prevalence of laboratory-confirmed infection and 95% confidence intervals were estimated by pathogen using binomial proportion testing and logistic regression. Univariate and multivariable logistic regression were used to identify associated factors. A total of 48,643 samples were included in the analysis. Prevalence estimates for parasitic infection were 5.23% [95%CI:4.87%,5.62%], 17.48% [95%CI:17.04%,17.93%], and 15.69% [95%CI:14.57%,16.85%] in Addis Ababa, Gondar, and Harar, respectively. Prevalence estimates for bacterial infection were 0.25% [95%CI:0.07%,0.65%] and 7.59% [95%CI:5.97%,9.50%] in Addis Ababa and Gondar, respectively; stool samples were not tested for bacterial pathogens in Harar. Stool sample submission and enteric infection detection varied by year at each site. Age, season, and year of submission were identified as factors associated with the detection of enteric pathogens in stool samples. Prevalence estimates differed across study sites and testing was not conducted for many enteric pathogens associated with diarrhea. Additional research to understand the scope of enteric infection is necessary for resource allocation toward robust diagnostic procedures and increased laboratory capacity for stool testing. Efforts to mitigate enteric infection should utilize seasonal and geographic infection trends to anticipate areas in need of additional resources.
肠道疾病是全球发病和死亡的主要原因；然而，在埃塞俄比亚，关于肠道感染患病率及相关趋势的信息有限。了解肠道感染的流行病学对于确定疾病负担和分配资源至关重要。本研究的目的是估计埃塞俄比亚三家医院中与特定寄生虫和细菌病原体相关的实验室确诊感染的患病率，评估趋势，并确定相关因素。收集了2018年至2022年在埃塞俄比亚亚的斯亚贝巴、贡德尔和哈拉尔的临床实验室检测的粪便样本的实验室和患者元数据，并进行了数字化处理。使用描述性统计来总结实验室结果，并评估样本提交和感染的趋势。通过二项式比例检验和逻辑回归，按病原体估计实验室确诊感染的患病率和95%置信区间。使用单变量和多变量逻辑回归来确定相关因素。分析共纳入48,643个样本。亚的斯亚贝巴、贡德尔和哈拉尔的寄生虫感染患病率估计分别为5.23%[95%CI:4.87%,5.62%]、17.48%[95%CI:17.04%,17.93%]和15.69%[95%CI:14.57%,16.85%]。亚的斯亚贝巴和贡德尔的细菌感染患病率估计分别为0.25%[95%CI:0.07%,0.65%]和7.59%[95%CI:5.97%,9.50%]；哈拉尔未对粪便样本进行细菌病原体检测。每个地点的粪便样本提交和肠道感染检测随年份而异。年龄、季节和提交年份被确定为与粪便样本中肠道病原体检测相关的因素。不同研究地点的患病率估计不同，并且未对许多与腹泻相关的肠道病原体进行检测。有必要进行更多研究以了解肠道感染的范围，以便为强大诊断程序和增加粪便检测实验室能力分配资源。减轻肠道感染的努力应利用季节性和地理感染趋势来预测需要额外资源的地区。
