Medical waste generation rate and management practices among government hospitals in Eastern Ethiopia. A descriptive survey.

Introduction: Healthcare facilities generate medical waste, also known as healthcare waste or health facility waste, during the healthcare delivery process, which is improperly managed as a result of underfunded healthcare systems, poor training, and lack of awareness of policies and legislation on handling medical waste as well as do not have national guidelines in place to adhere to the correct disposal of such wastage in developing countries like Ethiopia. Objectives: To estimate the healthcare waste generation rate among selected public hospitals in eastern Ethiopia. Methods: A cross-sectional study design was conducted in eight public in eastern Ethiopia from 1st June 2023 to 30th July 2023. The "Bed-Patient-healthcare wastes" model was used to estimate the healthcare waste generation rate based on WHO and empirical evidence. HCW generation rate = No of (Inpatients (Inpts) + Outpatients (Outpts))/day*0.53 kg/day. Meanwhile, general (GW), infectious (IW), pharmaceutical (PW), sharps (SW), and pathological (PtW) are computed as follows: GW = No. of (Inpt + Oupt)/day*0.53 kg/day and IW, PW, SW, and PtW = No. of Inpts/day*0.53 kg/day. In contrast, for hazardous and non-hazardous healthcare wastes, No of HCWs/day*0.8 and no. of HCWs/day*0.2 were utilized, and Key informant interviews and field observational were also applied. Descriptive analysis such as percentage, mean, and standard deviation were presented. Result: According to the current assessment, 105.1-142.8 kg/day healthcare waste was generated from outpatient and 167.3-244.2 kg/day from inpatients of public hospitals. From these, the Mean ± SD of daily healthcare waste generation rate estimated by non-hazardous and hazardous waste were 164.6 ± 80.9 kg/patients/day and 41.2 ± 20.2 kg/patients/day, respectively. In daily generation, the mean and standard deviations (Mean ± SD) of general wastes, infections waste, pharmaceutical wastes, sharp wastes, and pathological waste/patient were 62% (521.9), 23% (194.8), 4% (35.4), 2% (17.7), and 9% (70.9), respectively. Conclusion: The current assessment concluded that a large volume of healthcare waste is generated from selected public hospitals, which were not effectively segregated, separated at the source, and haven't conventional or standard treatment. As a result, the study advised that regional and global collaboration in hospital waste and wastewater management be encouraged.

Magnitude and associated factors of occupational hazard exposures among sanitary workers: Propose RASM model for risk mitigation for the public hospitals, eastern Ethiopia.

BACKGROUND: Hospital sanitation workers (SWs) are exposed to numerous occupational hazards due to workplace conditions such as unsafe and unhygienic working environment in the hospitals. Therefore, knowing magnitude, types and source of occupational hazard exposures with their determinants are very significant for further mitigations. METHODS: Hospital based cross-sectional study design was conducted in public hospitals, eastern Ethiopia from 1st May to August 30th, 2023. 809 SWs participated. Data was entered into Epi Data Version 3.1 and Stata 17MP version used for analysis. Descriptive analysis was applied to describe the data. While, multilevel logistic regression was explored to determine the association between outcome and independents among at individual level (model 1), at hospitals (model 2) and combination of the two (model 3). The crude odds ratio (COR) and adjusted odds ratio (AOR) for models 2 and 3 were reported. Variables with an AOR with a 95% confidence interval (CI) at a p-value < 0.05 were reported. RESULT: Out of 809 SWs, 729 (90.11%) responded. The overall magnitude of self-reported occupational hazard exposures among SWs was 63.65% (95% CI 0.60-0.67). Of this, biological, chemical, and ergonomic hazards accounted for 82.44%, 74.76%, and 70.92%, respectively. The multilevel logistic regression shows that having social recognition (AOR: 0.37, 95% CI 0.14, 0.91), neutral attitude (AOR: 0.48, 95% CI 0.17, 1.41) as compared to negative attitude. The model also found that SWs those supervised could reduce the likelihood of occupational hazard exposures by 50% times (AOR: 0.50, 95% CI 0.18, 1.38) as compared to non-supervised SWs. The final model predicted the variation of occupational hazard exposures among sanitary workers from the hospitals to hospitals was 26.59%. CONCLUSIONS: The concluded that hospital sanitary workers are facing biological, chemical, ergonomic, physical, psychological, mechanical, and electrical hazards. This study's findings predicted that dissatisfied with their environment, working more than 8 hr per a day,  a negative attitude towards workplace risks and inadequate supervision may serve as contributing factors for the likelihood of occupational hazard exposures among these groups. Thus, the study suggested that hospitals could reduce these hazard risks if they implement the Risk Assessment and Safety Management (RASM) model, which includes multi-modal strategies, indicators and tripartite philosophy.

Diarrheal disease and associated factors among children aged 6 to 59 months in Oda Bultum District, Eastern Ethiopia: a community-based cross-sectional study.

BACKGROUND: Diarrhea is a serious health problem in children under the age of five that is both preventable and treatable. In low-income countries like Ethiopia, children under the age five years frequently experience diarrhea. However, the burden and associated factors of these diarrheal diseases are understudied in Eastern Ethiopia, Thus, this study aimed to determine the factors associated with the prevalence of diarrheal diseases in Eastern Ethiopia from September 1-30, 2022. METHODS: A cross-sectional study was conducted on the total of 602 children aged 6 to 59 months in Oda Bultum district in eastern Ethiopia. A multistage sampling method was used. Three kebeles were selected from nine kebeles by the lottery method. Data was entered into Epi data 4.0.2 and exported to SPSS version 21 for analysis. Descriptive analysis was used for frequency, mean, and standard deviations. In addition, bivariable, and multivariable Poisson regression model was used to identify predictors of diarrhea along with a 95% confidence interval. Finally, statistical significance was declared at a p-value of 0.05. RESULT: A total of 602 children were included in this study. The prevalence of diarrhea 7.4% (47/602), 95% CI; 5.5-9.7%) among the children. Factors such as being unvaccinated for any vaccine (AOR = 10.82, 95%CI; 4.58-25.48) and born from a mother who had medium level of empowerment (AOR = 0.34, 95%CI; 0.11-0.88) in the household had statistically significant association with diarrhea among the children compared to their counterparts. CONCLUSION: The study found that nearly one out of thirteen children aged 6 to 59 months had any form of diarrheal diseases in Oda Bultum District, Eastern Ethiopia. In addition, the study revealed that children who were vaccinated for their age developed diarrhea less likely compared to those who did not receive any form of vaccine for their age. Moreover, children with mothers who had a medium level of empowerment were less likely to get diarrhea than children with mothers who had a low level of empowerment.

Global prevalence of musculoskeletal disorders among sanitary workers: a systematic review and meta-analysis.

Objectives. Sanitary workers are more likely to experience musculoskeletal disorders (MSDs) due to a lack of ergonomics principles and poor job design. Thus, this systematic review and meta-analysis aimed to quantify MSDs among sanitary workers. Methods. The PRISMA and PICOS protocols were used for flow diagrams and review questions, respectively. Articles published between 2000 and 2022 were eligible. The keywords '(Musculoskeletal Disorders) AND (Solid waste collectors *OR Street sweepers *OR Sewage workers *OR health facilities cleaners)' and MeSH terms were utilized. The data were analyzed using STATA version 17 with a 95% confidence interval (CI). Results. A total of 158 papers were qualified, with 26 studies from 17 countries and a total of 6586 sanitary workers. The global prevalence of MSDs among sanitation workers was 40.52% (95% CI [32.47, 48.67]; p < 0.05). It was 43.32% (95% CI [31.98, 54.68]; p < 0.05) in high-income countries and 38.58% (95% CI [26.94, 50.18]; p < 0.05) in low-income countries. By subgroup analysis, it was 45.12% (95% CI [32.57, 57.67]; p < 0.05) for solid waste collectors, which is the highest prevalence among other workers. Conclusion. Current evidence shows that sanitation workers have a higher prevalence of occupationally associated MSDs, which might be lowered by using ergonomic work design principles.

Determinants of Occupational Health and Safety Outcomes Among Sanitation Workers Across Worldwide: A Systematic Review on Cross-Sectional Studies.

As a result of working conditions, a variety of determinants or risk factors lead to the development of occupational health and safety impairments or outcomes such as injuries and musculoskeletal disorders among sanitary personnel, which must be identified in order to anticipate concerns. PubMed, Medline, Embase, and Lilacs databases were used from 2010 to April 2022. Searched strategies used logical words "AND/OR": Occupational *OR Work AND Injuries OR Musculoskeletal Disorder AND Associated Factors [Socio-demographic *OR Behavioral factors *OR Institution Factors *OR Work pattern] AND Sanitary workers [Waste collectors and emptier *OR Street Sweepers *OR Sewage workers *OR Health facilities Cleaners] AND Cross-Sectional Studies. The databases and other collected data and reports yielded a total of 86 studies and finally 16 studies were included. From total of sanitary workers (5833), 4990 (85.5%) were solid waste collectors, and 618 (10.6%) and 225 (3.9%) were and healthcare cleaners and street sweepers, respectively. Regarding associated factors, Age (OR: 22.57, 7.29-69.88); education (OR: 2.22, 1.22-4.00); and experience (OR: 1.92, 1.11-3.31) were predictors for occurrence of injuries. Smoking cigarettes (OR:2.6, 1.55-4.34); sleeping disturbance (OR: 2.57, 1.48-4.47); eating/smoking/drinking at work (OR: 3.85, 1.34-11.06); and lack of personal protective equipment (OR: 2.62; 1.48-4.63) are the other predictors. On other side, Education (OR: 6.73, 1.92-23.51), age (OR: 7.56, 2.18-26.18), and job experience (OR: 10.79, 3.49-33.38) are socio-demographic variables that impact the development of MSDs. Cigarette smoking (OR: 0.14, 0.03-0.64) and job satisfaction (OR: 11.43, 2.04-64.08) are behavioral factors. While, working longer than 8 h (OR: 3.5, 1.543-8.204) and time pressure (OR: 3.25, 1.08-9.77), working for more than 2 h (OR: 8, 2.25; 28.85) and having a bad back (OR: 15.7, 6.47-38.18) were risk factors for MSDs where all P-value < .05. According to current reviewed evidence, socio-demographic indicators, occupational safety with work pattern features, and behavioral factors all significantly contributed to musculoskeletal disorders; occupational injuries among sanitation workers, which require emphasis from government policy and other initiatives.

Occupational-Related Injuries and Associated Risk Factors Among Healthcare Workers Working in Developing Countries: A Systematic Review.

Background: Occupational-related diseases or illnesses account for an estimated 2.4 million deaths worldwide every year. Currently, occupational hazards threaten healthcare workers' (HCWs) lives, safety, and well-being. Therefore, providing the prevalence and major causes of occupational-related diseases may enable injury reduction and the creation of safer working environments, which are important for providing higher quality services. The current study aimed to determine the prevalence of occupational-related injuries and associated risk factors among HCWs, particularly in developing countries. Methods: The articles published in English were retrieved using a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings (MeSH), and keywords in electronic databases (SCOPUS/Science Direct, Web of Science, DOAJ, PubMed/MEDLINE, CINAHL, and Google Scholars). Using Joanna Briggs Institute critical appraisal tools, a quality assessment was conducted to determine the articles' relevance. In addition, the relevant articles were identified through a series of assessment and evaluation stages. Results: About 721 studies were searched using electronic databases, of which 36 articles included 139,578 HCWs. The average prevalence of occupational-related injuries among HCWs in the career and previous last year accounted for 60.17%, ranged from 32% to 87.8% and 39.16%, ranged from 1.14% to 87%, respectively. The current study found that sex and hours worked, stress at work, occupation, age, training in infection prevention, use of universal precautions, recapping needles, ward work experience, staffing and resource adequacy, awareness, outdated guidelines, and previous exposure to sharp injury were statistically associated with occupational-related injuries. Conclusions: This study revealed that 39% and 60% of HCWs experienced occupational-related injuries in the last year and during their career, respectively. Therefore, the appropriate measures must be taken to reduce the burden of occupational-related injuries by following standard precautions or occupational health and safety measures.

Sero-prevalence of hepatitis viral infections among sanitary workers across worldwide: a systematic review and meta-analysis.

BACKGROUND: Sanitation or sanitary workers are exposed to hepatitis virus infections because of filthy and dangerous working conditions. The current global systematic review and meta-analysis aimed to estimate the pooled sero-prevalence of occupationally associated hepatitis virus infection among them. METHODS: Preferred Reporting Items for Systematic Reviews (PRISMA), and Population, Intervention, Comparison, Outcome and study design (PICOS) were used for flow diagram, and review questions, respectively. Four databases other methods were used published articles from 2000 to 2022. Boolean logic (AND, OR), MeSH, and keywords were used: (Occupation *OR Job *OR Work) AND (Hepatitis A *OR Hepatitis B virus *OR Hepatitis C virus *OR Hepatitis E virus) AND (Solid waste collectors [SWCs] *OR Street sweepers [SS] *OR Sewage workers [STWs] *OR health care facilities cleaners [HCFCs)) AND (Countries). Stata MP/17 software was used for pooled prevalence analysis, meta-regression analysis (Hedges) at a 95% confidence interval (CI:95%). RESULTS: A total of 182 studies were identified studies, a total of 28 studies were included from twelve countries. Of these, from developed (n = 7) and developing countries (n = 5). From total a of 9049 sanitary workers, 5951(66%), 2280 (25%) and 818 (9%) were STWs, SWCs and SS, respectively. Globally, the pooled sero-prevalence of occupational-related hepatitis viral infections among sanitary workers was 38.06% (95% CI: 30-0.46.12). Of this, it was 42.96% (95% CI: 32.63-53.29) and 29.81% (95% CI: 17.59-42.02) for high-income and low-income countries, respectively. Meanwhile, by sub-analysis, the highest pooled sero-prevalence of hepatitis viral infections by categories, type and year were 47.66% (95%CI: 37.42-57.90), 48.45% (95% CI: 37.95-58.96), and 48.30% (95% CI: 36.13-60.47) for SWTs, HAV, and 2000 to 2010 year, respectively. CONCLUSION: The consistency of the evidence suggests that sanitation workers, particularly sewage workers, are susceptible to occupationally acquired hepatitis regardless of their working conditions, necessitating significant changes to occupational health and safety regulations from governmental policies and other initiatives to reduce risks among sanitary workers.

Global systematic review of occupational health and safety outcomes among sanitation and hygiene workers.

Introduction: Sanitary workers are exposed to a variety of occupational hazards in a variety of working environments, which can result in occupational-related outcomes. As a result, the goal of this review was to identify occupational health and safety outcomes among sanitary workers worldwide. Methods: PRISMA was used as flow diagram and PICOS was used review questions. The studies published in English were searched from databases and others methods ranging from 2000 to 2022. Boolean logic (AND, OR), MeSH, and keywords used: (Occupation *OR Job *OR Work) AND (Occupational related respiratory Symptoms *OR Disease) AND [Solid waste collectors (SWCs) *OR Street sweepers (SS) *OR Sewage workers and waste treatment (STWs)] AND (Countries). Results: A total of 228 studies were identified from 23 countries across the world. Studies were found via PubMed (n = 40), Medline (n = 25), Embase (n = 11) and Global Health (n = 66) and Google scholar (n = 63) and from previous (n = 23). From 8,962 of eligible sanitary workers, about 4,742 (54%), 1714 (19%) and 1,441 (16%) were sewage, sweepers and solid waste workers, respectively. A total study (n = 51) were eligible for occupational health and safety outcomes. Of these, respiratory problems accounted 27 (52%) and Gastroenteritis 14 (27%). Conclusion: Despite a large number of studies to date provides sanitary employees all over the world face occupational-related risks, hence more research is needed to enhance and quantify illness burden among sanitary workers.

Occupational Injuries and Associated Factors Among Municipal Solid Waste Collectors in Harar Town, Eastern Ethiopia: A Cross Sectional Study.

Background: Municipal solid waste collection is one of the most dangerous jobs in the world since it exposes the workers involved to occupational hazards and predisposes them to certain occupation-related morbidities. Occupational injuries among municipal solid waste collectors have not been adequately addressed or reported in developing countries, including Ethiopia. Therefore, this study aimed to determine the prevalence of occupational injuries and associated factors among municipal solid waste collectors in Harar Town, Ethiopia. Methods: A cross-sectional study was conducted in Harar town, Eastern Ethiopia from May 25, 2021 to June 25, 2021. Three hundred eighty-nine (389) municipal solid waste collectors were selected using a simple random sampling method. A self-administered structured questionnaire and an observational checklist were used to collect the data. The collected data was analyzed using SPSS version 20. Bivariate and multivariable logistic regression were used to determine the association between independent variables and the outcome variable. A P-value of <.05 was considered as a cut-off point for statistical significance. Results: The current study found that about 60.4% of municipal solid waste collectors were exposed to occupational injuries. Furthermore, the study found a statistically significant association between the prevalence of occupational injuries and having a primary education [AOR = 0.10, 95% CI (0.03-0.38)], a secondary education [AOR = 0.04, 95% CI (0.03-0.45)], work experience [AOR = 5.975, (95% CI (2.01-17.75)], the use of personal protective equipment [AOR = 0.09, (95% CI: 0.02-0.46)], and training [AOR = 0.10, 95% CI (0.03-0.30)]. Conclusions: The current study found that more than three-fifth of municipal solid waste collectors were exposed to occupational injury. Furthermore, the current study found that there was an statistical relationship between the prevalence of occupational injuries and having a primary education, a secondary education, work experience, the use of personal protective equipment, and training. Before and after hiring solid waste collectors, employers should provide personal protective equipment and tailored training on safety measures.

Knowledge, Attitude, and Practice of Abattoir Workers Toward Abattoirs Waste Management in Eastern Ethiopia.

BACKGROUND: During meat production, a large amount of wastes are generated that consist of feces, tissue waste, blood, fat, bone, animal trimmings, intestinal content, and urine that can be a potential risk to humans and the environment. Low knowledge, negative attitude, and poor practice can lead to poor waste management, which is more severe in developing countries like Ethiopia. Thus, the current study aimed to assess the knowledge, attitudes, and practices of abattoir workers toward abattoir waste management in Eastern Ethiopia. METHODS: A cross-sectional study was conducted in Eastern Ethiopia' abattoirs from 1st to 30th of January, 2020. Two hundred and sixty-seven (n = 267) abattoir workers in 4 selected abattoirs (Haramaya University, Haramaya town, Harar town and Dire Dawa City administration) were interviewed using a pretested structured questionnaire. The data were analyzed using SPSS version 20 statistical package. Pearson's correlation was used to determine the strength between knowledge and attitude, knowledge and practice, and attitude and practice. A P-value of .05 was considered as a cut-off point for statistical significance. RESULTS: This study revealed that 203 (76%) of the respondents had less knowledge, 69 (26%) had a positive attitude and 43 (16%) of them had a good practice toward abattoir waste management. There was a statistically significant difference between socio-demographic characteristics (education, work experience, and salary) and knowledge, attitudes and practices of the study participants. This study found moderate positive correlations between knowledge and attitude [r = .404, P = .013], weak positive correlations between knowledge and practice [r = .229, P = .009], and strong positive correlations between attitude and practice [r = .717, P = .023] of the abattoir workers toward waste management. CONCLUSION: This study concluded that more than one-quarter, less than one-quarter, and about 3-quarter of the participants had less knowledge, negative attitude, and poor practice, respectively toward abattoir waste management. Therefore, regulatory bodies and other relevant industries must implement effective control measures that can be important to increase the knowledge, attitude, and practices of abattoir workers toward waste management.

Worldwide Prevalence of Occupational Exposure to Needle Stick Injury among Healthcare Workers: A Systematic Review and Meta-Analysis.

BACKGROUND: Healthcare workers are at high risk of occupational exposure to needle stick injury worldwide. Occupational exposure to needle stick injury represents the most common sources of infection such as hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. Thus, this review aimed to determine the career time and previous one-year global pooled prevalence of occupational exposure to needle stick injury among healthcare workers. METHODS: The review considered articles written in English language and published from 2012 to 2020. The articles were searched using nine electronic databases (PubMed, Google Scholar, CINAHL, MEDLINE, Cochrane library, Web of Science, SCOPUS, MedNar, and ScienceDirect) using a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings, and keywords. Quality assessment was performed to determine the relevance of the articles using Joanna Briggs Institute critical appraisal tools. Several steps of assessment and evaluation were taken to select and analyze the relevant articles. RESULTS: The worldwide pooled prevalence of needle stick injuries among healthcare workers during career time and previous one year was 56.2% (95% CI: 47.1, 64.9) and 32.4% (95% CI: 22.0, 44.8), respectively. The career time pooled prevalence of needle stick injuries based on the socioeconomic development and study area was 54.8% and 55.1%, respectively, and one-year pooled prevalence of needle stick injury was 26.0% and 20.9%. CONCLUSION: The review found a high prevalence of occupational exposure to needle stick injury among healthcare workers and suggests the need to improve occupational health and safety services in the healthcare systems.

Prevalence of occupational exposure to needle-stick injury and associated factors among healthcare workers of developing countries: Systematic review.

BACKGROUND: Healthcare workers are at high risk of infection from blood-borne pathogens, such as Hepatitis B and C Virus, and Human Immunodeficiency. Occupational exposure to needle-stick injuries (NSIs) continue to have a major health problem in the healthcare systems of developing countries. Thus, this review article aimed to provide the evidence on the prevalence of NSI and associated factors among healthcare workers of developing countries. METHODS: The studies published from 2012 to 2019 were identified through systematic searches of electronic databases such as PubMed, Google Scholar, CINAHL, MEDLINE, Scopus, Med Nar, and Science Direct. The MeSH terms and/or keywords was used in conjunction with "AND" or "OR" (Boolean logic operators). All identified keywords and an index terms were checked across the included databases. Assessment and evaluation were taken to confirm the quality and relevance of the included articles, followed by extraction and analysis of data. RESULT: Overall, 2021 articles were identified using specified search terms from the initial searches of the literature (2012-2019). A total of 13 articles met eligibility criteria were included in the review. Among 6513 participants, 1009 and 2201 participants involved to determine 1-year and throughout career prevalence, respectively. The prevalence of NSI ranged from 19.9% to 54.0% with an overall prevalence of 35.7% and 38.5 to 100% with an overall prevalence of 64.1% in the previous 1 year and throughout career, respectively. Sex, workload, needle recapping, overuse of injection, and practice of universal precautions, training, occupation, working experience, and personal protective equipment were among the factors associated with the prevalence of NSIs in developing countries. CONCLUSION: The review indicated that NSIs have been identified as one of the most serious issues that affect the health and well-being of healthcare workers in the majority of healthcare systems of developing countries. There is a need to apply safety practices or other measures to reduce the risk of NSIs.

Prevalence of Microorganisms of Public Health Significance in Ready-to-Eat Foods Sold in Developing Countries: Systematic Review and Meta-Analysis.

BACKGROUND: The issue of microbial quality and safety of ready-to-eat foods has become a public health concern that needs to be addressed to protect the consumer's health. Contamination of ready-to-eat foods by enteric pathogens such as Escherichia coli, Salmonella, and Staphylococcus aureus bacteria is associated with potential health risks and can cause foodborne outbreaks. Thus, the systematic review and meta-analysis aimed at determining the overall evidence on the prevalence of microorganisms of public health significance in ready-to-eat foods based on previous studies. METHODS: The articles published from 2015 to 2020 were searched from multiple electronic databases such as PubMed, Google Scholar, MEDLINE, CINAHL, Science Direct, Web of Science, and the Directory of Open Access Journals. The JBI critical appraisal tool was applied to the included articles. To determine the heterogeneity among the included articles, I 2 statistics were used while publication bias was evaluated using the visual funnel plot. A Forest plot using the random effect model for meta-analysis was used to estimate the pooled prevalence of E. coli, Salmonella, and S. aureus in ready to eat foods. RESULTS: The pooled prevalence of E. coli, Salmonella, and S. aureus in ready to eat foods was 33.8% (95% CI: 19.9, 51.2; Q value = 67.080, I 2 = 89.56%), 26.0% (95% CI: 13.8, 43.6%; Q value = 83.67, I 2 = 91.63%), and 46.3% (95% CI: 24.8, 69.4%, I 2 = 94.9%), respectively. CONCLUSION: The findings show that contamination of ready-to-eat foods with pathogenic microorganisms continues to be a public health risk. Thus, effective food hygiene and safety systems are necessary to protect the health of the consumers and the public as a whole.