Prevalence and risk factors of childhood diarrhea among wastewater irrigating urban farming households in Addis Ababa.

INTRODUCTION: Childhood diarrhea is one of the major contributors to the morbidity of under-five children in Ethiopia. Although researchers determine the risk factors varyingly, the exposure route to the pathogens is usually complicated. This study aims to investigate the prevalence and risk factors of diarrhea among children under the age of five among wastewater irrigation farming households in Addis Ababa, Ethiopia. METHODS: Cross-sectional study was conducted among 402 farming households from November 2021 to February 2022. Data was collected using a face-to-face interviewer-administered questionnaire. Stata version 14 software was used to analyze data. Factors associated with the prevalence of diarrhea was identified using binary logistic regression. Multivariable analysis was carried out to determine an adjusted odds ratio at a confidence level of 95% and level of significance at 0.05. RESULTS: The overall prevalence of under-five children diarrheal cases was 22.3%. The odds of diarrhea are associated with a multitude of variables. Major wastewater-related determinants associated with diarrhea are body washing with irrigation water [AOR: 37.7, 95%CI (3.1, 358)], contaminated cloth with irrigation water [AOR:10.8,95%CI(0.6, 205)], use of protective clothing during farm work [28.9,95%CI (3.9, 215)], use of farm work cloths at home [AOR: 31.7, 95%CI (4.4, 226)], and bringing unwashed farm tools to home [94 (5.7, 1575)]. CONCLUSION: The high prevalence of under-five children diarrheal disease among wastewater irrigation households was strongly associated with factors related to occupational exposure. Thus, to decrease childhood diarrheal among urban agriculture farmers, appropriate precautions need to be taken.

Fecal Contamination in the Wastewater Irrigation System and its Health Threat to Wastewater-Based Farming Households in Addis Ababa, Ethiopia.

Due to rapidly growing demand, the production of vegetables is increasing along the Akaki Rivers. The objective of this study was to examine the degree of fecal contamination and levels of fecal contamination and dissemination throughout the wastewater irrigation system. Irrigation water, irrigated soil, and leafy vegetables were collected twice during 2 vegetable growing seasons, at the maturity period of the growing season, from 19 sampling points along the 2 Akaki Rivers. Composite samples were taken from all sampling points and E.coli was enumerated. The mean E.coli load in wastewater and non-wastewater sources were 1.16±5.53 CFU/100 ml and 2.232±1.292 CFU/100 ml respectively. All counts of E. coli in the wastewater exceeded the WHO's standards indicating that the irrigation water quality was unacceptable. In the wastewater-irrigated and non-wastewater-irrigated soil, the mean E.coli were 3.62 ±1.582 CFU/g and 1.322±87.1 CFU/g respectively. Meanwhile, the mean E.coli counts on the lettuce and Swiss chard were 78 ± 2 CFU/g and 44 ±3CFU/g respectively. The E.coli count on the leafy vegetables was found to be associated with the E.coli in the wastewater and soil. The production of leafy vegetables using wastewater with unacceptably high levels of E.coli and high occupational exposure introduces high levels of risk to the farming communities and to the consumers. Leafy, low-growing raw edible vegetables need careful treatment during food production and harvesting procedures or activities.

Meta-analysis of public health risks of lead accumulation in wastewater, irrigated soil, and crops nexus.

Lead (Pb) from different sources accumulate in the irrigation water, irrigated soil and in different parts of plants. Reports show contradictory findings and high variability of lead accumulation and associated public health risks. We hypothesized that lead accumulation in irrigation water, soil and edible plants is high enough to be a public health risk. By using the standard procedures for meta-analysis, 24 studies were qualified. The studies included in the meta-analysis are concentrated in few countries with strong authors' key words co-occurrence relationship. The mean concentration of Pb in the irrigation wastewater ranged from 0.0196 ± 0.01 mg/l to 52.4 ± 0.02 mg/l in wastewater and about 50% of the values are beyond the limits for irrigation water standard. The study also showed that the concentration of Pb in the irrigated soil vary significantly from a minimum of 0.04 ± 2.3 mg/l in Ethiopia to a maximum of 441 ± 19.8 mg/l in Iran (P < 0.01). Based on effect size analysis, the weight of the studies ranged from 0.1 to 5.4% indicating that the studies' contribution to the overall effect is barely different. The heterogeneity test statistics also indicates considerable variability between the studies (I2 = 98%, P-value < 0.001). The subgroup analysis showed large between-studies heterogeneity in both groups (Tau2 = 28.64; T2 = 98%). A total of 44 crops were studied, of which 38 were leafy and non-leafy vegetables. Most popular crops including spinach, cabbage and lettuce are most frequently studied crops. In all crops, the Pb level in crops produced by using untreated wastewater are beyond the WHO limit for edibility. In all of the studies, the pollution load index (PLI) and soil accumulation factor (SAF) is much higher indicating that there is a buildup of Pb concentration in wastewater irrigated soil. The plant concentration factor (PCF) calculated shows the high Pb accumulation potential of the edible parts of the crops. The health risk index (HRI) calculated shows that in all of the studied crops from India, Iraq, Morocco and Egypt are much higher than one indicating the high health risk of consumption.