Antenatal care service utilization disparities between urban and rural communities in Ethiopia: A negative binomial Poisson regression of 2019 Ethiopian Demography Health Survey.

BACKGROUND: Although there have been consistent improvements in maternal mortality, it remains high in developing countries due to unequal access to healthcare services during pregnancy and childbirth. Thus, this study aimed to further analyze the variations in the number of antenatal care utilizations and associated factors among pregnant women in urban and rural Ethiopia. METHODS: A total of 3962 pregnant women were included in the analysis of 2019 Ethiopian Demographic and Health Survey data. A negative binomial Poisson regression statistical model was used to analyze the data using STATA version 14.0. An incident rate ratio with a 95% confidence interval was used to show the significantly associated variables. RESULTS: Of the 3962 (weighted 3916.67) pregnant women, about 155 (15.21%) lived in urban and 848 (29.29%) rural residences and did not use antenatal care services in 2019. Women age group 20-24 (IRR = 1.30, 95%CI:1.05-1.61), 25-29 (IRR = 1.56, 95%CI:1.27-1.92), 30-34 (IRR = 1.65, 95%CI:1.33-2.05), and 35-39 years old (IRR = 1.55, 95%CI:1.18-2.03), attending primary, secondary, and higher education (IRR = 1.18, 95%CI:1.07-1.30), (IRR = 1.26, 95%CI:1.13-1.42) and (IRR = 1.25, 95%CI:1.11-1.41) respectively, reside in middle household wealth (IRR = 1.31, 95%CI:1.13-1.52), richer (IRR = 1.45, 95%CI:1.26-1.66) and richest (IRR = 1.68, 95%CI:1.46-1.93) increases the number of antenatal care utilization among urban residences. While attending primary (IRR = 1.34, 95%CI:1.24-1.45), secondary (IRR = 1.54, 95%CI:1.34-1.76) and higher education (IRR = 1.58, 95%CI:1.28-1.95), following Protestant (IRR = 0.76, 95%CI:0.69-0.83), Muslim (IRR = 0.79, 95%CI:0.73-0.85) and Others (IRR = 0.56, 95%CI:0.43-0.71) religions, reside in poorer, middle, richer, and richest household wealth (IRR = 1.51, 95%CI:1.37-1.67), (IRR = 1.66, 95%CI:1.50-1.83), (IRR = 1.71, 95%CI:1.55-1.91) and (IRR = 1.89, 95%CI:1.72-2.09) respectively, being married and widowed/separated (IRR = 1.85, 95%CI:1.19-2.86), and (IRR = 1.95, 95%CI:1.24-3.07) respectively were significantly associated with the number of antenatal care utilization among rural residences. CONCLUSION: The utilization of antenatal care is low among rural residents than among urban residents. To increase the frequency of antenatal care utilization, health extension workers and supporting actors should give special attention to pregnant women with low socioeconomic and educational levels through a safety-net lens.

Hand hygiene status and its associated factors among housemaids working in communal living residences in Jimma city, southwest Ethiopia.

Objective: Hand hygiene is a milestone, cost-effective, and convenient strategy to prevent the transfer of pathogenic micro-organisms. However, housemaids operating inside a kitchen can be the source of infection. In addition, hand hygiene among housemaids working in dwellings was underexplored. This study aimed to assess the hand hygiene status and associated factors among housemaids working in communal living residences in Jimma City, Southwest Ethiopia. Methods: A total of 230 housemaids were included in this cross-sectional study. Total samples were proportionally allocated for each residence and a simple random sampling technique was applied to select the study participants. Hand hygiene status and relevant characteristics were collected through face-to-face interviews and observations. Hand swab samples were collected and tested for bacterial contaminants. Then, it was inoculated aseptically using streak-plating methods on mannitol salt agar (MSA), MacConkey agar (MCA), salmonella-shigella agar (SSA), and eosin methylene blue (EMB) agar and then incubated at 37 °C for 24 h. Data was edited, cleaned, and double-entered into Epidata version 3.1 and then exported to the statistical package for social science statistics version 26 for further analysis. Binary logistic regression was used to identify associated factors. Statistically significant was declared at P value < 0.05. Results: Two hundred twenty-five housemaids were interviewed with a response rate of 97.8 %. The results showed that the proportion of good hand hygiene status among the housemaids was only 28.0 %. Although the majority of participants reported washing their hands frequently, the prevalence of bacterial contaminants on their hands was high at 72 %. The study identified several factors associated with hand hygiene status, including the occupational status of heads of households (AOR = 0.030, 95 % CI: 0.003, 0.348; P = 0.0050), the effectiveness of the heads of household (AOR = 13.955, 95 % CI: 1.442, 13.500; P = 0.0230), and the removal of accessories during handwashing (AOR = 20.844, 95 % CI: 2.190, 9.842; P = 0.0080). Conclusion: Overall, the hand hygiene status of housemaids was found to be poor and influenced by demographics and other relevant characteristics. The study emphasizes the need for a multimodal strategy involving household heads, local and national authorities, and other stakeholders to raise awareness and advocate for hand hygiene to prevent communicable diseases in the wider community, particularly in the study area.

Prevalence and antimicrobial susceptibility profile of bacteria isolated from the hands of housemaids in Jimma City, Ethiopia.

Introduction: Bacterial pathogens continue to be a major cause of foodborne gastroenteritis in humans and remain a public health problem. Housemaids operating inside a kitchen could be the source of infection and may transmit disease-inflicting pathogens through contaminated hands. Objective: This study aimed to assess the prevalence and antimicrobial susceptibility profile of bacteria isolated from the hands of housemaids in Jimma City, Ethiopia. Methods: A laboratory-based cross-sectional study was employed among 234 housemaids. Hand swab samples from the dominant hand of the study participants were collected under sterile conditions following standard operating procedures. Then, in the laboratory, the swabs were inoculated aseptically using streak-plating methods on the growth media, such as mannitol salt agar [Staphylococcus aureus and coagulase-negative staphylococci], MacConkey agar [Klebsiella species and Proteus species], salmonella-shigella agar [Salmonella species and Shigella species], and eosin methylene blue agar [Escherichia coli (E. coli)]. In addition, a set of biochemical tests was applied to examine bacterial species. Data were double-entered into EpiData version 3.1 and then exported to the Statistical Package for Social Science (SPSS) version 26 for further analysis. Descriptive analyses were summarized using frequency and percentage. Results: The proportion of housemaids' hands containing one or more positive bacterial isolates was 72% (95% CI: 66.2, 77.8). The dominant bacterial isolates were Staphylococcus aureus (31.6%), Escherichia coli (21.3%), Salmonella species (1.3%), Shigella species (6.7%), Klebsiella species (23.1%) and Proteus species (14.7%). Fingernail status (AOR =15.31, 95% CI: 10.372, 22.595) and the removal of a watch, ring, and bracelet during hand washing (AOR = 20.844, 95% CI: 2.190, 9.842) were significantly associated with the prevalence of bacterial isolation. Most Staphylococcus aureus isolates were susceptible to chloramphenicol (98.6%). Escherichia coli isolates were susceptible to tetracycline (75%), ceftriaxone (79.2%), chloramphenicol (87.5%), and ceftazidime (77.1%). Eighty percent of isolated Shigella species were susceptible to chloramphenicol and gentamicin respectively. In addition, Klebsiella and Proteus species exhibited high susceptibility to chloramphenicol. However, their isolates showed resistance against a number of the tested antimicrobials. Staphylococcus aureus isolates (28.2%) were resistance to tetracycline. Moreover, One-quarter of Escherichia coli isolates were resistance to tetracycline, ceftriaxone, chloramphenicol, and ceftazidime. Whereas 46.7% and 48.5% of isolated Shigella species and Proteus species were resistance to tetracycline and ceftriaxone. Conclusion: The hands of housemaids are important potential sources of pathogenic bacteria that would result in the potential risk of foodborne diseases. Most bacteria isolates were resistant to tetracycline, ceftriaxone, and ceftazidime. Therefore, practicing good hand hygiene helps to prevent and control the spread of antimicrobial-resistant microbes.

Intestinal Parasitosis and Associated Factors Among Food Handlers Working in the University of Southern Ethiopia.

Background: Intestinal parasite infections are major global public health problems. The majority of persons infected reside in Sub-Saharan Africa with a high burden of the disease. Very few studies have been done in Ethiopia and none exist at Wachemo University, Southern Ethiopia. The present study aimed to investigate intestinal parasitic infections and associated factors among Wachemo University students' cafeteria food handlers. Methods: Institution-based cross-sectional study was conducted on 212 randomly selected food handlers from 15, February to 05, March/2019. A structured questionnaire was used to collect data and standard laboratory procedures were employed to collect stool and finger specimens and analyzed them for intestinal parasites. Data were edited, cleaned, entered, using EPI data 3.3.1, and analyzed by statistical package for social science version 20. A stepwise logistic regression model was used to calculate the odds ratios and 95% confidence interval for the different factors. Results: Of 212, the majority 63.7% were females and 48.1% attended grades 9 to 10. Of the stool and fingernail specimens examined, 29.7 % and 5.6% were positive for different parasites, respectively. The most prevalent parasite is Ascaris lumbricoides (12.7%) followed by Hookworm (6.6%), Giardia lamblia (4.7%), Taenia saginata (2.4%), and mixed infection (3.3%). Although several factors showed significant association with intestinal parasitosis, attending secondary level education 94.5% (AOR: 0.055; 95% CI [0.007-0.413]), fingernail status (AOR: 0.330; 95% CI [0.113-0.965]), and hand washing with soap and water after toilet use (AOR: 0.332; 95% CI [0.125-0.884]) were the significant variables in multivariable analysis (P < .05). Conclusions: The results demonstrated intestinal parasite infections as a public health issue in Ethiopia that requires attention. Appropriate intervention programs like encouraging food handlers to practice good hygiene, routine hand washing at key times, and nail trimming should be implemented.

Urban Households' Biomass Energy Fuel Stacking and Its Implications for Sustainable Development Goal Seven: The Case of Jimma Town, Ethiopia.

Sustainable development goal seven aims to provide access to affordable, reliable, sustainable, and modern energy for all by 2030, but its progress and energy stacking conditions have not been evaluated. This study aims to assess the urban household energy profile and link its state to sustainable development goals. This study employs a cross-sectional study design on 265 households selected by systematic random sampling from a town called Jimma in Ethiopia and collects the data using interview-based semi-structured questionnaires. The study obtains information from all the selected households. The results show that more than 80% of the households have a grid electricity connection, but more than 85% of the households regularly use firewood and charcoal for cooking. On average, households use about 1236 kg of firewood and 630 kg of charcoal per year. Most households report power interruption, inability to afford electricity costs, and personal preferences for relying on biomass energy for cooking. Over 98% of the households use electricity for lighting, but few use it for appliances. This shows an inherent challenge attributed to the cooking energy services provided by biomass energy sources despite the accessibility of electricity. This shows the significant impacts of biomass energy stacking which connection to electricity alone cannot solve.