Altering of the sprayed wall after indoor residual spraying and associated factors among households in Boricha district, Sidama regional state, Ethiopia, 2019: community-based cross-sectional study.

BACKGROUND: Indoor residual spraying (IRS) has been the main tool used to control malaria. Reducing the life span and the density of the vector mosquitoes are direct effects of IRS towards restricting malaria transmission. Residents must not wash or re-plaster walls after the spray application for at least 6 months to fight against malaria with IRS. This study sought to assess the alteration of the sprayed wall after the IRS operation and associated factors among households in the Boricha district. METHODS: Community-based cross-sectional study was conducted among 608 households selected using multi-stage sampling. A structured interviewer-administered questionnaire was used to collect data. Data were analysed by SPSS version 25. Both bivariable and multivariable logistic regression analysis was done. Finally, the strength of the association was measured based on AOR with 95% CI and statistical significance was declared at a p-value less than 0.05. RESULT: From the total of 608 sprayed houses included in the study, 37.3% (95% CI: 33.41% - 41.15%) were found to have altered sprayed walls. The highest class of wealth index category (AOR = 2.50; 95% CI: 1.19, 5.16), low level of comprehensive knowledge about IRS (AOR = 6.08; 95% CI: 3.37, 10.94), did not get information within 2 weeks before spray (AOR = 2.09; 95% CI: 1.43, 3.05), absence of supervision after the spray operation (AOR = 1.77; 95% CI: 1.27, 2.73) and walking distance to nearest health facility (AOR = 2.39; 95% CI: 1.63, 3.35) remained significant factors of altering of the sprayed wall after IRS. CONCLUSION: The prevalence of alteration was relatively high. The highest socio-economic status, poor knowledge about indoor residual spraying, lack of information about IRS within two weeks before spray, absence of supervision after IRS, and walking distance of more than 30 min to reach the nearest health post were the factors affecting the alteration status of the sprayed wall. Future efforts to focus on successive awareness creation activities should be done before and after IRS operation to the community by concerned bodies.

Status of active trachoma infection among school children who live in villages of open field defecation: a comparative cross-sectional study.

BACKGROUND: Although many efforts are made by different stakeholders, magnitude of active trachoma remains high among children in Ethiopia. Open field defecation was found to be the main source of active trachoma. However, comparative information on the effect of open field defecation and non-open field defecation on active trachoma is scarce in Ethiopia. METHODS: Comparative community based cross-sectional study was conducted from June 1-30, 2019 in Boricha and Dale districts to assess prevalence of active trachoma among primary school children. We have selected four primary schools purposively from two districts in Sidama. Study participants were selected by using simpe random sampling method. Data were collected through face to face interview, direct observation and ophthalmic examination. Logistic regression analysis was conducted to assess factors associated with active trachoma infection among primary school children. Adjusted Odds Ratios with 95% confidence interval and p-value less than 0.05 were computed to determine the level of significance. RESULT: From the total of 746 study participants, only 701 study participants gave full response for interview questions making a response rate of 94%. The overall prevalence of active trachoma infection was 17.5% (95% CI, 14.1-20.8) among primary school students. Specifically, prevalence of active trachoma infection was 67.5% among children who lived in open field defecation villages, but it was 88.5% among school children who live in Non-ODF Kebeles. Factors like: Living in open field defecation Kebeles (AOR = 2.52, 95% CI, 1.5-4.1), having ocular discharge (AOR = 5.715, 95% CI, 3.4-9.4), having nasal discharge (AOR = 1.9, 95% CI, 1.06-3.39), and fly on the face (AOR = 6.47, 95% CI, 3.36-12.44) of children were positively associated with active trachoma infection. However, finger cleanness (AOR = 0.43, 95% CI, 0.21-0.9) was protective factor against active trachoma infection in this study. CONCLUSION: Significant variation in prevalence of active trachoma infection among school children between open filed and non-open field defecation Kebeles was observed. Surprisingly, the prevalence in open field defecation was significantly lower than non-open field defecation. Hence, this indicates active trachoma infection highly depends on the hand hygiene than environmental sanitation. Educational campaign of hand hygiene should be enhanced in the community for school students.

An exploratory study of knowledge, attitudes, and beliefs related to tobacco use and secondhand smoke among women in Aleta Wondo, Ethiopia.

BACKGROUND: By 2030, the Sub-Saharan African region is projected to be the epicenter of the tobacco epidemic. While smoking prevalence is currently low among women (< 2%), the prevalence among men (7.7% overall and up to 27% depending on region) makes exposure to secondhand smoke a pressing concern for women and children. To prevent the uptake of smoking among women and address tobacco-related risks, including secondhand smoke exposure, a greater understanding of women's related perceptions is needed. The purpose of this study was to explore Ethiopian women's knowledge, attitudes, and beliefs related to tobacco use and secondhand smoke exposure, and the potential influence of contextual factors including; khat use, exposure to pro- and anti-tobacco messaging, and religious affiliation. METHODS: A cross-sectional study using a systematic household sampling technique and an adapted interviewer-administered survey was conducted in Southern Ethiopia. The survey was administered to 353 women, 18-55 years of age, in Aleta Wondo town and surrounding districts between August-October 2014 (95.2% cooperation rate). RESULTS: General awareness of harm associated with personal tobacco use and exposure to secondhand smoke was high (> 94%); however, specific knowledge of associated health-risks was limited. More than 96% perceived female tobacco use as socially unacceptable. At the same time, more than 70% were able to name potential benefits of using tobacco for both personal consumption and non-personal use. Respondents reported greater experimentation with khat versus tobacco and 73% reported that their religion significantly influenced their tobacco-related attitudes. Overall, there were higher reports of exposure to anti-tobacco (70%) versus pro-tobacco (49%) messaging, in the last 30 days. CONCLUSIONS: The high level of awareness of health risks associated with tobacco use and SHS exposure and the high exposure to anti-tobacco messaging are community-level strengths that can proactively be built on to prevent the projected disease burden associated with tobacco. Findings have implications for the development of contextualized gender-specific tobacco control interventions, particularly in relation to the promotion of smoke-free homes.

Factors associated with secondhand tobacco smoke in the home: an exploratory cross-sectional study among women in Aleta Wondo, Ethiopia.

BACKGROUND: In Ethiopia, female smoking rates are currently low (1 %). However, because of male smoking rates (overall 7.7 % and up to 27 % depending on region), women and children's risk of second hand smoke (SHS) exposure is a pressing concern. In order to develop effective public health interventions that prevent the uptake and exposure to smoking, thereby averting the projected increase in tobacco-induced disease, an understanding of Ethiopian women's practices regarding tobacco is needed. The purpose of this study was to explore Ethiopian women's tobacco use and prevalence of SHS exposure, and to identify covariates associated with SHS exposure. METHODS: We conducted an exploratory cross-sectional study in Southern Ethiopia between August and October 2014, and systematically sampled households in Aleta Wondo town and surrounding districts. Trained interviewers verbally administered surveys to women 18-55 years of age. Descriptive statistics and multiple logistic regression analyses were performed. RESULTS: None of the 353 participants reported current tobacco use and less than 1 % reported ever use, however, 11 % reported ever use of the stimulant leaf khat. Twenty-seven women (7.6 %) reported living with a tobacco user, however, twice that number (14.4 %) overall, and 22 % of urban participants reported that smoking occurred daily in their home. When controlling for other factors, living with a tobacco user (OR = 9.91, 95 % CI [3.32, 29.59]), allowing smoking in the home (OR = 5.67, 95 % CI [2.51, 12.79]), place of residence (OR = 2.74, 95 % CI [1.11, 6.74)]), and exposure to point-of-sale advertising within the last 30 days (OR = 2.87, 95 % CI [1.26, 6.54]) contributed significantly to a model predicting the likelihood of reporting daily occurrence of smoking/SHS in the home. CONCLUSIONS: While few women reported having ever used tobacco, one in seven women in this study reported that smoking/SHS occurred daily in their homes. Therefore SHS exposure is a potential health concern for women and children in this rural community. Findings from this study provide baseline data for monitoring tobacco control policies in Ethiopia, particularly in relation to the promotion of smoke-free homes, and could be used to inform prevention program development.

Water, hygiene and sanitation practices are associated with stunting among children of age 24-59 months in Lemo district, South Ethiopia, in 2021: community based cross sectional study.

BACKGROUND: Stunting among children of ages 24-59 months is a major public health challenge in developing countries. It has been linked with poor water quality, water accessibility, a lack of environmental sanitation, and personal hygiene (WASH) practices, particularly in food-insecure areas. Stunting occurs during certain seasons in food-insecure settings. Therefore, a complete understanding of risk factors is the first step in the development of a preventive strategy. However, information is scarce about the prevalence and factors associated with stunting among children of ages 24-59 months in these settings. OBJECTIVE: This study aimed to assess the prevalence of and factors associated with stunting among children aged 24-59 months in Lemo district, south Ethiopia, in 2021. METHODS: A community based cross-sectional study was conducted from January 1-30/2021. Data were collected from a total of 415 randomly selected children and mother /guardian/. Logistic regression analysis was done to identify factors associated with childhood stunting. In binary logistic regression analysis, independent variables with p-value < 0.25 were fitted into multivariable logistic regression analysis to explore final predictors of stunting/ thinness/. Independent variables with AOR and 95% CI and P-value < 0.05 was computed and reported as predictors of stunting among children in this study. RESULTS: From a total of 450 children, only 415 were included in the final analysis, making a response rate of 92.2%. The prevalence of stunting among children was 33.5% (95% CI: 30.4 and 36.6%) in this study. Children ages 48-59 months (AOR = 2.8, 95% CI: 2.1, 12.1), children ages 36-47 months (AOR = 1.6, 95% CI: 1.1, 7.1), children of uneducated women (AOR = 1.8, 95% CI: 1.5, 4.2), children who lived near unimproved toilets (AOR = 1.7, 95% CI: 1.2, 2.6), children whose feces was disposed of unsafely (AOR = 2.8, 95% CI: 1.57, 5.31), and children whose mothers did not wash their hands before feeding their children (AOR = 6.2, 95% CI: 2.0, 19.1) were factors positively associated with stunting among children aged 24 months to 59 months. CONCLUSION: The prevalence of stunting is high compared with the national prevalence of stunting in food insecure areas. Policy makers, local leaders, and community health extension workers should enhance environmental sanitation and create awareness about personal hygiene. Furthermore, improved toilet construction and appropriate utilization should be encouraged. Furthermore, the local government should work to improve the socio-economic status of poor households.

Utilization of Insecticide-Treated Nets in Households for Under-5 Children and Associated Factors in East Mesekan District, Gurage Zone, Southern Ethiopia.

Introduction: Insecticide-treated nets (ITNs) are widely used tools that have been proven effective in preventing and controlling malaria. However, usage varies among households and can greatly affect the benefits of ITNs. Thus, this study aimed to assess the household utilization of insecticide-treated nets and its associated factors for under-5 children. Methods: A cross-sectional study was conducted in March-April 2020 in the East Mesekan district. A total of 591 households with under-5 children were chosen by using a systematic random sampling approach for the interviews. The data was collected using a pretested questionnaire. Epi-Data version 3.1 was used to enter data and SPSS version 21 for analysis. A P-value of .05 was considered statistically significant. Results: In this study, 58.2% (95% CI: [54.1%-62.2%]) of household participants used ITN for children under 5 years of age while sleeping the night before the survey. The study participants' overall knowledge and practice of malaria prevention were 27.1% and 23.9%, respectively. Having a family size of less than 5 (AOR = 0.60, 95% CI: [0.37-0.98]) and complaints of skin irritation (AOR = 0.43, 95% CI: [0.29-0.63]) significantly decreased ITN utilization. However, having 1 ITN (AOR = 2.15, 95% CI: [1.15-4.02]) or 2 ITNs (AOR = 2.58, 95% CI: [1.51-4.39]), as well as low (AOR = 2.07, 95% CI: [1.33-3.20]) and medium (AOR = 1.83, 95% CI: [1.11-3.02]) knowledge of ITN importance, increased ITN utilization significantly. Conclusions: The households' use of ITNs for children under the age of 5 was inadequate. It was significantly associated with having a family size of less than 5, complaints of skin irritation, owning 1 or 2 ITNs, and having low and medium knowledge of its importance. It is recommended that continuous and progressive health awareness about the consistent use of ITN for malaria prevention in the study area be promoted.

Indoor air bacterial load and antibiotic susceptibility pattern of isolates at Adare General Hospital in Hawassa, Ethiopia.

Background: Air is the agent of pathogenic microbes that cause significant problems in the hospital environment. Multidrug resistance poses a major therapeutic challenge to these airborne microorganisms in hospital indoor environments. Method and materials: This study was conducted at Adare General Hospital in Hawassa City, Sidama, Ethiopia. A cross-sectional study was conducted. The proportional allocation method was used to select the sampled 50 rooms from the total available rooms in each category of wards and staff offices. A total of 100 indoor air samples were collected using settle plates in all units twice a day, morning (9:00-4:00 a.m.) and afternoon (3:00-4:00 p.m.). The types and number of colonies were determined in the laboratory, and the pathogenic bacteria were isolated by appropriate bacteriological techniques. Antimicrobial susceptibility testing was performed on Mueller-Hinton agar for each potentially pathogenic bacterium isolated. For each bacterium, a total of 12 antibiotics were tested using the Kirby-Bauer disk diffusion method. The test organism was adjusted to McFarland turbidity standards of 0.5. Data were entered and analyzed using the SPSS version 25 window. Descriptive analysis and one-way analysis of variance were performed. Results: The indoor air bacterial load of Adare General Hospital was found in the range between 210 and 3,224 CFU/m3. The highest indoor air bacterial load was identified from the gynecology ward with a mean of 2,542.5CFU/m3 at p < 0.05. From 100 indoor air samples, a total of 116 bacterial pathogen isolates were obtained. Gram-positive isolates predominated at 72.4%, of which 37.1% were Staphylococcus aureus, 26.7% were coagulase-negative Staphylococci, and the rest 8.6% were Streptococcus pyogenes. The isolation of pathogenic bacteria Staphylococcus aureus and coagulase-negative Staphylococci showed a high level of resistance to ampicillin. Conclusion: A high bacterial load was found in the study area as compared to different indoor air biological standards. Staphylococcus aureus and coagulase-negative Staphylococci were the isolated predominant bacteria. Attention should be given to preventing and minimizing those environmental factors that favor the multiplication of bacteria in the indoor environment of a hospital for the safe health of patients, visitors, and staff.

Readiness of public schools before reopening during COVID-19 pandemic: School-based cross-sectional survey in southern Ethiopia.

BACKGROUND: School closures in response to the COVID-19 impacted children's education, protection, and wellbeing. After understanding these impacts and that children were not super spreaders, countries including Ethiopia decided to reopen schools with specified preconditions. But when deciding to reopen schools, the benefits and risks across education, public health and socio-economic factors have to be evaluated. However, there was information gap on status of schools as per preconditions. Hence, this study was designed to investigate status of schools in Southern Ethiopia. METHODS: School based cross-sectional study was conducted in October 2020 in Southern Ethiopia. Sample of 430 schools were included. National school reopening guideline was used to develop checklist for assessment. Data was collected by public health experts at regional emergency operation center. Descriptive analysis was performed to summarize data. RESULTS: A total of 430 schools were included. More than two thirds, 298 (69.3%), of schools were from rural areas while 132 (30.7%) were from urban settings. The general infection prevention and water, sanitation and hygiene (IPC-WASH) status of schools were poor and COVID-19 specific preparations were inadequate to meet national preconditions to reopen schools during the pandemic. Total score from 24 items observed ranged from 3 to 22 points with mean score of 11.75 (SD±4.02). No school scored 100% and only 41 (9.5%) scored above 75% while 216 (50.2%%) scored below half point that is 12 items. CONCLUSION: Both the basic and COVID-19 specific IPC-WASH status of schools were inadequate to implement national school reopening preconditions and general standards. Some of strategies planned to accommodate teaching process and preconditions maximized inequalities in education. Although COVID-19 impact lessened due to vaccination and other factors, it is rational to consider fulfilling water and basic sanitation facilities to schools to prevent communicable diseases of public health importance.

Assessment of Perceptions and Cancer Risks of Workers at a Polychlorinated Biphenyl-Contaminated Hotspot in Ethiopia.

BACKGROUND: Polychlorinated biphenyls (PCBs) are synthetic and persistent toxic chemicals with a high potential to bioaccumulate in human tissue. There is no existing literature on workers' perceptions and occupational cancer risk due to exposure to PCBs in Ethiopia. OBJECTIVES: The aim of the present study was to assess workers' perceptions of occupational health and safety measures of PCB management and to evaluate the cancer risk posed by PCBs to workers handling these chemicals in Ethiopia. METHODS: A total of 264 questionnaires were administered to workers at the study area to obtain information about PCB management. A mathematical model adopted from the United States Environmental Protection Agency (USEPA) was used to assess the potential cancer risk of people working in PCB-contaminated areas. RESULTS: The results showed that the majority of the workers had little knowledge of safe PCB management practices. Furthermore, 82.6% had not received training on chemical management and occupational health and safety protocols. The association between respondents' responses on the impact of PCBs to the use of personal protective equipment was statistically significant (p <0.005). Accidental ingestion, dermal contact and inhalation exposure pathways were considered in assessing the cancer risk of people working in these areas. The estimated cancer risk for PCBs via dermal contact was higher than for the accidental ingestion and inhalation pathways. The health risk associated with dermal contact was 73.8-times higher than the inhalation exposure route. Workers at the oil tanker and oil barrel area and swampy site are at higher risk of cancer via dermal contact at the 95th centile (879 and 2316 workers per million due to PCB exposure, respectively). However, there is very low cancer risk at the staff residence and garden area via the inhalation route. CONCLUSIONS: Training programs would help improve the knowledge of workers in the area of occupational health and safety of chemical handling. Further studies on PCBs in the exposed workers will provide information on their blood sera PCB levels and consequently identify potential health impacts. PARTICIPANT CONSENT: Obtained. ETHICS APPROVAL: Ethics approval was obtained from the Research Ethics Review Committee of Adama Hospital Medical College, Adama, Ethiopia. COMPETING INTERESTS: The authors declare no competing financial interests.