Antenatal care dropout and associated factors among mothers delivering in public health facilities of Dire Dawa Town, Eastern Ethiopia.

INTRODUCTION: More than two-thirds of the pregnant women in Africa have at least one antenatal care contact with a health care provider. However, to achieve the full life-saving potential that antenatal care promises for women and babies, four visits providing essential evidence-based interventions - a package often called focused antenatal care are required. Hence, identifying the factors associated with dropout of maternal health care utilization would have meaningful implications. The study aimed to assess antenatal care dropout and associated factors among mothers delivering in the public health facilities of Dire Dawa town, Ethiopia. METHODS: Facility-based cross-sectional study was conducted from January 1 to 30, 2020. Proportionate sampling and simple random sampling techniques were used to select 230 women. Data were collected using a structured and pretested interview administered questionnaire during delivery. The data were entered into Epidata version 3.1 and analyzed using SPSS version 20. A binary logistic regression model with a 95 % confidence interval was used to analyze the results. Bivariable analysis (COR [crude odds ratio]) and multivariable analysis (AOR [adjusted odds ratio]) was used to analyze the results. From the bivariable analysis, variables with a p-value < 0.25 were entered into the multivariable logistic regression analysis. From the multivariable logistic regression analysis, variables with a significance level of p-value < 0.05 were taken as factors independently associated with ANC dropout. RESULT: The proportion of antenatal care dropouts was 86 (37.4 %) (95 % CI: 31.3-43.9). In logistic regression analyses, those who had no past antenatal care follow up were more likely to have ANC dropout (AOR = 7.89; 95 % CI: 2.109-29.498) and those who had no professional advice were more likely to have antenatal care dropout (AOR = 4.64 95 % CI: 1.246-17.254). CONCLUSIONS: This study indicates that a high number of women had antenatal care dropout. Having no past ANC follow-up and professional advice were the major factors of ANC service utilization dropout. Hence, giving more information during the ANC visit is important to reduce the dropout rate from the maternity continuum of care.

Overall time spent by clients from entry to exit and associated factors in out-patient departments in public hospitals of Jimma Zone southwest, Ethiopia.

BACKGROUND: The overall time refers to the amount of time a patient spends in a health care facility, from the time he or she enters to the time he or she leaves. As a result of the imbalance between supply and demand, waiting times occur. Ethiopian hospitals are being reformed to improve the quality of care they provide. The time a patient spends in the hospital is one of the most important indicators of quality of care, as it provides insight into customer satisfaction and provider success. However, the overall time patients spend in hospitals was not studied. OBJECTIVE: The study aimed to assess the overall time spent by clients from entry to exit and associated factors in the outpatient departments of Jimma zone hospitals. METHODS: An institution-based cross-sectional study was conducted. Patients from outpatient units at Jimma zone public hospitals participated in the study from March 15 to May 17, 2018. Data were collected using a time and motion tool coupled with an interviewer-administered structured questionnaire on 249 samples. Participants in the study were selected using the consecutive sampling method. Overall time, in terms of waiting and service times at each section unit, and the relationship of socio-demographic and clinical factors with overall time was the main outcome variables. Data were analyzed using descriptive and linear regression analysis. Simple linear regression analysis was used to determine the relationship between the dependent and explanatory variables. Variables were considered significantly associated with the overall time if they had a p-value of less than 0.05 at the 95% confidence interval (CI). RESULT: The overall response rate was 94.8%. Overall, patients spent a median time of 342.5 minutes. Patients spent 12.7% of the total time as service time and 86% of the time waiting for care. The longest overall times were spent in the laboratory (170 minutes), imaging (95 minutes), other diagnostic units (84 minutes) and examination (83 minutes). The average overall time was increased by 52.03 minutes (95%CI 21.65, 82.412), 4.65 minutes (95%CI 3.983, 5.324), and 96.43 minutes (95%CI 52.076, 140.787) when the patient was referred, the number of patients at the queue was increased by one unit, and patients who had other diagnostic tests performed respectively with P <0.005 &adjusted R2 = 0.522. CONCLUSION AND RECOMMENDATIONS: The majority of patients stayed for a longer period. Most time was spent waiting for services, particularly in the examination, laboratory, and imaging units. This is strongly related to high patient load, an absence of some services, being referred patients, and patients who had other diagnostic tests. To reduce the number of patients in the queues, hospitals should work hand in hand with the Ministry of Health to enforce policies that are understood and adopted by all workers in the lower healthcare facilities. And hospital administrators are working to strengthen the triaging system to screen patients with minor illnesses. This is because most patients with minor illnesses queue with those with more complicated illnesses. Finally, we recommend that researchers conduct further research on service quality.

Food safety knowledge, attitude, and practice of street food vendors and associated factors in low-and middle-income countries: A Systematic review and Meta-analysis.

Access to safe food is considered a basic human right, but food-borne disease presents a significant public health concern globally. The problem is exacerbated in low- and middle-income countries. Due to the rise in urbanization and the popularity of street food in low- and middle-income countries, understanding the Knowledge, Attitude, and Practice (KAP) of street food vendors is crucial to ensuring food safety. Therefore, this review was aimed to estimate the pooled proportion of KAP of street food vendors toward food safety and its associated factors in low- and middle-income countries. A comprehensive search of published studies before January 30, 2023, was identified using databases like PubMed/MEDLINE, Cochrane Library, HINARI, Science Direct, and African Journals Online, as well as other sources. The preferred reporting items for systematic reviews and meta-analysis guidelines were followed. Data were extracted using Microsoft Excel, and analysis was performed using STATA 14/SE software. The quality of the included studies was assessed using the Joanna Briggs Institute's quality appraisal tool. A random-effects model was used to estimate the pooled proportion of KAP of street food vendors toward food safety and associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics were used to assess heterogeneity. Furthermore, sensitivity analysis and subgroup analysis was also conducted. In this study, fourteen eligible studies with a total of 2,989 study populations were included. The pooled proportions of good knowledge 62% (95% CI: 51-73), positive attitude 66% (95% CI: 47-86), and good practice 51% (95% CI: 36-65) toward food safety were found among street food vendors. Being of secondary school education (OR = 5.95, 95% CI: 4.05-7.85), having training in food safety (OR = 4.64, 95% CI: 2.62-6.67), having a higher monthly income (OR = 2.98, 95% CI: 1.06-4.9), and having good knowledge of food handling (OR = 2.26, 95% CI: 1.17-3.16) were found to be associated factors in the food safety practice of street food vendors. Based on the findings of this study, there was a significant gap in the KAP of street food vendors toward food safety. Therefore, the provision of training and strengthening health education about food safety are invaluable strategies for improving food safety.

A systematic review of the health effects of lead exposure from electronic waste in children.

Introduction: Electronic waste (e-waste) is an emerging human and environmental problem. Lead (Pb) is one of the most dangerous chemicals for human health, and it is the most prevalent heavy metal pollutant in e-waste. Despite the rapid growth of e-waste globally and the health effects of Pb, there is little information regarding the effects of Pb exposure from e-waste on children. Therefore, the aim of this review was to provide concise information on the health effects of Pb exposure from e-waste on children. Methods: A comprehensive search of databases was undertaken using PubMed/MEDLINE, Cochrane Library, Science Direct, HINARI, African Journal Online (AJOL), and additional sources were searched up to November 25, 2022. Eligibility criteria were determined using Population, Exposure, Comparator, and Outcome (PECO). The guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were used during the article selection process. The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (Registration ID: CRD42022377028). The Joanna Briggs Institute (JBI) quality appraisal checklist was used to assess the quality of the included studies. Results: From a total of 1,150 identified studies, 20 full-text studies were included in the systematic review. All most included studies were conducted in China recycling area for e-waste. The included studies were conducted with an exposed group versus a reference group. The majority of the included studies found that blood Pb levels were ≥5 µg/dl and that Pb exposures from e-waste were affecting children's health, such as a decrease in serum cortisol levels, inhibition of hemoglobin synthesis, impact on neurobehavioral development, affect physical development, etc. Conclusion: Lead exposure had a significant impact on children's health as a result of informal e-waste recycling. Therefore, formalizing the informal sector and raising public health awareness are important steps toward reducing Pb exposure from e-waste. Moreover, the concerned stakeholders, like national and international organizations, should work together to effectively manage e-waste.

The magnitude of standard precautions practice and its associated factors among healthcare workers in governmental hospitals of northeastern Ethiopia.

Background: Non-compliance with infection control guidelines of healthcare workers may increase their risk of exposure to infectious diseases but can be prevented through adherence to standard precautionary practices in healthcare settings. Objective: This study aimed to assess the magnitude of standard precautions practice and its associated factors among healthcare workers in government hospitals of South Wollo Zone, northeastern Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 1,100 healthcare workers. Proportional sample size allocation for each selected government hospital was conducted followed by simple random sampling to select study participants using human resource records from each hospital. Data were collected using structured and self-administered pretested questionnaires. The data were analyzed using descriptive statistics, bivariable binary, and multivariable logistic regression models. Variables with a p-value <0.05 with a 95% CI were considered as having statistical significance. Results: The overall magnitude of compliance with standard precautions among healthcare workers was 19.2%. The result indicated that work experience of <5 years (AOR = 2.51; 95% CI: 1.07-5.89), absence of continuous water supply (AOR = 2.24; 95% CI: 1.95-5.29), and negative attitude (AOR = 2.37; 95% CI: 1.17-4.79) were significantly associated with poor compliance of standard precautions practice. Conclusion: The overall magnitude of compliance with standard precautions among healthcare workers was low compared to the national magnitude of infection prevention practice. Interventions including consistent and effective training on infection prevention healthcare workers should be given regularly. Providing continuous water supply and building a positive attitude toward infection prevention practices among healthcare workers are also required.

Household water treatment practice and associated factors in Ethiopia: A systematic review and meta-analysis.

The provision of potable water is crucial to ensuring the health and dignity of individuals. In many developing countries, including Ethiopia, waterborne disease has become a major public health problem. There is a significant gap in accessing comprehensive national-wide evidence on Household Water Treatment (HWT) practices and associated factors in Ethiopia. Therefore, this study aims to assess the pooled HWT practice and associated factors in Ethiopia. A comprehensive search of published studies before October 15, 2022, was identified using databases and other sources. Data were extracted using Microsoft Excel, and analysis was performed using STATA 14/SE software. A random-effects model was used to estimate the pooled proportion of HWT practices and the odds ratio of associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics was used to assess heterogeneity. Duval and Tweedie's "trim and fill" method was performed to adjust the pooled estimate. A subgroup analysis was also conducted to identify the sources of heterogeneity. In this study, a total of 708 articles were retrieved, and 16 eligible studies were included. The pooled proportion of HWT practice in Ethiopia was found to be 21% (95% CI: 17-24). Having a formal education (OR: 2.42, 95% CI (2.11-2.74)), being male (OR: 1.32, 95% CI (1.13-1.51)), owning radio (OR: 1.33, 95% CI (1.18-1.47)), having a higher income (OR: 1.73, 95% CI (1.41-2.04)), unimproved water source (OR: 1.71, 95% CI (1.41-2.01)), fetching water at more frequently (OR: 3.31, 95% CI (1.99-4.64)), dipping methods of water drawing (OR: 2.08, 95% CI (1.66-2.51)), and taken training of water treatment (OR: 2.15, 95% CI (1.55-2.75)) were all found to be associated with HWT practice. Based on the findings of this study, the pooled proportion of HWT practice in Ethiopia was found to be one-fifth, which indicated that it was significantly low. Therefore, the authors recommend that households could better receive adequate information about HWT practices through strengthened health education and intensive training on HWT.

Drinking water contamination potential and associated factors among households with under-five children in rural areas of Dessie Zuria District, Northeast Ethiopia.

Objective: More than half of the 700 million people worldwide who lack access to a safe water supply live in sub-Saharan Africa, including Ethiopia. Globally, approximately 2 billion people use drinking water sources that are contaminated with fecal matter. However, little is known about the relationship between fecal coliforms and determinants in drinking water. Therefore, the objective of this study was to investigate the potential for contamination of drinking water and its associated factors in households with children under 5 years of age in Dessie Zuria district in northeastern Ethiopia. Methods: The water laboratory was conducted based on the American Public Health Association guidelines for water and wastewater assessment using a membrane filtration technique. A structured and pre-tested questionnaire was used to identify factors associated with the potential for contamination of drinking water in 412 selected households. A binary logistic regression analysis was performed to determine the factors associated with the presence or absence of fecal coliforms in drinking water, with a 95% confidence interval (CI) and a value of p ≤ 0.05. The overall goodness of the model was tested using the Hosmer-Lemeshow test, and the model was fit. Results: A total of 241 (58.5%) households relied on unimproved water supply sources. In addition, approximately two-thirds 272 (66.0%) of the household water samples were positive for fecal coliform bacteria. Water storage duration ≥3 days (AOR = 4.632; 95% CI: 1.529-14.034), dipping method of water withdrawal from a water storage tank (AOR = 4.377; 95% CI: 1.382-7.171), uncovered water storage tank at control (AOR = 5.700; 95% CI: 2.017-31.189), lack of home-based water treatment (AOR = 4.822; 95% CI: 1.730-13.442), and unsafe household liquid waste disposal methods (AOR = 3.066; 95% CI: 1.706-8.735) were factors significantly associated with the presence of fecal contamination in drinking water. Conclusion: Fecal contamination of water was high. The duration of water storage, the method of water withdrawal from the storage container, covering of the water storage container, the presence of home-based water treatment, and the method of liquid waste disposal were factors for fecal contamination in drinking water. Therefore, health professionals should continuously educate the public on proper water use and water quality assessment.

Living in a large family and low daily water consumption substantially expose for human scabies in rural Ethiopia: a matched analysis.

BACKGROUND: Scabies has been added to the neglected tropical diseases portfolio for large-scale disease control action since 2017 and is part of the WHO roadmap for NTDs 2021-2030, targeted at ending the neglect to achieve the sustainable development goals. Previous studies have not fitted matched analysis to identify predictors of scabies infestation in Ethiopia. Information is also scarce about predictors of scabies infestation in this area. Therefore, this study aimed to identify predictors of scabies infestation in rural Aneded District, northwest Ethiopia. METHODS: A community-based matched case-control study involving 183 cases and 549 controls was undertaken from March 1 to May 31, 2021, in rural Aneded District. A two-stage sampling technique with a house-to-house census for the screening of scabies cases was employed. A structured questionnaire with questions on sociodemographics, behavior, water supply, sanitation, and hygiene, and delivery of scabies-specific interventions was used. Pretesting, training of data collectors and supervisors, and supervision were applied to keep the data quality. A multivariable conditional logistic regression model was fitted to identify predictors of scabies. RESULTS: Unmarried individuals or those in separated families (adjusted matched odds ratio (AmOR = 2.71; 95% CI 1.30-5.65); those unable to read and write or in illiterate families (AmOR = 5.10; 95% CI 1.81-14.36); those in large families (AmOR = 6.67; 95% CI 2.83-15.73); households that had longer travel times for water collection (AmOR = 2.27; 95% CI 1.08-4.76); those that had low daily water consumption (AmOR = 6.69; 95% CI 2.91-15.37); households that disposed of solid wastes in open fields (AmOR = 5.60; 95% CI 2.53-12.40); and households that did not receive scabies-specific interventions (AmOR = 2.98; 95% CI 1.39-6.39) had increased odds of scabies. CONCLUSIONS: Being unmarried, illiteracy, large family, long travel time for water collection, low daily water consumption, open dumping of solid wastes, and inaccessibility of scabies-specific interventions are predictors of scabies. This information is instrumental for redesigning improved scabies-specific interventions that consider educational status, marital status, family size, water collection time, daily water consumption, solid waste disposal, and equity and optimization in delivering existing interventions in rural Ethiopia.

COVID-19 Vaccine Acceptance and Associated Factors Among College Students in Dessie City, Northeastern Ethiopia.

Background: The COVID-19 vaccine is regarded as an effective measure for reducing the pandemic's impact. But, COVID-19 disease burden reduction efforts are being affected by the rising vaccine resistance. Objective: To assess the COVID-19 vaccine acceptance and associated factors among college students in Dessie city, Northeastern Ethiopia. Methods: An institutional-based cross-sectional study was carried out among college students in Dessie town from July 1-20, 2021. The association between independent and dependent variables was assessed by binary logistic regression analysis using crude odds ratio and adjusted odds ratio. Variables having p values of less than 0.05 at the 95% confidence interval were regarded as potential determinants of COVID-19 vaccine acceptance. Results: A total of 422 college students participated in the study with a response rate of 95.6%. More than half 226 (56.2%) of the participants had willingness to accept COVID-19 vaccine. Respondents who had history of chronic medical illness (AOR: 4.340, 95% CI: 1.166, 16.149), training on COVID-19 vaccine (AOR: 4.755, 95% CI: 2.606, 6.674), history of regular vaccine uptake (AOR: 2.534, 95% CI: 1.412, 4.549), perception of COVID-19 severity (AOR: 4.109, 95% CI: 2.190, 7.710), perception that COVID-19 can be prevented by vaccine (AOR: 2.420, 95% CI: 1.160, 5.049), and development of herd immunity against COVID-19 vaccines (AOR: 2.566, 95% CI: 1.431, 4.599) were factors significantly associated with COVID-19 vaccine acceptance. Conclusion: The acceptance of COVID-19 vaccine among college students was low. The history of chronic medical illness, training on COVID-19 vaccine, history of vaccine uptake, perception that COVID-19 can be prevented by vaccine, perception of herd immunity development against COVID-19, and severity of COVID 19 infection were factors significantly associated with the acceptance of COVID-19 vaccine. Hence, it is necessary to promote COVID-19 vaccination among college students through health education and vaccine outreach.

Knowledge, Attitudes, and Misconceptions About COVID-19 Prevention Practices Among High and Preparatory School Students in Dessie City, Ethiopia.

Background: Knowledge, attitudes, and misconceptions of students about COVID-19 (coronavirus disease) prevention have been examined in relatively few studies. This study aimed to assess the knowledge, attitudes and misconceptions about COVID-19 prevention practices among high and preparatory school (grades 9 to 12) students in Dessie City, Ethiopia. Methods: This school-based cross-sectional study used a pre-tested structured questionnaire and direct observations from March 1 to 30, 2021 in 5 high and preparatory school students in Dessie City, Ethiopia. The sample size was proportionally allocated in each school based on the number of students registered in the first semester, stratified by grade level, and section. Data analysis employed 3 binary logistic regression models (Models I, II and III) with 95% CI (confidence interval). Bivariate analysis (crude odds ratio [COR]) and multivariable analysis (adjusted odds ratio [AOR]) were used. Variables with P-values <0.3 in the bivariate analysis were retained in the multivariable logistic regression analysis for each model. Variables with significance levels P<0.05 in the multivariable analysis of each model was identified as significant factors. Results: The levels of good knowledge, positive attitudes, and low misconceptions were 74.8%, 60.2%, and 56.1%, respectively. After adjusting for the covariates, grade 12, positive attitude and living in households with more than 5 members were identified as factors significantly associated with good knowledge about COVID-19 prevention practices. Good knowledge of COVID-19 prevention practices, household size >5, infection prevention and control (IPC) training, and low level of misconceptions were factors significantly associated with positive attitudes, whereas students age ≥18 years, positive attitude, and IPC training were factors significantly associated with less misconceptions about COVID-19 prevention measures. Conclusion: The prevalence of good knowledge, positive attitude, and low level of misconceptions of prevention practices for COVID-19 among students was relatively low. Therefore, Dessie City Health and Education Department and each high and preparatory school should implement continuous monitoring programs to ensure high prevention awareness and promote preventive behavior towards COVID-19.

Evaluation of the Effect of Wastewater Irrigation on the Microbiological Quality of Vegetables in Northeast Ethiopia: Implication for Food-Borne Infection and Intoxications.

background: Cultivation of vegetables using untreated wastewater is a common phenomenon in many drought-prone areas of the world. Consumption of such microbiologically unsafe vegetable increase the risk of food-borne diseases. As a result, evaluating the effect of wastewater irrigation on the microbiological quality of vegetables would be beneficial to consumers' health. method: A total of 192 vegetable samples (lettuce, cabbage, carrot, and tomato) and 64 irrigation water samples were collected and analyzed for total bacteria and coliform count using a standardized protocol over a 4 month period. One-way analysis of variance and Pearson correlation coefficient was used to analyze the data. Statistical significance was defined at a P-value of less than 0.05. result: Carrots were the least polluted vegetable, according to the study, while cabbage had the highest contamination levels. The mean bacterial count among the vegetables differs significantly (P < 0.05). The fecal coliform counts of the irrigation wastewater exceed the international wastewater irrigation standards. The mean microbial count between vegetables and water samples showed a significant positive relationship (P < 0.05). All of the analyzed vegetable samples were of borderline microbial quality for fecal coliform bacteria. conclusion: Irrigation wastewater has a low microbiological quality, which significantly contributes to the contamination of vegetables grown on it. recommendation: Measures should be taken to improve the microbial quality of wastewater as well as the quality of vegetables grown in order to protect consumers' health from food-borne diseases.

Access to and challenges in water, sanitation, and hygiene in healthcare facilities during the early phase of the COVID-19 pandemic in Ethiopia: A mixed-methods evaluation.

BACKGROUND: Inadequate water, sanitation, and hygiene (WASH) in healthcare facilities (HCFs) have an impact on the transmission of infectious diseases, including COVID-19 pandemic. But, there is limited data on the status of WASH facilities in the healthcare settings of Ethiopia. Therefore, this study aimed to assess WASH facilities and related challenges in the HCFs of Northeastern Ethiopia during the early phase of COVID-19 pandemic. METHODS: An institution-based cross-sectional study was conducted from July to August 2020. About 70 HCFs were selected using a simple random sampling technique. We used a mixed approach of qualitative and quantitative study. The quantitative data were collected by an interviewer-administered structured questionnaire and observational checklist, whereas the qualitative data were collected using a key-informant interview from the head of HCFs, janitors, and WASH coordinator of the HCFs. The quantitative data were entered in EpiData version 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 25.0 for data cleaning and analysis. The quantitative data on access to WASH facilities was reported using WHO ladder guidelines, which include no access, limited access, and basic access, whereas the qualitative data on challenges to WASH facilities were triangulated with the quantitative result. RESULTS: From the survey of 70 HCFs, three-fourths 53 (75.7%) were clinics, 12 (17.2%) were health centers, and 5 (7.1%) were hospitals. Most (88.6%) of the HCFs had basic access to water supply. The absence of a specific budget for WASH facilities, non-functional water pipes, the absence of water-quality monitoring systems, and frequent water interruptions were the major problems with water supply, which occurred primarily in clinics and health centers. Due to the absence of separate latrine designated for disabled people, none of the HCFs possessed basic sanitary facilities. Half (51.5%) of the HCFs had limited access to sanitation facilities. The major problems were the absence of separate latrines for healthcare workers and clients, as well as female and male staffs, an unbalanced number of functional latrines for the number of clients, non-functional latrines, poor cleanliness and misuse of the latrine. Less than a quarter of the HCFs 15 (21.4%) had basic access to handwashing facilities, while half 35 (50%) of the HCFs did not. The lack of functional handwashing facilities at expected sites and misuse of the facilities around the latrine, including theft of supplies by visitors, were the two most serious problems with hygiene facilities. CONCLUSION: Despite the fact that the majority of HCFs had basic access to water, there were problems in their sanitation and handwashing facilities. The lack of physical infrastructure, poor quality of facilities, lack of separate budget to maintain WASH facilities, and inappropriate utilization of WASH facilities were the main problems in HCFs. Further investigation should be done to assess the enabling factors and constraints for the provision, use, and maintenance of WASH infrastructure at HCFs.

COVID-19 infection prevention practices among a sample of food handlers of food and drink establishments in Ethiopia.

BACKGROUND: Cases of coronavirus disease (COVID-19) are increasing at an alarming rate throughout the world, including Ethiopia. Food handlers in food and drink establishments are at high risk of exposure to the virus due to their many daily contacts with customers. Since there is a paucity of evidence about infection prevention practices and associated factors among this high-risk group in Ethiopia including in Dessie City and Kombolcha Town, this study was designed to address this gap. METHOD: An institution-based cross-sectional study was conducted among 422 food handlers in Dessie City and Kombolcha Town food and drink establishments in July and August 2020. The study participants were selected using a simple random sampling technique. Data were collected by trained data collectors using a pretested structured questionnaire and an on-the-spot observational checklist. Data were entered into EpiData version 4.6 and exported to STATA version 14.0 for data cleaning and analysis. Data were analyzed using bivariable and multivariable logistic regression model at 95% confidence interval (CI). From the bivariable analysis, variables with a p-value <0.25 were retained into multivariable analysis. Finally, variables that had a p-value <0.05 were declared as factors significantly associated with good infection prevention practices of COVID-19 among food handlers. MAIN FINDINGS: The overall rate of good practice in infection prevention among food handlers was 43.9% (95% CI: 39.2-48.4%). Among the total 401 food handlers, 79.8% had good knowledge and 58.4% had a favorable attitude about COVID-19 infection prevention. Factors significantly associated with good COVID-19 infection prevention practices were: educational status of college or above (AOR = 1.97; 95% CI: 1.32-3.75), food handling work experience greater than five years (AOR = 2.55; 95% CI: 1.43-5.77), availability of written guidelines within the food and drink establishment (AOR = 2.68; 95% CI: 1.52-4.75), and taking training about infection prevention (AOR = 3.26; 95% CI: 1.61-6.61). CONCLUSION: Our findings showed that around one-third of food handlers had good infection prevention practices. Thus, to reduce COVID-19 transmission, integrated work is urgently needed to further improve food handlers' good practices, knowledge and attitude about infection prevention through providing health education, training and by making written infection prevention guidelines available in food and drink establishments.

Acceptance of COVID-19 Vaccine and Determinant Factors Among Patients with Chronic Disease Visiting Dessie Comprehensive Specialized Hospital, Northeastern Ethiopia.

BACKGROUND: Despite the implementation of different COVID-19 prevention measures, the incidence of the disease continues to rise. Hence, vaccines have been taken as the best option for controlling the transmission of the disease. Although the approved COVID-19 vaccines have proven to be safe and effective, multiple beliefs and misconceptions still exist influencing its acceptance. OBJECTIVE: To assess the acceptance of the COVID-19 vaccine and determinant factors among chronic patients visiting Dessie Comprehensive Specialized Hospital, Northeastern Ethiopia. METHODS: Institution-based cross-sectional study design was used among patients with chronic diseases visiting Dessie Comprehensive Specialized Hospital from May 1 to 20, 2021 using a consecutive sampling technique. Binary logistic regression analysis using crude odd ratio (COR) and adjusted odd ratio (AOR) was performed to assess the association between independent and dependent variables. Variables having p values of less than 0.05 at the 95% confidence interval (CI) were considered as factors of COVID-19 vaccine acceptance. RESULTS: A total of 416 respondents participated in the survey, with a response rate of 98.6%. About 59.4% of the respondents were willing to accept the COVID-19 vaccine. Participants who had health insurance (AOR=1.812; 95% CI: 1.703-3.059), knew anyone diagnosed with COVID-19 (AOR=2.482; 95% CI: 1.427-4.317), having good knowledge of the COVID-19 vaccine (AOR=6.890; 95% CI: 3.900-120.17), and having a positive attitude towards COVID-19 vaccine (AOR=7.725; 95% CI: 4.024-14.830) were factors affecting the acceptance of COVID-19 vaccine. CONCLUSION: The acceptance of the COVID-19 vaccine was low. Use of health insurance, knowing anyone who had been diagnosed with COVID-19, knowledge, and attitude towards the COVID-19 vaccine were factors of COVID-19 vaccine acceptance. Healthcare professionals should conduct continuous awareness creation campaigns on the importance of the COVID-19 vaccine, safety, and its efficacy. Further studies like longitudinal and qualitative studies should be conducted to identify additional barriers to vaccine acceptance particularly in high-risk groups.

Medical Students' Attitude and Perception Towards Basic Medical Science Subjects at Wollo University, Northeast Ethiopia.

INTRODUCTION: The knowledge of basic medical science could help to remember a fact and be used to understand causal mechanisms of disease process that improve the accuracy of diagnostic formulations. OBJECTIVE: To assess the perception and attitude of medical students towards basic medical science subjects along with retention rate and clinical relevance in Wollo University. METHODS: Institutional-based cross-sectional study design was employed in Wollo University from September, 2020 to October, 2020. A pre-tested and structured self-administered questionnaire was used for data collection. All opinions were rated using a positive-point Likert scale, which ranges from "strongly disagree" to "strongly agree." The data were entered and analyzed using SPSS version 20. RESULTS: A total of 153 students participated with a 100% response rate. Among them, 45 (29.4%), 38 (24.8%), 39 (25.5%), and 31 (20.3%) were PC-II, C-I, C-II, and Intern students, respectively. Ninety-six (62.7%) of medical students were very much interested in basic medical science subjects. But, 113 (73.9%) of them did not have plans to join the subjects as a future career. The main reasons in more than half 85 (55.7%) of the respondents were less financial growth followed by less chance of promotion 31 (20.3%). There were 66.7% of the students who considered anatomy as clinically relevant, whereas 53.6% and 47.1% considered physiology and biochemistry, respectively, to be clinically relevant. The number of students who could recall anatomy and physiology during relevant clinical discussions was 102 (66.7%) and 85 (55.6%), respectively. This percentage was relatively less for biochemistry (26.8%). CONCLUSION: In conclusion, medical students have a positive attitude towards basic medical science subjects. However, they are hesitant to join the field because it offers them less financial growth and few chances of promotion. Moreover, anatomy and physiology were highly relevant subjects during clinical practice. But, the retention rate of basic medical science knowledge during their clinical year was low.

Toxicity of Methanolic Extracts of Seeds of Moringa stenopetala, Moringaceae in Rat Embryos and Fetuses.

Moringa stenopetala is a medicinal plant that has been used in Ethiopian traditional medicine as a remedy for the treatment of hypertension, diabetes, and stomach pain. The study is aimed at assessing the toxicity of the methanol extracts of the seeds of Moringa stenopetala on the developing embryo and fetuses of rats. The seeds of Moringa were extracted by maceration using 80% methanol. The extract (250-1000 mg/kg) was orally administered to pregnant Swiss albino rats from days 6 to12 of gestation. Embryos and fetuses were recovered by laparotomy on gestational day 12 and day 20, respectively, and were assessed for developmental anomalies. On day 20, significant prenatal growth retardation such as reduced litter weight and crown-rump length were observed in near term fetuses of 1000 mg/kg treated rats. Litter weight in 1000 mg/kg and pair-fed control groups was 2.41 g ± 0.108 and 3.08 g ± 0.093, respectively. Delay in the development of an otic, optic, and olfactory system, as well as a reduction in a number of branchial bars, occurred on day 12 embryos of 1000 mg/kg treated rats. The rate of fetal resorption in 1000 mg/kg and pair-fed control groups was 1.6 ± 0.55 and 0.42 ± 0.52, respectively. There was also a high incidence of fetal death in the 1000 mg/kg treated group but it was not statistically significant. The offspring's of Moringa-treated rats did not show gross external malformations at all doses. These findings suggest that the methanol seed extract of Moringa stenopetala is not safe to rat embryos and fetuses. Its toxic effects were evidenced by a significant delay in embryonic and fetal development and an increase in fetal resorptions and fetal death.

COVID-19 Prevention Practices and Determinant Factors Among Healthcare Professionals Working in Hospitals of South Gondar Zone, Northwestern Ethiopia.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has been a global public health crisis since December 2019. Health care professionals (HCP) are highly vulnerable for contracting the disease. Due to the absence of known treatment, prevention is the best option for controlling its transmission. OBJECTIVE: The study aimed to assess COVID-19 prevention practices and determinant factors among HCP working in hospitals of South Gondar ZoneH, Northwestern Ethiopia. METHODS: Institution-based cross-sectional study design was used from July 1 to 30, 2020 among 372 HCPs. The participants were selected on random sampling technique basis. Data were entered into Epi data version 3.1 and exported to Statistical Package for Social Science (SPSS V.25) software for data cleaning and analysis. Binary logistic regression analysis was used to assess the association between independent variables and prevention practice of COVID-19. RESULTS: A total of 372 HCPs participated in the study with a response rate of 94.9%. Less than one-third 112 (30.1%) of the participants were females. About 308 (82.8%), 285 (76.6%), and 224 (60.2%) of the participants had good knowledge, positive attitude, and good prevention practice towards COVID-19, respectively. Being male (AOR =2.68; 95% CI (confidence interval): 1.50,4.81), 2-5 years working experience (AOR= 4.61; 95% CI: 1.70,12.47), greater than five years working experience (AOR= 5.86; 95% CI: 2.01,17.05), age of 31-40 years old (AOR= 2.49; 95% CI; 1.41,4.41), above 40 years (AOR= 6.94; 95% CI: 2.33-20.71), use of COVID-19 guideline (AOR= 4.79; 95% CI: 2.17-10.53), and using peers as sources of information about COVID-19 (AOR= 2.06; 95% CI: 1.07-3.94) were factors of COVID-19 prevention practices. CONCLUSION: Less than two-thirds of the participants had good COVID-19 prevention practices. Sex, work experience, age, use of COVID-19 guideline, and using peers as sources of information were factors of COVID-19 prevention practices. Hence, continuous information dissemination and experience sharing on COVID-19 prevention should be done continuously.

Developmental Toxicity of Ethanolic Extracts of Leaves of Achyranthes aspera, Amaranthaceae in Rat Embryos and Fetuses.

INTRODUCTION: Achyranthes aspera is one of the medicinal plants widely used for fertility control in the local health system of Ethiopia. OBJECTIVE: Assessment of developmental toxicity of ethanolic extracts of leaves of Achyranthes aspera in rat embryos and fetuses. METHODS: Fresh leaves were extracted by mixing the grinded powder with 70% ethanol. Then, the extract was given orally to gravid Wistar rats at doses of 250 mg/kg, 500 mg/kg and 1000 mg/kg from day 6-12 of gestation. On gestational days 12 and 20, embryos and fetuses were examined for developmental and gross malformations. RESULTS: On day 12 embryos, the number of implantation sites and somites in 1000 mg/kg treated rats were significantly reduced. The number of implantation sites in pair-fed control and 1000 mg/kg groups was 11.2±0.86 and 8.34±0.65, respectively. Retarded development of hindlimb, forelimb, optic and olfactory systems was detected at a high dose. In addition, the number of branchial bar was significantly reduced in 1000 mg/kg dose. In near-term fetuses, significant reduction of litter weight and crown-rump length was seen at 1000 mg/kg dose. Crown-rump length in pair-fed control and 1000 mg/kg treated groups was 2.82±0.17 cm and 2.31±0.11 cm, respectively. Fetal resorptions and deaths in 1000 mg/kg were 1.45±0.65 and 0.81±0.67, respectively. However, external anomalies were not detected for all offspring at all doses. CONCLUSION: The finding suggests that ethanolic leaf extracts of A. aspera have detrimental effects on the development of rat embryos and fetuses at a higher dose. The possible teratogenic effects were indicated with the substantial retardation in embryonic and fetal development, decrease in number of implantation sites and rise in fetal resorptions and death. Moreover, it resulted in significant reduction in litter weight and crown-rump length at a higher dose.

Water, sanitation, and hygiene as a priority intervention for stunting in under-five children in northwest Ethiopia: a community-based cross-sectional study.

BACKGROUND: Stunting was a significant public health problem for under-five in developing countries including Ethiopia. Globally, it was estimated 21.9% or 149 million (81.7 million in Asia and 58.8 million in Africa) under-five children stunted in 2018. In East Africa, 24 million are stunted which is the highest-burden from African regions. Hence, this study aimed to assess the prevalence of stunting and its association with Water Sanitation and Hygiene (WASH) in northwestern Ethiopia. METHOD: A community-based cross-sectional study design was conducted among 630 participants from December to mid-January 2019. From five kebeles, two were selected by a simple random sampling technique for the study. To reach study participants a systematic sampling technique was used. Data were collected by using an observational checklist, pretested questionnaire, and anthropometric measurement. Anthropometric indicator, height-for-age was determined using the current World Health Organization (WHO) growth standards. Multivariable logistic regression analysis was computed to analyze the data. From the multivariable analysis the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) and P-value < 0.05 were used to declare statistical significance. RESULT: The prevalence of stunting among under-five children was 35.6% (95%CI; 31.9-39.5%). The result from this study showed that having illiterate father and mother, give birth before marriage (single), large family size, short maternal height, unimproved drinking water source, unimproved sanitation, poor hygienic practice, having diarrhea in the previous 2 weeks before the data collection, method of child feeding, age at which complementary feeding started, frequency of feeding, not deworming and mothers who had antenatal care visit of fewer than three times were statistically associated with stunting. CONCLUSION: In this study, stunting was an important public health problem among under-five children. It remains the same as the national average prevalence of Ethiopia. To alleviate this problem proper family planning utilization, good dietary intake, maternal and paternal education, and WASH interventions are critical.

Prevention Practice of COVID-19 Using Personal Protective Equipment and Hand Hygiene Among Healthcare Workers in Public Hospitals of South Wollo Zone, Ethiopia.

Objective: The use of personal protective equipment and hand hygiene are often the most recommended line of defense against coronavirus disease-19 (COVID-19). The purpose of this study is to determine the magnitude of compliance and associated factors of personal protective equipment (PPE) utilization and hand hygiene practice among healthcare workers in public hospitals of South Wollo Zone, Northeastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted among 489 healthcare workers in public hospitals of South Wollo Zone, Northeastern Ethiopia from June 15 to July 30, 2021. Proportional sample size allocation to each selected hospital followed by simple random sampling techniques were used to select the study participants using human resource records from each hospital. A pre-tested and structured self-administered questionnaire with WHO's standardized hand hygiene and PPE utilization observational checklist were used to collect data. Bivariate and multivariable analyses with 95% CI and p-value < 0.05 were employed to identify the associated factors of personal protective equipment utilization. Results: About 32 and 22.3% of healthcare workers were compliant with personal protective equipment utilization and hand hygiene practice, respectively. Feedback for safety (AOR = 2.05; 95% CI: 1.26-3.35), training on COVID-19 prevention (AOR = 3.43; 95% CI: 2.01-5.86), and perception to infection risk (AOR = 1.98; 95% CI: 1.18-3.33) were significant factors of good compliance with personal protective equipment utilization. Conclusion: The magnitude of good compliance with personal protective equipment utilization and hand hygiene was low. Interventions to promote personal protective equipment utilization and hand hygiene should focus on feedback for safety, training on COVID-19 prevention, and perception of infection risk.