The association between children's exposure to pesticides and asthma, wheezing, and lower respiratory tract infections. A systematic review and meta-analysis.

Background: Exposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted considerable attention, but the existing evidence remains inconclusive and cannot be certain. Therefore, this systematic review and meta-analysis aim to determine the global pooled effect size of association with pesticide exposure and asthma, wheezing, and respiratory tract infections among children. Methods: A comprehensive search was conducted for relevant literature from electronic databases, including PubMed, Google Scholar, Hinari, Semantic Scholar, and Science Direct. Studies that provided effect size on the association between pesticide exposure and childhood asthma, wheezing, and respiratory tract infections in children were included. The articles were screened, data was extracted, and the quality of each study was assessed with four independent reviewers. Random effects models for significant heterogeneity and fixed effect models for homogeneous studies were conducted to estimate pooled effect sizes with 95% confidence intervals using Comprehensive Meta-Analysis version 3.3.070 and MetaXL version 2. Funnel plot and Higgins I 2 statistics were used to determine the heterogeneity of the included studies. Subgroup analyses were computed based on the types of pesticide exposure, study design, sample size category, and outcome assessment technique. Result: A total of 38 articles with 118,303 children less than 18 years of age were included in this meta-analysis. Pesticide exposure among children increased the risk of asthma by 24%; (OR = 1.24, 95% CI: 1.14-1.35) with extreme heterogeneity (I 2 = 81%, p < 0.001). Exposure to pesticides increased the odds of developing wheezing among children by 34% (OR = 1.34, 95% CI: 1.14-1.57), with high heterogeneity (I 2 = 79%, p < 0.001) and also increased the risk of developing lower respiratory tract infection by 79% (OR = 1.79, 95% CI: 1.45-2.21) with nonsignificant low heterogeneity (I 2 = 30%, p-value = 0.18). Conclusion: This meta-analysis provided valuable evidence supporting the association between childhood asthma, wheezing, and lower respiratory tract infection with pesticide exposure. The findings would contribute to a better understanding of the estimate of the effect of pesticide exposure on respiratory health in children and inform evidence-based preventive strategies and public health interventions.

Exposure to indoor air pollution and adverse pregnancy outcomes in low and middle-income countries: a systematic review and meta-analysis.

Introduction: Exposure to indoor air pollution such as biomass fuel and particulate matter is a significant cause of adverse pregnancy outcomes. However, there is limited information about the association between indoor air pollution exposure and adverse pregnancy outcomes in low and middle-income countries. Therefore, this meta-analysis aimed to determine the association between indoor air pollution exposure and adverse pregnancy outcomes in low and middle-income countries. Methods: International electronic databases such as PubMed, Science Direct, Global Health, African Journals Online, HINARI, Semantic Scholar, and Google and Google Scholar were used to search for relevant articles. The study was conducted according to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A random effect model at a 95% confidence interval was used to determine the association between indoor air pollution exposure and adverse pregnancy outcomes using STATA version 14. Funnel plot and Higgs I2 statistics were used to determine the publication bias and heterogeneity of the included studies, respectively. Results: A total of 30 articles with 2,120,228 study participants were included in this meta-analysis. The pooled association between indoor air pollution exposure and at least one adverse pregnancy outcome was 15.5% (95%CI: 12.6-18.5), with significant heterogeneity (I2 = 100%; p < 0.001). Exposure to indoor air pollution increased the risk of small for gestational age by 23.7% (95%CI: 8.2-39.3) followed by low birth weight (17.7%; 95%CI: 12.9-22.5). Exposure to biomass fuel (OR = 1.16; 95%CI: 1.12-1.2), particulate matter (OR = 1.28; 95%CI: 1.25-1.31), and kerosene (OR = 1.38; 95%CI: 1.09-1.66) were factors associated with developing at least one adverse pregnancy outcomes. Conclusions: We found that more than one in seven pregnant women exposed to indoor air pollution had at least one adverse pregnancy outcome. Specifically, exposure to particulate matter, biomass fuel, and kerosene were determinant factors for developing at least one adverse pregnancy outcome. Therefore, urgent comprehensive health intervention should be implemented in the area to reduce adverse pregnancy outcomes.

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.

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.

On the use of contingent valuation method to assess factors affecting the contribution of local people for the management of water hyacinth in Lake Tana, northwestern Ethiopia.

The colonization of freshwater lakes by invasive alien species is increasingly alarming primarily owing to nutrient loads from the watersheds. For the sustainable management of invasive weeds, preventive methods, such as watershed management and sustainable agricultural practices, are recommended. Watershed protection activities by the upstream local community are believed to be effective measures to reduce nutrient loading to the receiving water bodies and hence help prevent the spread of water hyacinth. However, their willingness and potential contributions determine the effectiveness of watershed management activities. The objective of this study is, therefore, to evaluate the preferences and contributions (willingness to pay and willingness to contribute labor) of the local community for the management of water hyacinth in Lake Tana (Ethiopia). A contingent valuation method for a hypothetical market "prevention of water hyacinth infestation of Lake Tana through watershed management program" was used to collect data from 560 randomly selected households. A multivariable interval regression model was used to identify factors affecting the contribution of local people. The mean yearly willingness to pay and to contribute labor of the respondents was 435.4 Ethiopian Birr (US$ 10) and 22.4 man-days, respectively. The place of residence (rural/urban), educational level, private farm plot area, annual income, and water hyacinth-related conference participation significantly influenced the willingness to pay. Similarly, the willingness to contribute labor was strongly associated with place of residence, location, educational level, and household family size. The economic value derived from this study reflects community preferences, which could be an input for informed and evidence-based decision-making regarding the prevention of weed expansion and sustainable use of ecosystem services. Therefore, local, regional, and national authorities are advised to mobilize the local community to contribute labor and/or money so as to halt the expansion of the weed.

Prevalence of active trachoma and its associated factors among 1-9 years of age children from model and non-model kebeles in Dangila district, northwest Ethiopia.

BACKGROUND: Trachoma is the leading infectious disease that leads to blindness worldwide, especially in developing countries. Though Ethiopia had targeted a trachoma elimination program by 2020, the problem worsens, particularly in the Amhara Region. Even though sustained intervention measures are undertaken across the region, it is unclear why trachoma is still a significant public health problem. So, this study assessed the prevalence of active trachoma and associated factors among 1-9 years of age children from model and non-model kebeles in Dangila district Amhara Region, Northwest Ethiopia. METHODS: A community-based comparative cross-sectional study was conducted from 20th September 2019 to 29th October 2019. A multistage stratified random sampling technique was used to reach 704 children from model and non-model kebeles. Samples were allocated proportionally to model and non-model kebeles. A structured and pretested data collection tool and observational checklist was used to manage the necessary data. Data were coded and entered in Epidata version 4.6, and further analysis was done using SPSS version 20 software. Bivariable and multivariable logistic regression analysis was employed to identify factors associated with active trachoma. Adjusted Odds Ratios (AOR), p-value, and respected Confidence Interval (CI) were used to report the findings. RESULTS: Seven hundred four children were included in this study, with a response rate of 97.8%. The overall prevalence of active trachoma was 6% (95% CI: 4.5, 8.1). The prevalence of active trachoma among non-model and model Kebele was not significantly different. Still, the prevalence of active trachoma among children from model Kebele were [4.5%, (95% CI: 2.4%, 7.1%)] relatively lower compared with non-model kebeles, [7.6%, 95% CI: (4.9%, 10.9%)]. Moreover, not using latrine (AOR = 4.29, 95% CI: 1.96, 9.34), fly-eye contact (AOR = 2.59, 95% CI: 1.11, 6.03), presence of sleep in eyes (AOR = 2.46, 95% CI: 1.10, 5.47), presence of ocular discharge (AOR = 2.79, 95% CI: 1.30, 6.00), presence of nasal discharges (AOR = 2.67, 95% CI: 1.21, 5.90) and washing faces with soap (AOR = 0.22, 95% CI: 0.07, 0.69) were found significantly associated with the prevalence of active trachoma among children 1-9 years old. CONCLUSIONS: The prevalence of active trachoma in the model and non-model kebeles was high and did not show a statistical difference. Attention to be given to latrine utilization, washing face with soap, and other personal hygiene activities.

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.

Self-Reported Food Safety Practices and Associated Factors Among Health Extension Model and Non-Model Households in Northeastern Ethiopia: A Comparative Cross-Sectional Study.

Purpose: Eating contaminated food continues to cause numerous food-borne diseases globally. Understanding the causes of poor food safety practices is key to preventing food-borne diseases. Therefore, this study aimed to assess the prevalence of food safety practices and associated factors among health extension model and non-model households in Kombolcha, Ethiopia. Methods: A comparative cross-sectional study was conducted among 327 model households and 329 non-model households in Kombolcha. Four kebeles were selected randomly from a total of 12 kebeles, followed by a systematic random sampling method to select a total of 656 households. The data were collected through face-to-face interviews with household heads and observations from April 15 to May 15, 2021. Data were entered into EpiData version 3.1 and analyzed using SPSS version 25.0. Determinants of food safety practices were determined by using multivariable logistic regression model at a p-value <0.05. Results: The overall prevalence of food safety practices was 44.7% (95% CI: 40.5-48.4%), of which 57.8% (95% CI: 53.0-63.1%) were model and 31.6% (95% CI: 26.5-36.7%) were non-model households, with significant variation among household types. Being a model household (AOR=2.99; 95% CI: 1.98-4.52), having a female household head (AOR=3.13; 95% CI: 2.13-4.59), proper solid waste management (AOR=2.32; 95% CI: 1.54-3.48), good knowledge of food safety (AOR=2.05; 95% CI: 1.43-3.03), and good attitude (AOR=1.74; 95% CI: 1.22, 2.49) were significant predictors of good food safety practices. Conclusion: The prevalence of good food safety practices was not satisfactory. Being a model household, having a female household head, proper solid waste management, good knowledge, and good attitude were significantly associated with good food safety practices. Therefore, the identified modifiable factors are potential areas of intervention to enhance good food safety practices.

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.

Occupational blood exposure beyond needle stick injuries: hospital-based cross-sectional study among healthcare workers in governmental hospitals of Northern Ethiopia.

BACKGROUND: Occupational blood exposure is one of the major public health problems that healthcare workers (HCWs) are encountering. Most previous occupational blood exposure studies are delimited to needle stick injury, which could underestimate the real level of blood exposure. On the other hand, others deal with crude blood and body-fluids exposure, which possibly overestimate the magnitude of blood exposure. Therefore, this study aimed at determining the prevalence of occupational blood exposure and identifying associated factors among HCWs in the Southern Tigrai zone governmental hospitals of Northern Ethiopia considering all the potential means of blood exposure (needle stick injury, sharp medical equipment injury, and blood splash) while excluding blood-free body-fluids. METHODS: A hospital based cross-sectional study design was employed to gather data from randomly selected HCWs in three governmental hospitals from February to March, 2020. A multivariable logistic regression model was used to identify the independent factors associated with the outcome variable. RESULTS: From the total of 318 HCWs, 148 (46.5 %) were exposed to blood at least once in their lifetime. Working for more than 40 h per week (AOR= 9.4; 95 % CI: 7.61, 11.41), lack of adequate personal protective equipment (PPE) (AOR=3.88; 95 % CI: 1.64, 5.42), Hepatitis B virus vaccination (AOR=0.54; 95 % CI: 0.12,0.78), recapping used needle sticks (AOR=3.18; 95 % CI: 1.28, 8.83), and lack of infection prevention and patient safety (IPPS) training (AOR=13.5; 95 % CI: 8.12,19.11) were detected to significantly increase the likelihood of occupational blood exposure. CONCLUSIONS: As nearly half of the HCWs were exposed to blood, reducing work load below 40 h per week by employing additional staff members, supplying adequate PPE, avoiding recapping of used needle sticks, and providing IPPS training for the HCWs should be practiced.

Food insecurity status and determinants among Urban Productive Safety Net Program beneficiary households in Addis Ababa, Ethiopia.

BACKGROUND: Measuring household food insecurity in specific geographic areas provides vital information that enables appropriate and effective intervention measures to be taken. To that end, this study aimed to assess the prevalence of food insecurity and associated factors among Urban Productive Safety Net Program (UPSNP) beneficiary households in Addis Ababa, Ethiopia's capital city. METHODS: A community-based cross-sectional study was conducted among 624 UPSNP beneficiary households in nine districts of Addis Ababa from June to July 2019. A multi-stage sampling method was used; study participants were selected using a simple random sampling technique after establishing the proportionally allocated sample size for 9 districts. Data were collected by trained personnel using a pretested, structured questionnaire. The outcome variable was food insecurity as measured by Household Food Insecurity Access Scale (HFIAS), a tool developed by the Food and Nutrition Technical Assistance Scale (FANTA) and validated for developing countries, including Ethiopia. A binary (crude odds ratio [COR]) and multivariable (adjusted odds ratio [AOR]) logistic regression analysis were employed at 95% CI (confidence interval). From the bivariate analysis, factors having a p-value<0.25 were included in the multivariable analysis. From the multivariable analysis, any variable at p-value < 0.05 at 95% CI was declared significantly associated with household food insecurity. Model fitness was also checked using the Hosmer-Lemeshow test with p-value>0.05. RESULTS: The prevalence of household food insecurity was 77.1% [95%CI:73.8-80.7] during the month prior to the survey. Illiteracy of household head [AOR: 2.56; 95%CI:1.08-6.07], family size of 4 or more [AOR: 1.87, 95%CI:1.08-3.23], high dependency ratio [AOR: 3.95; 95%CI:1.31-11.90], household lack of access to credit [AOR:2.85; 95%CI:1.25-6.49], low household income [AOR: 4.72; 95%CI:2.32-9.60] and medium household income [AOR: 9.78; 95%CI:4.29-22.35] were significantly associated with household food insecurity. CONCLUSION: We found that three in four of Addis Ababa's UPSNP beneficiary households were food-insecure. Implementation of measures to improve household income, minimize the dependency ratio of households, and arrange access to credit services are paramount ways to tackle food insecurity problems in Addis Ababa.

Prevalence and associated factors of needle stick and sharps injuries among healthcare workers in northwestern Ethiopia.

BACKGROUND: Needle stick and sharp injuries (NSSIs) are a common problem among healthcare workers (HCWs). Although the factors related to NSSIs for HCWs are well documented by several studies in Ethiopia, no evidence has been reported about the magnitude of and factors related to NSSIs in hospitals in northwestern Ethiopia. METHODS: An institution-based cross-sectional study was carried out from January to March 2019 among 318 HCWs in three randomly-selected hospitals of the eight hospitals found in South Gondar Zone. Sample sizes were proportionally allocated to professional categories. Study participants were selected by systematic random sampling methods using the monthly salary payroll for each profession as the sampling frame. Data were collected using a self-administered questionnaire. The outcome of this study was the presence (injured) or absence of NSSIs during the 12 months prior to data collection. A binary logistic regression model with 95% confidence interval (CI) was used for data analysis. Variables from the bi-variable analysis with a p-value ≤ 0.25 were retained into the multivariable analysis. From the multivariable analysis, variables with a p-value less than 0.05 was declared as factors significantly associated with NSSIs. MAIN FINDINGS: The prevalence of NSSIs was 29.5% (95% CI: 24.2-35.5%) during the 12 months prior to the survey. Of these, 46.0% reported that their injuries were moderate, superficial (33.3%) or severe (20.7%). About 41.4% of the injuries were caused by a suture needle. Factors significantly associated with NSSIs were occupation as a nurse (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.18-4.26), disposal of sharp materials in places other than in safety boxes (AOR = 3.93, 95% CI: 2.10-5.35), recapping of needles (AOR = 2.27, 95% CI: 1.13-4.56), and feeling sleepy at work (AOR = 2.24, 95% CI: 1.14-4.41). CONCLUSION: This study showed that almost one-third of HCWs had sustained NSSIs, a proportion that is high. Factors significantly associated with NSSIs were occupation as a nurse, habit of needle recapping, disposal of sharp materials in places other than in safety boxes and feeling sleepy at work. Observing proper and regular universal precautions for nurses during daily clinical activities and providing safety boxes for the disposal of sharp materials, practicing mechanical needle recapping and preventing sleepiness by reducing work overload among HCWs may reduce the incidence of NSSIs.

COVID-19 Prevention Practices and Associated Factors among Diabetes and HIV/AIDS Clients in South-Wollo Zone, Ethiopia: A Health Facility-Based Cross-Sectional Study.

BACKGROUND: Coronavirus-2019 (COVID-19) is affecting many people. Chronic patients are highly vulnerable to contracting an infection. Most people recover within a week, but chronic patients can face severe illness or death. The increasing of cases, complications, and mortality demands compulsory preventive measures. Therefore, this study was designed to identify major preventive practices and associated factors. METHODS: A facility-based cross-sectional study was employed from November to December 2020 among diabetics and HIV/AIDS follow-up clients in Dessie referral hospital. Data were entered into EpiData manager 4.6.0 version and exported to Statistical Package for Social Science (SPSS) version 25.0 for data cleaning and analysis. Logistic regression analysis was done and an adjusted odds ratio (AOR) with its 95% confidence interval (CI) was used for determining the strength of association. RESULTS: Data were collected from 426 participants with a mean age of 46.54 years. The overall poor prevention practice rate of COVID-19 among diabetic and HIV/AIDS follow-up clients was 68.8% 95% CI (64.6-72.8%). Factors significantly associated with poor prevention practice were femaleness (AOR; 1.61; 95% CI; 1.03-2.51), illiterate [AOR; 2.59; 95% CI; 1.33-5.09]), family size greater than four (AOR; 2.06; 95% CI; 1.32-3.23), absence of health professional in the household (AOR; 1.79; 95% CI; 1.13-2.84), not having health insurance (AOR; 1.85; 95% CI; 1.18-2.89) and urban residence (AOR; 0.38; 95% CI; 0.18-0.79). CONCLUSION: The overall proportion of prevention practice towards COVID-19 among diabetic and HIV/AIDS follow-up clients was poor. Illiteracy, having a family size greater than four, not having health professionals in the household, not having health insurance and urban residency were associated with poor prevention practices. Therefore, continuous health educations about good preventive behavioral practice should be enhanced by the health professionals.

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.

Knowledge, Attitude, and Preventive Practices Towards COVID-19 Among Students of Ethiopian Higher Education Institutions.

INTRODUCTION: COVID-19 has been a global public health problem since December 2019. Higher education institutions are risky areas for the transmission of COVID-19. But, still there is insufficient information on the prevention of the disease in this setting. OBJECTIVE: To assess knowledge, attitude, and prevention practices towards COVID-19 among students of Ethiopian higher education institutions. METHODS: Institutin  -based cross-sectional study design was conducted from December 1 to 30, 2020 among randomly selected 407 undergraduate students from higher education institutions in Ethiopia. The outcome variables were knowledge, attitude, and practices towards COVID-19. Binary logistic regression models at 95% confidence interval (CI) were used to determine the factors affecting knowledge, attitude, and practices towards COVID-19. In multivariable analysis, variables with a p-value of less than 0.05 were considered statistically significant and independently associated with outcome variables at 95% CI. RESULTS: About 75.9% (95% CI: 72.2-79.9%) of University students had a good knowledge, 62.4% (95% CI: 58.2-67.1%) had a positive attitude, and 56.8% (95% CI: 52.6-61.9%) had a good COVID-19 prevention practices. Students over the age of 30 (AOR=5.8; 95% CI: 1.5, 10.6), third-year students (AOR=3.1; 95% CI: 1.1, 8.9), and being health science students (AOR=4.4; 95% CI: 2.2, 8.9) were significantly associated with a good knowledge towards COVID-19. Urban residents (AOR=0.6; 95% CI: 0.3-0.9), having an average family monthly income of $75USD (AOR=3.5; 95% CI: 1.8-6.7), use of at least one type of social media (AOR=4.7; 95% CI: 1.7-12.9), and having a positive attitude (AOR=2.2; 95% CI: 1.3-3.5) were significantly associated with COVID-19 prevention practices. CONCLUSION: Despite three-fourths of the participants had a good knowledge, the attitude and prevention practices were low. Age, study year, College of study, presence of chronic illnesses, use of social media, family income, and residence were factors of knowledge, attitude, and prevention practices towards COVID-19. Hence, multiple information dissemination strategies using multiple media outlets should be implemented continuously.

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.

Knowledge, attitude, and preventive practices towards COVID-19 and associated factors among adult hospital visitors in South Gondar Zone Hospitals, Northwest Ethiopia.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is currently the critical health problem of the globe, including Ethiopia. Visitors of healthcare facilities are the high-risk groups due to the presence of suspected and confirmed cases of COVID-19 in the healthcare setting. Increasing the knowledge, attitude, and practices towards COVID-19 prevention among hospital visitors are very important to prevent transmissions of the pandemic despite the lack of evidence remains a challenge in Ethiopia. Therefore, this study was designed to investigate the status of knowledge, attitude, and preventive practice towards COVID-19 and associated factors among hospital visitors in South Gondar Zone Hospitals, Northwest Ethiopia. METHODS: A facility-based cross-sectional study design was employed during August 1 to 30, 2020 from randomly selected 404 adult hospital visitors in South Gondar Zone Hospitals, Northwest Ethiopia. The data was collected using interviewer-administered questionnaire. The outcome of this study was good or poor knowledge, positive or negative attitude and good or poor preventive practice towards COVID-19. Three different binary logistic regression models with 95% CI (Confidence interval) was used for data analysis. For each mode, bivariable analysis (crude odds ratio [COR]) and multivariable analysis (adjusted odds ratio [AOR]) was used during data analysis. From the bivariable analysis, variables with a p-value <0.25 were retained 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 knowledge, attitude and preventive practices towards COVID-19. MAIN FINDINGS: About 69.3% of the respondents had good knowledge, 62.6% had a positive attitude, and 49.3% had good preventive practice towards the prevention of COVID-19. We found that factors significantly associated with good knowledge about COVID-19 were educational status who can read and write (AOR = 2.78; 95%CI: 1.18-6.56) and college and above (AOR = 6.15; 95%CI: 2.18-17.40), and use of social media (AOR = 2.96; 95%CI: 1.46-6.01). Furthermore, factors significantly associated with a positive attitude towards COVID-19 includes the presence of chronic illnesses (AOR = 5.00; 95%CI; 1.71-14.67), training on COVID-19 (AOR = 3.91; 95%CI: 1.96-7.70), and peer/family as a source of information (AOR = 2.45; 95%CI: 1.06-5.63). Being a student (AOR = 7.70; 95%CI: 1.15-15.86) and participants who had a good knowledge on COVID-19 (AOR = 4.49; 95%CI: 2.41-8.39) were factors significantly associated with good practice towards COVID-19. CONCLUSION: We found that knowledge, attitude, and preventive practices towards prevention of COVID-19 among adult hospital visitors were low. Therefore, we recommended that different intervention strategies for knowledge, attitude and preventive practices are urgently needed to control the transmission of COVID-19 among adult hospital visitors. Health education of those who could not read and write about COVID-19 knowledge issues and advocating use of social media that transmit messages about COVID-19 are highly encouraged to increase the good knowledge status of adult hospital visitors. Furthermore, providing training about COVID-19 prevention methods and using various sources of information about COVID-19 will help for improving positive attitude towards COVID-19 prevention, whereas for increasing the status of good preventive practices towards COVID-19, improving the good knowledge about COVID-19 of adult hospital visitors are essential.

Prevalence and associated factors of acute respiratory infection among street sweepers and door-to-door waste collectors in Dessie City, Ethiopia: A comparative cross-sectional study.

BACKGROUND: Acute respiratory infections are rising in developing countries including Ethiopia. Lack of evidence for the prevalence and associated factors of acute respiratory infection among street sweepers and door-to-door waste collectors in Dessie City, Ethiopia is a challenge for the implementation of appropriate measures to control acute respiratory infection. Thus, this study was designed to address the gaps. METHODS: A comparative cross-sectional study was conducted among 84 door-to-door waste collectors and 84 street sweepers from March to May 2018. A simple random sampling technique was used to select study participants. Data were collected by trained data collectors using a pretested structured questionnaire and on-the-spot direct observation checklist. Data were analyzed using three different binary logistic regression models at 95% confidence interval (CI): the first model (Model I) was used to identify factors associated with acute respiratory infection among street sweepers, whereas the second model (Model II) was used to identify factors associated with acute respiratory infection among door-to-door waste collectors, and the third model (Model III) was used for pooled analysis to identify factors associated with acute respiratory infection among both street sweepers and door-to-door waste collectors. From each model multivariable logistic regression, variables with a p-value <0.05 were taken as factors significantly associated with acute respiratory infection. RESULTS: The overall prevalence of acute respiratory infection among studied population was 42.85% with 95% CI (35.1, 50.0%). The prevalence of acute respiratory infection among street sweepers was 48.80% (95% CI: 37.3, 64.8%) and among door-to-door waste collectors was 36.90% (95% CI: 27.4, 46.4%). There was no statistically significant difference between the prevalence of acute respiratory infection among the two groups due to the overlapping of the 95% CI. Among the street sweepers, we found that factors significantly associated with acute respiratory infection were not cleaning personal protective equipment after use (adjusted odds ratio [AOR]: 2.40; 95% CI: 1.15, 5.51) and use of coal/wood for cooking (AOR: 3.95; 95% CI: 1.52, 7.89), whereas among door-to-door waste collectors, were not using a nose/mouth mask while on duty (AOR: 5.57; 95% CI: 1.39, 9.32) and not receiving health and safety training (AOR: 3.82; 95% CI: 1.14-7.03) were factors significantly associated with acute respiratory infection among door-to-door-waste collectors. From the pooled analysis, we found that not using a nose/mouth mask while on duty (AOR: 2.19; 95% CI: 1.16, 4.53) and using coal/wood for cooking (AOR: 2.74; 95% CI: 1.18, 6.95) were factors significantly associated with acute respiratory infection for both street sweepers and door-to-door waste collectors. CONCLUSION: The prevalence of acute respiratory infection among street sweepers and door-to-door waste collectors has no statistically significant difference. For both groups, not using a nose/mouth mask while on duty and using coal/wood for cooking fuel factors associated with acute respiratory infection. The municipality should motivate and monitor workers use of personal protective equipment including masks and gloves. Workers should use a nose/mouth mask while on duty and should choose a clean energy source for cooking at home.

Water, sanitation, and hygiene conditions and prevalence of intestinal parasitosis among primary school children in Dessie City, Ethiopia.

BACKGROUND: Intestinal parasitosis is a major public health problem that affects the health of primary school children in low- and middle-income countries where water, sanitation, and hygiene (WASH) conditions are deficient. Since there is a paucity of information on the prevalence and associated factors of this problem among primary school children in Dessie City in Ethiopia, this study was designed to address these gaps. METHODS: A school-based cross-sectional study was conducted among 407 stratified-sampled primary school children in five primary schools at Dessie City from April to June 2018. Data were collected using a pretested structured questionnaire, an observation checklist and laboratory analysis of stool samples. Stool specimen from each study participant was collected using clean, properly labeled and leak-proof stool cup. A portion of stool from each study participant collected sample was processed using saline wet mount technique and examined by microscope. The remaining specimens were preserved with 10% formalin and transported to Dessie Comprehensive Specialized Hospital laboratory to be processed by using formol-ether concentration technique. Then, slide smears were prepared from each processed stool specimen and finally, it was microscopically examined with 10x as well as 40x objectives for the presence or absence of intestinal parasites. Factors significantly associated with intestinal parasitosis were determined using binary logistic regression model at 95% CI (confidence interval). Thus, bivariate (COR [crude odds ratio]) and multivariable (AOR [adjusted odds ratio]) logistic regression analyses were carried out. From the multivariable analysis, variables having a p-value of less than 0.05 were declared as factors significantly associated with intestinal parasitosis among primary school children. MAIN FINDINGS: The overall prevalence of intestinal parasitosis was found to be 16.0% (95% CI: 12.5-19.4%), of these, 50.8% were positive for protozoa, 32.2% for helminth infections and 16.9% for double co-infections. Entamoeba histolytica was the most prevalent parasite (29.2%), followed by Giardia lamblia (21.5%), Ascaris lumbricoides (18.5%), Hymenolepis nana (9.2%) and Enterobius vermicularis (4.6%). Prevalence rates were similar among government (16.3%) and private (15.7%) school children. Water consumption was less than 5 liters per capita per day in 4 of the 5 schools. Thirty-eight (9.3%) of primary school students reported that they practiced open defecation. About two-thirds (285, 70.0%) said they always washed their hands after defecation. Mother's education (illiterate) (AOR = 3.3; 95% CI: 1.20-9.37), father's education (illiterate) (AOR = 3.9; 95% CI: 1.40-10.82), fathers who could read and write (AOR = 3.3; 95% CI: 1.25-7.86), handwashing before meal (sometimes) (AOR = 2.2; 95% CI: 1.11-4.17) and poor knowledge of WASH (AOR = 9.3; 95% CI: 2.17-16.70) were statistically associated with presence of intestinal parasitic infections. CONCLUSION: We concluded that the prevalence of intestinal parasitosis in the study area among Grades 4-8 primary school children had public health significance. Factors significantly associated with intestinal parasitosis among primary school children's were illiterate mothers and fathers, irregular handwashing of children before meals, and poor knowledge of WASH. Health education to improve students' WASH knowledge and mass deworming for parasites are recommended as preventive measures; and improvements to the quality of WASH facilities in primary schools are strongly recommended to support these measures.

Pneumonia remains a leading public health problem among under-five children in peri-urban areas of north-eastern Ethiopia.

BACKGROUND: Pneumonia is a leading cause of morbidity and mortality among children under five years of age in developing countries, including Ethiopia. However, data on this serious illness among highly susceptible and vulnerable children living in local peri-urban areas are limited. Establishing the prevalence of pneumonia and identifying the associated factors are important for proper planning and intervention. METHODS: A community-based cross-sectional study was conducted among 560 systematically selected children under the age of five years in peri-urban areas of Dessie City from January through March 2019. Data were collected using a pretested structured questionnaire, physical examination of children and direct observation of housing conditions. Pneumonia was examined using World Health Organization (WHO) guidelines as the presence of the symptoms of fast breathing or indrawn chest with or without fast breathing during the two weeks prior to the study. A principal component analysis was used to construct a household wealth index. Data were analyzed using a binary logistic regression model at 95%CI (confidence interval). The analysis involved estimating the crude odds ratio (COR) using bivariate analysis, and adjusted odds ratio (AOR) using multivariable analysis. From the multivariable analysis, variables at p-value of less than 0.05 were declared statistically significant. MAIN FINDINGS: The prevalence of pneumonia among children under five was 17.1% (95%CI: 13.9%-19.9%). Of the participating children, 113 (21.0%) had a cough, 92 (17.1%) had fast breathing, 76 (14.1%) had fever, and 40 (7.4%) of the children had chest indrawn. Domestic fuel was the most common source of cooking fuel 383 (71.1%). Majority 445 (82.6%) of children were fully vaccinated and 94 (17.4%) were not fully vaccinated. Most (481, 89.2%) of the children were got exclusive breastfeeding. Slightly more than half (284, 52.7%) of the under-five children had acute malnutrition and 27.1% of the children had a childhood history of ARI. The multivariable analysis showed using domestic fuel as the energy source for cooking (adjusted odds ratio [AOR] = 3.95, 95%CI: 1.47-10.62), cooking in the living room (AOR = 6.23; 95%CI: 1.80-21.68), overcrowding (AOR = 3.37, 95%CI: 1.56-7.27), child history of acute respiratory infection (ARI) (AOR = 6.12 95%CI: 2.77-13.53), family history of ARI (AOR = 4.69, 95%CI: 1.67-13.12) and acute malnutrition (AOR = 2.43, 95%CI: 1.18-5.04) were significantly associated with childhood pneumonia. CONCLUSION: In this study, pneumonia remains a leading public health problem among under five children in the study area and higher than national averages. Domestic fuel as the energy source for cooking, cooking in the living room, overcrowding, child history of ARI, family history of ARI and acute malnutrition were predictors of pneumonia. Community-based interventions focusing on improving housing conditions, reduced use of domestic biofuels, adequate and balanced food intake, including exclusive breastfeeding of infants, and early treatment of ARIs.