Detection of spatial, temporal and spatiotemporal distribution of diarrhea incidence among under-five children in Central Gondar zone, Northwest Ethiopia: a time-series study (2019-2022).

Under-five children's diarrhea is a significant public health threat and the World Health Organization (WHO) reported it as the second leading cause of children's death worldwide. In this study area, little is known about the spatiotemporal distribution of under-5 diarrhea incidence. This study was therefore, conducted among all districts in the Central Gondar zone to assess the spatial, temporal, and spatiotemporal variation in diarrhea incidence among under-five children in the Central Gondar zone. The data for children under 5 years of age with diarrhea was obtained from Central Gondar Zone Health Department diarrhea reports from January 2019 to December 2022. All districts were included and geo-coded. The spatial data were created in ArcGIS 10.8.1. Global and local spatial autocorrelation were used to detect hot spots and cold spots. The Poisson model was generated by applying the Kulldorff method in SaTScan™9.6 to analyse the the purely temporal, spatial, and space-time clusters. The study revealed spatial variation of under-5 diarrhea where Gondar City, Gondar Zuria, East Dembia, and Lay Armacho districts were the high-rate spatial clusters during the study period. A year search window for temporal scan statistic identified 01 January 2020-30 December 2021 as risk periods across all districts. Spatiotemporal scan statistics detected high-rate clusters at Gondar City, Gondar Zuria, East Dembia, Lay Armacho, and Alefa between 2019 and 2022. In conclusion, there has been a spatial, temporal, and spatiotemporal variability of under-5 children's diarrhea in the Central Gondar Zone. Interventional and preventive strategies should be developed and given priority to the areas that has been detected as a hotspot in this study to reduce the mortality and morbidity of under 5 children.

Microbiological quality of edible vegetable oils produced and marketed in Gondar City, Northwest Ethiopia.

Edible oils are imported and produced in Ethiopia, notably in Gondar, and their production has expanded considerably in recent years. The expansion of locally produced edible vegetable oils with severe quality control, substandard edible oil production, and quality deterioration may contribute to the contamination of microbes, which may cause public health problems. This study determines the microbiological quality of edible vegetable oils being produced and marketed in Gondar City, Northwest Ethiopia, in 2021. A laboratory-based cross-sectional study design was conducted from May to July 2021 in Gondar City. A simple random sampling technique was used to collect 17 edible vegetable oil samples. Aseptically collected samples were analyzed in the microbiology lab room. The microbiological quality of vegetable oil was assessed using standard microbiological procedures and techniques. The collected data were entered into a Microsoft Excel 2016 spreadsheet and Stata Version 14. A non-parametric Kruskal-Wallis test was used to assess significant variation. Seventeen edible vegetable oil samples were examined and found to contain a varying number of bacteria, yeast, and molds. Staphylococcus aureus, Klebsiella Pneumoniae, and Pseudomonas aeruginosa were the identified bacteria, whereas Saccharomyces cerevisiae, Aspergillus niger, Aspergillus flavus, and Aspergillus fumigatus were the identified fungi. Total coliform and fecal coliform isolates were also identified in the oil samples. A level of microbial contamination that has public health importance was observed in some of the oil samples analyzed, and the isolated microorganisms indicate unhygienic handling, processing, and storage practices in the oil production and market sites. The introduction of strict rules, regulations, and updated manufacturing technologies and processes to ensure food safety and quality is needed.

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.

Cloth sharing with a scabies case considerably explains human scabies among children in a low socioeconomic rural community of Ethiopia.

BACKGROUND: In 2020, scabies were integrated into the WHO roadmap for neglected tropical diseases, aimed at ending the negligence to realize the SDGs. Ethiopia has also introduced scabies as a notifiable disease in drought-prone localities since 2015. Many of the previous studies employed study designs that might be subject to bias. Moreover, there is no scientific evidence about scabies in this area. Hence, this study aimed to determine the prevalence and associated factors of scabies among children aged below 15 years in rural Ethiopia. METHODS: A community-based cross-sectional study was carried out among 942 children in rural kebeles of Lay Gayent District from March through May 15, 2021. A two-stage sampling technique was applied. Data on sociodemographics, housing, water supply and sanitation, children's personal hygiene, and caregivers' knowledge about scabies were collected by a structured questionnaire. Data quality was maintained through pretesting, training of data collectors and supervisors, and supervision. An adjusted binary logistic regression was modelled to identify factors associated with scabies. The Hosmer-Lemeshow goodness-of-fit test was run to check the model fitness. RESULTS: The prevalence of scabies was 21.5% (95% CI 19.0-24.3). Maternal illiteracy (adjusted odds ratio (AOR) = 1.61; 95% CI 1.07-2.43); low household wealth (AOR = 2.04; 95% CI 1.25-3.33); unimproved water source (AOR = 1.58; 95% CI 1.05-2.40); not cleaning a house daily (AOR = 2.43; 95% CI 1.63-3.62); not trimming nails (AOR = 2.21; 95% CI 1.50-3.25); cloth sharing with a scabies case (AOR = 11.77; 95% CI 6.94-19.97); and low caregiver knowledge about scabies (AOR = 2.44; 95% CI 1.64-3.63) were factors associated with scabies. CONCLUSIONS: Scabies remains a significant public health issue among children aged below 15 years in the district. Maternal illiteracy, low household wealth, unimproved water source, not cleaning a house daily, not trimming nails, cloth sharing with a scabies case, and low caregiver knowledge about scabies were factors associated with scabies. Community-wide interventions with prime emphasis on improving maternal education and caregivers' knowledge about scabies, upgrading household wealth, ensuring a safe water supply, providing healthy housing, and ensuring adequate personal hygiene are warranted.

Prevalence of Respiratory Symptoms and Risk Factors Among Street Sweepers in Gondar City Northwest, Ethiopia, 2021: A Cross-Sectional Study.

Background: Street sweepers are exposed to a variety of risk factors such as dust, bioaerosols, and volatile organic matter, which are responsible for the development of various respiratory symptoms and lung function impairments. However, there is a limited data on the prevalence of respiratory symptoms and associated factors among street sweepers in Ethiopia, especially in the study area. Objective: This study aimed to assess the prevalence of respiratory symptoms and associated factors among street sweepers in Gondar town, northwest Ethiopia, in 2021. Methods: Using simple random sampling technique, a total of 391 workers were selected between August 10 and September 15, 2021. The data was entered and analyzed using the Epi Info Version 7 and Statistical Package for Social Science (SPSS) 22 software, respectively. Descriptive statistics, bivariable, and multivariable logistic regression model were used. P ⩽ .05 and adjusted odds ratios (AOR) with 95% confidence interval (CI) were used to declare the statistical significance. Result: A total of 391 respondents, with a response rate of 99.2% participated. The prevalence of respiratory symptoms among street sweepers was 35.3% (95% CI: 30.2, 40.5). History of respiratory illness (AOR = 7.75, (95% CI: 3.45, 17.45), washing personal protective equipments (PPE) after use (AOR = 4.77; 95% CI: 2.02, 11.28), previous work in cement (AOR = 3.10, 95% CI: 1.32, 7.34), and flour factories (AOR = 2.13, 95% CI: 2.02, 4.43), and alcohol drinking (AOR = 3.77, 95% CI: 1.94, 7.29) were associated with respiratory symptom among street sweepers. Conclusion: The overall prevalence of respiratory symptoms among street sweepers was 35.3%. Previous respiratory illness, washing personal protective equipment after use, previous work in a cement and flour factory, and drinking alcohol were independently associated with respiratory symptoms. To reduce the respiratory symptoms among street sweeper, it is advisable implementing safe work practice measures and behavioral changes among workers.

Household-stored drinking water quality among households of under-five children with and without acute diarrhea in towns of Wegera District, in North Gondar, Northwest Ethiopia.

Contamination of drinking water in household water storage containers and inadequate water supplies are common public burdens in low- and middle-income countries, including towns in Wegera District, Ethiopia. Our study aimed to assess the quality of drinking water and identify factors associated with diarrhea in households with under-five (U5) children with and without diarrhea in Ambagiorgis and Gedebge towns in Wegera District. Stored drinking water samples from households with U5 children with and without diarrhea had fecal coliform (FC) counts of 59 (86.8%) and 55 (82.1%) (p > 0.05) and fecal streptococci (FS) counts of 29 (42.7%) and 24 (35.8%) (p > 0.05), respectively. The very high sanitary risk scores were 32 (47.1%) and 21 (31.3%) for FC (p > 0.05); 25 (36.8%) and 3 (4.5%) for FS (p < 0.001), respectively. Contamination of the stored drinking water samples with FS was significantly higher in households with diarrhetic U5 children in the low- and medium-risk ranges (p < 0.05). Water turbidity of 47 (69.1%) and 23 (34.3%) in households with U5 children with and without diarrhea, respectively, was above the permissible level (p < 0.001). The residual free chlorine (RFC) in all the household-stored drinking water samples was below the World Health Organization (WHO) permissible level and temperatures of all the household-stored drinking water samples were permissible. Promotion and advocacy of good stored drinking water handling practices are essential for decreasing the high risk of microbial contamination in both study areas. We recommend education interventions targeting personal hygiene and drinking water handling at the household level.

Enteric pathogens and associated risk factors among under-five children with and without diarrhea in Wegera District, Northwestern Ethiopia.

INTRODUCTION: Childhood diarrhea is highly prevalent in slums in developing countries, but it remains understudied. The objectives of this study were to explore the prevalence of Giardia, rotavirus and bacterial enteropathogens among diarrheic and non-diarrheic children and investigate socio-environmental determinants of diarrhea in two Ethiopian towns. METHODS: A cross-sectional study was conducted from June to October 2016. Prevalence of childhood diarrhea was established using information gathered during interviews with mothers/guardians. Saline wet mounts of fresh stool samples were used to test for the presence of Giardia. Stool samples were cultured on MacConkey agar and suspected colonies were characterized using biochemical tests. Susceptibility testing was done by the disk diffusion method. ELISA was used to screen for rotavirus. RESULTS: A total of 225 children were included in this study. Four enteropathogens (Giardia, rotavirus, Shigella and Salmonella) were identified from 31% (35/112) diarrheic and 12% (14/113) from non-diarrheic children (p < 0.001). The prevalence of rotavirus infection was 18.0% among diarrheic children and 3.3% among non-diarrheic children unvaccinated against rotavirus (p < 0.01). The prevalence of Giardia was 21.0% among diarrheic and 8.0% among non-diarrheic children (p < 0.01). Diarrheic children had significantly higher rates of bloody stool (p < 0.02), vomiting, fever and breastfeeding for children beyond 23 months of age (p < 0.001). Giardia and rotavirus were identified in more diarrheic than non-diarrheic children. CONCLUSION: The high prevalence of Giardia and rotavirus in the study area indicates the need for coordinated healthcare activities in the two communities. Vaccination against rotavirus infections and educational interventions are recommended.