High prevalence of soil-transmitted helminths and schistosomiasis among primary schoolchildren in Southwest Ethiopia: the need for health strategies alongside mass drug administration.

BACKGROUND: Soil-transmitted helminths (STH) and schistosomiasis remain widely prevalent in Ethiopia. The aim of this study was to evaluate the prevalence of STH and schistosomiasis among schoolchildren in Gidi Bench district (Southern Nations, Nationalities, and People's Republic, Southwest Ethiopia) and the association with knowledge and health-related behaviors. METHODS: A cross-sectional study was conducted. Stool samples, analyzed by the Kato-Katz technique and a knowledge, attitudes and practices questionnaire, were collected. RESULTS: Out of 611 participants (mean age 12.8±3.1 y), 129 (21.1%) were infected with schistosomiasis and 382 (62.5%) had STH. More than 30% (n=195, 31.9%) were infected with a single intestinal parasite, while 138 (22.6%) and 47 (7.7%) were infected with two or three parasitic infections, respectively. Boys and those who did not participate in school clubs had higher infection rates (p=0.05). Lower parasitic infection was associated with using a latrine when available, washing hands and vegetables and wearing shoes regularly. Higher rates of infection were found among those who reported swimming and washing cloths and utensils in the river regularly. CONCLUSIONS: Schistosomiasis and STH were highly prevalent among schoolchildren in Gidi Bench district. Infection rates were associated with gender, lack of knowledge on parasitic infections and unhealthy behaviors. Findings from this study may assist in decision making regarding disease prevalence and methods of control alongside mass drug administration.

Schistosomiasis Control in Ethiopia: The Role of Snail Mapping in Endemic Communities.

Introduction: Schistosomiasis, a neglected tropical disease (NTD), remains a public health problem in Ethiopia. Freshwater snails, acting as intermediate hosts, release cercariae, the infectious parasite, into the water, which penetrate human skin that encounters infested waters. The objective of this study was to map snail abundance along rivers and study its association with schistosomiasis infection in communities using these rivers. Materials and Methods: A cross-sectional study was carried out at 20 river sites in Mizan Aman city administration, Bench Sheko zone, South West Ethiopia Peoples (SWEP) region, Ethiopia, to study the distribution of host snails and transmission sites for intestinal schistosomiasis. This study used a quantitative database consisting of data on the prevalence of infected snails, the characteristics of rivers and riverbanks, and the prevalence of schistosomiasis in the community, based on stool samples collected from community members near the sampling sites. Results: Aquatic snails were found in 11 of the 20 sites sampled. A total of 598 snails was collected, including Biomphalaria pfeifferi, Biomphalaria sudanica, Radix natalensis and Bulinus globosus species; the most abundant species was Biomphalaria pfeifferi. Stool samples were collected from 206 community members from all 20 sites. Forty-one (19.9%) were positive for Schistosoma mansoni. A positive correlation was found between the presence of snails and positive stool samples (r = 0.60, p = 0.05) and between the presence of infected snails and the prevalence of infection (r = 0.64, p = 0.03). Locations with muddy riverbanks were associated with the presence of snails (r = 0.81, p < 0.001). Conclusions: These results emphasize the importance of mapping snails for the control of schistosomiasis by defining hotspots of infection and identifying factors associated with the presence of infected snails. The results support the need for a continuous mapping of snails and the introduction of snail control as a major element for the successful control of schistosomiasis in endemic communities.

Assessment of Healthcare Waste Generation Rate and Its Management System in Health Centers of Bench Maji Zone.

BACKGROUND: It is known that the basic role of healthcare system is to preserve the health of patients and protect the public from diseases. However, in the process of performing these activities, health facilities generate hazardous waste that could be potentially harmful to healthcare workers, the public and the environment if there is insufficient handling, treatment and disposal of those wastes. Unfortunately, healthcare waste management is, in many regions, not yet carried out with a satisfactory degree of safety. Therefore, the aim of this study was to assess healthcare waste generation rate and its management system in health centers of Bench Maji Zone. METHODS: A cross-sectional study was conducted from February to August, 2016. Observational checklist, key informant interview guide and weight scale were used to assess healthcare waste generation rate and its management system in selected health centers. Training, pre-test, instrument calibration and daily meeting were used to improve data quality. The Data was entered, compiled and analyzed using EpiData version 3.1 and SPSS version 21. The results on waste management system were reported using different descriptive statistics. RESULTS: Out of the total HCW generated in health centers, more than half (57.9%) was general or non-risk HCW, and the remaining 42.1% was hazardous healthcare waste. The amount of HCW generated in the studied health centers was different from WHO's norm which may be attributed to different factors such as economy, patient flow, difference in services provided, poor waste segregation practice, available waste management system and seasonal factors. CONCLUSION: HCW was not adequately managed which is characterized by lack of HCW segregation at source of generation and inadequate facilities to manage HCW. Therefore, it is important to develop a HCW management plan for keeping human health as well environmental sustainability.

Assessment of Child Immunization Coverage and Associated Factors with Full Vaccination among Children Aged 12-23 Months at Mizan Aman Town, Bench Maji Zone, Southwest Ethiopia.

Immunization remains one of the most important and cost-effective public health interventions to reduce child mortality and morbidity. Globally, it is estimated to avert between 2 and 3 million deaths each year. In Ethiopia, immunization coverage rates stagnated and remained very low for many years. Thus, this study was aimed to assess child immunization coverage and factors associated with full vaccination among children aged 12-23 months in Mizan Aman town. The study design was community-based cross-sectional survey. Data was collected by using pretested structured questionnaire. A total of 322 mothers/caretakers were interviewed. Based on vaccination card and mothers/caretakers' recall, 295 (91.6%) of the children took at least a single dose of vaccine. From total children, 27 (8.4%) were not immunized at all, 159 (49.4%) were partially immunized, and 136 (42.2%) were fully immunized. Mothers/caretakers educational level, fathers' educational level, place of delivery, maternal health care utilization, and mothers/caretakers knowledge about vaccine and vaccine-preventable disease showed significant association with full child immunization. The finding from this study revealed that child immunization coverage in the studied area was low. Thus the town health office and concerned stakeholders need to work more to improve performance of the expanded program on immunization in this area.