Access to water, sanitation and hygiene (WASH) services and drinking water contamination risk levels in households of Bishoftu Town, Ethiopia: A cross-sectional study.

Background and Aims: Access to safe drinking water, sanitation, and hygiene is a fundamental human right and essential to control infectious diseases. However, many countries, including Ethiopia, do not have adequate data to report on basic water, sanitation, and hygiene (WASH) services. Although contaminated drinking water spreads diseases like cholera, diarrhea, typhoid, and dysentery, studies on drinking water contamination risk levels in households are limited in Ethiopia. Therefore, closing this gap needs investigation. Methods: A community-based cross-sectional study was conducted. A total of 5350 households were included. A systematic, simple random sampling technique was used to select the participants. The information was gathered through in-person interviews using a standardized questionnaire. Furthermore, 1070 drinking water samples were collected from household water storage. Results: This investigation revealed that 9.8%, 83.9%, and 4.9% of households used limited, basic, and safely managed drinking water services, respectively. Besides, 10.2%, 15.7% and 59.3% of households used safely managed, basic and limited sanitation services, respectively. Yet, 10.6% and 4.2% of households used unimproved sanitation facilities and open defecation practices. Also, 40.5% and 19.4% of households used limited and basic hygiene services. On the other hand, 40.1% of households lacked functional handwashing facilities. In this study, 12.1%, 26.3%, and 42% of households' drinking water samples were positive for Escherichia coli, fecal coliforms, and total coliforms, respectively. Also, 5.1% and 4.5% of households' drinking water samples had very high and high contamination risk levels for E. coli, respectively. We found that 2.5% and 11.5% of households and water distributors had unacceptable fluoride concentrations, respectively. Conclusion: The majority of households in Bishoftu town lack access to safely managed sanitation, drinking water, and basic hygiene services. Many households' water samples had very high and high health risk levels. Hence, the government and partner organizations should implement water and sanitation safety plans.

Associations of WHO/UNICEF Joint Monitoring Program (JMP) Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia: a cross-sectional study.

OBJECTIVE: To determine the associations of WHO/UNICEF Joint Monitoring Program Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia. DESIGN: A community-based cross-sectional study. SETTING: Bishoftu town, Ethiopia, January-February 2022. PARTICIPANTS: A total of 1807 mothers with at least one child under 5 years were included. Sociodemographic and WASH variables were collected using a structured questionnaire. 378 drinking water samples were collected. OUTCOME: The response variable was diarrhoeal disease among children under 5 years. RESULTS: The 2-week prevalence of diarrhoeal disease among children under 5 years was 14.8%. Illiteracy (adjusted OR 3.15; 95% CI 1.54 to 6.47), occupation (0.35; 0.20 to 0.62), mother's age (1.63; 1.15 to 2.31), family size (2.38; 1.68 to 3.39), wealth index (5.91; 3.01 to 11.59), residence type (1.98; 1.35 to 2.90), sex of the child (1.62; 1.17 to 2.24), child's age (3.52; 2.51 to 4.93), breastfeeding status (2.83; 1.74 to 4.59), food storage practice (3.49; 1.74 to 8.26), unimproved drinking water source (8.16; 1.69 to 39.46), limited drinking water service (4.68; 1.47 to 14.95), open defecation practice (5.17; 1.95 to 13.70), unimproved sanitation service (2.74; 1.60 to 4.67), limited sanitation service (1.71; 1.10 to 2.65), no hygiene service (3.43; 1.91 to 6.16) and limited hygiene service (2.13; 1.17 to 3.86) were significantly associated with diarrhoeal disease. CONCLUSION: In this study, diarrhoea among children is a significant health issue. Child's age, drinking water service, residence type and hygiene service were the largest contributors with respect to the prevalence of diarrhoeal disease. This investigation provides information that could help to inform interventions to reduce childhood diarrhoea. The findings suggest that state authorities should initiate robust WASH strategies to achieve the Sustainable Development Goal 3 agenda.

Adherence to infection prevention and control measures and risk of exposure among health-care workers: A cross-sectional study from the early period of COVID-19 pandemic in Addis Ababa, Ethiopia.

Background and Aim: Healthcare workers (HCWs) are considered a high-risk group for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure, ascribed to the amount of time they spend in health-care facilities (HCFs). This study aimed to assess HCWs' compliance with Infection Prevention and Control (IPC) procedures and the risk of exposure during the early period of the pandemic in Addis Ababa, Ethiopia. Methods: A descriptive cross-sectional survey was conducted from June to September 2020. With a response rate of 79.2%, a standardized questionnaire was administered among 247 HCWs, working in eight HCFs. Descriptive and multivariate regression analysis was carried out in STATA version 16. Results: About 22.5% (55) of the HCWs had proper adherence to IPC procedures. Of the total participants, 28.2% (69) had proper use of Personal Protective Equipment (PPE), 40% (98) had proper hand hygiene practices, and 33.1% (81) had frequently cleaned their working environment. HCWs who received training on IPC protocols were four times more likely to follow IPC standards than those with no training (adjusted odds ratio [AOR] = 3.93; 95% confidence interval [CI]: 1.46, 10.58). Besides, HCWs working in treatment centers were four times more likely to follow IPC standards than those working in conventional hospitals (AOR = 3.61; 95% CI:1.63, 8.02). Nurses were four times more likely to have adherence to IPC measures than cleaners and runners (AOR = 4.37; 95% CI: 1.38-13.88). Conclusion: The nature and magnitude of the pandemic did not introduce the required degree of adherence to IPC procedures, per se does not match the level of diligence needed to halt SARS-CoV-2 transmission. Our finding suggested that providing periodic training of HCWs with particular emphasis on nonclinical staff is commendable. Furthermore, it is necessary to maintain resilent IPC in HCF through continous follow up and safety drills, to assess the readiness of HFCs' adherance to IPC measures under normal circumstances, which could improve prepardeness for an effective response during epidemics.

Determinants of vaccine acceptance, knowledge, attitude, and prevention practices against COVID-19 among governmental healthcare workers in Addis Ababa and Adama, Ethiopia: A cross-sectional study.

Background and Aims: COVID-19 vaccines are vital tools for infection prevention and control of the pandemic. However, coronavirus immunization requires acceptance among healthcare workforces and by the community. In Ethiopia, studies focused on determinants of vaccine acceptance, knowledge, attitude, and prevention practices (KAP) contrary to the novel coronavirus among healthcare staff are limited. Hence, closing this gap requires research. Methods: A cross-sectional study was conducted on 844 governmental healthcare workers. A stratified, simple random sampling technique was used to select the respondents. Data were collected using a structured questionnaire. Binary and multivariable logistic regression statistical models were used to analyze the data. Results: This study indicated that only 57.9% of the participants had good COVID-19 vaccine acceptance, meaning they took at least a dose of the vaccine themselves. We found that 65%, 60.9%, and 51.3% of the participants had good knowledge, prevention practices, and attitude against the pandemic. The novel coronavirus vaccine acceptance rate was 2.19 times more likely among females (adjusted odds ratio [AOR] = 2.19 with 95% confidence interval [CI]: 1.54-3.10) than among male participants. Further, respondents who did not report having any chronic diseases were 9.40 times higher to accept COVID-19 vaccines (AOR = 9.40 with 95% CI: 4.77, 18.53) than those who reported having a chronic condition. However, healthcare workers who had a habit of chewing khat at least once per week were 4% less likely to take the vaccine (AOR = 0.04 with 95% CI: 0.01, 0.32) than those who had no habit of chewing khat. Conclusion: Many core factors influencing COVID-19 vaccine acceptance were identified. A significant number of participants had poor vaccine acceptance, KAP against COVID-19. Therefore, the government should adopt urgent and effective public health measures, including public campaigns to enhance public trust in COVID-19 vaccines. In addition, continuous, timely, and practical training should be provided to healthcare workers.

Tobacco use prevalence and its determinate factor in Ethiopia- finding of the 2016 Ethiopian GATS.

BACKGROUND: Tobacco, one of the risk factors for non-communicable diseases, kills 8 million people each year. Like other sub-Saharan countries, Ethiopia faces the potential challenge of a tobacco epidemic. However, there is no organized data on the prevalence of tobacco use in the country. Therefore, this study aims to determine adult tobacco use in Ethiopia. METHODS: The study was conducted using the WHO and CDC GATS survey methods. Complex survey analysis was used to obtain prevalence and population estimates with 95% confidence intervals. Bivariate regression analyses were employed to examine factors related to tobacco use. RESULTS: The overall tobacco use percentage was 5.0% [95% CI (3.5, 6.9)], of which 65.8% [95% CI (53.4, 76.3)] only smoked tobacco products; 22.5% [95% CI (15.7, 31.2)] used smokeless tobacco only; and 11.8% [95% CI (6.5, 20.4)] used both smoked and smokeless tobacco products. In 2016, more men adults (8.1%) used tobacco than women did (1.8%). Eight out of eleven states have a higher smoking rate than the national average (3.7%). Gender, employment, age, religion, and marital status are closely linked to current tobacco use (p-value< 0.05). Men adults who are employed, married, and mostly from Muslim society are more likely to use tobacco. CONCLUSION: The prevalence of tobacco use is still low in Ethiopia. However, the percentage of female smokers is increasing, and regional governments such as Afar and Gambella have a relatively high prevalence. This calls for the full implementation of tobacco control laws following the WHO MPOWER packages. A tailored tobacco control intervention targeting women, younger age groups, and regions with a high proportion of tobacco use are recommended.

Investigating the Association between Wood and Charcoal Domestic Cooking, Respiratory Symptoms and Acute Respiratory Infections among Children Aged Under 5 Years in Uganda: A Cross-Sectional Analysis of the 2016 Demographic and Health Survey.

Background: Household air pollution associated with biomass (wood, dung, charcoal, and crop residue) burning for cooking is estimated to contribute to approximately 4 million deaths each year worldwide, with the greatest burden seen in low and middle-income countries. We investigated the relationship between solid fuel type and respiratory symptoms in Uganda, where 96% of households use biomass as the primary domestic fuel. Materials and Methods: Cross-sectional study of 15,405 pre-school aged children living in charcoal or wood-burning households in Uganda, using data from the 2016 Demographic and Health Survey. Multivariable logistic regression analysis was used to identify the associations between occurrence of a cough, shortness of breath, fever, acute respiratory infection (ARI) and severe ARI with cooking fuel type (wood, charcoal); with additional sub-analyses by contextual status (urban, rural). Results: After adjustment for household and individual level confounding factors, wood fuel use was associated with increased risk of shortness of breath (AOR: 1.33 [1.10-1.60]), fever (AOR: 1.26 [1.08-1.48]), cough (AOR: 1.15 [1.00-1.33]), ARI (AOR: 1.36 [1.11-1.66] and severe ARI (AOR: 1.41 [1.09-1.85]), compared to charcoal fuel. In urban areas, Shortness of breath (AOR: 1.84 [1.20-2.83]), ARI (AOR: 1.77 [1.10-2.79]) and in rural areas ARI (AOR: 1.23 [1.03-1.47]) and risk of fever (AOR: 1.23 [1.03-1.47]) were associated with wood fuel usage. Conclusions: Risk of respiratory symptoms was higher among children living in wood compared to charcoal fuel-burning households, with policy implications for mitigation of associated harmful health impacts.

Sanitary condition and its microbiological quality of improved water sources in the Southern Region of Ethiopia.

In the Southern Nations, Nationalities, and Peoples' Region of Ethiopia, improved water is the main source of water for household purposes. Access to improved water closer to their homes benefits the community in many ways. It improves their health status, saves their time and energy, and improves their productivity in jobs and education they are engaged in. However, due to natural and human activities, improved water sources do not always deliver good quality of water. It can be contaminated by different pathogenic microorganisms and chemicals. The result indicated that 44.7% and 50.9% of the samples were contaminated with Escherichia coli and enterococci respectively, and from the sanitary condition survey, 57.6% of the water sources exhibited from intermediate- to very high-risk level. And the risk priority matrix identifies 95 (27.9%) samples with high risk and 54 (15.9%) of the samples with very high risk. The main risks identified at those unsafe water sources were that the drainage canals were blocked with mud, grass, leaves, and stones; animals drinking the overflow water and grazing in the proximity of water sources and feces such as cow dung were observed; inadequate protection of water sources such as absence of fences and diversion ditches; and stagnant water near the source. The study conducted in the Southern Nations, Nationalities, and Peoples' Region has clearly indicated that people may be at risk of being exposed to pathogens in half of the improved water sources when used for drinking based on the microbial indicator data or the sanitary inspection risk score. Though no correlation resulted from water quality and sanitary condition of sources, the risk priority matrix did enable prioritization of 54 very high-risk-level water sources for urgent targeted interventions from a total of 340 improved drinking water sources. From this, targeted interventions, improving water management practices, identifying and implementing effective water treatment options, providing sustainable energy sources for the supply of continuous water, and implementing climate resilience water safety planning, are recommended.

Aneugenicity and clastogenicity in freshwater fish Oreochromis niloticus exposed to incipient safe concentration of tannery effluent.

Conventional effluent bioassays mostly rely on overt responses or endpoints such as apical and Darwinian fitness. Beyond the empirical observation, laboratory toxicity testing needs to rely on effective detection of prognostic biomarkers such as genotoxicity. Indeed, characterization of tannery effluent requires slotting in of genotoxic responses in whole effluent toxicity testing procedures. Hence, the prime objective of the present experimental investigation is to apply the technique of biological assay as a tool of toxicity testing to evaluate the induction of micronuclei (MN) in peripheral erythrocytes, and exfoliated cells of gill and kidney of O.niloticus exposed to Maximum tolerable concentrations (MTCs) of composite Modjo tannery effluent (CMTE) and to compare the sensitivity of each cells origin to the induction of MN. After 72h of exposure, cellular aberrations were detected using MN and nuclear abnormality (NA) tests. The induction of MN was significantly higher in exposed groups (P<0.05) when compared to the control group; moreover the tissue specific MN response was in the order, gill cells>peripheral erythrocyte>kidney. Total NA was found to increase significantly (P<0.05), when compared to the non-exposed group. NA was also further ramified as blebbed (BL), bi-nucleated (BN), lobbed (LB) and notched (NT) abnormalities. The result of each endpoint measured has demonstrated that at a concentration of total chromium (0.1, 0.73 and 1.27mg/L), a perceptible amount cellular aberration was measured, further implicating somber treat of genotoxicity to fishes, if exposed to water contaminated with tannery effluent. This further highlight that conventional effluent monitoring alone cannot reveal the effects expressed at cellular and genetic levels further demanding the incorporation of effluent bioassays in risk assessment and risk management/abatement programs.