To do's after war: Priorities for acute diarrheal diseases intervention among under-five children in conflict settings of Raya Kobo district, Northeastern Ethiopia.

Introduction: Diarrheal diseases are significant causes of under-five children mortality and morbidity in developing countries. This is particularly alarming among the community living in conflict zones where less attention is given for basic services including water, food, and health. However, there are no detailed investigations on acute diarrhea among under-five children in conflict-affected areas, which impedes intervention approaches. Therefore, this study was designed to assess the prevalence of acute diarrhea and associated factors among under-five children in conflict-affected setting of Raya Kobo, Northeast Ethiopia. Methods: A community-based cross-sectional study was employed among 463 under-five children in Raya Kobo district, from February to March 2021. The study participants were selected from ten rural kebeles. Pre-tested questionnaire and observational checklist were used to collect the data. Bivariate and multivariable logistic regression analyses were computed to identify factors associated with the prevalence of acute diarrhea. Results: The prevalence of acute diarrhea among under-five children was 21% (95% confidence interval (CI): 18.50-23.91%). Unimproved drinking water source (Adjusted odds ratio (AOR) = 2.89; 95%CI: 1.38-6.06), disposal of garbage in open field (AOR = 3.33; 95%CI:1.66-6.67), having low monthly income (AOR = 5.73; 95%CI: 3.07-10.59), absence of latrine facility (AOR = 3.18; 95%CI: 1.09-8.78), poor hand washing practice at critical times (AOR = 2.52; 95%CI:1.28-4.05), not regularly cleaning food utensil before child feeding (AOR = 2.54; 95%CI:1.31-4.94), and not received Rota vaccine (AOR = 4.28; 95%CI: 1.82-10.11) were the determinant factors. Conclusions: To reduce the burden of acute diarrheal diseases, post-war intervention approaches should emphasize on advocating for Rota virus vaccination, regularly cleaning food utensils before feeding, improving hand washing practice at critical times, provision of improved drinking water source, and use of proper solid and domestic sewage discharge/disposal methods.

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.

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.

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 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.

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.

COVID-19 Prevention Practices and Associated Factors Among Farmers in Peri-Urban Areas of Northeastern Ethiopia.

BACKGROUND: COVID-19 is a global health threat due to its rapid spread and ability to kill millions of people. The majority of pandemic-fighting approaches rely on prevention activities, which can be influenced by a variety of factors. Farmers are more vulnerable to COVID-19, so evaluating existing prevention practices and associated factors is critical to prevent the COVID-19 pandemic. OBJECTIVE: To assess COVID-19 prevention practices and associated factors among farmers in peri-urban areas of Northeastern Ethiopia. METHODS: A community-based cross-sectional study design was conducted among 409 selected farmers. Data were collected using face-to-face interviews and on-the-spot-observational checklist. Data were analyzed using bivariable logistic regression model at 95% CI (confidence interval). During the bivariable analysis (crude odds ratio [COR]), varibales having a p-value of less than 0.250 were included into the multivariable analysis (adjsuted odds ratio [AOR]). Factors associated with COVID-19 preventive practices were determined using a multivariable analysis at a p-value of 0.050. RESULTS: Of 409 participants, 206 (63.6%), 157 (38.4%), and 117 (28.6%) of them had satisfactory knowledge, positive attitude, and good prevention practices about COVID-19, respectively. Age of the farmers with greater than or equal to 45 years (AOR: 3.2; 95% CI: 1.7-6.1), educational status of secondary school and above (AOR: 3.1; 95% CI: 1.4-6.6), and income level of having greater than or equal to 2,001.00 Ethiopian birr (ETB) (AOR: 1.9; 95% CI: 1.1-3.4) were all found to be significantly associated with the COVID-19 prevention practices. CONCLUSION: Even though the majority of farmers had satisfactory knowledge, a considerable proportion of them had a negative attitude and poor COVID-19 prevention practices. Age, educational status, and income level are factors associated with COVID-19 prevention practices. Hence, health education should be given to improve the farmers' knowledge, attitudes and prevention practices to minimize the risk of COVID-19 among farmers in semi-urban areas of northestern Ethiopia.

Menstrual hygiene practices among high school girls in urban areas in Northeastern Ethiopia: A neglected issue in water, sanitation, and hygiene research.

BACKGROUND: Poor menstrual hygiene practices influence school girls' dignity, well-being and health, school-absenteeism, academic performance, and school dropout in developing countries. Despite this, menstrual hygienic practices are not well understood and have not received proper attention by school WASH programs. Therefore, this study examined the extent of good menstrual hygiene practices and associated factors among high school girls in Dessie City, Amhara Region, northeastern Ethiopia. METHODS: A school-based cross-sectional study was employed to examine 546 randomly selected high school students in Dessie City, northeastern Ethiopia. Pretested interviewer-administered questionnaires and a school observational checklist were used for data collection. EpiData Version 4.6 and the Statistical Package for the Social Sciences Version 25.0 were used for data entry and analysis, respectively. Bivariate and multivariable logistics regression analyses were employed to identify factors associated with good menstrual hygiene practices. During bivariable analysis, variables with P-values less than 0.25 were retained for multivariable analysis. In the multivariable analysis, variables with a P-value less than 0.05 were declared to be significantly associated with good menstrual hygiene practices. RESULTS: Of the respondents, 53.9% (95% CI [49.6, 58.2]) reported good menstrual hygiene practices. The following factors were found to be significantly associated with good menstrual hygiene practices: age range 16-19 years (AOR = 1.93, 95% CI: [1.22-3.06]); school grade level 10 (AOR = 1.90, 95% CI: [1.18-3.07]); maternal education (primary) (AOR = 3.72, 95% CI: [1.81-7.63]), maternal education (secondary) (AOR = 8.54, 95% CI: [4.18-17.44]), maternal education (college) (AOR = 6.78, 95% CI: [3.28-14.02]) respectively]; having regular menses [AOR = 1.85, 95% CI: (1.03-3.32); good knowledge regarding menstruation (AOR = 2.02, 95% CI: [1.32-3.09]); discussing menstrual hygiene with friends (AOR = 1.79, 95% CI: [1.12-2.86]), and obtaining money for pads from the family (AOR = 2.08, 95% CI: [1.15-3.78]). CONCLUSION: We found that more than half of high school girls had good menstrual hygiene practices. Factors significantly associated with good menstrual hygiene practices include high school girls age 16-18 years, girls grade level 10, maternal education being completed primary, secondary and college level, having regular menses, good knowledge regarding menstruation, discussing menstrual hygiene with friends and obtaining money for pads from the family. Therefore, educating of high school student mothers about MHP should be a priority intervention area to eliminate the problem of menstrual hygiene among daughters. Furthermore, in order to improve the MHP among high school girls, further attention is needed to improving knowledge regarding menstruation among high school girls, encouraging high school girls' families to support their daughters by buying sanitary pads and promoting discussions among friends about menstrual hygiene. Schools need to focus on making the school environment conducive to managing menstrual hygiene by increasing awareness of safe MHP and providing adequate water/sanitation facilities.

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.

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.