Pesticide safety practice and its public health risk in African regions: systematic review and meta-analysis.

BACKGROUND: Although pesticides play an integral role in food security and preventing public health from vector-borne diseases, inappropriate handling and continual use of restricted organochlorine pesticides pose short- and long-term adverse effects and become public health concerns in the African region. This study aimed to determine the combined level of protective equipment use, management of empty pesticide containers, and leftover pesticide residues in the African region. METHODS: The preferred reporting items for systematic reviews and the meta-analysis protocol were used to carry out this study. The Scopus, PubMed, Web of Science, Google Scholar, DOAJ, and National Repository databases were searched for articles published between November 12, 2023, and January 2, 2024. The meta-analysis data were visualized using a forest plot. A random-effects model was applied when heterogeneity existed in pooled studies. Subgroup analysis of the data was performed based on the location where the study was conducted and the publication year. Meta-regression and sensitivity analysis were performed to evaluate the robustness of the pooled prevalence of studies. Publication bias was assessed using a funnel plot. The authors used the Joanna Briggs Institute Critical Assessment tool to determine the quality of the studies. RESULTS: In this review, 2174 articles were identified from the included electronic databases, 24 of which were included in the present study. The study revealed that the combined mean prevalence of wearing a mask, glove, boot/safety shoes, overall wear, and head cover accounted for 18% (95% CI: 11.9 to 26.1%, p < 0.001), 18% (95% CI: 11.7 to 26.9%, p < 0.001), 23% (95% CI: 15.7 to 33.3%, p < 0.001), 26% (95% CI: 16.2 to 38.7%, p < 0.001), and 14% (95% CI: 8.90 to 22.0%, p < 0.001), respectively. The prevalence of pesticides stored in the living room and pesticide containers used for different purposes was 51% and 26%, respectively. CONCLUSIONS: Poor pesticide safety practices were identified. A substantial proportion of the respondents reported storing pesticide residues in their living rooms, and the reuse of pesticide empty containers. Regional institutions should lead the designing of safety strategies to reduce the public health risks of pesticide exposure.

Sero-prevalence of hepatitis viral infections among sanitary workers across worldwide: a systematic review and meta-analysis.

BACKGROUND: Sanitation or sanitary workers are exposed to hepatitis virus infections because of filthy and dangerous working conditions. The current global systematic review and meta-analysis aimed to estimate the pooled sero-prevalence of occupationally associated hepatitis virus infection among them. METHODS: Preferred Reporting Items for Systematic Reviews (PRISMA), and Population, Intervention, Comparison, Outcome and study design (PICOS) were used for flow diagram, and review questions, respectively. Four databases other methods were used published articles from 2000 to 2022. Boolean logic (AND, OR), MeSH, and keywords were used: (Occupation *OR Job *OR Work) AND (Hepatitis A *OR Hepatitis B virus *OR Hepatitis C virus *OR Hepatitis E virus) AND (Solid waste collectors [SWCs] *OR Street sweepers [SS] *OR Sewage workers [STWs] *OR health care facilities cleaners [HCFCs)) AND (Countries). Stata MP/17 software was used for pooled prevalence analysis, meta-regression analysis (Hedges) at a 95% confidence interval (CI:95%). RESULTS: A total of 182 studies were identified studies, a total of 28 studies were included from twelve countries. Of these, from developed (n = 7) and developing countries (n = 5). From total a of 9049 sanitary workers, 5951(66%), 2280 (25%) and 818 (9%) were STWs, SWCs and SS, respectively. Globally, the pooled sero-prevalence of occupational-related hepatitis viral infections among sanitary workers was 38.06% (95% CI: 30-0.46.12). Of this, it was 42.96% (95% CI: 32.63-53.29) and 29.81% (95% CI: 17.59-42.02) for high-income and low-income countries, respectively. Meanwhile, by sub-analysis, the highest pooled sero-prevalence of hepatitis viral infections by categories, type and year were 47.66% (95%CI: 37.42-57.90), 48.45% (95% CI: 37.95-58.96), and 48.30% (95% CI: 36.13-60.47) for SWTs, HAV, and 2000 to 2010 year, respectively. CONCLUSION: The consistency of the evidence suggests that sanitation workers, particularly sewage workers, are susceptible to occupationally acquired hepatitis regardless of their working conditions, necessitating significant changes to occupational health and safety regulations from governmental policies and other initiatives to reduce risks among sanitary workers.

Prevalence and determinants of maternal near miss in Ethiopia: a systematic review and meta-analysis, 2015-2023.

BACKGROUND: One of the most challenging problems in developing countries including Ethiopia is improving maternal health. About 303,000 mothers die globally, and one in every 180 is at risk from maternal causes. Developing regions account for 99% of maternal deaths. Maternal near miss (MNM) resulted in long-term consequences. A systematic review and meta-analysis was performed to assess the prevalence and predictors of maternal near miss in Ethiopia from January 2015 to March 2023. METHODS: A systematic review and meta-analysis cover both published and unpublished studies from different databases (PubMed, CINHAL, Scopus, Science Direct, and the Cochrane Library) to search for published studies whilst searches for unpublished studies were conducted using Google Scholar and Google searches. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Duplicated studies were removed using Endnote X8. The paper quality was also assessed based on the JBI checklist. Finally, 21 studies were included in the study. Data synthesis and statistical analysis were conducted using STATA Version 17 software. Forest plots were used to present the pooled prevalence using the random effect model. Heterogeneity and publication bias was evaluated using Cochran's Q test, (Q) and I squared test (I2). Subgroup analysis based on study region and year of publication was performed. RESULT: From a total of 705 obtained studies, twenty-one studies involving 701,997 pregnant or postpartum mothers were included in the final analysis. The national pooled prevalence of MNM in Ethiopia was 140/1000 [95% CI: 80, 190]. Lack of formal education [AOR = 2.10, 95% CI: 1.09, 3.10], Lack of antenatal care [AOR = 2.18, 95% CI: 1.33, 3.03], history of cesarean section [AOR = 4.07, 95% CI: 2.91, 5.24], anemia [AOR = 4.86, 95% CI: 3.24, 6.47], and having chronic medical disorder [AOR = 2.41, 95% CI: 1.53, 3.29] were among the predictors of maternal near misses from the pooled estimate. CONCLUSION: The national prevalence of maternal near miss was still substantial. Antenatal care is found to be protective against maternal near miss. Emphasizing antenatal care to prevent anemia and modifying other chronic medical conditions is recommended as prevention strategies. Avoiding primary cesarean section is recommended unless a clear indication is present. Finally, the country should place more emphasis on strategies for reducing MNM and its consequences, with the hope of improving women's health.

Global Occupational Exposure to Blood and Body Fluids among Healthcare Workers: Systematic Review and Meta-Analysis.

Background: Occupational exposure to blood and body fluids has become a serious public health problem for healthcare workers and is a major risk for the transmission of various infections such as human immune-deficiency virus, hepatitis B virus, and hepatitis C virus. This systematic review and meta-analysis aims to determine the career time and previous one-year global pooled prevalence of occupational exposure to blood and body fluids among healthcare workers. Methods: For the review, the articles published in English were searched using the electronic databases (SCOPUS/Science Direct, PubMed, Web of Science, Google Scholar, CINAHL, MEDLINE, Cochrane Library, DOAJ, and MedNar) with a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings (MeSH), and keywords. A quality assessment was conducted to determine the relevance of the articles using JBI critical appraisal tools. Furthermore, several steps of assessment and evaluation were taken to select and analyze the relevant articles. Results: Of the 3912 articles identified through the electronic database search, 33 that met the inclusion criteria were included in the final analysis. The current study found that the global pooled prevalence of blood and body fluids among healthcare workers during career time and in the previous one year accounted for 56.6% (95% CI: 47.3, 65.4) and 39.0% (95% CI: 32.7, 45.7), respectively. Based on subgroup analysis by publication year, survey year, and World Health Organization regions, the highest prevalence of blood and body fluid exposure in the last 12 months was observed among articles published between 2004 and 2008 (66.3%), conducted between 2003 and 2008 (66.6%), and conducted in the Southeast Asia Region (46.9%). The highest career time prevalence was 60.6%, 71.0%, and 68.4% for articles published between 2015 and 2020, conducted between 2015 and 2019, and reported in the African region, respectively. Conclusion: The current study revealed a high prevalence of occupational exposure to blood and body fluids among healthcare workers and suggests the need to improve occupational health and safety services in healthcare systems globally.

Public health implications of heavy metals in foods and drinking water in Ethiopia (2016 to 2020): systematic review.

BACKGROUND: Besides their benefits, heavy metals are toxic, persistent, and hazardous to human health, even at their lower concentrations. Consumption of unsafe concentrations of food contaminated with heavy metals may lead to the disruption of numerous biological and biochemical processes in the human body. In developing country including Ethiopia, where untreated or partially treated wastewater is used for agricultural purposes, the problems related to the consumption foods contaminated with heavy metals may poses highest risk to human health. Therefore, this review was aimed to determine the public health implications of heavy metals in foods and drinking water in Ethiopia. METHODS: The articles published from 2016 to 2020 were identified through systematic searches of electronic databases that include MEDLINE/PubMed, EMBASE, CINAH, Google Scholar, WHO, and FAO Libraries. The data was extracted using a predetermined data extraction form using Microsoft Excel, 2016. The methodological quality of the included studies was assessed using mixed methods appraisal tool (MMAT) version 2018 and Joanna Briggs Institute Critical Appraisal tools to determine the relevance of the studies. Finally, the results were evaluated based on the FAO/WHO guidelines for foods and drinking water. RESULTS: A total of 1019 articles published from 2016 to 2020 were searched from various electronic databases and by manual searching on Google. Following the initial screening, 317 articles were retrieved for evaluation and 49 articles were assessed for eligibility, of which 21 studies were included in the systematic review. The mean concentration of Cr, Cd, Pb, As, Hg, Zn, Cu, Ni, Co, Fe and Mn in fruits and vegetables ranged from 2.068-4.29, 0.86-1.37, 1.90-4.70, 1.01-3.56, 3.43-4.23, 19.18-98.15, 4.39-9.42, 1.037-5.27, 0.19-1.0, 199.5-370.4, 0.26-869 mg/kg, respectively. The mean concentration Cr, Cd, Pb, As, Zn, and Fe in meat and milk ranged from 1.032-2.72, 0.233-0.72, 1.32-3.15, 0.79-2.96, 78.37-467.7, and 505.61-3549.9 mg/kg, respectively. The mean concentration of Cr, Cd, Pb, Zn, and Cu in drinking water ranged 0.0089-0.054, 0.02-0.0237, 0.005-0.369, 0.625-2.137, and 0.176-1.176 ml/L, respectively. The mean concentration of Cr, Cd, Pb, Zn, Cu, Ni, Co, Fe, and Mn in other edible cereals ranged from 0.973-2.165, 0.424-0.55, 0.65-1.70, 70.51-81.58, 14.123-15.98, 1.89-13.8, 1.06-1.59, 67.866-110.3, and 13.686-15.4 mg/kg, respectively. CONCLUSION: This systematic review identified heavy metals in foods and drinking water and determined their public health implications. The results of this finding imply that the majority of the studies reported high concentrations of toxic heavy metals in foods and drinking water that are hazardous to human health. Therefore, effective food safety and risk-based food quality assessment are essential to protect the public health.

Worldwide Prevalence of Occupational Exposure to Needle Stick Injury among Healthcare Workers: A Systematic Review and Meta-Analysis.

BACKGROUND: Healthcare workers are at high risk of occupational exposure to needle stick injury worldwide. Occupational exposure to needle stick injury represents the most common sources of infection such as hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. Thus, this review aimed to determine the career time and previous one-year global pooled prevalence of occupational exposure to needle stick injury among healthcare workers. METHODS: The review considered articles written in English language and published from 2012 to 2020. The articles were searched using nine electronic databases (PubMed, Google Scholar, CINAHL, MEDLINE, Cochrane library, Web of Science, SCOPUS, MedNar, and ScienceDirect) using a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings, and keywords. Quality assessment was performed to determine the relevance of the articles using Joanna Briggs Institute critical appraisal tools. Several steps of assessment and evaluation were taken to select and analyze the relevant articles. RESULTS: The worldwide pooled prevalence of needle stick injuries among healthcare workers during career time and previous one year was 56.2% (95% CI: 47.1, 64.9) and 32.4% (95% CI: 22.0, 44.8), respectively. The career time pooled prevalence of needle stick injuries based on the socioeconomic development and study area was 54.8% and 55.1%, respectively, and one-year pooled prevalence of needle stick injury was 26.0% and 20.9%. CONCLUSION: The review found a high prevalence of occupational exposure to needle stick injury among healthcare workers and suggests the need to improve occupational health and safety services in the healthcare systems.

Global Public Health Implications of Traffic Related Air Pollution: Systematic Review.

Background: Traffic-related air pollution (TRAP) has significant public health implications and a wide range of adverse health effects, including cardiovascular, respiratory, pulmonary, and other health problems. This study aimed to determine the public health impacts of traffic-related air pollution across the world that can be used as an input for protecting human health. Methods: This study considered studies conducted across the world and full-text articles written in English. The articles were searched using a combination of Boolean logic operators (AND, OR, and NOT), MeSH, and keywords from the included electronic databases (SCOPUS, PubMed, EMBASE, Web of Science, CINAHL, and Google Scholars). The quality assessment of the articles was done using JBI tools to determine the relevance of each included article to the study. Results: In this study, 1 282 032 participants ranging from 19 to 452 735 were included in 30 articles published from 2010 to 2022. About 4 (13.3%), 9 (30.0%), 12 (40.0%), 8 (26.7%), 2 (6.7%), 15 (50.0%), 3 (10.0%), 3 (10.0%) 1 (3.3%), and 3 (10.0%) of articles reported the association between human health and exposure to CO, PM10, PM2.5, NOx, NO, NO2, black carbon, O3, PAH, and SO2, respectively. Respiratory diseases, cancer, cognitive function problems, preterm birth, blood pressure and hypertension, diabetes, allergies and sensitization, coronary heart disease, dementia incidence, and hemorrhagic stroke were associated with exposure to TRAP. Conclusions: Exposure to nitrogen dioxide, nitrogen oxide, sulfur dioxide, and fine particulate matter was associated with various health effects. This revealed that there is a need for the concerned organizations to respond appropriately.

Organochlorine pesticides in Ethiopian waters: Implications for environmental and human health.

Despite the global ban on organochlorine pesticides (OCPs) since the 1970s, their use continues in many developing countries, including Ethiopia, primarily due to the lack of viable alternatives and weak regulations. Nonetheless, the extent of contamination and the resulting environmental and health consequences in these countries remain inadequately understood. To address these knowledge gaps, we conducted a comprehensive analysis of reported concentrations (n=398) of OCPs (n=30) in distinct yet interconnected water matrices: water, sediment, and biota in Ethiopia. Our analysis revealed a notable geographical bias, with higher concentrations found in sediments (0.074-1161.2 µg/kg), followed by biota (0.024-1003 µg/kg) and water (0.001-1.85 µg/L). Moreover, DDTs, endosulfan, and hexachlorohexenes (HCHs) were among the most frequently detected OCPs in higher concentrations in Ethiopian waters. The DDT metabolite p,p'-DDE was commonly observed across all three matrices, with concentrations in water birds reaching levels up to 57 and 143,286 times higher than those found in sediment and water, respectively. The findings showed a substantial potential for DDTs and endosulfan to accumulate and biomagnify in Ethiopian waters. Furthermore, it was revealed that the consumption of fish contaminated with DDTs posed both non-carcinogenic and carcinogenic risks while drinking water did not pose significant risks in this regard. Importantly, the issue of OCPs in Ethiopia assumes even greater significance as their concentrations were found to be eight times higher than those of currently used pesticides (CUPs) in Ethiopian waters. Consequently, given the ongoing concerns about OCPs in Ethiopia, there is a need for ongoing monitoring, implementation of sustainable mitigation measures, and strengthening of OCP management systems in the country, as well as in other developing countries with similar settings and practices.

Heavy metals in Ethiopian drinking water and public health risks: Insights from nationwide and regional analysis.

The ambitious sustainable development goal (SDG) 6 of the United Nations, which aims to achieve universal access to safe water and sanitation by 2030, remains elusive for many developing countries like Ethiopia. This is often due to a multitude of intricate factors, including the escalating degradation of water quality. Here, we present a comprehensive nationwide and regional analysis of heavy metal pollution in drinking water sources and the associated human health risks in Ethiopia based on a dataset of 11 heavy metal concentrations (n = 975) collated from available studies. Results indicate significant variations in heavy metal pollution in drinking water sources in Ethiopia, with 44 % of the total concentration exceeding maximum permissible limits. The mean concentrations were ranked as follows: Pb (1.92 mg/L) > Zn (1.25 mg/L) > Fe (0.56 mg/L) > Mn (0.43 mg/L) > Cu (0.40 mg/L) > Co (0.30 mg/L) > As (0.12 mg/L) > Ni (0.12 mg/L) > Cr (0.10 mg/L) > Cd (0.06 mg/L) > Hg (0.04 mg/L). We found that children are more vulnerable to non-carcinogenic health risks than adults, with the highest hazard quotient (HQ) exceedances of up to a factor of 1823 and 762, respectively. Furthermore, a Monte Carlo-based probabilistic risk assessment highlighted significant concerns regarding co-exposure to multiple heavy metals. The measured concentrations, ingestion rates, and exposure frequencies were identified as sensitive parameters. Overall, a higher risk was attributed to Pb and As, with river drinking water sources and the Tigray region requiring immediate mitigation measures. In conclusion, the findings emphasize the urgent need to test and purify water before consumption and to implement effective public health interventions. Furthermore, a multifaceted approach including regular monitoring, source protection, and proper waste management is recommended to expedite the achievement of SDGs and promote water sustainability in resource-limited Ethiopia and sub-Saharan Africa.

Mixed-methods approach in evaluating safe abortion care services at public health facilities in North Shewa zone, central Ethiopia: a multicenter institutional cross-sectional study.

Background: Of the 55.7 million abortions that were performed globally, 25.1 million (45.1%) were not safe. Nearly 97% of these took place in developing countries. Approximately 71% of economically developed countries allow safe abortion care (SAC) services, whereas only 16% of developing countries permit it. In sub-Saharan Africa, 92% of mothers live in 43 countries where SAC services are restricted by law. Most Ethiopian women continue to self-terminate unwanted pregnancies in hazardous conditions. The aim of this evaluation was to assess input, care providers' compliance with national guidelines, and clients' satisfaction. Methods: A multicenter cross-sectional study design with a mixed-methods approach was used. Seven public health facilities were randomly selected where 75 health caseworkers were directly observed; 296 clients and 14 key informants were interviewed, respectively. A resource inventory checklist was used to assess all inputs. The overall SAC services evaluation was summarized from 40 indicators: 13 resource availability indicators, 14 healthcare workers' compliance to national guidelines indicators, and 13 clients' satisfaction toward SAC services indicators. A multivariate logistic regression model was fit to determine factors that affect client satisfaction at a p-value <0.005. Results: There were 75 healthcare providers in the maternal and child health departments in the study area. Except for the interruption of water and electricity, maternal waiting area, counseling, and procedural room, all are available making 94% of resources availability. All healthcare workers were compliant in providing anti-pain medication during procedures, identifying clients if they were targeted for an HIV/AIDS test, and providing their test results as per the guideline. Nevertheless, they were poorly compliant in respecting the clients (9, 12%) and taking vital sign (33, 44%). The overall compliance was 62.3%, while only 51% were satisfied with waiting time and privacy of counseling room. The overall client satisfaction was 65%. The overall evaluation of SAC services was 72.9%. Conclusion: Resource availability was excellent, which was in line with national SAC expectations while the healthcare workers' compliance to national guidelines was fair, which deviated from expectations. The clients' satisfaction and the overall evaluation were good, which was below the hypothesized expectation.

Occupational-Related Injuries and Associated Risk Factors Among Healthcare Workers Working in Developing Countries: A Systematic Review.

Background: Occupational-related diseases or illnesses account for an estimated 2.4 million deaths worldwide every year. Currently, occupational hazards threaten healthcare workers' (HCWs) lives, safety, and well-being. Therefore, providing the prevalence and major causes of occupational-related diseases may enable injury reduction and the creation of safer working environments, which are important for providing higher quality services. The current study aimed to determine the prevalence of occupational-related injuries and associated risk factors among HCWs, particularly in developing countries. Methods: The articles published in English were retrieved using a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings (MeSH), and keywords in electronic databases (SCOPUS/Science Direct, Web of Science, DOAJ, PubMed/MEDLINE, CINAHL, and Google Scholars). Using Joanna Briggs Institute critical appraisal tools, a quality assessment was conducted to determine the articles' relevance. In addition, the relevant articles were identified through a series of assessment and evaluation stages. Results: About 721 studies were searched using electronic databases, of which 36 articles included 139,578 HCWs. The average prevalence of occupational-related injuries among HCWs in the career and previous last year accounted for 60.17%, ranged from 32% to 87.8% and 39.16%, ranged from 1.14% to 87%, respectively. The current study found that sex and hours worked, stress at work, occupation, age, training in infection prevention, use of universal precautions, recapping needles, ward work experience, staffing and resource adequacy, awareness, outdated guidelines, and previous exposure to sharp injury were statistically associated with occupational-related injuries. Conclusions: This study revealed that 39% and 60% of HCWs experienced occupational-related injuries in the last year and during their career, respectively. Therefore, the appropriate measures must be taken to reduce the burden of occupational-related injuries by following standard precautions or occupational health and safety measures.

Incidence of Urinary Tract Infection Among Patients: Systematic Review and Meta-Analysis.

Healthcare-associated infection is one of the most common and severe threats to patients' health and remains a significant challenge for healthcare providers. Among healthcare-associated infections, urinary tract infection (UTI) is one of the most common infections. This study aimed to determine the global incidence of UTI among patients. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used to perform this systematic review and meta-analysis. The articles were searched from April 4 to August 5, 2022, from electronic databases (Scopus, PubMed, Web of Science, Google Scholar, DOAJ, and MedNar) using Boolean logic operators, MeSH terms, and keywords. The quality of the study was assessed using the JBI Critical Assessment tool. One thousand nine ninety three articles were retrieved from the electronic databases, of which 38 articles conducted on 981 221 patients were included in the current study. The study found the global pooled incidence of UTI accounted for 1.6%. Based on the subgroup analysis by survey period and WHO region, the highest incidence of UTI was reported in the African Region [3.6%] and among studies conducted between 1996 and 2001 [3.7%]. This study revealed the overall pooled incidence of UTI was 1.6%. The highest incidence of UTI (3.6%) was reported in the African region. This indicates that there is a need to implement safety measures.

Global Incidence of Surgical Site Infection Among Patients: Systematic Review and Meta-Analysis.

Healthcare-associated infections pose one of the most severe threats to patients' health and remain a major challenge for healthcare providers globally. Among healthcare-associated infections, surgical site infection is one of the most commonly reported infections. It remains a major cause of morbidity and mortality across the world. The aim of this study was to provide a pooled incidence of surgical site infection among patients on a regional and global scale. This study was conducted under the PRISMA guidelines developed for systematic review and meta-analysis. The studies were searched using electronic databases (SCOPUS, PubMed/MEDLINE, Web of Science, Google Scholar, DOAJ, and MedNar) from June 1st, 2022 to August 4th, 2022, using Boolean logic operators (AND, OR, and NOT), Medical Subject Headings (MeSH), and keywords. The quality of the study was assessed using the Joanna Briggs Institute Critical Assessment tool to determine the relevance of each included article to the study. A comprehensive meta-analysis version 3 was used to estimate the pooled prevalence of surgical site infections among the patients. A total of 2124 articles were retrieved from the included electronic databases. Finally, after applying inclusion criteria, 43 articles conducted in 39 countries were included in the current study. The global pooled incidence of SSI was found to be 2.5% (95% CI: 1.6, 3.7). Based on the subgroup analysis by WHO region and survey period, the incidence of SSI was 2.7% (95% CI: 2.2, 3.3%) and 2.5% (95% CI: 1.8, 3.5%), respectively. The highest incidence was reported in the African Region (7.2% [95% CI: 4.3, 11.8%]) and among studies conducted between 1996 and 2001 (2.9% [95% CI: 0.9%, 8.8%]). This study revealed that the overall pooled incidence of SSI was 2.5%. SSI estimates varied among the WHO regions of the world. However, the highest incidence (2.7%) was observed in the African region. This indicates that there is a need to implement safety measures, including interventions for SSI prevention to reduce SSI and improve patient safety.

Detection and Determination of Staphylococcus aureus in Camel Milk and Associated Factors in Fedis, Eastern Hararghe, Ethiopia.

Background: Camel milk is the key food for pastoralists in the arid and semi-arid areas of the eastern lowlands of Ethiopia. Unless it is handled under good hygienic conditions, milk can be a good medium for bacterial growth and can lead to foodborne diseases caused by various pathogenic microorganisms, such as Staphylococcus aureus. The current study was aimed to determine the prevalence of Staphylococcus aureus in raw camel milk and associated factors in Fedis, Eastern Ethiopia. Methods: A cross-sectional study was conducted from December 2, 2018 to May 26, 2019 in Fedis, Eastern Hararghe, Ethiopia. The questionnaire was used to determine the hygienic practices of camel milkers and sellers. Laboratory analysis was conducted to determine the level of Staphylococcus aureus. A total of 156 (78 from households and 78 from selling sites) milk samples were collected randomly from selected camel herd owners and selling sites for the isolation and enumeration of Staphylococcus aureus. Data analysis was carried out using SPSS software version 22.0. Finally, Chi-square and Fisher's exact tests were used to analyze the data. A P-value of .05 was considered as the cut-off point for statistical significance. Results: A total of 156 samples, including 78 samples of raw milk from the households and 78 samples from the market were purchased to determine Staphylococcus aureus. Out of 156 samples, Staphylococcus aureus was detected in 60 (38.5%) samples, of which 27 (34.6%) and 33 (42.3%) were among those collected from household and market, respectively. The overall mean Staphylococcus aureus count was 4.83 log CFU/mL, with household and market samples accounted for 2.76 and 5.08 log CFU/mL, respectively. Furthermore, 23 (38.3%) of the samples were contaminated with Staphylococcus aureus beyond the recommended level (4-5 log CFU/mL). There was a statistically significant association (P-value of <.05) between the prevalence of Staphylococcus aureus and other variables such as age of the camel, parity, lactation stages, and sources of milk. Conclusion: More than one-third of milk samples were contaminated with Staphylococcus aureus at levels higher than the maximum permitted level. The findings of the current study suggests that there is a potential risk of foodborne infection and intoxication. Therefore, implementation of adequate hygiene and safety practices is very important to prevent the consumption of contaminated fruit juices, which leads to foodborne illness.

Global COVID-19 vaccine acceptance rate: Systematic review and meta-analysis.

Background: A vaccine against COVID-19 is a vital tool in managing the current pandemic. It is becoming evident that an effective vaccine would be required to control COVID-19. Effective use of vaccines is very important in controlling pandemics and paving the way for an acceptable exit strategy. Therefore, this systematic review and meta-analysis aims to determine the global COVID-19 acceptance rate that is necessary for better management of COVID-19 pandemic. Methods: This review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols and considered the studies conducted on acceptance and/or hesitancy of COVID-19 vaccine. Articles were searched using electronic databases including PubMed, Scopus, Web of Science, Embase, CINAHL, and Google Scholar. The quality of the study was assessed using the Joanna Briggs Institute (JBI) critical assessment tool to determine the relevance of each included article to the study. Results: Of the 6,021 articles identified through the electronic database search, 68 articles were included in the systematic review and meta-analysis. The global pooled acceptance rate of the COVID-19 vaccine was found to be 64.9% [95% CI of 60.5 to 69.0%]. Based on the subgroup analysis of COVID-19 vaccine acceptance rate by the World Health Organization's region, the countries where the study was conducted, occupation, and survey period, the prevalence of COVID-19 vaccine acceptance rate was 60.8% [95% CI: 56.3, 65.2%], 61.9% [95% CI: 61.3, 62.4%], 81.6% [95% CI: 79.7, 83, 2%] and 64.5% [95% CI: 60.3, 68.5%], respectively. Conclusions: This review revealed the variation in the level of COVID-19 vaccine acceptance rate across the world. The study found that the overall prevalence of COVID-19 vaccine acceptance was 64.9%. This finding indicated that even if the COVID-19 vaccine is developed, the issue of accepting or taking the developed vaccine and managing the pandemic may be difficult.

Knowledge, Attitude, and Practice of Abattoir Workers Toward Abattoirs Waste Management in Eastern Ethiopia.

BACKGROUND: During meat production, a large amount of wastes are generated that consist of feces, tissue waste, blood, fat, bone, animal trimmings, intestinal content, and urine that can be a potential risk to humans and the environment. Low knowledge, negative attitude, and poor practice can lead to poor waste management, which is more severe in developing countries like Ethiopia. Thus, the current study aimed to assess the knowledge, attitudes, and practices of abattoir workers toward abattoir waste management in Eastern Ethiopia. METHODS: A cross-sectional study was conducted in Eastern Ethiopia' abattoirs from 1st to 30th of January, 2020. Two hundred and sixty-seven (n = 267) abattoir workers in 4 selected abattoirs (Haramaya University, Haramaya town, Harar town and Dire Dawa City administration) were interviewed using a pretested structured questionnaire. The data were analyzed using SPSS version 20 statistical package. Pearson's correlation was used to determine the strength between knowledge and attitude, knowledge and practice, and attitude and practice. A P-value of .05 was considered as a cut-off point for statistical significance. RESULTS: This study revealed that 203 (76%) of the respondents had less knowledge, 69 (26%) had a positive attitude and 43 (16%) of them had a good practice toward abattoir waste management. There was a statistically significant difference between socio-demographic characteristics (education, work experience, and salary) and knowledge, attitudes and practices of the study participants. This study found moderate positive correlations between knowledge and attitude [r = .404, P = .013], weak positive correlations between knowledge and practice [r = .229, P = .009], and strong positive correlations between attitude and practice [r = .717, P = .023] of the abattoir workers toward waste management. CONCLUSION: This study concluded that more than one-quarter, less than one-quarter, and about 3-quarter of the participants had less knowledge, negative attitude, and poor practice, respectively toward abattoir waste management. Therefore, regulatory bodies and other relevant industries must implement effective control measures that can be important to increase the knowledge, attitude, and practices of abattoir workers toward waste management.

Bacteriological Quality of Locally Prepared Fresh Fruit Juice Sold in Juice Houses of Eastern Ethiopia.

BACKGROUND: Currently, fresh fruit juices are widely consumed as a drink worldwide due to their nutritional values and health benefits. Fresh fruit juices are an important source of nutrients, vitamins, and fibers that are important for human health. Fruit juices are nutritious and perishable food that can serve as an ideal medium for the growth and multiplication of pathogenic microorganisms. Therefore, this study aimed to determine the bacteriological quality of locally prepared fresh fruit juices sold in juice houses of eastern Ethiopia from 4 April to 12 June 2020. METHODS: A cross-sectional study was used that included administrative questionnaires and laboratory-based investigations. A total of 78 fruit juice samples that include mango, avocado, papaya, and mixed juices were collected aseptically from the juice houses. The most probable number method was used to determine the total coliform, fecal coliform and Escherichia coli. The pour plate count method was used to determine the total viable bacteria count. Finally, data were analyzed using descriptive statistical tests that included analysis of variance, Chi-square and Fisher's exact tests. A P-value of .05 was considered as a cut-off point for statistical significance. RESULTS: Among the 78 juice samples analyzed, 85.9% of the samples had total viable bacterial count, 64.1% had total coliform count, 60.3% had fecal coliform, and 33.3% of the samples had Escherichia coli higher than the maximum permitted level of Gulf standard 2000. The study found a significant association between bacterial contamination and educational status (χ2 = 31.663), training in food hygiene and safety (χ2 = 23.04), method of fruit preservation (χ2 = 17.98), place to keep the juice (χ2 = 13.7), action done with the juice gone bad (χ2 = 12.78), frequency of cleaning materials used to keep the juice (χ2 = 12.78), type of dish washing (χ2 = 19.75), availability of hand washing equipment (χ2 = 12.78), and types of waste receptacles (χ2 = 26.25) (P-value <.05) (Table 5). CONCLUSION: In general, majority of fruit juice samples were contaminated with one or more different bacteria species higher than the maximum permitted level. Furthermore, the study found the association between bacterial contamination and other variables such as hygienic and safety conditions. Therefore, the implementation of adequate hygiene and safety practices is very important to prevent the consumption of contaminated fruit juices, which leads to foodborne illness.

Occupational-Related Upper and Lower Extremity Musculoskeletal Pain Among Working Population of Ethiopia: Systematic Review and Meta-Analysis.

BACKGROUND: Currently, work-related musculoskeletal disorders are a significant public health concern and are a leading cause of disability-adjusted life years and reduced quality of life worldwide. In developing countries, including Ethiopia, as a result of poor occupational health and safety practices and underreporting of the problems, work-related musculoskeletal disorders have been increased, remaining less prioritized, and there is no adequate evidence on the prevalence of musculoskeletal disorders. Thus, the current study aimed to determine and provide the overall prevalence of occupational-related upper and lower extremity musculoskeletal pain among the working population of Ethiopia. METHODS: The current study considered full-text articles conducted in Ethiopia, written in English, and published from 2017 to 2020. Ten electronic databases: PubMed/MEDLINE, Web of Science, SCOPUS, Google Scholar, MedNar, Embase, CINAHL, Cochrane Library, African Index Medicus, and African Journals Online database were used to search the articles using a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings, and main keywords. The quality assessment of the articles was performed using the Joanna Briggs Institute Critical Appraisal tools to determine the relevance of the article to the current study. RESULTS: Of the 1377 articles identified from the included electronic databases, 12 studies were included in the systematic review and meta-analysis. The study found that the pooled prevalence of occupational-related elbow pain, wrist/hand pain, knee/leg pain, foot/ankle pain, and hip/thigh pain in the previous one year was 19.7% (95% CI: 12.3, 30.1), 24.2% (95% CI: 17.4, 32.7), 25.0% (95% CI: 18.5, 32.8), 20.2% (95% CI: 12.8, 30.4), and 15.5% (95% CI: 9.9, 23.4), respectively. Based on a subgroup analysis, the last year's pooled prevalence of occupational-related elbow, wrist/hand, knee/leg, foot/ankle, and hip/thigh pain was increased to 33.7% [95% CI: 31.9, 35.5], 29.7% [95% CI: 28.2, 31.2], 31.5% [95% CI: 29.9, 33.2], 30.6% [95% CI: 29.0, 32.4], and 27.3% [95% CI: 25.5, 29.2], respectively. CONCLUSION: Occupational-related musculoskeletal disorders continue to have a potential impact on workers' health and productivity. The current study found that the overall pooled prevalence of occupational-related upper and lower extremity musculoskeletal disorders in the last year ranged from 15.5 to 33.7%. Implementing occupational health and safety measures play an important role in preventing work-related musculoskeletal disorders and other occupational hazards.

Bacteriological Quality and Public Health Risk of Ready-to-Eat Foods in Developing Countries: Systematic Review and Meta Analysis.

Background: Ready-to-eat foods are foods that are consumed at the point of sale or later, without any further processing or treatment. Foodborne diseases are on the rise worldwide, involving a wide range of diseases caused by pathogenic bacteria, and are becoming a public health problem. Therefore, this study sought to identify and determine the bacteriological quality and public health risks in ready-to-eat foods in developing countries. Methods: The studies published from 2012 to 2020 were identified through systematic searches of various electronic databases such as Google Scholar, PubMed and MEDLINE, MedNar, EMBASE, CINAHL, Scopus, and Science Direct. The articles were searched using a Boolean logic operator ("AND," "OR," "NOT") combination with Medical Subject Headings (MeSH) terms and keywords. All identified keywords and an index term were checked in all included databases. In addition, a quality assessment is performed to determine the relevance of the article, and then the data are extracted and analyzed. Results: The current study found that the pooled prevalence of Staphylococcus aureus, Enterobacter species, Klebsiella, Escherichia coli, Salmonella, Bacillus cereus, Pseudomonas species, and Shigella in ready-to-eat foods was 30.24% (95% CI: 18.8, 44.65), 11.3% (95% CI: 6.6, 18.7), 9.1% (95% CI: 7.0, 11.8), 23.8% (95% CI: 17.5, 31.5), 17.4% (95% CI: 11.6, 25.31)], 26.8% (95% CI: 13.7, 45.9), 6.1% (95% CI: 2.8, 12.6), 34.4% (95% CI: 18.1-55.4), respectively. Conclusions: Most of the reviewed articles reported on various pathogenic bacterial species that are potentially harmful to human health, such as Staphylococcus aureus, Salmonella, Shigella, and Escherichia coli in ready-to-eat food above the maximum allowable limit. Therefore, relevant national and international organizations must take corrective measures to prevent foodborne diseases and protect human health.