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Girmay AM, Weldetinsae A, Mengesha SD, Adugna EA, Alemu ZA, Wagari B, Serte MG, Awoke KS, Bedada TL, Weldegebriel MG, Dinssa DA, Alemayehu TA, Kenea MA, Tekulu KT, Gobena W, Fikresilassie G, Wube W, Melese AW, Redwan E, Hoffmann V, Tessema M, Tollera G. 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. BMJ Open 2023; 13:e071296. [PMID: 37500269 PMCID: PMC10387618 DOI: 10.1136/bmjopen-2022-071296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
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.
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Affiliation(s)
- Aderajew Mekonnen Girmay
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abel Weldetinsae
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Sisay Derso Mengesha
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ermias Alemayehu Adugna
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Zinabu Assefa Alemu
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Bedasa Wagari
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melaku Gizaw Serte
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Kaleab Sebsibe Awoke
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tesfaye Legesse Bedada
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mesaye Getachew Weldegebriel
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Danial Abera Dinssa
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tsigereda Assefa Alemayehu
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Moa Abate Kenea
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Kirubel Tesfaye Tekulu
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Waktole Gobena
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Getinet Fikresilassie
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wendayehu Wube
- Department of Hygiene and Environmental Health, Ministry of Health, Addis Ababa, Ethiopia
| | - Abayew Wassie Melese
- Department of Hygiene and Environmental Health, Ministry of Health, Addis Ababa, Ethiopia
| | - Ekram Redwan
- Department of Hygiene and Environmental Health, Ministry of Health, Addis Ababa, Ethiopia
| | - Vivian Hoffmann
- International Food Policy Research Institute (IFPRI), Washington, DC, USA
- Department of Economics and School of Public Policy and Administration, Carleton University, Ottawa, Ontario, Canada
| | - Masresha Tessema
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Getachew Tollera
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Kember M, Grandy S, Raudonis R, Cheng Z. Non-Canonical Host Intracellular Niche Links to New Antimicrobial Resistance Mechanism. Pathogens 2022; 11:pathogens11020220. [PMID: 35215166 PMCID: PMC8876822 DOI: 10.3390/pathogens11020220] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 12/04/2022] Open
Abstract
Globally, infectious diseases are one of the leading causes of death among people of all ages. The development of antimicrobials to treat infectious diseases has been one of the most significant advances in medical history. Alarmingly, antimicrobial resistance is a widespread phenomenon that will, without intervention, make currently treatable infections once again deadly. In an era of widespread antimicrobial resistance, there is a constant and pressing need to develop new antibacterial drugs. Unraveling the underlying resistance mechanisms is critical to fight this crisis. In this review, we summarize some emerging evidence of the non-canonical intracellular life cycle of two priority antimicrobial-resistant bacterial pathogens: Pseudomonas aeruginosa and Staphylococcus aureus. The bacterial factors that modulate this unique intracellular niche and its implications in contributing to resistance are discussed. We then briefly discuss some recent research that focused on the promises of boosting host immunity as a combination therapy with antimicrobials to eradicate these two particular pathogens. Finally, we summarize the importance of various strategies, including surveillance and vaccines, in mitigating the impacts of antimicrobial resistance in general.
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