Water Safety Practices Along the Water Service Chain in Addis Ababa: A Cross-Sectional Study in a Cosmopolitan City

This study investigated water safety practices and risk levels along Addis Ababa's water supply service chain. The data came from 23 random woredas, 384 random households, 115 microbiological water quality tests, and diagnostic inspections from source to point of use. Findings from this study indicate that the surface water sources (53%) and the water source catchments (62%) are characterized by very high-risk and high risk contamination levels respectively. Conversely, the water treatment process (5%) and temporary reservoir (20%) indicates a low risk level. Whereas the water distribution system (40%), water source boreholes (44%), and Household level (29%) water safety practices are identified as medium risk levels. The microbial analysis of the drinking water at the source and point of use indicated low (<11 CFU/100 ml) to high levels (>100 CFU/100 ml) of risk with significant levels of contamination at the household level. Moreover, the household-level water safety practice assessment revealed intermediate to very high levels of risks. The Chi2 test shows that water supply type is significantly associated with occupation(X2(12,384) = 23.44, P < .05) and education(X2(8,384) = 15.4, P < .05). Multinomial regression analysis also showed better occupation is associated with increased access to safe bottled water compared to safe piped water on premises. It can be concluded that the water safety practice encountered low to very high levels of risk of contamination at different components along the water supply service chain and the household level. This study suggests ways to improve Addis Ababa residents' health and well-being through water safety interventions. These include safeguarding water sources, supporting local safe water businesses, providing household water treatment, and handling options, and addressing the barriers and incentives for adopting safe water practices.

Analysis of Achyranthes aspera leaf extract and acute toxicity study on fingerlings of Nile tilapia, Oreochromis niloticus

Schistosomiasis is a debilitating chronic disease with great socioeconomic and public health impact affecting the poor rural populations who lack access to sanitation, and safe water supply. The high cost of synthetic molluscicides, their toxicity to non-target organisms, and their persistence in the environment have forced the research of plant-derived molluscicides. Although plant molluscicides are cheap, biodegradable, ecofriendly and less toxic to higher animals, unregulated applications could affect non-target organisms. Therefore, ecotoxicological studies are essential to assess the toxicity of these substances to economically and ecologically significant fish species and to establish safe dosage level. This study is intended to investigate the acute toxicity of a molluscicidal plant Achyranthes aspera to Nile tilapia fingerlings, Oreochromis niloticus (O. niloticus) (n = 7) were exposed to serial dilutions of A. aspera leaf aqueous extract using maceration method for 96 h in triplicate setup. Phytoconstituents were identified by GC-MS. Mortality data were analyzed by probit regression to determine lethal concentrations. The NOAEC was ascertained through hypothesis testing based on survival data. The respective piscicidal LC1 and LC10 values were 897.43 and 1063.87 mg/L while the LC50 is 1310.74 mg/L. In addition, the NOAEC was 1100 mg/L (p > 0.05). This piscicidal toxicity is much lower than its molluscicidal potency may be due to the presence of rotenones and triterpenoides which are commonly found in piscicidal natural products. The GC-MS analysis revealed 12 phytoconstituents including a monoterpene. This study indicates that A. aspera has low toxicity to Nile tilapia could be due to monoterpenes are nontoxic. The findings of this study demonstrate that, at this dose, the plant is safe to the test fish. Thus it can be effective, eco-friendly and sustainable alternative for the development of molluscicides for snail control.

Public health risks associated with drinking water consumption in the upper Awash River sub-basin, Ethiopia, sub-Saharan Africa

The Upper Awash sub-basin characterized by urban, industrial, agricultural and population growth, has impacted the quality of its water sources. This study focuses on the assessment of public health risks associated with drinking water sources in the sub-basin. In accordance with WHO guidelines, 120 water samples were collected from 60 water supply schemes in dry and wet seasons located in areas with low and high water pollution risk (WPR). Multi-meter, Photometer, Digital Arsenator, and Microbiological test kit measured the concentration of parameters. The assessment uses methods of hazard identification, exposure and dose-response analysis, and risk characterization, including Hazard Quotient (HQ), Cancer Risk (CR), Hazard Index (HI), and probability of infection. Monte Carlo simulation analyzes non-cancer risks from Nitrite, Nitrate, Chromium, Iron, Fluoride, and Arsenic, and CRs from Chromium and Arsenic, and infection risks from Escherichia coli (E.coli). As a result, the Hazard Quotient (HQ) of Nitrate was beyond unity (HQ > 1) in the dry season for all groups. HQ of Chromium was HQ > 1 for Women (1.1E+00) and Children (1.4E+00) in the wet season in the high WPR area. Chromium HQ > 1 for children (1.4E+00) in the wet season and Fluoride (HQ > 1) for Children (3.2E+00) in the dry season in the low WPR area. Arsenic CR was above 1 in 10,000 persons for children in the dry season, for all groups, and for women and children in the wet season in the high WPR areas. The CR of chromium ranged from 1 in 1000 persons, which is beyond the limit. Moreover, the Hazard Index (HI) was higher than the unity (HI > 1) for most cases. All E coli infection risks daily and annually exceeded the acceptable risks. Therefore, Public health concerns in the Sub-basin were quantified, and evidences were generated for risk management to undertake source protection through integrated watershed management and appropriate water treatment technologies.

Rural community perceptions and practices toward the novel coronavirus (COVID-19) prevention in Konso Zone, Southern Ethiopia: a lesson for the next pandemic

Background

Corona Virus Disease (COVID-19) has provided a lesson on preparedness and coping mechanisms for similar pandemics to different community segments. To control and prevent the spreading of COVID-19, people need to possess the correct attitude and perception to follow the appropriate practices against the causative agent. Therefore, this study aimed to assess the rural community's perceptions and practices toward COVID-19 prevention among southern Ethiopia's Konso zone rural communities.

Methods

A community-based cross-sectional study conducted from April to May 2022 on 605 study participants in the Kena district of the Konso zone of Ethiopia. Participants were recruited using simple random sampling techniques. Face-to-face interviews were conducted to collect data using structured questionnaires developed from the World Health Organization guide and related literature. A logistic regression model was used to identify determinants of perception and practice.

Results

Among the 564 participants, 296 (52.5%) believed they would go to the healthcare facility if they contracted COVID-19. About 276 (48.9%) perceived that COVID-19 is not a stigma and should not be concealed. About 233 (41.3%) perceived COVID-19 would be controlled. However, the majority, 451 (80%), 440 (78%), 384 (68.1%), 381 (67.6%), 337 (59.8%), and 317 (56.2%) perceived that the cause of COVID-19 is sin, eating some food items were effective against the virus, no cases in their locality, living far away from COVID-19 area, the virus does not exist, respectively. Overall, only 22.5% of the study participants have good perceptions. About 58.5% practiced handwashing to prevent COVID-19, and 45.2% covered their mouth and nose while coughing/sneezing. Among the participants, 39.8% were vaccinated, and about a quarter (24.8%) of the respondents had good prevention practices. Participants with better educational status, use of social media as a source of information, and those with better income levels are found to be protective factors while being married is a risk factor.

Conclusion

The status of the participant's perception and preventive practices toward COVID-19 was meager. There was a substantial magnitude of wrong perceptions about controlling such pandemics. High inaccurate perceptions and low preventive practice need an urgent and sustained improvement strategy to tackle similar pandemics or epidemics.

Prevalence and risk factors of childhood diarrhea among wastewater irrigating urban farming households in Addis Ababa

INTRODUCTION

Childhood diarrhea is one of the major contributors to the morbidity of under-five children in Ethiopia. Although researchers determine the risk factors varyingly, the exposure route to the pathogens is usually complicated. This study aims to investigate the prevalence and risk factors of diarrhea among children under the age of five among wastewater irrigation farming households in Addis Ababa, Ethiopia.

METHODS

Cross-sectional study was conducted among 402 farming households from November 2021 to February 2022. Data was collected using a face-to-face interviewer-administered questionnaire. Stata version 14 software was used to analyze data. Factors associated with the prevalence of diarrhea was identified using binary logistic regression. Multivariable analysis was carried out to determine an adjusted odds ratio at a confidence level of 95% and level of significance at 0.05.

RESULTS

The overall prevalence of under-five children diarrheal cases was 22.3%. The odds of diarrhea are associated with a multitude of variables. Major wastewater-related determinants associated with diarrhea are body washing with irrigation water [AOR: 37.7, 95%CI (3.1, 358)], contaminated cloth with irrigation water [AOR:10.8,95%CI(0.6, 205)], use of protective clothing during farm work [28.9,95%CI (3.9, 215)], use of farm work cloths at home [AOR: 31.7, 95%CI (4.4, 226)], and bringing unwashed farm tools to home [94 (5.7, 1575)].

CONCLUSION

The high prevalence of under-five children diarrheal disease among wastewater irrigation households was strongly associated with factors related to occupational exposure. Thus, to decrease childhood diarrheal among urban agriculture farmers, appropriate precautions need to be taken.

Micropollutant Removal Efficiency of Advanced Wastewater Treatment Plants: A Systematic Review

Introduction

Various review papers have been published regarding the occurrence and fate of micropollutants (MPs). MPs in the aquatic environment are still not well reviewed to generate comprehensive summaries with a special focus on their removal from wastewater using conventional and advanced treatment processes. Therefore, this review aimed to provide a synopsis of the efficiency of the advanced wastewater treatment plants in the removal of MPs.

Materials and methods

A systematic search of published literature was conducted on the National Library of Medicine (NLM) database, Web of Science, Joanna Briggs Institute (JBI) database, Scopus, and Google Scholar, based on studies with evidence of removal of MPs in the wastewater treatment process. Screening of the published articles was made using pre-specified inclusion and exclusion criteria.

Results

Amongst the 1545 studies searched, 21 full-length articles were analyzed that showed 7 treatment options related to the removal of MPs from wastewater. MPs from wastewater effluents were successfully and effectively removed by advanced treatment techniques. Advanced Oxidation Processes (AOPs), membrane processes, and adsorption processes have all been shown to be potential solutions for the removal of MPs in advanced treatment plants (WWTPs). But, there are 2 critical issues associated with the application of the advanced treatment options which are high operational cost and the formation of dangerous by-products and concentrated residues.

Conclusion

This study identified that the removal of MPs using WWTPs was commonly incomplete with varying removal efficiency. Therefore, the adaptation and scale-up of the cost-effective and efficient combined wastewater treatment technology are vital to creating an absolute barrier to MPs emissions.

Trihalomethanes and physicochemical quality of drinking water in Addis Ababa, Ethiopia

Background

Trihalomethanes (THMs) are the most dominant fraction of all the byproducts formed during chlorination of water. Disinfection by product (DBP) formation in water is a function of numerous factors, including pH, temperature, residual chlorine, source water characteristics, and organic matter. No study has determined the THM level in the drinking water supply of Addis Ababa, Ethiopia.

Methods

A cross-sectional design was conducted to collect water samples in the water supply distribution networks of Addis Ababa, Ethiopia. Twenty-one (21) sampling stations yielded a total of one hundred twenty (120) samples of drinking water. The sample handling and collection procedures were carried out in accordance with USEPA guidelines. A DB-5 capillary column was used to separate the THMs, which were detected using GC-ECD (gas chromatography-electron capture detector). Spectrophotometric and in situ methods were used for physicochemical parameters. Redundancy analysis (RDA) was used for data analysis of trihalomethanes and environmental variables using CANOCO 4.5.

Results

The mean concentration of total trihalomethanes in drinking water in Addis Ababa was 76.3 μg/L. The concentration of chloroform in the drinking water supply in Addis Ababa, Ethiopia, ranged between 4.03 and 79.4 μg/L. The mean total THMs in the Legedadi and Gefersa water supply systems were 77.4 μg/L and 69.66 μg/L, respectively. The residual chlorine, phosphates, UV absorbance at 254 nm, and combined chlorine had positive correlations with THM formation. However, electron conductivity had a negative correlation with THM formation.

Conclusions

Chloroform contributed the most to TTHMs in nearly all samples. The residual chlorine, UV absorbance, phosphate and hardness as calcium, and electron conductivity were found to be the main predictors determining the abundance and distribution of trihalomethanes. The monitoring and regulation of the THMs is required on a regular basis to analyse trends and guide the water treatment and distribution system.

Evaluating the relationship between community water and sanitation access and the global burden of antibiotic resistance: an ecological study

BACKGROUND

Antibiotic resistance is a leading cause of death, with the highest burden occurring in low-resource settings. There is little evidence on the potential for water, sanitation, and hygiene (WASH) access to reduce antibiotic resistance in humans. We aimed to determine the relationship between the burden of antibiotic resistance in humans and community access to drinking water and sanitation.

METHODS

In this ecological study, we linked publicly available, geospatially tagged human faecal metagenomes (from the US National Center for Biotechnology Information Sequence Read Archive) with georeferenced household survey datasets that reported access to drinking water sources and sanitation facility types. We used generalised linear models with robust SEs to estimate the relationship between the abundance of antibiotic resistance genes (ARGs) in human faecal metagenomes and community-level coverage of improved drinking water and sanitation within a defined radii of faecal metagenome coordinates.

FINDINGS

We identified 1589 metagenomes from 26 countries. The mean abundance of ARGs, in units of log10 ARG fragments per kilobase per million mapped reads classified as bacteria, was highest in Africa compared with Europe (p=0·014), North America (p=0·0032), and the Western Pacific (p=0·011), and second highest in South-East Asia compared with Europe (p=0·047) and North America (p=0·014). Increased access to improved water and sanitation was associated with lower ARG abundance (effect estimate -0·22, [95% CI -0·39 to -0·05]) and the association was stronger in urban (-0·32 [-0·63 to 0·00]) than in rural (-0·16 [-0·38 to 0·07]) areas.

INTERPRETATION

Although additional studies to investigate causal effects are needed, increasing access to water and sanitation could be an effective strategy to curb the proliferation of antibiotic resistance in low-income and middle-income countries.

FUNDING

Bill & Melinda Gates Foundation.

Depth profile of reservoir water quality in the Southwest of Ethiopia

The objective of this research was to investigate the variation of water quality parameters at different depths of the Gilgel Gibe I reservoir in Oromia Jimma zone during wet seasons. Five stations within the reservoir were selected, and water quality parameters were determined at four different depths (surface, 5 m, 10 m, and 15 m). Water quality parameters were analyzed on-site using a HACH, HQ40d portable multi-meter, and turbidity was measured using Wag tech turbidity meter and in the laboratory using the standard method. Comparison of water quality parameters among depths were conducted using one-way ANOVA and Tukey's pairwise comparisons with 5% significance level. The probable contributing source of the investigated physicochemical water quality parameters at different depth was identified using Principal components analysis. The results show that depth wise except for total suspended solids (TSS), total dissolved solids (TDS), total phosphorus (TP) and soluble reactive phosphorus (SRP) the rest showed statistically significant difference at p < 0.05 level. Negative correlations were found between depth and dissolved oxygen (DO), water temperature, pH, nitrate (N0₃^-) and chlorophyll a (Chl.a) while positive correlations were found between electrical conductivity (EC), biochemical oxygen demand (BOD₅), turbidity and N0₃^-. The study revealed that the release of nutrients associated with increased concentration of BOD5 at the bottom depth caused low concentration of dissolved oxygen due to oxygen consumption. This was further aggravated through the decomposition of organic matter, indicating organic pollution resulting from runoff from the catchment. The presence of dense masses of blue-green algae in the pelagic zone of Gilgel Gibe I reservoir suggested the presence of ample nutrients for its blooming and significant reduction of water quality, indicating possible eutrophic conditions. Therefore, catchment management is required to protect aquatic life and the reservoir function as a whole from reservoir water quality degradation.

Fecal Contamination in the Wastewater Irrigation System and its Health Threat to Wastewater-Based Farming Households in Addis Ababa, Ethiopia

Due to rapidly growing demand, the production of vegetables is increasing along the Akaki Rivers. The objective of this study was to examine the degree of fecal contamination and levels of fecal contamination and dissemination throughout the wastewater irrigation system. Irrigation water, irrigated soil, and leafy vegetables were collected twice during 2 vegetable growing seasons, at the maturity period of the growing season, from 19 sampling points along the 2 Akaki Rivers. Composite samples were taken from all sampling points and E.coli was enumerated. The mean E.coli load in wastewater and non-wastewater sources were 1.1⁶±5.5³ CFU/100 ml and 2.23²±1.29² CFU/100 ml respectively. All counts of E. coli in the wastewater exceeded the WHO's standards indicating that the irrigation water quality was unacceptable. In the wastewater-irrigated and non-wastewater-irrigated soil, the mean E.coli were 3.6² ±1.58² CFU/g and 1.32²±87.1 CFU/g respectively. Meanwhile, the mean E.coli counts on the lettuce and Swiss chard were 78 ± 2 CFU/g and 44 ±3CFU/g respectively. The E.coli count on the leafy vegetables was found to be associated with the E.coli in the wastewater and soil. The production of leafy vegetables using wastewater with unacceptably high levels of E.coli and high occupational exposure introduces high levels of risk to the farming communities and to the consumers. Leafy, low-growing raw edible vegetables need careful treatment during food production and harvesting procedures or activities.

Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes

BACKGROUND

Assessments of disease burden are important to inform national, regional, and global strategies and to guide investment. We aimed to estimate the drinking water, sanitation, and hygiene (WASH)-attributable burden of disease for diarrhoea, acute respiratory infections, undernutrition, and soil-transmitted helminthiasis, using the WASH service levels used to monitor the UN Sustainable Development Goals (SDGs) as counterfactual minimum risk-exposure levels.

METHODS

We assessed the WASH-attributable disease burden of the four health outcomes overall and disaggregated by region, age, and sex for the year 2019. We calculated WASH-attributable fractions of diarrhoea and acute respiratory infections by country using modelled WASH exposures and exposure-response relationships from two updated meta-analyses. We used the WHO and UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene public database to estimate population exposure to different WASH service levels. WASH-attributable undernutrition was estimated by combining the population attributable fractions (PAF) of diarrhoea caused by unsafe WASH and the PAF of undernutrition caused by diarrhoea. Soil-transmitted helminthiasis was fully attributed to unsafe WASH.

FINDINGS

We estimate that 1·4 (95% CI 1·3-1·5) million deaths and 74 (68-80) million disability-adjusted life-years (DALYs) could have been prevented by safe WASH in 2019 across the four designated outcomes, representing 2·5% of global deaths and 2·9% of global DALYs from all causes. The proportion of diarrhoea that is attributable to unsafe WASH is 0·69 (0·65-0·72), 0·14 (0·13-0·17) for acute respiratory infections, and 0·10 (0·09-0·10) for undernutrition, and we assume that the entire disease burden from soil-transmitted helminthiasis was attributable to unsafe WASH.

INTERPRETATION

WASH-attributable burden of disease estimates based on the levels of service established under the SDG framework show that progress towards the internationally agreed goal of safely managed WASH services for all would yield major public-health returns.

FUNDING

WHO and Foreign, Commonwealth & Development Office.

Menstrual hygiene management practices and determinants among schoolgirls in Addis Ababa, Ethiopia: The urgency of tackling bottlenecks - Water and sanitation services

Background

Menstrual hygiene management (MHM) service provision and improving schoolgirls' hygienic practices in schools are among the major challenges for low and middle income countries, including Ethiopia, in meeting the 2030 Sustainable Development Goals. This study was conducted to assess schoolgirls' MHM practices and what influences those practices in Addis Ababa, the capital city of Ethiopia.

Methods

A cross-sectional study was conducted on 401 adolescent schoolgirls and 98 school directors that were selected using a multistage sampling method. Pretested semi-structured interviewer-administered questionnaires and observational checklists were used to collect data.

Results

During menstruation, about 90% of schoolgirls used commercially made disposable sanitary pads. However, only 45.9% of girls had access to emergency pads from their schools. Of the 98 directors, 79 (80.6%) responded that they had MHM provisions for schoolgirls. However, 42 (42.9%) schools had no water and soap in the pad changing rooms/toilets, and 70% lacked a covered dustbin for disposal/storage of soiled sanitary pads. Besides, more than 55% of the schools practiced open burning and dumping to dispose of used menstrual materials. More than half of the schools had no sanitary pad changing rooms, three-quarters of them lack MHM education, and only 2.5% had a bathing area. The location of schools (AOR = 5.44, 95% CI: (2.34-12.66)), health club availability (AOR = 3.14, 95% CI: (1.53, 6.42)), being informed about MHM before menarche (AOR = 2.04, 95% CI: (1.04, 4.00)), and availability of emergency sanitary pad at schools (AOR = 2.59, 95% CI: (1.36, 4.91)) were significantly associated with the status of schoolgirls menstrual hygiene practices.

Conclusions

About one-quarter of the schoolgirls had poor menstrual hygiene practices. Being a student in inner-city schools, attending a school that had a health club, being informed about MHM before menarche, and having access to emergency pads from schools were the determinant factors for good menstrual hygiene practices. However, most schools lack water, soap, and a covered dustbin in the pad changing rooms/toilets. Moreover, only a few schools provided MHM education and emergency pads. Improving water and sanitation services along with tailored MHM education are urgently needed to circumvent unsafe MHM practices among adolescent schoolgirls.

Aflatoxin contamination of animal feeds and its predictors among dairy farms in Northwest Ethiopia: One Health approach implications

Background

In dairy farming, animal feed is the first line of food safety. Animal feed can become contaminated and spoiled on farms or in storage facilities due to the diverse microorganisms that are naturally present around or on various animal feeds. This study aims to assess the level of aflatoxin and predictors in animal feeds among dairy farms in the South Gondar Zone of Ethiopia.

Methods

A total of 100 samples of each animal feed ingredient (atella, hay, commercial concentrates, and cut and carry pasture) were obtained. A total of 400 animal feed ingredient samples were tested separately among 100 randomly chosen dairy farmers for aflatoxin analysis. Simultaneously, swabs from cow udders and water samples were also collected. Using a structured and pretested questionnaire, the knowledge and practices of animal feed administrators responsible for managing animal feed were also evaluated. Descriptive statistics and logistic regression models were used to identify determinants.

Results

From the total animal feed analyzed, 96% was positive for aflatoxins. Feed storage facilities, feed storage duration, education of animal feed administrators, mixed concentrates, and previous training were found to be associated with aflatoxin contamination levels in animal feeds.

Conclusions

The levels of aflatoxin contamination in animal feeds were found to be higher than the recommended limit; these findings suggest the spread of aflatoxin contamination between humans and animals. Furthermore, the occurrence of aflatoxins in the environment results from milk becoming contaminated with aflatoxins. A One Health strategy should therefore receive special consideration to tackle such problems and safeguard consumer safety.

Exposure and carcinogenic risk assessment of trihalomethanes (THMs) for water supply consumers in Addis Ababa, Ethiopia

Background

Trihalomethanes (THMs), a class of DBPs (disinfection byproducts) that includes chloroform, bromodichloromethane (BDCM), chlorodibromomethane (CDBM), and bromoform. To the best of authors' knowledge, no study has addressed the relationship between the concentration of THMs and lifetime cancer risks (LCR) in drinking water supply system in Addis Ababa, Ethiopia. Therefore, this study aimed to determine the lifetime cancer risks of exposure to THMs in Addis Ababa, Ethiopia.

Method

A total of 120 duplicate water samples were collected from 21 sampling points in Addis Ababa, Ethiopia. The THMs were separated by a DB-5 capillary column and detected by an electron capture detector (ECD). Cancer and non-cancer risk assessments were performed.

Results

The average total THMs (TTHMs)concentration in Addis Ababa, Ethiopia, was 76.3 μg/L. Chloroform was the most dominant THM species identified. The total cancer risk for males was higher than that for females. The average LCR for TTHMs via ingestion in drinking water in this study was unacceptably high risk 93.4 × 10 - 2 . An average LCR through dermal routes was also of unacceptably high risk 4.3 × 10 - 2 . The LCR by chloroform contributes the highest (72%) of the total risk, followed by BDCM (14%), DBCM (10%) and bromoform (4%).

Conclusions

The cancer risk of drinking water due to THMs in Addis Ababa was higher than the level recommended by the USEPA. The total LCR from the targeted THMs was higher via the three exposure routes. Males were at higher THM cancer risk than females. The hazard index (HI) indicated that the dermal route caused higher HI values than the ingestion route. It is essential to apply alternatives to chlorine, i.e., chlorine dioxide (ClO₂), ozone and ultraviolet radiation, in Addis Ababa, Ethiopia. The monitoring and regulation of the THMs is required on a regular basis to analyse the trends and guide the water treatment and distribution system.

Availability of data and materials

The datasets generated for this analysis are available from the corresponding author upon reasonable request.

Determination of pesticide residues in the serum of flower farm workers: A growing occupational hazards in low income countries

Ethiopia is one the major exporter of cut flowers in East Africa. However, the sector is blamed for the intensive use of pesticides which leads to exposure of workers. This study aims to investigate the level of pesticides in blood serum of flower farm workers as a predictor to occupational exposure. A cross-sectional laboratory based study was conducted in central Ethiopia among 194 flower farm workers. Blood sample were collected from 100 study participants (50 from farm workers and 50 civil servants as control). Blood-serum separation, extraction, and clean-up was performed following standard analytical methods. Ten organochlorine pesticides (OCPs) (o,p'-DDT, p,p'-DDD, p,p'-DDE, p,p'-DDT, heptachlor, heptachlor epoxide, endosulfan, dieldrin, methoxychlor, dibutychloridate), and three pyrethroids (cypermethrin, permethrin and deltamethrin) were detected in the serum of the study participants. From the detected pesticides p,p'-DDT and p,p'-DDE were observed at high mean concentration (81.5 ± 83.5, and 12.5 ± 6.7 ng/mL),(38.0 ± 31.8 and 6.84 ± 7.4 ng/mL) in the flower farm and controls, respectively. From the Mann-Whitney U-test, there is a significant difference for total DDT (P < 0.02), p,p'-DDE (P < 0.001), cypermethrin (P < 0.001), heptachlor (P < 0.04), heptachlor-epoxide (P < 0.001) and dibutyl chlorendate (P < 0.01) among the flower farm workers and controls. Multinomial regression revealed, being flower farm worker is a significant predictor of moderate to high residues of p,p'-DDE, total DDT, heptachlor-epoxide and dibutyl chlorendate. The pesticides under study were detected more frequently in the flower farm workers than controls which is an indicative for occupational exposure to pesticides and strict regulation is important for the safety of workers.

Prevalence and Trends of Drinking Water Disinfection Byproducts-Related Cancers in Addis Ababa, Ethiopia

BACKGROUND

Disinfection byproducts (DBPs) from chlorinated drinking water have been linked to an increased risk of cancer in the bladder, stomach, colon, and rectum. No studies showed the independent trends and prevalence of these cancers in Ethiopia. Therefore, this study aimed to determine the prevalence and trends of disinfection byproducts-related cancers in Addis Ababa, Ethiopia.

METHODS

Data were collected from the Addis Ababa Cancer Registry. Spatial data sets were produced and classified into households receiving chlorinated surface water and less chlorinated groundwater. The Cochran-Armitage trend test was used to evaluate whether there was a disinfection byproducts-related cancers (DBRCs) trend among communities receiving chlorinated water. Negative binomial regression was used to analyze the incidence rate.

RESULTS

A total of 11, 438 cancer cases were registered between 2012 and 2016, and DBRCs accounted for approximately 17%. The majority of the total cancer cases were female; 7,706 (67%). The prevalence of DBRCs was found to be higher in communities supplied with chlorinated water. From 2012 to 2016, the trend of colon cancer increased (β = 10.3, P value = .034); however, esophageal cancer decreased (β = -6.5, P value = .018). Approximately 56% of colorectal cancer patients and 53% of stomach cancer patients are known to be using chlorinated surface water for drinking regularly. In addition, approximately 57.1% and 54% of kidney and bladder cancer patients, respectively, used chlorinated surface water.

CONCLUSION

The prevalence of DBRCs in this study was found to be high. The colon cancer trend increased substantially from 2012 to 2016. The prevalence of DBRCs was higher in communities supplied with chlorinated surface water. Similarly, the prevalence of DBRCs was higher among males than females. Further study is required to validate the association between DBRCs and water chlorination.

Effectiveness of interventions to improve drinking water, sanitation, and handwashing with soap on risk of diarrhoeal disease in children in low-income and middle-income settings: a systematic review and meta-analysis

BACKGROUND

Estimates of the effectiveness of water, sanitation, and hygiene (WASH) interventions that provide high levels of service on childhood diarrhoea are scarce. We aimed to provide up-to-date estimates on the burden of disease attributable to WASH and on the effects of different types of WASH interventions on childhood diarrhoea in low-income and middle-income countries (LMICs).

METHODS

In this systematic review and meta-analysis, we updated previous reviews following their search strategy by searching MEDLINE, Embase, Scopus, Cochrane Library, and BIOSIS Citation Index for studies of basic WASH interventions and of WASH interventions providing a high level of service, published between Jan 1, 2016, and May 25, 2021. We included randomised and non-randomised controlled trials conducted at household or community level that matched exposure categories of the so-called service ladder approach of the Sustainable Development Goal (SDG) for WASH. Two reviewers independently extracted study-level data and assessed risk of bias using a modified Newcastle-Ottawa Scale and certainty of evidence using a modified Grading of Recommendations, Assessment, Development, and Evaluation approach. We analysed extracted relative risks (RRs) and 95% CIs using random-effects meta-analyses and meta-regression models. This study is registered with PROSPERO, CRD42016043164.

FINDINGS

19 837 records were identified from the search, of which 124 studies were included, providing 83 water (62 616 children), 20 sanitation (40 799 children), and 41 hygiene (98 416 children) comparisons. Compared with untreated water from an unimproved source, risk of diarrhoea was reduced by up to 50% with water treated at point of use (POU): filtration (n=23 studies; RR 0·50 [95% CI 0·41-0·60]), solar treatment (n=13; 0·63 [0·50-0·80]), and chlorination (n=25; 0·66 [0·56-0·77]). Compared with an unimproved source, provision of an improved drinking water supply on premises with higher water quality reduced diarrhoea risk by 52% (n=2; 0·48 [0·26-0·87]). Overall, sanitation interventions reduced diarrhoea risk by 24% (0·76 [0·61-0·94]). Compared with unimproved sanitation, providing sewer connection reduced diarrhoea risk by 47% (n=5; 0·53 [0·30-0·93]). Promotion of handwashing with soap reduced diarrhoea risk by 30% (0·70 [0·64-0·76]).

INTERPRETATION

WASH interventions reduced risk of diarrhoea in children in LMICs. Interventions supplying either water filtered at POU, higher water quality from an improved source on premises, or basic sanitation services with sewer connection were associated with increased reductions. Our results support higher service levels called for under SDG 6. Notably, no studies evaluated interventions that delivered access to safely managed WASH services, the level of service to which universal coverage by 2030 is committed under the SDG.

FUNDING

WHO, Foreign, Commonwealth & Development Office, and National Institute of Environmental Health Sciences.

Contamination and ecological risk assessment of toxic metals in Awetu watershed stream waters and sediments, Ethiopia

The study analyzed the contamination level and ecological risk assessment of toxic metals Awetu watershed streams. A total of 20 water and 20 sediment samples were collected and analyzed for the toxic metals of Arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), manganese (Mn), nickel (Ni), lead (Pb), tin (Sn), and zinc (Zn). Sediment samples showed severe contamination levels based on ranges in sediment quality guidelines (SQGs). Water samples showed high grades of contamination factor and potential ecological risk factor by toxic metals. The synergistic effects of toxic metals in the sampling sites were evaluated by Nemerow pollution index, potential ecological risk index and modified degree of contamination and were found to have similar results. Dololo stream (D1, D2, D3, and D4) and Kito (K1, K2, and K3) were found at 'toxic' contamination and 'severe' ecological risk. Cd, Mn, Ni, Pb, and Sn contributed to the highest ecological risk. Toxic metal contamination in Dololo stream is attributed to institutions carrying out various anthropogenic activities along the stream bank, including traditional metal plating, garages, laboratory effluents, extensive agriculture, carwash, irresponsible waste disposal, and urban population growth. The result shows Awetu watershed streams are seriously contaminated by toxic metals. Therefore, future pollution control and management plans should accentuate the strict regulation of discharge of wastes from these anthropogenic activities.

Habitat preference of blackflies in Omo Gibe river basin (southwest Ethiopia): Implications for onchocerciasis elimination and control

Ecological control of blackflies (Simulium damnosum) can be an alternative or additional tool to enhance onchocerciasis elimination efforts. However, limited research is conducted on the ecology of blackflies in Ethiopia. In this study, we determined the habitat preference of blackfly larvae and their relationship with aquatic macroinvertebrate predators in the Omo Gibe river basin of southwest Ethiopia. Environmental and biological data were collected from 150 sampling sites during both dry and wet seasons in 2019. Generalized Linear Models (GLMs) were used to identify factors affecting the occurrence and abundance of S. damnosum larvae. Canonical Correspondence Analysis (CCA) was used to investigate the relationship between environmental and biological variables and the abundance of S. damnosum larvae. The findings of this study indicated the abundance of S. damnosum larvae increased with increasing turbidity, alkalinity and altitude, but decreased with increasing concentrations of five-day Biological Oxygen Demand (BOD5), orthophosphate and magnesium ion. Both the presence and abundance of S. damnosum larvae decreased with the increasing abundance of stonefly larvae (Perlidae). Simulium damnosum larvae were found less likely in the presence of mayfly larvae (Baetidae) and were less abundant where Chironomidae are abundant. In conclusion, the findings of this study showed that the habitat preference of S. damnosum larvae is determined by environmental factors and that the presence and abundance of the larvae are affected by macroinvertebrate predators. It is essential to establish buffer zones as a part of watershed management to retain pollutants and prevent them from entering directly into water courses to improve water quality and the assemblages of macroinvertebrate predators and enhance biocontrol of blackflies.

Enteric bacterial pathogens and their antibiotic‐resistant patterns from the environmental sources in different regions of Ethiopia: A laboratory‐based cross‐sectional study

Background and Aim

Antimicrobial resistance (AMR) resulting in the most significant public health and economic threat. Unfortunately, it is one of the missing topics on sustainable development goals (SDGs). Therefore, this laboratory‐based study aimed at determining enteric bacterial pathogens and their antibiotic‐resistant patterns from the environmental sources in different regions of Ethiopia.

Methods

A laboratory‐based cross‐sectional study was conducted by following the standard microbial culture and the Kirby‐Bauer disc diffusion method for identification and AMR patterns of the enteric bacteria using a total of 180 environmental samples from January through June 2020. We employed descriptive statistics to examine the prevalence rate, comparability of results, and summary of AMR patterns of enteric bacteria and a 95% confidence Interval (CI) for considering the statistical significance and give conclusions by using Stata 14.1.

Results

The mean prevalence rates (SD) at 95% CI of AMR enteric bacterial pathogens were 53.13 (2.51)% (52.31, 53.95), 45 (1.85)% (44.40, 45.60), 32.5 (3.01)% (31.10, 33.00), and 31.12 (1.95)% (30.80, 31.45) in Wastewaters, leachate from solid waste dumping sites, waste receiving water bodies (Lake Tana at Bahir Dar and Boye Wetland at Jimma), and Soils sequentially. Specifically, Escherichia coli, Shigella, and Salmonella were 90 (3.10)% (89.00, 91.10), 67.5 (2.58)% (66.72, 68.41), and 45(1.58)% (44.48, 45.52), respectively, investigated in wastewater. In addition, solid waste dumping sites were contaminated with E. coli 80 (3.97)% (79.34, 80.66), Shigella 61 (2.87)% (59.06, 60.94), and Salmonella 42 (5.67)% (40.15, 43.85). This study implies that the waste discharges are the main source of contamination for AMR pathogens to the two aquatic water bodies.

Conclusion

The finding indicated that wastewater and solid waste dumping sites were important sources for AMR enteric pathogens. The finding might have indicated the tip of the iceberg about the environmental contamination with antimicrobial‐resistant enteric pathogens.

Drinking Water Source, Chlorinated Water, and Colorectal Cancer: A Matched Case-Control Study in Ethiopia

BACKGROUND

There is no study conducted on the association between disinfection byproducts (DBPs) in chlorinated drinking water and colorectal cancer (CRC) in Ethiopia. Therefore, this study aimed to determine the relation between chlorine based DBPs in drinking water and CRC in Addis Ababa, Ethiopia.

METHODS

A facility based matched case control study was conducted involving 224 cases and 448 population controls from June 2020 to May 2021. Cases were defined as histologically confirmed CRC cases. Cases were matched with controls by residence, age, and sex using frequency and individual matching. Geocoding of cases, health facility, and georeferencing of controls were carried out. Data was collected using a pretested structured questionnaire. Pearson Chi square and Fisher's exact tests were employed to assess associations. Stratified analysis was used to detect confounding factors and effect modification. A multivariable conditional logistic regression was used to identify risk factors of CRC.

RESULTS

Of 214 CRC cases, 148 (69.2%) used chlorinated water whereas out of 428 controls 161 (37.6%) used chlorinated water. In the final regression model, drinking chlorinated surface water (adjusted matched odds ratio [adjusted mOR] = 2.6; 95% CI 1.7-4.0), history of swimming (adjusted mOR = 2.4; 95% CI 1.4-4.1), years at the place of current residence (adjusted mOR = 1.5; 95% CI 1.1-2.2), hot tap water use for showering (adjusted mOR; 3.8 = 95% CI 2.5-5.9) were significantly associated with CRC. The stratified analysis confirmed that smoking and meat ingestion were not effect modifiers and confounders.

CONCLUSION

Drinking chlorinated water for extended years is a significant risk factor for CRC in Addis Ababa, Ethiopia. In addition, hot tap water use for showering, and swimming history are risk factors for CRC. This information is essential to design integrated interventions that consider chlorination by-products and exposure routes toward the prevention and control of CRC in Ethiopia. Initiating alternative methods to chlorine disinfection of drinking water is also essential.

Malacological and Parasitological Surveys on Ethiopian Rift Valley Lakes: Implications for Control and Elimination of Snail-Borne Diseases

Schistosomiasis is one of the snail-borne diseases responsible for the second-highest burden of diseases among neglected tropical diseases. The use of mass drug administration to the populations most at risk is a backbone of the strategy to prevent and control schistosomiasis transmission. However, it offers no protection against re-infection, and humans are often re-exposed when they return to water bodies where snails release cercariae. Surveys on cercarial infection in snails could provide better insights on human disease risk. Hence, in this study, we investigated cercarial infection in snails and also determined the epidemiology of Schistosoma mansoni among fishermen at Ethiopian Rift Valley lakes. Freshwater snails were collected from the shorelines of Ethiopian Rift Valley lakes for examination of cercarial infection during 2020. Environmental data on water quality variables and physical characteristics of snail habitats were collected. Stool samples were collected from fishermen and the Kato-Katz technique was applied for the quantification of Schistosoma mansoni eggs. A malacological survey indicated that six morphologically distinguishable types of cercariae were found in snails. Infected snails with cercaria were more likely present in habitats with high five-day biological oxygen demand and low dissolved oxygen. The overall prevalence of Schistosoma mansoni infection among the fishermen at Ethiopian Rift Valley lakes was found to be 21.5%. This indicates that fishermen at Ethiopian Rift Valley lakes are one of the groups of people harboring schistosome cercariae which are potentially responsible for the transmission of schistosomiasis to lakeshore communities who have contact with lake water. Therefore, complementary medical treatment, public health interventions, environmental management and snail reduction are needed to control the transmission of schistosomiasis.

Exposure of infants to organochlorine pesticides from breast milk consumption in southwestern Ethiopia

Breast milk is often used as an environmental bioindicator since it serves as an important medium to accumulate organochlorine pesticides. The main aim of this study is to determine the level of organochlorine pesticides in human breast milk collected from three districts of southwestern Ethiopia (Asendabo, Deneba, and Serbo) at three times points baselines (1st month), midline ( six months), and end line (12 months) and risk of infants’ exposure. A longitudinal study was conducted to assess pesticide residues in human breast milk samples and evaluate the risk-exposure of infants to these pesticides from consumption of mother’s milk in Ethiopia. Breast milk samples were collected from 168 mothers at three time points and pesticides were extracted using the quick, easy, cheap, effective, rugged, and safe (QuEChERS) method. The level of pesticide residues in human milk samples and exposure of infants to the pesticides was evaluated by calculating the estimated daily intake and compared with the provisional tolerable daily intake of the pesticides under study. The results indicated that, from the eight organochlorine pesticides analyzed in 447 breast milk samples at three sampling times, DDT and its metabolites were detected. p,p′-DDE and p,p′-DDT were detected in all (100%) of the breast milk samples while, p,p-DDD, and o,p-DDT were detected in 53.9%, and 42.7%, respectively. The mean concentration of total DDT at three time points(baseline, midline and endline) were 2.25, 1.68 and 1.32 µg/g milk fat, respectively. The mean concentration of total DDT from the three districts was 1.85 µg/g milk fat which is above the maximum residue limit (MRL = 0.02 µg/g milk fat set by FAO/WHO). The mean ratio of DDT/DDE for the three areas was calculated less than five (< 5) indicates historical DDT use in the study area. The estimated daily intake of infants at the first month of breastfeeding was 11.24 µg/kg-BW/day, above the provisional tolerable daily intake (PTDI) for total DDT set by FAO/WHO, which is 10 µg/kg body weight. An intake of OCPs is a big concern for infants' health in Ethiopia and countries with a similar condition, particularly at the first month of lactation. Strict regulations of the health-threatening pesticide by the regulatory body (Environment, Forest and Climate Change Commission) at the country and regional levels is advocated.

Exposure and health risk assessment from consumption of Pb contaminated water in Addis Ababa, Ethiopia

Exposure to lead (Pb) through drinking water has been linked to adverse health outcomes. Children are particularly susceptible. This study was designed to measure Pb contamination level in drinking water of the Ethiopian city Addis Ababa and assess the associated health risks. Eighty-eight fully-flushed drinking water samples were collected from all ten sub-cities of Addis Ababa. Pb concentration was measured using an Inductively Coupled Plasma Mass Spectrometer (ICP-MS). The chronic daily intake (CDI), the hazard quotient (HQ), and the cancer risk (CR) of Pb were determined to assess exposure levels and health effects. Blood lead level (B-Pb) for children was modelled using the integrated exposure uptake biokinetic model (IEUBK). The mean concentration of Pb in the drinking water was 17.8 μg/l, where >50% of the samples exceeded WHO's 10 μg/l guideline. Significant spatial variation of Pb was noticed among sub-cities. The mean CDI was 1.43 and 0.59 μg/kg/day for children and adults, respectively. The HQ showed that 8% of children and 2.3% of adults exceeded the safe limit. The predicted geometric mean of B-Pb ranged from 3.23 to 14.65 μg/dl. The risk of a child having a B-Pb level >5 μg/dl at the median water Pb concentration (10.5 μg/l) was estimated at 13.4%. Based on the 95^th percentile Pb concentration (75.1 μg/l), 89.6% of children would have B-Pb levels above the 5 μg/dl threshold. The estimated CR was found in the range of 1 × 10^-7 to 9.9 × 10^-5; hence cancer risks are not a concern. The study concluded that Addis Ababa's drinking water is likely to be a source of lead exposure where consumers at specific city locations are at risk of numerous non-cancer health effects. The impacts are expected to be severe in the Ethiopian context; hence further investigations and coordinated interventions are required.

Risk perceptions and attitudinal responses to COVID-19 pandemic: an online survey in Ethiopia

BACKGROUND

Effective risk communication is one of the critical strategies in the response to COVID-19. This study examined risk perceptions and attitudinal responses to COVID-19 among the educated section of the society in Ethiopia.

METHODS

An internet-based survey was conducted from April 22 to May 04, 2020, in Ethiopia. A questionnaire addressing the perception of health threat-combination of perceived vulnerability (PV) and perceived seriousness (PS), and perceived efficacy-combinations of perceived response efficacy (PRE), perceived self-efficacy (PSE), and perceived collective efficacy (PCE). The data were analyzed using SPSS 21.0. Descriptive statistics were computed after the standardization of the scores. The scores for overall efficacy and threat were split by median value and response classifications were generated through threat by efficacy interactions. For statistical significance, 95% CI and p-value < 0.05 were used.

RESULTS

A total of 929 respondents submitted their responses. Eight hundred and twenty-eight (89.1%) of the respondents were male and 753 (81.1%) were Christian. The perceived threat to COVID-19 was generally low (median = 58.3). The median score for overall efficacy, PRE, and PSE were 79.8, 87.5, and 80.0, respectively. However, the median value (66.7) for PCE was relatively low. Perceived threat significantly varied by age, education, occupation, and place of residence (p < 0.05). Perceived efficacy significantly differed by gender, residence, and use of some sources of information (p < 0.05). In terms of response to COVID-19, 290 (31.2%), 239 (25.7%), 175 (18.8%) and 225 (24.2%) of the respondents were in the responsive, pro-active, avoidant, and indifferent attitudinal categories, respectively. The avoidant and indifferent groups constituted a fear control response (mal-adaptive motivation towards COVID-19 protective behavior) whereas responsive and pro-active categories formed a danger control response (self-protective motivation). These responses varied significantly by residence, region, religion, and sources of information (p < 0.05).

CONCLUSIONS

Understanding people's perceived health threat and efficacy is a critical step toward creating risk communication campaigns. Hence, this study provided an insight that has the potential to inform the COVID-19 risk communication campaigns targeting the educated section of the society, by ensuring a balanced combination of threat appeals and efficacy messages for improved self-protective responses.

Entomological and Anthropological Factors Contributing to Persistent Malaria Transmission in Kenya, Ethiopia, and Cameroon

Introduction

In order to improve our understanding of the fundamental limits of core interventions and guide efforts based on prioritization and identification of effective/novel interventions with great potentials to interrupt persistent malaria transmission in the context of high vector control coverage, the drivers of persistent disease transmission were investigated in three eco-epidemiological settings; forested areas in Cameroon, coastal area in Kenya and highland areas in Ethiopia.

Methods

Mosquitoes were sampled in three eco-epidemiological settings using different entomological sampling techniques and analysed for Plasmodium infection status and blood meal origin in blood-fed specimens. Human behavioural surveys were conducted to assess the knowledge and attitude of the population on malaria and preventive measures, their night activities, and sleeping pattern. The parasitological analysis was conducted to determine the prevalence of Plasmodium infection in the population using rapid diagnostic tests.

Results

Despite the diversity in the mosquito fauna, their biting behaviour was found to be closely associated to human behaviour in the three settings. People in Kenya and Ethiopia were found to be more exposed to mosquito bites during the early hours of the evening (18-21h) while it was in the early morning (4-6 am) in Cameroon. Malaria transmission was high in Cameroon compared to Kenya and Ethiopia with over 50% of the infected bites recorded outdoors. The non-users of LLINs were 2.5 to 3 times more likely to be exposed to the risk of acquiring malaria compared to LLINs users. Malaria prevalence was high (42%) in Cameroon, and more than half of the households visited had at least one individual infected with Plasmodium parasites.

Conclusions

The study suggests high outdoor malaria transmission occurring in the three sites with however different determinants driving residual malaria transmission in these areas.

Psychological distress during the COVID-19 pandemic in Ethiopia: an online cross-sectional study to identify the need for equal attention of intervention

BACKGROUND

The COVID-19 pandemic led individuals to suffer from different levels of mental health problems such as psychological distress, anxiety, depression, denial, panic, and fear. This study aimed at determining the prevalence of psychological distress and associated factors among the Ethiopian population during the COVID-19 pandemic.

METHODS

A cross-sectional study was performed through an online survey using different online platforms. The questionnaire was created through Google Form and the survey link was administered by e-mail, LinkedIn, Telegram, and Facebook. Educated Ethiopian population who have access to the internet were invited to participate through an online survey and addressed to 929 respondents. The study participants completed the survey anonymously without any personal identifier. The psychological distress was assessed using the Kessler 10-item tool to measure psychological distress. Data were analyzed using SPSS and logistic regression to examine mutually adjusted associations, expressed as adjusted odds ratios. A generalized additive model was also employed to identify additional predictors using R.

RESULTS

The prevalence of high psychological distress among the study population was 236 (25.5%). Of all respondents, 421 (45.1%) had low psychological distress, 274 (29.4%) had moderate psychological distress, 164 (17.6%) had high psychological distress, and 72 (7.3%) had very high psychological distress. Psychological distress increased with being at young and middle-aged adults, getting information from social media, and not correctly practicing infection prevention and control measures to prevent COVID-19 infection. Respondents with high perceived severity had increased psychological distress. On the contrary, those with the highest score of perceived response efficacy had low distress.

CONCLUSION

Prevalence of psychological distress was substantial. The need for intervention of psychological distress inline with the prevention of COVID-19 is critically essential. The intervention target groups are those whose information sources are from social media, young and middle-aged adults, and those who do not correctly practice infection prevention and control measures against COVID-19 infection.

Sources and level of heavy metal contamination in the water of Awetu watershed streams, southwestern Ethiopia

The present study aimed to investigate the contamination source, level, and spatial distribution of globally alarming trace metals from Awetu watershed streams, southwestern Ethiopia. Surface water samples were collected from 20 sampling sites in December 2019. Water samples were collected in 500 ml polyethylene bottles previously washed with deionized water and rinsed with the sample to be collected from different stretches and acidified with 5 ml concentrated nitric acid. The samples were digested with open acid digestion and the contents of the metal were analysed using inductively coupled plasma optical emission spectrometry (ICP-OES) ranged from 18 - 351 μg/L for As, 5–19 μg/L for Cd, 232–421 μg/L for Cr, 314–920 μg/L for Pb and 10–16 μg/L for Hg. The highest concentrations of As were detected at K3, Cd at K2, Pb and Cr at D4, and Hg at D5. Analysis of variance results revealed that the Cd concentrations were statistically significant among all the streams except for Boye. Streams found at the center of Jimma city with effluents emanated from Jimma University, garage maintenances, car-wash and agricultural areas had higher values than the streams in the periphery. This study concluded that a higher concentration of trace elements is associated with the type of waste entering the streams. Trace elements concentration in the watershed is to the level that can pose a risk to downstream users. Public awareness creation to establish waste management systems and river quality monitoring should be implemented to minimize the public health risk and deterioration of the aquatic ecosystem.

Relevance of macroinvertebrate communities as a water quality monitoring tool in ecosystems under harsh environmental conditions in the Rift Valley region

Ecological assessment was performed in different thermal springs located in the Ethiopian Rift Valley area: Gergedi, Sodere, Halaba, and Gara. We assessed the habitat conditions, physicochemical characteristics, and macroinvertebrate composition at 12 sampling sites in four thermal spring systems. The physicochemical properties of the water samples varied among the sampling stations. Temperature ranged from 38.5 to 90°C among the 12 sites. Dissolved oxygen, which is essential to aquatic ecosystem normal functioning, was not detected at three sampling sites. An average of 109 macroinvertebrates were identified in three sampling campaigns. Relatively higher macroinvertebrate abundance 94 (86.2%) was registered in Gergedi than any other thermal spring sites. The macroinvertebrate abundance was 9 (8.3%) and 6 (5.5%) for the Gara and Sodere thermal springs. No macroinvertebrate communities were observed in all sites of Halaba thermal spring. From all macroinvertebrate groups, 82 (75.2%) were dipterans, 20 (18.4%) Oligochaeta, 5 (4.6%) Gastropoda, and the rest Hemipterans and Coleopterans, which comprises 2 (1.8%) individuals. Chironomidae was the dominant invertebrate taxa at all sites, and when the water temperature exceeds 42°C, it becomes the only taxon in the thermal springs. Macroinvertebrates were absent in thermal springs where the water temperature is 52°C or higher. Other diversity measures were not sensitive enough to discriminate sampling sites regardless of physicochemical variabilities except the richness and abundance. Water temperature, chloride, pH, and phosphate were identified as major determinants of macroinvertebrate richness in the Ethiopian Rift Valley region.

Evaluation of Long-Lasting Insecticidal Nets (DuraNet®) Under laboratory and Semi-Field Conditions Using Experimental Huts Against Anopheles Mosquitoes in Jimma Zone, Southwestern Ethiopia

BACKGROUND

Long-Lasting Insecticidal Nets (LLINs) efficacy could be compromised due to a lot of influences together with user compliance and vector population insecticide resistance status. Thus, this study was to assess the biological efficacy of DuraNet® with the help of the World Health Organization cone bioassay and field experimental hut.

METHODS

A laboratory and a semi-field conditions experimental huts against Anopheles Mosquitoes were conducted in southwestern Ethiopia from September 2015 to January 2016. The bio efficacy of DuraNet® was evaluated using the WHO cone bioassay test and then its field efficacy was evaluated using experimental huts against the malaria vector population.

RESULTS

World Health Organization cone bioassay tests against pyrethroid-resistant An. arabiensis led to mean percent mortality and knockdown of 78% and 93%, respectively. Washing of DuraNet® successively reduced its efficacy from 93% knockdown (0 wash) to 45% knockdown (20 washes). Similarly, mean mortality decreased from 84% (0 wash) to 47% (20 washes). A total of 1575 female mosquitoes were collected over 40 nights out of which 1373(87.8%) were An. gambiae s.l., 116 (7.4%) were Anopheles coustani and 107 (6.8%) were An. pharoensis. The mean blood-feeding rate was significantly lower (P < .001) in hut containing unwashed DuraNet® when compared to hut containing untreated DuraNet®. The mean mortality rate was significantly higher (P < .001) in hut containing DuraNet® when compared to hut containing untreated DuraNet®. Unwashed DuraNet® showed the highest personal protection 88.7% and 100% against An. Arabiensis and An. pharoensis, respectively.

CONCLUSION

Both DuraNet® and PermaNet 2.0 moderate efficacy against a pyrethroid-resistant population of An. arabiensis from Ethiopia. The bio efficacy of DuraNet® was found below the WHO recommendation. Therefore, the real impact of the observed insecticide resistance against DuraNet® to be further studied under phase-III trials, the need for new alternative vector control tools remains critical.

Psychological impact of COVID-19 outbreak among Jimma University Medical Centere visitors in Southwestern Ethiopia: a cross-sectional study

BACKGROUND

COVID-19 has posed several medical, psychosocial and economic impacts among the majority of the society. The ambiguity of its transmission, the intense desire of self-protection, family, and friends, the unknown impact of catching the disease itself, unstoppable spread, the panic and outright misinformation lead to acute stress reaction syndrome. However, reliable data related to this contagion lack the prevalence of acute stress reaction syndrome and associated factors among Jimma University Medical Centre hospital visitors in Southwestern Ethiopia.

AIMS

The main objective of the study was to assess the prevalence and factors associated with acute stress reaction syndrome during the COVID-19 outbreak among Jimma University Medical Centre Hospital visitors, Ethiopia.

METHODS

An interviewer-administered cross-sectional study was conducted among 247 visitors of the Jimma University Medical Centre in Ethiopia. The study was conducted within 2 weeks of the first COVID-19 cases detected on 13 March 2020 in Ethiopia. Data on demographic and socioeconomic status were collected during the interview using structured questionnaires. The psychological impact was assessed using the Impact of Event Scale-Revised, and symptoms of insomnia were measured using the Insomnia Severity Index. Social support was evaluated using Oslo three-item Social Support Scale. Logistic regression was employed to determine the associations between dependent and independent variables. Besides, psychosocial stress score was generated using principal component analysis. A paired permutation test was also performed to determine the variability of psychosocial stress between groups.

RESULTS

The mean age of participants was 30.47 years, and 76.5% of the participants were male. Acute stress reaction syndrome was detected in 44.1% of hospital visitors. Of the participants, 38.5%, 17.4%, 8.5% and 35.6% had a minimal, mild, moderate and severe psychological impact, respectively. Factors positively associated with acute stress reaction syndrome were individuals who perceived that COVID-19 leads to stigma (adjusted OR (AOR): 3.24, 95% CI 1.11 to 9.45), mild insomnia (AOR: 14.74, 95% CI 6.14 to 35.40), moderate to severe insomnia (AOR: 35.1, 95% CI 10.76 to 114.66), low social support (AOR: 4.08, 95% CI 1.31 to 12.67) and governmental employees (AOR: 8.09, 95% CI 1.38 to 47.18).

CONCLUSION

The study revealed the existence of a high prevalence of acute stress reaction syndrome during the COVID-19 outbreak among different groups of the community. Therefore, our results will contribute to the global awareness of the psychological impact of the COVID-19 outbreak.

Mental health of healthcare professionals during the early stage of the COVID-19 pandemic in Ethiopia

BACKGROUND

The coronavirus (COVID-19) pandemic causes healthcare professionals to suffer mental health problems such as psychological distress, anxiety, depression, denial and fear. However, studies are lacking related to Ethiopia and to Africa in general.

AIMS

To study the mental health of healthcare professionals during the COVID-19 pandemic in Ethiopia.

METHOD

A hospital-based cross-sectional study was conducted at Jimma University Medical Center among 249 healthcare professionals. The data were collected using self-administered questionnaires between 22 and 28 March 2020. The psychological impact was assessed using the Impact of Event Scale - Revised (IES-R) and symptoms of insomnia were measured using the Insomnia Severity Index (ISI). Social support was evaluated using the three-item Oslo Social Support Scale. Data were analysed using logistic regression to examine mutually adjusted associations, expressed as adjusted odds ratios. The psychosocial status of the healthcare professionals was predicted using a classification tree model supported by the genetic search method.

RESULTS

The prevalence of psychological distress among healthcare professionals was 78.3%. The mean IES-R score was 34.2 (s.d. = 19.4). The ISI score indicated that the prevalence of insomnia was 50.2%. Higher psychological distress was associated with younger age, having insomnia, not having a daily update on COVID-19, and feeling stigmatised and rejected in the neighbourhood because of hospital work.

CONCLUSIONS

This study indicates that, in Ethiopia, the prevalence of psychological distress among healthcare professionals is high and associated with specific sociodemographic risks.

Myths, beliefs, and perceptions about COVID-19 in Ethiopia: A need to address information gaps and enable combating efforts

BACKGROUND

The endeavor to tackle the spread of COVID-19 effectively remains futile without the right grasp of perceptions and beliefs presiding in the community. Therefore, this study aimed to assess myths, beliefs, perceptions, and information gaps about COVID-19 in Ethiopia.

METHODS

An internet-based survey was conducted in Ethiopia from April 22 to May 04, 2020. The survey link was promoted through emails, social media, and the Jimma University website. Perceptions about COVID-19 have considered the World Health Organization (WHO) resources and local beliefs. The data were analyzed using Statistical Package for Social Science (SPSS) software version 20.0. Classifications and lists of factors for each thematic perception of facilitators, inhibitors, and information needs were generated. Explanatory factor analysis (EFA) was executed to assist categorizations. Standardized mean scores of the categories were compared using analysis of variance (ANOVA) and t-tests. A significant difference was claimed at p-value <0.05.

RESULTS

A total of 929 responses were gathered during the study period. The EFA generated two main categories of perceived facilitators of COVID-19 spread: behavioral non-adherence (55.9%) and lack of enablers (86.5%). Behavioral non-adherence was illustrated by fear of stigma (62.9%), not seeking care (59.3%), and hugging and shaking (44.8%). Perceived lack of enablers of precautionary measures includes staying home impossible due to economic challenges (92.4%), overcrowding (87.6%), and inaccessible face masks (81.6%) and hand sanitizers (79.1%). Perceived inhibitors were categorized into three factors: two misperceived, myths (31.6%) and false assurances (32.9%), and one correctly identified; engagement in standard precautions (17.1%). Myths about protection from the virus involve perceived religiosity and effectiveness of selected food items, hot weather, traditional medicine, and alcohol drinking, ranging from 15.1% to 54.7%. False assurances include people's perception that they were living far away from areas where COVID-19 was rampant (36.9%), and no locally reported cases were present (29.5%). There were tremendous information needs reported about COVID-19 concerning protection methods (62.6%), illness behavior and treatment (59.5%), and quality information, including responses to key unanswered questions such as the origin of the virus (2.4%). Health workers were perceived as the most at-risk group (83.3%). The children, adolescents, youths were marked at low to moderate (45.1%-62.2%) risk of COVID-19. Regional, township, and access to communication showed significant variations in myths, false assurances, and information needs (p <0.05).

CONCLUSIONS

Considering young population as being at low risk of COVID-19 would be challenging to the control efforts, and needs special attention. Risk communication and community engagement efforts should consider regional and township variations of myths and false assurances. It should also need to satisfy information needs, design local initiatives that enhance community ownership of the control of the virus, and thereby support engagement in standard precautionary measures. All forms of media should be properly used and regulated to disseminate credible information while filtering out myths and falsehoods.

Exploring the association between childhood diarrhea and meteorological factors in Southwestern Ethiopia

Childhood diarrhea has been one of the major public health concerns in countries that have limited resources like Ethiopia. Understanding the association between childhood diarrhea and meteorological factors would contribute to safeguard children from adverse health effects through early warning mechanisms. Thus, this study aimed at exploring the association between childhood diarrhea and meteorological factors to enable reducing health risks. A retrospective study design was used to explore the association between meteorological factors and childhood diarrhea in southwestern Ethiopia from 2010 to 2017. Mann Kendall trend test and Spearman's correlation were computed to test the association of childhood diarrhea and meteorological factors. The space-time permutation model was used to identify the risky periods, seasons with most likely clusters, and high childhood diarrhea. Similarly, a negative binomial regression model was fitted to determine the predictability of meteorological factors for childhood diarrhea. The highest childhood diarrhea morbidity was 92.60 per 1000 per under five children. The risk of childhood diarrhea increased by 16.66% (RR: 1.1666; 95% CI: 1.164-1.168) per increase in 1 °C temperature. Furthermore, rainfall was found to be a significant risk factor of childhood diarrhea, with 0.16% (RR: 1.00167; 95% CI: 1.001306-1.001928) per 1 mm increase in rainfall. The temperature was positively correlated with the occurrence of childhood diarrhea. But the association with rainfall showed spatial variability. The space-time permutation model revealed that dry season was found to be a high-risk period with excess childhood diarrhea. The results showed that the observed association between meteorological factors and childhood diarrhea could be used as evidence for early warning systems for the prevention of childhood diarrhea.

The role of local knowledge in enhancing the resilience of dinki watershed social-ecological system, central highlands of Ethiopia

This study was designed to explore the role of local knowledge (LK) in enhancing the resilience of Dinki watershed in the central highlands of Ethiopia. The data were collected through focus group discussions, key informant interviews, and household surveys. The qualitative data were analyzed through thematic analysis. Whereas descriptive statistics and logistic regression were used for quantitative data analyses. The result showed that the majority of the respondents have local knowledge and used in their daily activities. Furthermore, the LK is reported to have the adaptive capacity in managing land resource degradation, treating disease, mitigating food insecurity, and enhancing social capital, among others. Likewise, the logistic regression analysis showed that age, gender, and education status of the household head were significantly correlated (p<0.05) to knowledge level, indicating their predictive power for the acquisition of LK. Accordingly, old-aged (60+ years) male respondents who attended primary education were higher to acquire LK than their counterparts. The result realized that the adaptive roles (land resource management, medication, climate change adaptation, etc.) of local knowledge systems could contribute to enhancing resilience. More importantly, the presence of social mechanisms is insurance to maintain LK. Thus, both intergenerational and intragenerational information gaps are filled with education and promotion on the roles of local knowledge systems. Besides, local-decision options should participate in custodians to share their experiences, that could contribute to sustaining ecosystem resilience.

Spatiotemporal and hotspot detection of U5-children diarrhea in resource-limited areas of Ethiopia

Under-five children (U5-children) diarrhea is a significant public health threat, where the World Health Organisation (WHO) reported it as the second leading cause of children's death worldwide. Nearly 1.7 billion cases occur annually with varied temporal and spatial factors. Identification of the spatiotemporal pattern and hotspot areas of U5-children diarrhea can assist targeted intervention and provide an early warning for more effective response measures. This study aimed at examining spatiotemporal variability along with the detection of hotspot areas for U5-children diarrhea in the Bench Maji Zone of southwestern Ethiopia, where resources are limited and cultural heterogeneity is highest. Retrospective longitudinal data of ten years of diarrhea records from January 2008 to December 2017 were used to identify hotspot areas. The incidence rate per 1,000 per year among children was calculated along with seasonal patterns of cases. The spatiotemporal analysis was made using SaTScan version 9.4, while spatial autocorrelations and hotspot identification were generated using ArcGIS 10.5 software. A total of 90,716 U5-children diarrhea cases were reported with an annual incidence rate of 36.1 per 1,000 U5-children, indicating a relative risk (RR) of 1.6 and a log-likelihood ratio (LLR) of 1,347.32 (p < 0.001). The highest incidence of diarrhea illness was recorded during the dry season and showed incidence rate increment from October to February. The risky clusters (RR > 1) were in the districts of Bero, Maji, Surma, Minit Shasha, Guraferda, Mizan Aman Town, and Sheko with annual cases of 127.93, 68.5, 65.12, 55.03, 55.67, 54.14 and 44.97 per 1,000, respectively. The lowest annual cases reported were in the four districts of Shay Bench, South Bench, North Bench, and Minit Goldiya, where RR was less than a unit. Six most likely clusters (Bero, Minit Shasha, Surma, Guraferda, South Bench, and Maji) and one lower RR area (North Bench) were hotspot districts. The U5-children's diarrhea in the study area showed an overall increasing trend during the dry seasons with non-random distribution over space and time. The data recorded during ten years and analyzed with the proper statistical tools helped to identify the hotspot areas with risky seasons where diarrhea could increase.

Environmental and biotic factors affecting freshwater snail intermediate hosts in the Ethiopian Rift Valley region

BACKGROUND

Knowledge of the distribution and habitat preference of freshwater snail intermediate hosts can provide information to initiate and set-up effective snail control programmes. However, there is limited research conducted on the factors driving the occurrence and abundance of freshwater snail intermediate hosts in the Ethiopian Rift Valley. Hence, in this study, we investigated how environmental and biotic factors influence the occurrence and abundance of the snail intermediate hosts in Ethiopian Rift Valley region.

METHODS

Data on freshwater snails, physico-chemical water quality parameters, physical characteristics of habitat, predators and competitors, and anthropogenic activity variables were collected from 174 sampling sites during the wet season of 2017 and 2018. Generalized linear models were used to identify the main environmental and biotic factors affecting the occurrence and abundance of the snail species.

RESULTS

It was found that Bulinus globosus (31.7%) was the most abundant snail species followed by Lymnaea natalensis (21.6%), Lymnaea truncatula (15.1%) and Biomphalaria pfeifferi (14.6%). Generalized linear models indicated that physico-chemical parameters (water temperature, turbidity, chlorophyll-a, dissolved oxygen, chemical oxygen demand, alkalinity, calcium, magnesium, nitrate and ammonia), physical habitat characteristics (water depth, canopy cover, macrophyte cover and substrate type) and biotic factors (abundance of predators and competitors) were found to be the main variables determining the occurrence and abundance of snail species in the Ethiopian Rift Valley region. In terms of anthropogenic activities, human settlement, farming, bathing and swimming, clothes washing, grazing, drainage of land, car washing, boating, fishing and silviculture were also important variables determining the occurrence and abundance of snail species in the region.

CONCLUSIONS

The findings reported herein suggest that integrated snail control strategies should be considered to control snails via protection of water bodies from disturbance by anthropogenic activities. In this way, it is possible to reduce the concentration of organic matter and dissolved ions in aquatic ecosystems which are conducive for the presence of snails.

Knowledge, perceptions and preventive practices towards COVID-19 early in the outbreak among Jimma university medical center visitors, Southwest Ethiopia

BACKGROUND

Novel-coronavirus disease-2019 (COVID-19) is currently a pandemic and public health emergency of international concern, as avowed by the World Health Organization (WHO). Ethiopia has become one of the affected countries as of March 15, 2020.

OBJECTIVE

This study aimed to assess the knowledge, perceptions, and practices among the Jimma University medical center (JUMC) visitors in Jimma town.

METHODS

A cross-sectional study was conducted on 247 sampled visitors, from 20-24 March 2020. Consecutive sampling was used to recruit the participants. The study tools were adapted from WHO resources. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Descriptive statistics were used to describe the status of knowledge, perception, and practices. Logistic regression was executed to assess the predictors of dominant preventive practices.

RESULTS

Of the 247 respondents, 205 (83.0%) knew the main clinical symptoms of COVID-19. 72.0% knew that older people who have chronic illnesses are at high risk of developing a severe form of COVID-19. About 95.1% knew that the COVID-19 virus spreads via respiratory droplets of infected people, while 77 (31.2%) of the respondents knew about the possibility of asymptomatic transmission. Only 15 (6.1%) knew that children and young adults had to involve preventive measures. Overall, 41.3% of the visitors had high knowledge. The majority, 170(68.8%), felt self-efficacious to controlling COVID-19. 207(83.3%) believed that COVID-19 is a stigmatized disease. Frequent hand washing (77.3%) and avoidance of shaking hands (53.8%) were the dominant practices. Knowledge status and self-efficacy (positively), older age, and unemployment (negatively) predicted hand washing and avoidance of handshaking.

CONCLUSIONS

The status of knowledge and desirable practices were not sufficient enough to combat this rapidly spreading virus. COVID-19 risk communication and public education efforts should focus on building an appropriate level of knowledge while enhancing the adoption of recommended self-care practices with special emphasis on high-risk audience segments.

Individual and community-level risk factors in under-five children diarrhea among agro-ecological zones in southwestern Ethiopia

Under-five children diarrhea remains a major public health problem in resource-limited areas, including Ethiopia, due to multiple risk factors. This study aimed to identify individual and community-level risk factors affecting under-five children diarrhea (UFCD) in five districts of the Bench Maji Zone, southwestern Ethiopia. A community-based cross-sectional study was conducted from February to April 2018. A total of 826 households were recruited from five randomly selected districts using stratified sampling. A multivariable logistic regression model was fitted to identify risk factors associated with UFCD. The prevalence of UFCD in the study area was found to be 18.3%. Children less than six months of age are more at risk for diarrhea (95% CI for AOR2.5;1.23-4.90). Most probably initiating supplementary feedings before six months of age is one of the main risk factor for diarrhea (95% CI for AOR 0.65; 0.45-0.98). Similarly, mothers with low educational status (95% CI for AOR 0.30; 0.10-0.84), limited knowledge of mothers' about diarrhea (95% CI for AOR 0.24; 0.15-0.40), absence of hand washing among mothers/caregivers at critical times (95% CI for AOR 4.6; 2.88-7.67), and sharing of the residence with domestic animals (95% CI for AOR 2.87, 1.75-4.67) were the predictors of UFCD at individual-level. Children living in semi pastoral areas (95% CI for AOR 0.22; 0.10-0.50) unvaccinated children for rotavirus prevention (95% CI AOR 5.22, 3.33-8.20), households obtaining water from unimproved sources (95% CI for AOR 2.53; 1.60-4.40), and households with unimproved latrine facilities (95% CI for AOR 0.60; 0.33-0.99) were the risk factors of UFCD at the community-level. The study revealed that UFCD is a critical health concern in southwestern Ethiopia, where integrated intervention approach at individual and community level could help to alleviate the problem. At individual level, behavioral change intervention on handwashing, exclusive breast-feeding before the age of six months, and awareness on diarrhea prevention methods are critical areas of intervention. Likewise, provision of safe and adequate water source combined with household water chlorination, and vaccination for rotavirus are interventions at community that need to be integrated with the individual-level of intervention. This could significantly contribute for the reduction of UFCD in the resource limited areas through intersectoral collaboration of the health and other sectors.

Exploring households' resilience to climate change-induced shocks using Climate Resilience Index in Dinki watershed, central highlands of Ethiopia

This study assessed households’ resilience to climate change-induced shocks in Dinki watershed, northcentral highlands of Ethiopia. The data were collected through a cross-sectional survey conducted on 288 households, three focus group discussions, and 15 key informant interviews. The Climate Resilience Index (CRI) based on the three resilience capacities (absorptive, adaptive and transformative) frame was used to measure households’ resilience to climate change-induced shocks on an agro-ecological unit of analysis. A principal component analysis (PCA) and multiple regression analysis were used to identify determinant factors and indicators to households’ resilience, respectively. Findings indicate that the indexed scores of major components clearly differentiated the study communities in terms of their agro-ecological zones. Specifically, the absorptive capacity (0.495) was the leading contributing factor to resilience followed by adaptive (0.449) and transformative (0.387) capacities. Likewise, the Midland was relatively more resilient with a mean index value of 0.461. Both the PCA and multiple regression analysis indicated that access to and use of livelihood resources, such as farmlands and livestock holdings, diversity of income sources, infrastructure and social capital were determinants of households’ resilience. In general, it might be due to their exposure to recurrent shocks coupled with limited adaptive capacities including underdeveloped public services, poor livelihood diversification practices, among others, the study communities showed minimal resilience capacity with a mean score of 0.44. Thus, in addition to short-term buffering strategies, intervention priority focusing on both adaptive and transformative capacities, particularly focusing on most vulnerable localities and constrained livelihood strategies, would contribute to ensuring long-term resilience in the study communities.

Reduction of pesticide residues from teff (Eragrostis tef) flour spiked with selected pesticides using household food processing steps

Teff (Eragrostis tef) is an ancient cereal that is indigenous from Ethiopia. Nowadays, teff grain is becoming popular to many parts of the world. Teff is gluten-free in nature, has high iron and fiber content, and many other health benefits make this crop interesting to many consumers. Since no insect pests are attacking the teff grains, farmers do not apply pesticides on it, unlike maize and other grains. Nevertheless, residues of organochlorine pesticides have been detected at an alarming level that could pose a consumer risk. Teff is often consumed as injera which is a fermented flat pancake. The main aim of the present study is, therefore, to investigate the effect of household food processing (doughing and baking) on the reduction of pesticide residues from teff. Pesticide residues previously detected in teff grain such as permethrin, cypermethrin, deltamethrin, chlorpyrifos ethyl, p,p'-DDE, p,p'-DDD, o,p'-DDT, and p,p'-DDT were spiked and extracted followed by the subsequent household processing which are generally doughing (dough making followed by fermentation) and baking. From the findings of this study, doughing decrease the pesticide residues in the range of 59.9-86.4% and baking in the range of 63.2-90.2%. Kruskal-Wallis analysis indicates that the reduction of pesticide residues by baking is significantly different from doughing (p-value < 0.0001). There is also a significant difference between non-fermented and fermented dough (p-value = 0.012). The processing factor for doughing and baking was less than one (PF < 1 = reduction factor) which indicates the reduction of pesticides due to teff processing. The cumulative effect of these processing methods is important to evaluate the risks associated with the ingestion of pesticides, particularly in teff grain.

Resilience dynamics after interventions made among school children of rural Ethiopia

Objectives of this study are to evaluate the impact of interventions on school children resilience and well-being; assess sensitivity of resilience evaluation tools; and identify shift in resilience among children in poor rural communities of Ethiopia. Qualitative and quantitative data are collected using semi-structured Pre- and Post- Interview Analysis (PIA), child and youth resilience measure (CYRM) and mental health continuum (MHC) questionnaires among the control and intervention groups. The study identified that PIA questions were not sensitive enough to detect all child resilience indicators. Resilience intervention has brought important positive change on most of the resilience indicators. However, no significant improvement observed on problem solving skills, and avoidance of troubling thoughts and feelings. However, the qualitative finding showed that children improved problem solving skill, such as intervening early marriage, avoiding physical abuse, and supporting needy children. In addition, integrated interventions have brought substantial resilience impacts on children school performance, their interaction and social relations. Besides, integration of parents, teachers and community has brought significant change on the result of child resilience and well-being. Younger children under intervention showed lower resilience and well-being score compared to the older ones. Shift of resilience between male and female was observed when compared between the control and intervention groups. In the control communities, female students are more resilience and psychosocial well-being than male students. On the other side, among intervention groups, males showed better resilience than females. This suggests that context specific resilience intervention by gender could be necessary among school children of East Gojjam and similar communities.

Use of broken brick to enhance the removal of nutrients in subsurface flow constructed wetlands receiving hospital wastewater

Eight horizontal subsurface flow pilot scale artificial wetlands were constructed to evaluate the effectiveness of broken brick to remove nutrients from hospital wastewater. The average total suspended solids (TSS), 5-day biochemical oxygen demand (BOD5), chemical oxygen demand (COD), total Kjeldahl nitrogen (TKN), NH4-N, NO₃-N, and phosphate percent removal efficiency of constructed wetlands were, respectively, 93.2%, 90.4%, 83.7%, 64%, 64.3%, 52.1% and 56.1% in the dry season and 89.7%, 85.8%, 82.9%, 66%, 62.7%, 56.1% and 59.5% in the rainy season. Broken brick bed wetlands provide better removal efficiency of TKN, ammonia, nitrate, and phosphate with an average removal rate of 73%, 71.3%, 79.6% and 77.1% in the dry season and 74.7%, 70.7%, 70.9% and 73.6% in the rainy season, respectively, and it provides better adsorption sites for ammonium, nitrate, and phosphate. Typha with the broken brick bed significantly improved (P < 0.05) the treatment performance of the constructed wetland systems for the removal of ammonia, nitrate, and phosphate. The seasonal variation could not significantly influence the removal of all the pollutants, but better performance of nitrate and phosphate was achieved in a dry season. Use of locally available broken brick as a substrate media can increase the nutrient removal efficiency of wetlands at a cheaper cost when applied in full scale constructed wetlands.

Effect of watershed land use on tributaries' water quality in the east African Highland

A study was carried out on four tributaries of Gilgel Gibe Reservoir to identify water physicochemical characteristics in different land use categories (farmland, naturally vegetated land, and settlement). Water samples were collected from 12 sampling sites along four permanent streams flowing into Gilgel Gibe Reservoir. Data sets were evaluated using nonparametric statistical techniques. Dissolved oxygen (DO), temperature, biochemical oxygen demand (BOD₅), total phosphorus (TP), soluble reactive phosphorus (SRP), total nitrogen (TN), turbidity, total dissolved solids (TDS), and total suspended solids (TSS) spatially showed significant differences in the wet season and DO, temperature, and BOD₅ varied significantly during the dry season. When excluding DO, electrical conductivity (EC), and TP during the wet and dry seasons, the remaining variables showed significant differences. During the wet season, concentrations of most water quality parameters were greatest in influents from agricultural land. Pollution and eutrophication risk is closely associated with drainage from agricultural land, requiring that emphasis and priorities be given to land use management and conservation.

Health Risk Perceptions Are Associated with Domestic Use of Basic Water and Sanitation Services-Evidence from Rural Ethiopia

We examine factors associated with the use of basic water supply and sanitation services as part of an integrated community-based nutrition programme which included a drinking water, sanitation and hygiene (WaSH) intervention and emphasise findings related to health risk perceptions. Data were collected from 2658 households in four regions in Ethiopia with a cross-sectional survey in WaSH intervention areas, as well as in control areas, where the intervention was not implemented. The data were analysed using bivariate and multivariable regression analysis. Awareness of health risk factors related to inadequate WaSH was high in the programme area. The use of basic water and sanitation services was associated with several health risk perceptions: Perceiving water quality as good increased the odds of using basic water services as opposed to believing the water quality was poor (OR 3.94; CI 3.06–5.08; p ≤ 0.001). Believing that drinking unsafe water was the main cause for diarrhoea increased the odds of using basic water services (OR 1.48; CI 1.20–1.81; p ≤ 0.001). In the WaSH intervention group, the use of basic sanitation was more likely than in the control group. The use of basic sanitation was associated with households who had previously received sanitation training, as opposed to such who had not (OR 1.55; CI 1.22–1.97; p ≤ 0.001). Perceiving dirty space as the main cause of diarrhoea (OR 1.81; CI 1.50–2.19; p ≤ 0.001), and privacy when using a latrine (OR 2.00; CI 1.67–2.40; p ≤ 0.001), were associated with higher odds of using basic sanitation. Households that indicated a disadvantage of owning a latrine was maintenance costs were less likely to use basic sanitation (OR 0.49; CI 0.38–0.63; p ≤ 0.001). Risk perceptions were important determinants of use of basic services. The findings point to risk perceptions motivating the application of positive WaSH-related and health-protective behaviours. This suggests that well-designed health risk communication strategies may be effective for engaging households in healthy WaSH behaviour.

Seasonal and spatial variation of reservoir water quality in the southwest of Ethiopia

This research investigated the spatiotemporal variation of water quality in the Gilgel Gibe reservoir, Ethiopia, using physicochemical water quality parameters. Nonparametric tests and multivariate statistical techniques were used to evaluate data sets measured during dry and rainy seasons. Electrical conductivity (EC), pH, biochemical oxygen demand (BOD₅), total phosphorus (TP), total nitrogen (TN), nitrate (NO₃^-), total dissolved solids (TDSs), and total suspended solids (TSSs) were all significantly different among seasons (Mann-Whitney U test, p < 0.01). In addition, principal component analysis distinguished dry season samples from wet season samples. The dry season was positively associated with EC, pH, TP, TN, NO₃^-, TDS, and TSS and negatively associated with BOD₅. The wet season was in contrast associated with high values of turbidity, soluble reactive phosphorus (SRP), water temperature, and dissolved oxygen (DO). Within the reservoir, spatial variation was observed for some of the water quality parameters, with significant difference at p = < 0.05. Overall, high nutrient concentrations suggest eutrophic conditions, likely due to high nutrient loading from the watershed. Levels of TSS, attributed to inputs from tributaries, have been excessive enough to inhibit light penetration and thus have a considerable impact on the aquatic food web. Our findings indicate that the reservoir is at high risk of eutrophication and siltation, and hence, urgent action should target the planning and implementation of integrated watershed management for this and similar reservoirs in the region.

Molluscicidal effect of Achyranthes aspera L. (Amaranthaceae) aqueous extract on adult snails of Biomphalaria pfeifferi and Lymnaea natalensis

Background

Intestinal schistosomiasis caused by Schistosoma mansoni is a wide spread disease in most parts of Ethiopian highlands. Snail control is one major strategy in schistosomiasis control. The use of molluscicidal plant products is becoming interesting due to their environmental friendliness, accessibility and easy application. This research is aimed to evaluate the molluscicidal effect of Achyranthes aspera on Biomphalaria pfeifferi and Lymnaea natalensis snails, which are of great medical and veterinary importance in Ethiopia.

Methods

Adult B. pfeifferi snails were exposed to the various concentrations of A. aspera aqueous leaf extract for 24, 48 and 72 h. Similarly, adult L. natalensis snails were exposed to the extract for 24 h. Mortality data were analyzed using probit regression model. Phytochemical content of the plant was analyzed using standard screening methods.

Results

The plant’s molluscicidal effect on the two snail species was demonstrated. The 24 h LC₅₀ and LC₉₀ values against L. natalensis were 69.5 and 93.9 ppm respectively. In the 24, 48 and 72 h exposure of B. pfeifferi, the LC₅₀ values were 72.4, 69.9, 64.7 ppm and the LC₉₀ were 96.5, 93.8, 92.8 ppm, respectively. The phytochemical screening tests indicated presence of saponins.

Conclusion

From the findings of this study, A. aspera has a molluscicidal potential. The result provides a useful foundation for further in-depth studies to ensure its wider applicability in different water bodies and evaluate its toxic effects on non-target species.

Electronic supplementary material

The online version of this article (doi:10.1186/s40249-017-0349-4) contains supplementary material, which is available to authorized users.

Exposure to DDT and its metabolites from khat (Catha edulis) chewing: Consumers risk assessment from southwestern Ethiopia

Khat (Catha edulis) is one of the most consumed plant in the horn of African countries. However, it is a stimulant plant that has several side effects on the health of consumers. On top of that, the khat leaves used for human consumption are often contain contaminants such as pesticide residues. The present study aims to investigate the level of DDT residue and its metabolites (p'p-DDE, p'p-DDD, o'p-DDT and p'p-DDT) in khat samples and to undertake exposure assessment to consumers. The khat samples were collected from local markets in southwestern Ethiopia. Consumption survey was undertaken using 24 h recall method for both male and female khat consumers. The finding showed that 80% of the khat samples contained DDT and its metabolites. Some of the residues were above the maximum residue limit (MRL) set by Food and Agricultural Organization (FAO). The concentration of p'p-DDE and p'p-DDT in khat were in the range of 0.033-0.113 and 0.010-0.026 mg/kg, respectively. High concentration of the metabolite (p'p-DDE) compared to the parent compound (p'p-DDT) revealed the historical use of DDT in the study area. Probabilistic exposure analysis indicated that the mean and 97.5 percentile (P97.5), of the estimated daily intake of total DDT were 0.002 and 0.006 mg/kg bw/day, respectively. The study concluded that khat consumers are exposed to the stimulant effect of the plant as well as DDT and its metabolites in Jimma zone.