Does owning improved latrine facilities enhance the safe disposal of child feces in Africa? a systematic review and meta-analysis

INTRODUCTION

Improved sanitation refers to those that effectively avoid human contact with excreta in a hygienic manner. Having improved latrines is a key factor in adopting safe ways of disposing of child feces. However, previous studies in Africa that examined how owning improved latrine facilities associated with household child feces disposal practices has shown inconsistent results, and no systematic review of these findings has been done. Therefore, this study aims to synthesize the evidence on the significance of households having improved latrine facilities for safe child feces disposal practices among households with under five-year-old children in Africa.

METHODS

The searched databases include: PubMed/Medline, Ovid/Embase, ScienceDirect, AJOL and the Cochrane Library. In the search process, Google Scholar and references of other studies were considered. This review included studies that were published in English without any time restrictions. The outcome of this study was an estimate of the association between the ownership of an improved latrine and the disposal practices of children's feces. Two reviewers used the Excel data extraction tool to extract the relevant data from the studies that were included in the review. Using Stata version 16, a meta-analysis was performed with a random effects statistical model. The inverse index of variance (I2) was used to assess heterogeneity. Forest plots were used to show the pooled estimate with a 95% confidence interval. Publication bias was assessed using Egger's test and a funnel plot.

RESULTS

Out of the 616 studies that were retrieved, 15 were included in the systematic review analysis and 10 were included in the meta-analysis. All studies that were included are cross-sectional studies done in Ethiopia, Nigeria, Gambia, Malawi, Eswatini, Ghana, Zambia, and a study used data from sub-Saharan Africa. Improved latrine facilities significantly enhanced the practice of safe child feces disposal, as shown by the overall effect size (OR = 2.74; 95% CI = 1.24-1.35, I2  =  99.95%). In the subgroup analysis by sample size, the presence of improved latrines significantly enhanced safe child feces disposal in studies with sample sizes less than 1000 (OR = 3.24; 95% CI = 2.86-3.62, I2  =  61.38%), while there was no significant difference in studies with sample sizes greater than 1000 (OR = 2.67; 95% CI = 0.69-4.64, I2  =  99.97%). However, studies that involved children under 5 years old indicated that improved latrine facilities significantly enhanced the practice of safe child feces disposal (OR = 4.02; 95% CI = 2.03-6.09; I2  =  99.96%).

CONCLUSIONS

In this research study, we examined the ownership of improved latrine facilities among households with five-year-old children to enhance the disposal of child feces in a safer manner in Africa. The high heterogeneity among the studies and the cross-sectional design of the included studies limit the causal inference and generalizability of the findings. Therefore, meta-analyses of longitudinal and experimental studies are needed to confirm the causal relationship between improved latrine facilities and safe child feces disposal practices in Africa.

Occupational exposure to dust and respiratory symptoms among Ethiopian factory workers: A systematic review and meta-analysis

BACKGROUND

Occupational respiratory disorders are a major global public health concern among workers exposed to dust particles in dust-generating workplaces. Despite fragmented research findings on the magnitude of respiratory problems and the lack of a national occupational respiratory disease recording and reporting system at the Ethiopian factory, the prevalence of respiratory symptoms among factory workers were unknown. Therefore, the aim of this meta-analysis was to summarize and pool estimates from studies that reported the prevalence of respiratory symptoms and predictors among Ethiopian factory workers who worked in dusty environments.

METHODS

A systematic literature searches were conducted using electronic databases (PubMed, Science Direct, African Journals Online, and Web of Science). The primary and secondary outcomes were prevalence of respiratory symptoms and predictors, respectively. The STATA version 17 was used to analyze the data. A random effect meta-analysis model was used. Eggers test with p-value less than 5%, as well as the funnel plot, were used to assess publication bias.

RESULTS

The searches yielded 1596 articles, 15 of which were included in the systematic review and meta-analysis. The pooled prevalence of respiratory symptoms among Ethiopian factory workers was 54.96% [95% confidence interval (CI):49.33-60.59%]. Lack of occupational health and safety (OSH) training [Odds Ratio (OR) = 2.34, 95%CI:1.56-3.52], work experience of over 5 years [OR = 3.19, 95%CI: 1.33-7.65], not using personal protective equipment (PPE) [OR = 1.76, 95%CI:1.30-2.39], and working more than eight hours per day [OR = 1.89, 95%CI:1.16-3.05] were all significant predictors of respiratory symptoms.

CONCLUSION

The prevalence of respiratory symptom was found to be high in Ethiopian factory workers. To prevent workers from being exposed to dust, regular provision and monitoring of PPE use, workers OSH training, and adequate ventilation in the workplace should be implemented.

Utilization of Insecticide-Treated Nets in Households for Under-5 Children and Associated Factors in East Mesekan District, Gurage Zone, Southern Ethiopia

INTRODUCTION

Insecticide-treated nets (ITNs) are widely used tools that have been proven effective in preventing and controlling malaria. However, usage varies among households and can greatly affect the benefits of ITNs. Thus, this study aimed to assess the household utilization of insecticide-treated nets and its associated factors for under-5 children.

METHODS

A cross-sectional study was conducted in March-April 2020 in the East Mesekan district. A total of 591 households with under-5 children were chosen by using a systematic random sampling approach for the interviews. The data was collected using a pretested questionnaire. Epi-Data version 3.1 was used to enter data and SPSS version 21 for analysis. A P-value of .05 was considered statistically significant.

RESULTS

In this study, 58.2% (95% CI: [54.1%-62.2%]) of household participants used ITN for children under 5 years of age while sleeping the night before the survey. The study participants' overall knowledge and practice of malaria prevention were 27.1% and 23.9%, respectively. Having a family size of less than 5 (AOR = 0.60, 95% CI: [0.37-0.98]) and complaints of skin irritation (AOR = 0.43, 95% CI: [0.29-0.63]) significantly decreased ITN utilization. However, having 1 ITN (AOR = 2.15, 95% CI: [1.15-4.02]) or 2 ITNs (AOR = 2.58, 95% CI: [1.51-4.39]), as well as low (AOR = 2.07, 95% CI: [1.33-3.20]) and medium (AOR = 1.83, 95% CI: [1.11-3.02]) knowledge of ITN importance, increased ITN utilization significantly.

CONCLUSIONS

The households' use of ITNs for children under the age of 5 was inadequate. It was significantly associated with having a family size of less than 5, complaints of skin irritation, owning 1 or 2 ITNs, and having low and medium knowledge of its importance. It is recommended that continuous and progressive health awareness about the consistent use of ITN for malaria prevention in the study area be promoted.

Pesticide Use Practice and Associated Factors Among Rural Community of Malga District, Sidama Regional State, South Ethiopia

In Ethiopia, like that of the other developing countries, pesticides are widely used for a variety of purposes, but their unsafe use causes a major environmental and health hazard. The aim of this study was to assess pesticide use practice and its associated factors among the rural community of Malga district, Sidama region, southern Ethiopia. A community based cross-sectional study was conducted from February to March 2021 at Malga District. Data were collected from 549 farmers by a structured and pretested interviewer-administered questionnaire. Binary and multivariable logistic regression was used for the data analysis. Adjusted odds ratios and their 95% confidence intervals (CIs) were calculated to determine the association between safe practices of pesticide use and several related factors. Safe practice of pesticide use was observed in 193 (35.2%). The participants who had primary education [AOR = 5.605, 95% CI: 3.309, 9.495], secondary education and above [AOR = 9.847, 95% CI: 5.007, 19.368], used pesticide for 10 years and above [AOR = 6.790, 95% CI: 3.589, 12.843], used pesticide between 6 and 10 years [AOR = 1.913, 95% CI: 1.166, 3.141] pesticide bought from any shop [AOR = 2.320, 95% CI: 1.364, 3.947], agricultural office [AOR = 7.187, 95% CI: 3.654, 14.137] were associated with safe use of pesticides. The safe practice of pesticide use was low in the study area. Continuous training programs should be implemented on the safe practice of pesticide use to the local farmers.

Qualitative Analysis of Onsite Sanitation Challenges in an Urban Setting: The Case of Jimma Town, Ethiopia

On-site sanitation is the most popular sanitation option for households in many African countries, including Ethiopia. Despite the option being common, there are challenges attributed to the sustainability of those facilities. This community-based exploratory study aimed to explore the challenges in the provision of safe urban on-site sanitation in Jimma town, Ethiopia. Data were collected through key informant semi-structured interviews, transit walks through the village, and focus group discussion (FGD). The FGD was audio recorded and notes were taken by experts. Records and notes were transcribed separately and thematically analyzed. Three major themes or challenges were discovered. Accordingly, the first theme was the community's perception and taboos surrounding human waste. The second theme was urban land use and informal settlements. Ensuring standards separately for sanitation facilities is difficult because of the expansion of illegal settlements. The third theme was poor sanitation planning, operation and maintenance, and institutional setting. Urbanization without infrastructure generally has a complex nature that leads to a fragile sanitation situation in the future. The results suggest the need for multi-dimensional system development and a collaborative sanitation master plan. Furthermore, interventions aimed at breaking the taboo on human waste as a sanitation platform may turn challenges into opportunities.

Food Hygiene Practices and Associated Factors Among Street Food Vendors in Urban Areas of Gedeo Zone, Southern Ethiopia

Background

Street food is expanding all around Ethiopia. Street vendors have become commonplace near schools, hospitals and bus stations. Because street vended food is sold in unsanitary surroundings near streets, it can be contaminated with variety of pathogens, exposing consumers to foodborne illnesses. There haven't been enough studies on Ethiopian street food, and little is known about how hygienic these foods are. The local authorities don't even have a regulatory system to ensure food safety for street food vendors. Thus, this study aimed to assess food hygiene practices among street food vendors and associated factors.

Methods

Community-based cross-sectional analytical study design was conducted from June, 2021 to July, 2021 including 402 respondents. Structured questionnaire and observational checklists were used for assessing food hygiene practices. Data were analyzed using SPSS statistics (version 25.0). Binary logistic regression analyses were used to check association of covariates with food hygiene practices. Adjusted odds ratio, and P-value less than 0.05 at 95% confidence interval were used to report significant association.

Results

Out of 402, 390 individuals responded. About 123 (31.5%) (95% CI: 27.2-36.4) of vendors had good food hygiene practices. Being female (AOR = 0.15; 95% CI: 0.09-0.27), age (19-25 years (AOR = 0.29; 95% CI: 0.11-0.81) and 26 to 35 years (AOR = 0.24; 95% CI: 0.08-0.74), marital status (being married (AOR = 0.52; 95% CI: 0.29-0.93), educational status (college and above (AOR = 3.42; 95% CI: 1.35-8.62), monthly income (1001-2000 Ethiopian Birr (AOR = 0.36; 95% CI: 0.19-0.68), being inspected (AOR = 13.15; 95% CI: 2.76-62.66) and lack of water at vending site (AOR = 0.40; 95% CI: 0.17-0.97) were factors significantly associated with food hygiene practices of street vendors.

Conclusion

Few street food vendors who adhered to good food hygiene were present. Significant variables of food hygiene behaviors included gender, age, marital status, education level, monthly income, inspection frequency, and the availability of water at vending sites. The vendors' food hygiene practices needed to be improved, which necessitated continual assistance, frequent inspections, and public awareness campaign.

The epidemiology of road traffic accidents and associated factors among drivers in Dilla Town, Southern Ethiopia

Background

Data on the magnitude of road traffic accidents (RTAs) were mostly obtained through police records and hospital registration data. However, insufficient data reporting masked the gravity of the problem, and little attention was paid to the magnitude and correlation of road traffic accidents from the driver's perspective. Therefore, this study aimed to assess the prevalence of RTA and related factors among drivers.

Methods

A community-based cross-sectional study involving 316 drivers was conducted in Southern Ethiopia. The participants were chosen using a systematic random sample technique, and the data were obtained using an interview-administered structured questionnaire. To analyze the data, SPSS software (version 20) was employed. In addition to descriptive statistics, binary logistic regression analysis was also employed to find factors connected to traffic accidents. RTA factors were considered statistically significant if they had a P-value of 0.05 or below in the multivariate analysis.

Result

The RTA among drivers was 126 (39.9%) (95% confidence interval (CI): 34.2-45.6%) in the previous year. The following factors were associated with RTA: vehicle maintenance (AOR = 0.11, 95% CI: 0.09, 0.96), media utilization (AOR = 0.38, 95% CI: 0.18, 0.65), participation in driving-related training (AOR = 0.73, 95% CI: 0.28, 0.91), punishment for prior traffic violations (AOR = 0.56, 95% CI: 0.47, 0.83), and risky driving behavior (AOR = 7.89, 95% CI: 3.22, 12.38).

Conclusion

Two-fifths of the drivers were involved in a traffic accident. Risky driving behaviors, vehicle maintenance, media usage, attending driving-related training in the previous 2 years, and prior experience with traffic police punishment or warning were all strongly linked to road traffic accidents. In light of these statistics, the Federal Ministry of Transport of Ethiopia and other stakeholders should support making it mandatory for drivers to check their vehicles' safety, provide them with safety training, raise awareness about vehicle maintenance and risky driving behaviors, and enforce strict penalties for traffic violations.

Predictors of Hand-Washing Practices at Critical Times Among Mothers of Under-5 Years Old Children in Rural Setting of Gedeo Zone, Southern Ethiopia

BACKGROUND

Various communicable and infectious diseases could be contained by proper hand washing leading to a reduction in mortality and morbidity of children.

OBJECTIVE

To assess predictors of hand-washing practices at critical times among mothers of under 5 years old children in rural setting of Gedeo zone, Southern Ethiopia.

METHOD

An institutional-based cross-sectional survey was conducted among 422 women with children under the age of 5 attended the Dilla Zuria health facility and were chosen using a systematic sampling method. Data was gathered using pre-tested interview-administered structured questionnaires. Data was entered into EPI info version 17 and analyzed using SPSS version 25. Binary logistic regression was employed to identify the association between dependent and independent variables. Finally, for variables with a P < .05 in multivariable analysis, adjusted odds ratio (AOR) with a 95% confidence interval (CI) was determined and interpreted.

RESULTS

The hand washing practice of mothers at critical times was 44.9% [95% CI: 40.1, 49.7%]. The pertinent predictors were favorable attitude [AOR = 7.77, 95% CI: 4.56, 10.37], availability of water source near the household [AOR = 5.31, 95% CI: 3.56, 10.37], and constant availability of soaps at household [AOR = 2.32, 95% CI: 1.33, 6.70].

CONCLUSION

In our study, hand-washing practices at critical times was low. The pertinent predictors were attitude, the presence of a water source near the household, and the presence of soap. Therefore, it is advised to encourage domestic hygiene education to improve mothers' attitudes and to increase the availability of water and soap close to the household to promote handwashing with soap and water at critical times.

The link between indoor air pollution from cooking fuels and anemia status among non-pregnant women of reproductive age in Ethiopia

Objective:

The effect of indoor air pollution from different fuel types on the anemia status among non-pregnant women is rarely studied. This study aimed to assess the link between indoor air pollution from different fuel types and anemia among non-pregnant women of reproductive ages in Ethiopia.

Method:

The secondary data from the 2016 Ethiopian Demographic and Health Survey data have been employed for this study. The anemia status of women in reproductive age was the outcome variable with multiple outcomes as (moderate to severe, mild, and no anemia) and households using biomass fuel and clean fuel were selected for this study. Multinomial logistic regression was employed to estimate the association of biomass fuel use with the anemia status controlling for the predictor variables. Relative risk ratio was calculated at 95% confidence interval. An independent-sample t-test was used to assess the mean difference in blood hemoglobin level (g/dL) between the two fuel users. A p value < 0.05 was considered significant.

Result:

From the total of 10,961 participants included in this study, the proportion of anemia in women of non-reproductive age was 41.8% and 19.4% among biomass fuel and clean fuel users, respectively, with a mean blood hemoglobin level of 12.71 (±1.81) g/dL. In the final model, women using biomass fuel for cooking were 47% more likely to have mild anemia than households who use cleaner fuels, whereas the association was insignificant for moderate to severe anemia. Biomass fuel users were also found to have 5.8 g/dL lower blood hemoglobin level than the clean fuel user (p < 0.001).

Conclusion:

The use of biomass fuel was associated with reduced blood hemoglobin levels and significantly associated with mild anemia levels in women of reproductive age in Ethiopia. National efforts should be in place to reduce indoor air pollution from biomass fuels.

PCR-based detection of pathogens in improved water sources: a scoping review protocol of the evidence in low-income and middle-income countries

INTRODUCTION

Occurrence of diverse human enteric bacterial, viral and protozoal pathogens in improved drinking water because of pathogenic microbial contamination is of increasing public health concern, particularly in low-income and middle-income countries (LMICs). Detecting microbial pathogens in water supplies comprehensively and accurately is beneficial to ensure the safety of water in LMICs where water contamination is a major concern. Application of PCR-based methods in detecting the microbial quality of water provides more accurate, sensitive and rapid outcomes over conventional methods of microbial identification and quantification. Therefore, exploring water quality outcomes generated through PCR-based methods is important to better understand the status and monitor progress towards internationally set goals for LMICs. This scoping review aims to map the existing evidence on the magnitude and characteristics of diarrhoeagenic pathogens as detected by PCR-based methods in improved water sources within the context of LMICs.

METHODS AND ANALYSIS

This study will be undertaken in line with the Joanna Briggs Institute (JBI) methodology for scoping reviews. We will consider the available publications covering PCR-based microbial water quality assessment of improved drinking water sources in LMICs. Searches will be undertaken in PubMed/Medline, Scopus, Web of Science, JBI, Cochrane Library and Google Scholar. A grey literature search will be conducted in Google and ProQuest.

ETHICS AND DISSEMINATION

The College of Natural and Computational Science Institution Review Board of Addis Ababa University gave formal ethical approval to this study protocol. The findings of this study will be disseminated to the concerned body through peer-reviewed publications, presentations and summaries.

Health related quality of life and its association with social support among people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia: a systematic review and meta-analysis

Background

People living with HIV/AIDS (PLWHA) are frequently confronted with severe social issues such as rejection, abandonment, criticism, and stigma. This would negatively affect their quality of life. Several studies have been conducted so far to assess factors affecting the health-related quality of life among people living with HIV/AIDS who are on antiretroviral therapy (ART) in Ethiopia. However, to our knowledge, there is no previous study that has summarized the results of the studies that investigated health-related quality of life (HRQOL) among PLWHA in Ethiopia. Therefore, the purpose of this review was to estimate the pooled prevalence of HRQOL and its association with social support among people living with HIV/AIDS (PLWHA) on ART in Ethiopia.

Methods

A systematic search was carried out using several electronic databases (PubMed, Science Direct, Web of Science, and Cochrane electronic), Google Scholar, Google, and a manual search of the literature on health-related quality of life among people living with HIV/AIDS who are on ART. A Microsoft Excel data extraction sheet was used to extract pertinent data from an individual study. To assess the heterogeneity of primary articles, the Cochrane Q test statistics and the I2 test were carried out, and a random effects meta-analysis was used to estimate the pooled prevalence of HRQOL.

Result

Out of the 493 articles reviewed, ten with a total of 3257 study participants were eligible for meta-analysis. The pooled prevalence of HRQOL among people living with HIV/AIDS who are on antiretroviral therapy in Ethiopia was 45.27%. We found that strong perceived social support was significantly associated with higher levels of subjectively perceived HRQOL. PLWHA who were on ART and had good social support were four times more likely to report higher HRQOL when compared to their counterparts [AOR = 4.01, 95% CI 3.07–5.23].

Conclusion

A substantial number of PLWHA had poor HRQOL in Ethiopia. Social support was significantly associated with HRQOL among people living with HIV/AIDS. Hence, it’s recommended to encourage suitable intervention at every follow-up visit, and psycho-social support is also warranted to improve the quality of life.

Effective Handwashing Practice in Dilla University Referral Hospital; Duration of Hand Rubbing and the Amount of Water as Key Enablers

BACKGROUND

Ineffective hand hygiene in healthcare settings is a global challenge that is associated with a high rate of nosocomial infections. The study aimed to measure the effectiveness of handwashing at Dilla University referral hospital.

METHOD

This study consisted of 2 parts; the survey work and laboratory analysis. A total of 63 participants were selected to take surveys using an interviewer-administered questionnaire to collect the data regarding the socio-demographic and hand hygiene-related practices. A laboratory tests (swab test) was used to assess handwashing effectiveness from 63 participants by taking 126 swab test (63 before and after hand washing sessions). A swab test was collected from the palms of each participant before and after hand washing using a sterile technique. The cultures were then incubated aerobically overnight at 37°C, and examined for microbial growth. The bacterial load was reported as the number of colony-forming units (CFU).

RESULT

The proportion of effective hand washing in Dilla University Referral Hospital was 82.5%. The mean colony-forming unit before and after handwashing were 55 and 2 CFU/ml, respectively with an average reduction of 94.6% in terms of CFU/ml. The mean amount of water used for effective handwashing was 336.03 (±219.46) ml. There was a significant mean difference in the amount of water used and duration of hand rubbing between effective and non-effective handwashing among the participants (P < 0.01). The bacterial load before and after handwashing indicated that there was a significant (53.3 mean CFU) reduction in bacterial load after handwashing practice which indicated that the handwashing intervention in the Referral hospital was effective (P < 0.01).

CONCLUSION

The proportion of effective Hand washing in Dilla University referral Hospital was 82.5% with a 94.6% reduction in terms of (CFU/ml). The amount of water use and the duration of hand rubbing showed a significant difference in the reduction of the microbial load.

Environmental and Behavioral Factors Associated With Handwashing With Soap After Defecation in a Rural Setting of 2 Districts of the Jimma Zone, Ethiopia

BACKGROUND

Handwashing with soap can prevent the spread of fecal oral microbes in the home environment. Despite the lack of water and for a variety of reasons, soap-based handwashing is not practiced in developing countries after defecation.

OBJECTIVE

The objective of the study was to determine the environmental and behavioral factors associated with hand washing with soap after defecation of respondents with children under the age of 5 years in a rural setting.

METHODS

Data used were taken from 756 households with children under the age of 5 that participated in a cross-sectional study conducted from July 22 to August 9, 2018, in 2 selected districts in the Jimma Zone, Southwest Ethiopia. It included post-defecation hand washing with soap and other variables such as sociodemographic information, environmental and behavioral factors. Stata version 16 was used to analyze the data. We use binary logistic regression models. To declare statistical significance, a P-value of less than .05 with an adjusted odds ratio and a confidence interval of 95% was used.

RESULTS

The prevalence of soap-based post defecation hand washing practices among respondents was 64.4%. Hand washing practice after defecation with soap has a significant association with having more than 1 child under 5 years of age (AOR = 1.60; 95% CI: 1.05-2.45), households living with cattle (AOR = 2.00; 95% CI: 1.30-3.07), use of unimproved latrine (AOR = 0.55; 95%CI: 0.31-0.98), with the presence of feces in the compound of the households interviewed (AOR = 7.08; 95% CI: 4.07-12.35) and regular cleaning water containers before filling drinking water (AOR = 2.16; 95% CI: 1.13-4.15).

CONCLUSIONS

Most of the study participants washed their hands with soap after defecation. The presence of feces in the compound, having more than 1 child, living with cattle, and cleaning water containers routinely before filling drinking water all enhanced post-defecation handwashing with soap. However, when using unimproved latrines, respondents' post-defecation handwashing behavior with soap may be significantly reduced.

Hygienic Food Handling Practices and Associated Factors Among Food Handlers in Ethiopia: A Systematic Review and Meta-Analysis

BACKGROUND

The food handling practices of food handlers can have a significant impact on the hygienic status of the food. The aim of this study was to determine the prevalence and factors associated with hygienic food handling practices among food handlers in Ethiopia.

METHODS

PubMed, Science Direct, Google Scholar, and the Cochrane Library databases were used to find articles. Only cross-sectional studies that met the criteria for inclusion were considered. STATA version 16 statistical software was used to perform the meta-analysis. The study's heterogeneity was determined using Cochrane Q test statistics and the I ² test. A random effect model was used to calculate the pooled prevalence of hygienic food handling practices.

RESULTS

To estimate the pooled prevalence of hygienic food handling practices in Ethiopia, 9 out of 33 reviewed studies were included. The prevalence of hygienic food handling practices was found to be 48.36% (95% CI: 39.74-56.99) in this study. Factors associated with hygienic food handling practices included; lack of food safety training (OR = 5.38; 95% CI: 1.71, 16.89), negative attitude (OR = 3.28; 95% CI: 1.50, 7.13), lack of access to handwashing facilities (OR = 4.84; 95% CI: 1.72, 13.65), lack of regular medical checkup (OR = 5.37; 95% CI: 3.13, 9.23), and lack of secondary education (OR = 2.51; 95% CI: 1.46, 4.32) among food handlers.

CONCLUSION

In this study, the prevalence of hygienic food handling practices among Ethiopian food handlers was significantly low. Unhygienic food handling practices were attributed to a lack of food safety training, regular medical checkups, handwashing facilities, an unfavorable attitude toward food hygiene practices, and a lack of formal education. As a result, food handlers should receive ongoing food safety and hygiene training.

Factors associated with preventive practices of COVID-19 among health care workers in Dilla University Hospital, Southern Ethiopia

Implementation of prevention measures is essential for decreasing COVID-19 morbidity and mortality. In health care settings, wearing face masks, avoiding handshakes and spitting, and thoroughly washing hands with soap and water or using an alcohol-based hand rub have been recommended as preventive measures to reduce the risk of COVID-19 transmission. Therefore, this study aimed to assess factors associated with COVID-19 prevention practices among health care workers at Dilla university hospital in Southern Ethiopia. An institutional-based cross-sectional study was conducted among 238 health care workers in Dilla university hospital from June 13, 2021- July 12, 2021. A stratified random sampling techniques were used to select study participants. Data were collected by using pre-tested structured self-administered questionnaires. A binary logistic regression analysis was used to identify factors related to COVID-19 prevention practice among health care professionals. For statistical significance factors with p-value less than 0.05, an Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was calculated and interpreted. One hundred thirty-four participants [56.3%, 95% CI: 50 - 60.3%] had good COVID-19 prevention practices. Being a frontline worker [AOR=12.6, 95% CI: 3.9-41.6], being female [AOR= 0.7, 95% CI: 0.35-0.84], being a nurse [AOR= 8, 95% CI: 2.4-27], and implementation of Infection Prevention and Control (IPC) guideline [AOR = 4.0, 95% CI: 1.56-10.08] were all factors associated with good COVID-19 prevention practice. COVID-19 prevention practices were low among healthcare professionals in the study settings. Being frontline worker, being a nurse, being female, and implementation of IPC guidelines were all associated with COVID-19 preventive measures practices among health care workers. Health care workers may need to improve the way and habit of practicing prevention methods towards COVID-19.

High Strength Wastewater Reclamation Capacity of Vetiver Grass in Tropics: The Case of Ethiopia

It is generally accepted that industrial wastewater like tannery effluent is high strength wastewater. The aim of this study was to examine the capacity of Vetiver grass for the treatment of high strength wastewater in a constructed wetland. Two constructed wetland beds were designed and one of them was not planted used as a control group. The grass was planted with 20 cm by 20 cm distance from each seedling. The biometric characteristics of Vetiver grass was evaluated by taking randomly selected clusters of the grass. The concentration of chromium in the extract of parts of the grass was determined by atomic absorption spectrophotometer. The Chromium bioaccumulation and Translocation factor was estimated. Composite samples before and after treatment of 4 different hydraulic retention time was collected. The physiochemical analysis of the wastewater has been carried out. The constructed wetland bed with Vetiver grass performed that, BOD, COD, NH₄-N, NO₃-N, TN, PO₄-P, and TP were reduced at the retention time of 9 days by 91.9%, 96.3%, 62%, 86%, 88.7%, 96.3%, and 92.2% respectively. Chromium was also reduced by 97% at retention time of both 7 and 9 days over the planted bed. The bed with plant performs significantly better than without plant at P-value <.01. Therefore, Vetiver grass has a capacity to reclaim high strength industrial wastewater in tropical areas.

Utilization of Community-Level Fluoride-Filtered Water and its Associated Factors in Dugda Woreda of East Shewa Zone, Oromia Region, Ethiopia

BACKGROUND

Long-term consumption of water containing an excessive amount of fluoride causes dental and skeletal fluorosis. De-fluoridation options differ in terms of scale, efficacy, long-term viability, and user acceptance. Therefore, this study aimed to identify the challenges of using fluoride-filtered water and its associated factors among households.

METHODS

A cross-sectional study was conducted from April to May, 2018 among 405 randomly selected households in Dugda Woreda of Ethiopia Rift Valley East Shewa Zone, Oromia Region. A structured interviewer-administered questionnaire was used to collect the data. SPSS version 20 was used to enter and analyze the collected data. Logistic regression analysis was used to identify association between dependent and independent factors and explained by odds ratio with 95%CI.

RESULTS

A total of 228 (56.3%) households were found to utilize fluoride filtered water from community water supply schemes for drinking and cooking purposes. No family history of fluorosis (AOR = 44.4, 95%CI: 18.8, 104.74), monthly income of less than 1000 ETB (AOR = 0.03, 95%CI: 0.004, 0.23), good knowledge of community fluoride filter schemes (AOR = 5.93, 95%CI: 1.30, 26.9), and not afford to pay bill of ⩾0.50 ETB [AOR = 0.4, 95%CI: 0.20, 0.91] were factors significantly associated with utilization of community-level fluoride-filtered water.

CONCLUSION

In this study, more than half of the households used fluoride filtered water. Family monthly income, affordability, presence of family members with the history of fluoride exposure, and knowledge about community fluoride filter schemes were factors significantly associated with utilization of community-level fluoride-filtered water.

Bacteriological Quality of Drinking Water and Associated Factors at the Internally Displaced People Sites, Gedeo Zone, Southern Ethiopia: A Cross-sectional Study

BACKGROUND

Providing safe and adequate Water, Sanitation and Hygiene (WASH) services in response to emergencies is a major problem. Globally, few studies have investigated the bacteriological quality of drinking water at the IDP sites. Therefore, the objective of this study was to evaluate the bacteriological quality of drinking water and associated factors at the IDP sites of Gedeo zone.

METHODS

A cross-sectional study was conducted on 213 water samples collected from November to December 2018. The membrane filter technique was used to retain bacteria and lauryl sulphate broth media was used to detect faecal coliforms. After incubation of 14 hours at 44°C, faecal coliforms with yellow colonies were counted and expressed in terms of CFU/100 ml of water. The data were entered into Epi data version 3.1 and exported to STATA version 14 for analysis. Binary logistic regression analysis with 95%CI and P ⩽ .05 was used to identify factors associated with an outcome variable.

RESULTS

Out of 213 water samples collected, 107 (50.2%) samples were tested positive for faecal coliforms. The presence of latrines in uphill (AOR: 6.7, 95%CI: 1.0-42.9), other sources of pollution (AOR: 5.0, 95%CI: 1.1-22.3), inadequate fencing (AOR: 7.1, 95%CI: 1.3-40.2) and lack of diversion ditch (AOR: 6.3, 95%CI: 1.0-37.6) were factors significantly associated with faecal contamination of springs. Dug wells that had a latrine within 10 m (AOR: 11.4, 95%CI: 1.8-72.1), other pollution sources within 10 m (AOR: 7.9, 95%CI: 1.9-32.4), inadequate fencing (AOR: 2.8, 95%CI: 1.0-7.9), drawing water using a bucket with rope (AOR: 7.3, 95%CI: 1.6-33.4) and unsanitary well cover (AOR: 3.4, 95%CI: 1.1-10.4) were factors significantly associated with faecal contamination of wells.

CONCLUSIONS

The majority of the water sources in internally displaced people sites were tested positive for faecal coliforms. The presence of latrine in uphill, other sources of pollution, inadequate fencing, lack of diversion ditch, drawing water using a bucket with rope and unsanitary well cover were factors associated with the presence of faecal coliforms. Therefore, adequate fencing, proper diversion ditch construction and hygiene promotion should be done to protect water sources from faecal contamination. Furthermore, latrines and other point sources of contamination should be located at least 10 m away or at a lower elevation from water sources.

Associations Between Improved Water Supply and Sanitation Usage and Childhood Diarrhea in Ethiopia: An Analysis of the 2016 Demographic and Health Survey

BACKGROUND

Diarrheal disease is one of the leading causes of death in children under the age of 5. Access to and use of improved water and sanitation services is associated with this, but there is little country-level evidence for this relationship in Ethiopia. Therefore, associations between improved water supply and sanitation usage and childhood diarrhea in Ethiopia have been identified as the objective of this study.

METHODS

This study was a cross-sectional study using data from Ethiopia's 2016 Demographic and Health Survey. Through interviews with mothers/caregivers who had children under the age of 5 years, data was collected. The outcome of this study was the response of the mothers/caregivers interviewed to the 2-week occurrence of diarrhea. Logistic regression analysis was used to examine the relationship between dependent and independent variables.

RESULTS

The survey results found that the use of improved drinking water and latrine facilities was 59.3% (95% CI: 58.36-60.31) and 17.3% (95% CI: 16.59-18.09), respectively. With respect to the handling practices of child feces, 24.8% (95% CI: 23.8-25.70) of the child feces of the interviewed mothers/caregivers were disposed of safely. The prevalence of childhood diarrhea in the preceding 2 weeks was 11% (95% CI: 10.36-11.61). Residence of Somali Region (AOR = 1.81, 95% CI: 1.25-2.61), having more than 2 under-5 children (AOR = 1.21, 95% CI: 1.01-1.46), having more than 5 family members (AOR = 1.18, 95% CI: 1.03-1.36), sex of the indexed child (AOR = 0.88, 95% CI: 0.77-0.99) and unsafe child feces disposal practices (AOR: 1.32; 95% CI: 1.14-1.54) were significantly associated with childhood diarrhea.

CONCLUSION

Residing in the Somali region, having more than 2 children under the age of 5 and having more than 5 household members, indexed child sex, and safe disposal of child feces were significantly associated with diarrhea. Therefore, in Ethiopia, the prevention of childhood diarrhea should concentrate on eliminating household crowding and encouraging the safe disposal of child feces.

Childhood Malnutrition and the Association with Diarrhea, Water supply, Sanitation, and Hygiene Practices in Kersa and Omo Nada Districts of Jimma Zone, Ethiopia

BACKGROUND

Inadequate water supply, sanitation, hygiene practices, and diarrhea are related to malnutrition, but there is limited evidence in Ethiopia about their association. Thus, the objective of this study was to describe childhood malnutrition and the association with diarrhea, water supply, sanitation and hygiene practices.

METHODS

A case-control study design was performed from December 2018 to January 2019 in Kersa and Omo Nada districts of the Jimma Zone, Ethiopia. Both children aged 6 to 59 months were chosen randomly from malnourished and well-nourished children in 128 cases and 256 controls, respectively. Bodyweight, length/height, mid-upper arm circumference, and presence of edema of the children were measured according to the WHO references. Then, the nutritional status of the children was identified as a case or control using the cutoff points recommended by the WHO. To see the association-dependent and independent variables, logistic regression analysis was used.

RESULTS

A total of 378 children were included in this study (98.44%). Malnutrition was significantly increased among children who delayed breastfeeding initiation(AOR = 3.12; 95% CI: 1.62-6.00), had diarrhea (AOR = 9.22; 95% CI: 5.25-16.20), were living in households indexed as the poorest (AOR = 2.50; 95% CI: 1.12-5.62), defecated in a pit latrine without slab/open pit (AOR = 2.49; 95% CI: 1.17-5.30), collecting drinking water from less than/equal to 1 km distance (AOR = 4.77; 95% CI: 1.01-22.71) and sometimes practiced hand washing at the critical times (AOR = 2.58; 95% CI: 1.16-5.74) compared with their counterparts. However, lactating during the survey (AOR = 0.35; 95% CI: 0.18-0.67), water collection from unprotected sources (AOR = 0.22; 95% CI: 0.05-0.95) and collection and disposal of under-5 children feces elsewhere (AOR = 0.06; 95% CI: 0.01-0.49) significantly reduced the likelihood of malnutrition.

CONCLUSIONS

Early initiation of exclusive breastfeeding, diarrhea prevention, and the use of improved latrine and handwashing practices at critical times could be important variables to improve the nutritional status of children.

Effectiveness of solar disinfection water treatment method for reducing childhood diarrhoea: a systematic review and meta-analysis

OBJECTIVE

This study aimed to pool out the available evidence on the effectiveness of the solar disinfection water treatment method for reducing childhood diarrhoea.

DESIGN

Systematic review and meta-analysis.

SETTING

Global.

METHODS

Searches were conducted in Medline/PubMed, Scopus, Google Scholar, Cochrane Library databases and references to other studies. The review included all children living anywhere in the world regardless of sex, ethnicity and socioeconomic status published in English until December 2019. Studies that compared the diarrhoea incidence between the intervention group who were exposed to solar disinfection water treatment and the control group who were not exposed to such water treatment were included. The outcome of interest was the change in observed diarrhoea incidence and the risk from baseline to postintervention. Two independent reviewers critically appraised the selected studies. Effect sizes were expressed as risk ratios, and their 95% CIs were calculated for analysis.

RESULTS

We identified 10 eligible studies conducted in Africa, Latin America and Asia that included 5795 children aged from 1 to 15 years. In all identified studies, solar disinfection reduced the risk of diarrhoea in children, and the effect was statistically significant in eight of the studies. The estimated pooled risk ratio of childhood diarrhoea among participants that used the solar disinfection water treatment method was 0.62 (95% CI 0.53 to 0.72). The overall pooled results indicated that the intervention of solar disinfection water treatment had reduced the risk of childhood diarrhoea by 38%.

CONCLUSIONS

The intervention of solar disinfection water treatment significantly reduced the risk of childhood diarrhoea. However, the risk of bias and marked heterogeneity of the included studies precluded definitive conclusions. Further high-quality studies are needed to determine whether solar disinfection water treatment is an important method to reduce childhood diarrhoea.

PROSPERO REGISTRATION NUMBER

CRD42020159243.

Association between microbial water quality, sanitation and hygiene practices and childhood diarrhea in Kersa and Omo Nada districts of Jimma Zone, Ethiopia

INTRODUCTION

Diarrhea is one of the leading causes of child morbidity and mortality in low- and middle-income countries like Ethiopia. The use of safe drinking water and improved sanitation are important practices to prevent diarrhea. However, limited research has been done to link water supply, sanitation and hygiene practices and childhood diarrhea. Therefore, this study aimed at assessing the association between microbial quality of drinking water, sanitation and hygiene practices and childhood diarrhea.

METHODS

Community-based matched case-control study design was applied on 198 paired children from June to July 2019 in Kersa and Omo Nada districts of Jimma Zone, Ethiopia. Cases are children < 5 years of age with diarrhea during the two weeks before the survey. The controls are children without diarrhea during the two weeks before the survey. Twenty-five percent matched pair samples of water were taken from households of cases and controls. Data were collected using structured questionnaire by interviewing mothers/caregivers. A sample of water was collected in nonreactive borosilicate glass bottles and analyzed by the membrane filtration method to count fecal indicator bacteria. A conditional logistic regression model was used; variables with p-value less than 0.05 were considered as significantly associated with childhood diarrhea.

RESULTS

A total of 396 (each case matched with control) under-five children with their mothers/caregivers were included in this study. In the analysis, variables like presence of under-five child in their home (AOR = 2.76; 95% CI: 1.33-5.71), wealth status (AOR = 5.39; 95% CI: 1.99-14.55), main sources of drinking water (AOR = 4.01; 95% CI: 1.40-11.44), hand washing practice before water collection (AOR = 4.28; 95% CI: 1.46-12.56), treating water at household level (AOR = 1.22; 95% CI: 0.48-3.09), latrine use all the times of the day and night (AOR = 0.22; 95% CI: 0.06-0.78), using pit as method of waste disposal (AOR = 4.91; 95% CI: 1.39-13.29) and use of soap for hand washing (AOR = 2.89; 95% CI: 1.35-6.15) were significantly associated with childhood diarrhea. Moreover, 30% of sampled water from cases and 26% of sampled water from controls families were free from Escherichia coli whereas all sampled water analyzed for Total coliforms were positive.

CONCLUSIONS

We conclude that the main sources of drinking water, hand washing before water drawing from a storage container, domestic waste disposal place and use of soap for hand washing were the most important factors for the prevention of childhood diarrhea.

The effectiveness of solar disinfection water treatment method for reducing childhood diarrhea: a systematic review and meta-analysis protocol

BACKGROUND

Several studies employing the effectiveness of solar disinfection water treatment method for reducing diarrhea have reported heterogeneous outcomes, necessitating a systematic review to provide an exhaustive summary of current evidence. Thus, the objective of this review is to pool out the available evidence on the effectiveness of solar disinfection water treatment method for reducing childhood diarrhea.

METHODS

Searches will be conducted in PubMed/Medline, Scopus, Google Scholar, Cochrane Library databases, and reference of other studies published through in December 2019. Studies that compare the diarrhea incidence among the intervention group who were exposed to solar disinfection water treatment and the control group who were not exposed to such water treatment were included. The primary outcome of the study is the change in observed diarrhea incidence risk from baseline to post-intervention. Randomized controlled trial study designs will be included. Selected studies will be critically appraised by two independent reviewers. Extracted data will include details about the interventions, populations, study methods, and outcomes of significance to the review question and objectives. Effect sizes will be expressed as risk ratio, and their 95% confidence intervals will be calculated for analysis.

DISCUSSION

This review and meta-analysis will systematically explore and integrate the evidence available on the effectiveness of solar disinfection water treatment method for reducing diarrhea. In this review, information about the potential impact of solar disinfection water treatment to inactivate pathogenic microbes for reducing diarrhea will be gathered and summarized. The findings from this study will provide directions for future research and public health professionals with an understanding of the importance of solar disinfection water treatment and point to directions for applicability of the interventions in the community.

Water supply, sanitation and hygiene interventions and childhood diarrhea in Kersa and Omo Nada districts of Jimma Zone, Ethiopia: a comparative cross-sectional study

BACKGROUND

Diarrhea is a major public health problem that disproportionately affects children in developing countries, including Ethiopia. Most of the diseases can be prevented through safe drinking water supply and provision of basic sanitation and hygiene. However, there is a paucity of information on childhood diarrhea related to interventions in kebeles (smallest administrative structure) where community-led total sanitation (CLTS) implemented and not implemented (non-CLTS). Thus, the aim of this study was to assess and compare the association of water supply, sanitation and hygiene interventions, and childhood diarrhea in CLTS implemented and non-implemented kebeles.

METHOD

A comparative cross-sectional study was conducted in Kersa and Omo Nada districts of Jimma Zone, Ethiopia from July 22 to August 9, 2018. Systematically selected 756 households with under-5 children were included in the study. Data were collected through interview using structured questionnaires. Water samples were collected in nonreactive borosilicate glass bottles. The binary logistic regression model was used; variables with a p value < 0.05 were considered as significantly associated with childhood diarrhea.

RESULTS

The prevalence of childhood diarrhea in the past 2 weeks was 17.7% (95% CI: 13.9-21.5) in CLTS kebeles and 22.0% (95% CI: 17.8-26.2) in non-CLTS kebeles. The occurrence of childhood diarrhea, increased among children whose families did not treat drinking water at home compared to those who treated in both CLTS (AOR = 2.35; 95% CI: 1.02-05.98) and non-CLTS (AOR = 1.98; 95% CI: 0.82-4.78) kebeles. About 96% of households in CLTS and 91% of households in non-CLTS kebeles had pit latrine with and without superstructure. Children from families that used water and soap to wash their hands were 76% less likely to have diarrhea in CLTS kebeles (AOR = 0.76; 95% CI: 0.31-1.88) and 54% less likely to have diarrhea in non-CLTS kebeles (AOR = 0.54; 95% CI: 0.17-1.72) when compared to children from families who used only water. The odds of having diarrhea was 1.63 times higher among children whose families live in CLTS non-implemented kebeles compared to those children whose families live in CLTS implemented kebeles (AOR = 1.63; 95% CI: 0.98-2.68).

CONCLUSIONS

No significant difference was observed in the prevalence of childhood diarrhea between CLTS and non-CLTS kebeles.