Contribution of wastewater irrigated vegetables to the prevalence of soil-transmitted helminth infection among female farmers in Addis Ababa, Ethiopia.

BACKGROUND: Untreated or inadequately treated wastewater carrying human feces can host helminth eggs and larvae, contaminating the soil and plants that are irrigated with it. In Addis Ababa, farmers use untreated wastewater to grow vegetables; however, there are little data currently available published on vegetables' contribution to the prevalence of helminth among female farmers along the Akaki River, in Addis Ababa, Ethiopia. METHODS: A cross-sectional study was conducted in Addis Ababa City in February 2022. A stratified random sampling method was used to sample farming households. The sample size for each district was determined by a proportional allocation to the total number of households in the area. Two hundred and fifty-two composite vegetable samples and 101 farmers' stool samples were collected and analyzed for helminth prevalence. Data on socio-demographics were collected by trained data collators using a structured questionnaire. Kato-Katz concentration was used to detect STH from a stool sample. Stata version 14.0 was used to process the data. Poisson regression was used to identify the association between STH prevalence in the vegetable and the farm's stool. RESULTS: Helminths were found in 67.5% of vegetables sampled and 20.8% of female farmers' stools. Ascaris lumbricoides eggs (vegetable 48.4% and stool 9.9%) were identified in all analyzed samples. Hookworm eggs (vegetable 13.1% and stool 8.9%) and Trichuris trichiura eggs (vegetable 5.9% and stool 2%) were also isolated. The total number of helminth eggs present in wastewater-irrigated vegetables and female farmers' stool had a positive association (p < 0.05) with a regression coefficient of 1.92 (95% CI = 1.56-2.28). CONCLUSIONS: The study found a significant prevalence of helminth infections, particularly Ascaris lumbricoides, in stool and vegetable samples irrigated with wastewater. A clear association was found between vegetable production and a higher prevalence of helminth infections among female farmers. Therefore, it is important to ensure that farmers are educated in the importance of food washing and sanitation/hygiene practices when using wastewater irrigation for vegetable crops.

Prevalence and factors associated with Schistosoma mansoni infection among primary school children in Kersa District, Eastern Ethiopia.

Background: Schistosomiasis is a neglected tropical disease and an important parasite negatively impacting socio-economic factors. Ethiopia's Federal Ministry of Health targeted the elimination of schistosomiasis infection in school-aged children by 2020. However, Schistosoma mansoni still affects approximately 12.3 million school-aged children in Ethiopia. Although the study was conducted in some regions of the country, previous studies were conducted on urban school children and were limited to the burden of infection. Overall, there is a lack of information about schistosomiasis in eastern Ethiopia, particularly among school children. Therefore, this study aimed to assess the prevalence and factors associated with Schistosoma mansoni infection among primary school children in Kersa district, Eastern Ethiopia. Methods: A cross-sectional study was conducted among 419 school children using systematic random sampling from April 10 to May 09, 2019. The stool samples were collected and examined using the Keto-Katz method. A structured and pretested questionnaire was used to collect data from participants. Data were entered using Epi-Data version 3.1 and analysed using SPSS version 24. A bivariable and multivariable logistic regression analyses were used to identify factors associated with Schistosoma mansoni infection. P-value < 0.05 and adjusted odds ratio (AOR) (95% confidence interval (CI)) were used to identify statistically significant associations. Results: This study's overall prevalence of S. mansoni was 19.4% (95% CI [16-23]). Absence of the latrines in household (AOR = 2.35, 95% CI [1.25-4.38]), swimming in the river (AOR = 2.82, 95% CI [1.33-5.88]), unprotected water sources (AOR = 3.5, 95% CI [1.72-7.10]), irregular shoe wearing habits (AOR = 2.81, 95% CI [1.51-5.23]), and water contact during cross of river (AOR = 2.192; 95% CI [1.113-4.318]) were factors independently associated with S. mansoni infection. Conclusion: Schistosoma mansoni infection remains a public health problem in the study area. Using a latrine in each household, using protected water, wearing shoes regularly, and reducing water contact were necessary to control Schistosoma mansoni infection.

Distribution of helminth eggs in environmental and stool samples of farming households along Akaki River in Addis Ababa, Ethiopia.

BACKGROUND: Helminth infections are a public health issue in countries with poor sanitation facilities. However, there little information on the epidemiological association between helminths in wastewater and soil samples and rates of helminth infection among farming households along the Akaki River in Addis Ababa, Ethiopia. METHODS: A cross-sectional study was conducted between November 2021 and February 2022. A stratified random sampling technique was used to select farming households. The sample size for each district was determined by a proportionate allocation to the number of households. From wastewater-irrigated farms, 70 wastewater samples, 28 soil samples, and 86 farmers' stool samples were collected and analyzed for helminths. A questionnaire was used to gather ethnographic data, about farming households, whereas wastewater and soil sample analysis was used to generate quantitative data on helminth loads. The data were systematically analysed by developing themes, and bias evaluated using triangulation validation methodologies. Potential pathways to helminth infection were evaluated by measuring. Total number of helminth eggs in wastewater, soil samples and farmer's stools was investigated using Poisson regression. RESULTS: In this study, 82.9% of wastewater samples, 57.1% of soil samples, and 18.6% of farmers' stool samples contained helminth eggs. The most prevalent helminth was Ascaris lumbricoides in all samples (wastewater 67%, soil 25%, and stool 10.5%), followed by hookworm (wastewater 10%, soil 21.4%, and stool 6.9%) and Trichuris trichiura eggs (wastewater 5.7%, soil 10.7%, and stool 1.2%). There was a positive association between the total number of helminth eggs in wastewater and soil samples with counts in farmers' stool. The Poisson regression coefficients for wastewater and soil were, 1.63 (95% CI = 1.34-1.92) and 1.70 (95% CI = 1.39-2.01), (p < 0.05). CONCLUSIONS: This research has shown a clear association between the total helminth eggs in wastewater and soil samples and farmer stools along the Akaki River. Therefore, an integrated approach is essential to address the issue in this area and prevent the spread of further helminth infections.

Prevalence and risk factors of diarrhea among children less than five years of age in the rural suburbs of Dire Dawa, Eastern Ethiopia; Robust Poisson Regression Analysis.

Background: Diarrhea is the second leading cause of under-five mortality in Ethiopia. Information on the prevalence and the impacting factors of diarrhea in the rural suburbs of Dire Dawa is inadequate. Objective: This study was aimed at determining risk factors of diarrhea among children less than five years of age in the rural suburbs of Dire Dawa, eastern Ethiopia. Methods: A cross-sectional study was conducted from 02 May 2018, to 31 May 2018. The required 1146 children for this study were selected from the rural suburbs of Dire Dawa using multi-stage sampling. Both bi-variable and multivariable Robust Poisson regressions were used for identifying the risk factors. Explanatory variables with a p-value < 0.05 were considered as independently associated with diarrhea. Results: The prevalence of diarrhea among the children was 23% (95% CI: 20.7 - 25.4). The type of house floor (aPR [adjusted prevalence ratio] = 0.89, 95% CI: 0.84 - 0.95) and sharing latrine with neighbours (aPR = 1.18, 95% CI: 1.09 - 1.26) were the significant factors associated with childhood diarrhea. Conclusion: Earthen house floor and shared use of latrine were the risk factors associated with childhood diarrhea. Hence, improving the house floor condition and construction of private latrine together with health education are recommended.

Bacteriological quality of drinking water from source and point of use and associated factors among households in Eastern Ethiopia.

BACKGROUND: Biological deterioration of drinking water is the major cause of waterborne disease globally. However, there is a paucity of information on identifying the point where deterioration of the bacteriological quality of drinking water occurs (source or point of use) and associated factors among households in developing countries, especially in Ethiopia. METHOD: A community based cross-sectional study design was conducted among 425 households in Eastern Ethiopia. Households with at least one child under-five years of age were included in the study. A total of 448 Water samples (425 from households and 23 from water sources) were collected and analyzed by the membrane filtration method to identify Thermotolerant coliform. Binary logistic regression was performed to assess the association between each independent and dependent variable. Adjusted Odd Ratios along with 95% Confidence intervals were estimated to identify factors associated with the outcome variable. RESULT: This study revealed that 21.7%; 95% CI (4.5%, 39.1%) of water sources and 83.3%; 95% CI (79.8%, 87.1%) of households' drinking water were contaminated by thermotolerant coliform. Drinking water samples from households with poor wealth index [AOR = 9.63; 95%CI (2.92, 31.69)], households with unimproved sanitation facility [AOR = 2.81; 95%CI (1.31, 6.01)], households which shares their house with animal [AOR = 3.73; 95%CI (1.66, 8.37)], households that didn't practice household water treatment [AOR = 3.42; 95%CI (1.60, 7.31)] and not washing hands before water collection [AOR = 7.04; 95%CI (2.22, 22.30)] were significantly associated with deterioration of bacteriological quality of household drinking water. CONCLUSION: This study indicates that the bacteriological quality of drinking water deteriorates from source to point of use. Thus, health education programs on water, sanitation, hygienic practice must be enhanced to improve the quality of drinking water.

Handwashing effect on diarrheal incidence in children under 5 years old in rural eastern Ethiopia: a cluster randomized controlled trial.

BACKGROUND: Handwashing with soap reduces diarrheal diseases burden considerably. However, the importance of handwashing in homes has received little attention in rural eastern Ethiopia. The effectiveness of handwashing may be reduced by lack of information on when and in what event hands must be washed, the frequency of handwashing, the individual who should wash his/her hands, and the procedure of handwashing. In these areas, indicators of adherence to handwashing are yet to be established. This study aimed at assessing the efficiency of handwashing on reducing diarrheal disease in children under 5 years old in rural kebeles of Dire Dawa, east Ethiopia. METHODS: Community-based cluster randomized controlled trial was conducted in rural kebeles of Dire Dawa for 4 months starting from October 2018 to January 2019. Selected clusters were randomized in intervention and control arms using draw method and data collectors conducted the baseline survey. Households assigned to the intervention group were given two bars of plain soap on a bi-monthly basis together with information promoting hand hygiene. Control households were allowed to continue their habitual handwashing practices. We compared the diarrheal incidences of the intervention and non-intervention households. Generalized estimation equations using Poisson family and log choice of the link was employed to calculate adjusted incidence rate ratio with its 95% confidence interval. RESULTS: We recorded a significant lesser diarrheal incidence in the handwashing arm than in the non-intervention arm (6.9 versus 13.8 episodes per 100 person weeks of observation). In all, there was a 41% reduction in diarrheal incidence in the intervention arm in relation to the non-intervention arm. CONCLUSION: Handwashing with soap complemented with hand hygiene promotion significantly decreased diarrheal episodes in children under 5 years old in rural kebeles of Dire Dawa. We recommend the promotion and adaptation of washing hands using soap at recommended times to be an effective means of reducing childhood diarrhea morbidity in rural populations of Ethiopia towards achieving the Sustainable Development Goal 6. TRIAL REGISTRATION: PACTR, PACTR201807815961394 . Registered 16 July 2018.

Adequacy of Improved Sources of Drinking Water, Sanitation, and Hygiene Practice for the Reduction of Diarrheal Disease Among People Living with HIV/AIDS, Harar Region, Ethiopia.

BACKGROUND: Home-based care services like improved water supply, sanitation, and hygiene (WaSH) practice are vital for people living with HIV/AIDS (PLWHA) to improve their quality of life. The negative impact of inadequate WaSH services is more pronounced among HIV-infected individuals leading them to low economic productivity, poor-nourished, immuno-compromised, and death. The aim of this study was to investigate the adequacy of improved sources of drinking water, sanitation, and hygiene practice for the reduction of diarrheal disease among people living with HIV/AIDS, Harar region, Ethiopia. METHODS: A cross-sectional study was conducted on 422 PLWHA in the Harar region related to WaSH as home-based care services and the prevalence of diarrheal disease using a standardized survey questionnaire. Descriptive statistics and multivariate Poisson regressions models were performed by SPSS Version 25. Using generalized linear models, adjusted prevalence ratio (APR) with 95%Cl and p-value were computed to assess the strength of association between the outcome and explanatory variables. A significant association was assured when the p-value is less than 0.05. RESULTS: In the present study, the two-week prevalence of diarrheal disease was 25%, of which 16% experienced two or more diarrheal episodes. Moreover, 87% of PLWHA used an improved source of drinking water, 66% used improved sanitation facilities, and 68% have good hygiene practices. Only 37% of the respondents acquired a basic water service level (≥20lcd) and 58% of PLWHA acquired the recommended quantity of safe water for drinking (≥1.5lcd). In multivariate analysis, the adjusted prevalence ratio of the 2-week prevalence of diarrhea was lower by 8% (APR =1.08; 95%Cl: 1.02, 1.14), 7% (APR =1.07; 95%Cl: 1.01, 1.14), and 5% (APR =1.05; 95%Cl: 1.00, 1.11) among PLWHA who have good hygiene practice, wash their hand with soap 24 hours before the survey, and used sanitation facility consistently, respectively. CONCLUSION: The current study results showed that PLWHA has inadequate access to improved drinking water sources, improved sanitation facilities, and hygienic practice; these triggers stakeholders for proper interventions, effective integration of adequate WaSH services to the HIV/AIDS program to enhance the quality of life of PLWHA.

Comparing the effect of independent and combined interventions of household chlorination and handwashing on diarrhea of under-fives in rural Dire Dawa, Eastern Ethiopia: a cluster randomized controlled trial.

INTRODUCTION: in poorly developed countries, no single intervention is adequate to interrupt diarrhea occurrence in rural households. However, the effect sizes of multiple interventions and participants combined adherence to the interventions are understudied. This study aimed at comparing combined intervention of water sanitation and hygiene (WASH) with each individual intervention in reducing diarrhea among under-five children in rural Dire Dawa. METHODS: a cluster randomized controlled factorial trial was conducted between October 2018 and January 2019. Householders in the first, second and third arms received waterguard, soap and both, respectively. However, householders in the control arm were followed with their customary practices. Generalized estimation equations (GEE) with log link Poisson distribution was used to compute adjusted incidence rate ratio and the corresponding 95% CIs. RESULTS: overall, 36% (aIRR = 0.64, 95% CI: 0.57 - 0.73), 41% (aIRR = 0.588, 95% CI: 0.53 - 0.65), and 41% (aIRR = 0.585, 95% CI: 0.53 - 0.65) reduction in incidence of diarrhea was observed in the water treatment, handwashing and combined arms, respectively. This study showed no additional benefit of combining the two interventions than the individual intervention. CONCLUSION: we recommend implementing either household water disinfection using sodium hypochlorite or household handwashing with hand hygiene promotion independently at large scale to vulnerable population to reduce diarrheal morbidity.

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.

Trichotomy of awareness, outlook and practice of food handlers towards food and water safety in food establishments in Addis Ababa, Ethiopia.

INTRODUCTION: Food and waterborne diseases are the commonest global public health problems. Specifically, in Ethiopia, public health problems associated with deterioration of food and water safety situations are much more complicated due to poverty, economic and environment related risks. Awareness, outlook and practice of food handlers are the three important factors that play major roles in the occurrence and outbreak of food borne diseases. Therefore, this study aimed to evaluate awareness, outlook and practice of food handlers towards food and water safety. METHODS: Institution based cross sectional study was conducted among food handlers of Addis Ababa city administration. In this study, 416 participants were selected using a stratified, simple random sampling technique; and were interviewed using structured questionnaire. Linear Regression Model and analysis of variance were used for data analysis. RESULTS: In this study, 55.5%, 66.1% and 60.6% of the food handlers had good awareness, outlook and proper hygiene practices respectively. This study revealed that, 17.5% and 23.1% of the respondents did not know about food and water borne disease respectively. Only 39.4% of the participants had proper practice of covering mouth with tidy cloth when they cough. Moreover, 75.7% of the food handlers reported that they did not wear personal protective devices during the working time. Predictor variables like educational status and length of work experience were correlated positively and significantly with awareness. However, being married was correlated negatively with awareness. CONCLUSION: Assessing awareness, outlook and practice of food handlers regarding food and water safety is a vital activity to reduce public health problems. Significant number of food handlers had poor awareness, outlook and practice towards food and water safety. There is a call for enhancing the awareness, outlook and practice of food and water safety to achieve an excellent practice. Better food and water safety policy and firm regulatory actions are needed.

Diarrheal disease and associated behavioural factors among food handlers in Addis Ababa, Ethiopia.

INTRODUCTION: Diarrheal diseases are threat everywhere, but its frequency and impact are more severe in developing countries. Diarrhea occurs world-wide and causes 4% of all deaths and 5% of health loss to disability. In 2016, it was the eighth leading cause of mortality. Moreover, data from the World Health Organization indicated that diarrheal diseases are causes for an estimated 2 million deaths annually. Therefore, this study aimed to assess diarrheal diseases and associated behavioural factors. METHOD: An institution based cross-sectional study was conducted. A stratified random sampling method was employed to select 1050 study participants. Participants were interviewed using structured questionnaire. To analysis the data, binary logistic regression and multivariable logistic regression analysis was conducted. RESULTS: The two weeks prevalence of diarrhea was found to be 3.4%. Further, 1.6%, 10.5%, 10.7% and 9% of the food handlers had acute watery diarrhea, cough, an infection of runny nose and incidence of any fever respectively. Regular hand washing after toilet (AOR = 0.13 with 95% CI: 0.024, 0.72), using toilet while wearing protective clothes/gown (AOR = 5.39 with 95% CI; 1.59, 18.32), habit of eating raw beef and raw vegetables (AOR = 6.27 with 95% CI: 1.89-20.78), type of toilet (AOR = 4.07 with 95% CI: 0.29-6.67 were associated significantly with diarrhea. CONCLUSION: This assessment proved to be an essential activity for reduction of community diarrheal diseases, as a significant number of food handlers had diarrhea. Good sanitation, hygiene practice and a healthy lifestyle behavior can prevent diarrhea. A strong political commitment with appropriate budgetary allocation is essential for the control of diarrheal diseases.

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.

Self-medication practice and associated factors among adult community members of Jigjiga town, Eastern Ethiopia.

BACKGROUND: Self-medication is the use of any drug or medication to treat an illness or ailment without the supervision of a licensed medical doctor/health care providers. Self-medication practice in Eastern Ethiopia is quite common. However, there is little information with regard to magnitude and associated factors. The objective of this study was to assess the magnitude of self-medication practice and associated factors among adult community members of Jigjiga town, Eastern Ethiopia. METHODS: A community based cross-sectional study was conducted from June 27- July 12, 2017. Multistage sampling method was used and the number of kebeles and Sub-kebeles were selected using simple random sampling technique. Finally, sampled households in the Sub-kebeles were selected using systematic random sampling. Data were collected using face to face interview with 547 adult (≥18 years) participants. It was entered and cleaned using EPI-Data version 3.02 and exported to Statistical Package for Social Science (SPSS) Version 23 for further analysis. Bi-variable and multivariable logistic regression models were carried out to identify factors associated with the self-medication. RESULT: The magnitude of self-medication was found to be 37.5% (95% CI: (33.6%-41.7%). Educational status of secondary school [(AOR = 0.46; 95% CI: (0.22-0.98)], high income [(AOR = 3.00; 95% CI: (1.77-5.06)], advised by neighbors, friends or relatives to take drug for their complaint [(AOR = 2.59; 95% CI: (1.62-4.14)], used old prescription /past experience to bought drugs [(AOR = 12.19; 95% CI: (6.65-22.35)], follow advertisements of drugs by television [(AOR = 0.21; 95% CI: (0.05-0.85)], and perception about Hospital drugs (clinics, health centers and hospitals) do not work [(AOR = 2.36; 95% CI: (1.39-3.99)] were significantly associated with self-medication. CONCLUSION: High income, advice by neighbors, friends or relatives to take drug for their complaint, old prescription/past experience use to bought drugs, and perception of hospital drugs do not work was positively associated with self-medication. Therefore, health education should be given to the community on the importance of hospital drugs (clinics, health centers and hospitals) to shift their perception.

Risk factors for acute childhood diarrhea: A cross-sectional study comparing refugee camps and host communities in Gambella Region, Ethiopia.

BACKGROUND: Diarrhea is one of the most common causes of child morbidity and mortality in refugee camps, aggravated by inadequate water, sanitation and hygiene services, and malnutrition, particularly in developing countries. METHODOLOGY: A comparative cross-sectional study was conducted to assess acute diarrhea and associated risk factors among under-five children in refugee and host communities in Gambella Region, Ethiopia. Descriptive statistics were used, and bivariate and multivariate logistic regressions were performed to identify variables associated with diarrhea. RESULTS: A total of 1667 under-five children was included in this study, and prevalence of diarrhea differed between the refugee (38%) and host (33%) communities [OR = 1.37, 95% CI 1.04, 1.8]. Refugee camp households using uncovered water containers, consuming low quantities of water, and lacking hand washing setups were more likely to report children with diarrhea. Within host communities, households were more likely to report acute childhood diarrhea if they consumed surface water or did not have a latrine. CONCLUSION: The two-week prevalence of diarrhea was significantly higher among children in the refugee camps than those in the host communities. Therefore, further collaboration between government and non-government organizations is required to identify persisting factors of diarrhea transmission in various communities in the region.