Non-compliance with smoke-free law in public places: a systematic review and meta-analysis of global studies.

Introduction: Non-compliance with smoke-free law is one of the determinants of untimely mortality and morbidity globally. Various studies have been conducted on non-compliance with smoke-free law in public places in different parts of the world; however, the findings are inconclusive and significantly dispersed. Moreover, there is a lack of internationally representative data, which hinders the evaluation of ongoing international activities towards smoke-free law. Therefore, this meta-analysis aimed to assess the pooled prevalence of non-compliance with smoke-free law in public places. Methods: International electronic databases, such as PubMed/MEDLINE, Science Direct, Cochrane Library, CINAHL, African Journals Online, HINARI, Semantic Scholar, google and Google Scholar were used to retrieve the relevant articles. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA) guidelines. The Higgs I2 statistics were used to determine the heterogeneity of the reviewed articles. The random-effects model with a 95% confidence interval was carried out to estimate the pooled prevalence of non-compliance. Results: A total of 23 articles with 25,573,329 study participants were included in this meta-analysis. The overall pooled prevalence of non-compliance with smoke-free law was 48.02% (95% CI: 33.87-62.17). Extreme heterogeneity was observed among the included studies (I2 = 100%; p < 0.000). The highest non-compliance with smoke-free law was noted in hotels (59.4%; 95% CI: 10.5-108.3) followed by homes (56.8%; 95% CI: 33.2-80.4), with statistically significant heterogeneity. Conclusion: As the prevalence of non-compliance with smoke-free law is high in public places, it calls for urgent intervention. High non-compliance was found in food and drinking establishments and healthcare facilities. In light of these findings, follow-up of tobacco-free legislation and creating awareness that focused on active smokers particularly in food and drinking establishments is recommended.

Observational assessment of hand hygiene compliance among healthcare workers in public hospitals of Northeastern Ethiopia.

This study examined the magnitude and predictors of hand hygiene compliance among 325 healthcare workers in three public hospitals of Northeastern Ethiopia using standardized observational tool. A multivariable logistic regression analysis was computed to identify factors associated with non-compliance. The overall proportion of observed hand hygiene non-compliance was 41.8% (95%CI: 36.6-48.1). Having <5 years of work experience (AOR = 1.5; 95%CI: 1.2-2.5), absence of hand washing soap (AOR = 3.1; 95%CI: 2.3-5.4), work overload (AOR = 2.5; 95%CI: 1.9-4.1), pipe water supply interruption (AOR = 2.8; 95%CI: 2.1-4.9), lack of hand hygiene training (AOR = 3.1; 95%CI: 2.2-4.4), and absence of infection prevention committee (AOR = 2.1; 95%CI: 1.5-4.9) were determinant factors for hand hygiene non-compliance. Therefore, regional health bureau and hospitals' managers should work towards the provision of regular hand hygiene trainings, uninterrupted piped water supply, hand washing soap, and establishment of functional infection prevention committee. Moreover, healthcare workers should be also committed to comply with hand hygiene.

Infection prevention and control compliance of healthcare workers towards COVID-19 in conflict-affected public hospitals of Ethiopia.

OBJECTIVE: Non-compliance with COVID-19 infection prevention and control (IPC) is one of the global public health problems particularly among those frontline healthcare workers. However, there are no detailed investigations on COVID-19 IPC compliance among healthcare workers in conflict-affected settings. The objective of this research was to assess compliance with COVID-19 IPC measures and determine the factors associated with it among healthcare providers in Ethiopian governmental hospitals affected by conflict. DESIGN: A cross-sectional study was carried out within institutional settings. STUDY SETTING AND PERIOD: The study was conducted in three public hospitals located in northeastern Ethiopia during the period of March to April 2022. PARTICIPANTS: Simple random sampling technique was used to select 325 healthcare workers after proportional allocation was made to each public hospital. PRIMARY OUTCOME MEASURES: The primary outcome was non-compliance with COVID-19 IPC. A multivariable logistic regression analysis was employed to identify factors associated with the lack of adherence to the COVID-19 IPC protocol. RESULTS: Nearly half (150, 46.2%) of the healthcare workers had non-compliance with COVID-19 IPC protocol. Absence of hand washing soap (adjusted OR (AOR)=2.99; 95% CI 2.46 to 5.76), workload (AOR=2.25; 95% CI 1.33 to 3.84), disruption in the supply of piped water (AOR=1.82; 95% CI 1.11 to 2.99), did not undergo training in COVID-19 IPC (AOR=2.85; 95% CI 1.85 to 4.84), absence of COVID-19 IPC guidelines (AOR=2.14; 95% CI 1.11 to 4.13) and chewing khat (AOR=2.3; 95% CI 1.32 to 3.72) were determinant factors for non-compliance. CONCLUSIONS: The magnitude of non-compliance with COVID-19 IPC was high. Hospital managers and federal ministry of health should provide regular training on COVID-19 IPC, continuous piped water and personal protective facilities for healthcare workers. Ultimately, improving the security situation in the area would help improve COVID-19 IPC compliance among healthcare workers in these and other similar conflict-affected settings.

Prevalence of occupational respiratory symptoms and associated factors among industry workers in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Occupational respiratory diseases are major global public health problems, particularly for industry workers. Several studies have investigated occupational respiratory symptoms in various parts of Ethiopia. The findings have been inconsistent and inconclusive, and there is no nationally representative data on the subject. Therefore, this study aimed to estimate the pooled prevalence and factors associated with occupational respiratory symptoms among industry workers in Ethiopia (2010-2022). METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework Guidelines, search was conducted on several international databases including PubMed, CINAHL, African Journals Online, Hinari, Global Health, and Google scholar. The extracted data was analyzed using STATA 14. Random effect model was used to estimate the effect size. Egger regression test and I2 statistics were used to determine potential publication bias and heterogeneity, respectively among the reviewed articles. RESULTS: The meta-analysis included a total of 15 studies with 5,135 participants, revealing a pooled prevalence of 51.6% (95% CI: 43.6-59.6) for occupational respiratory symptoms among industry workers in Ethiopia. The absence of personal protective equipment (OR = 1.97, 95% CI: [1.17-3.32]), lack of occupational health and safety training (OR = 3.04, 95% CI: [2.36-3.93]), previous dust exposure (OR = 3.17, 95% CI: [2.3-4.37]), poor working environment (OR = 2.4, 95% CI: [1.7-3.2]), work experience greater than five years (OR = 4.04, 95% CI: [1.61-10.16]), smoking (OR = 6.91, 95% CI: [2.94-16.2]), and previous respiratory illness (OR = 4.25, 95% CI: [2.44-7.42]) were found to associate with the symptoms. CONCLUSIONS: The high prevalence of occupational respiratory symptoms among industry workers in Ethiopia underscores the urgent need for effective interventions. The provision of personal protective equipment and improvement of working environments by the government, industry owners, and other stakeholders are crucial in reducing occupational respiratory symptoms. Additionally, prioritizing occupational health and safety training for industry workers can help prevent and mitigate the impact of occupational respiratory diseases. REGISTRATION: This systematic review has been registered in the International Prospective Registry of Systematic Review (PROSPERO) with a specific registration number CRD42022383745.

A Retrospective Study on the Burden of Malaria in Northeastern Ethiopia from 2015 to 2020: Implications for Pandemic Preparedness.

Background: Regardless of various prevention and control strategies, malaria continues to be a significant public health problem in Ethiopia. As there are few studies on malaria trend analysis in Northeastern Ethiopia, it hinders the evaluation of ongoing and prioritization of new malaria intervention strategies, particularly during the period of pandemics. Therefore, the present study investigated the trend of malaria prevalence in Northeastern Ethiopia from 2015 to 2020. Methods: An institution-based retrospective study was employed to assess the trend of malaria prevalence over a 6-year period (2015-2020) in three districts (Jile tumuga, Aruma fursi, and Dawachefa) of Northeastern Ethiopia. Data were extracted from clinical records of malaria cases by trained medical laboratory technologists. The associations between the prevalence of malaria and independent variables (age group, malaria transmission season, and districts) were assessed using chi-square test. P-values with a cut-off point of 0.05 were used to determine statistically significant associations. Results: In our study area, a total of 212,952 malaria suspected patients were diagnosed over the 6 years. Of these, 33,005 (15.5%) were confirmed malaria cases. The identified Plasmodium species were Plasmodium falciparum and P. vivax, accounting for 66.4% and 33.6%, respectively. These with the age of >15 years old were the most affected (41.9%). The highest numbers of malaria cases (34.6%) were recorded during spring season (September to November). The prevalence of Plasmodium species showed a significant association with age (X2=9.7; p=0.002), districts (X2=13.5; p<0.001), and malaria transmission season (X2=16.5; p<0.001). Conclusion: In our study area, P. falciparum is the dominant species. We noted that malaria remains a public health concern and fluctuates throughout the years. Therefore, national, regional, zonal, and district health bureaus should strengthen the ongoing and devise appropriate prevention and control strategies even during the period of pandemics.

Occupational safety of janitors in Ethiopian University during COVID-19 pandemic: Results from observational study.

Introduction: Janitors are at high risk of COVID-19 infection, as they are among the frontline workers for the prevention and control of COVID-19. Poor occupational safety practices could contribute to loss of lives of janitors and the general public. However, there are no detailed investigations on occupational safety practices of janitors involved in different settings, such as universities where there are crowds of people. In addition, although observation is recognized as a better tool to investigate occupational safety practices, previous studies mainly employed self-administered questionnaires and/or face-to-face interviews as data collection mechanisms. Therefore, this study aimed to assess occupational safety practices to prevent COVID-19 transmission and associated factors among Ethiopian University janitors using an observation tool and a self-administered questionnaire. Methods: An institutional-based cross-sectional study was conducted among 410 janitors of Bule Hora University (Ethiopia) from November to December, 2021. A multivariable logistic regression model was used to identify the independent factors associated with occupational safety practices. Results: Occupational safety practices for COVID-19 were good only among 53.9% of the janitors. Training on COVID-19 prevention measures (AOR = 2.62; 95% CI: 1.57-4.37), availability of policy and protocol in the work place (AOR = 5.46; 95% CI: 3.57-8.36), and availability of soap/bleach (AOR = 2.71; 95% CI: 1.64-4.46) were found to significantly increase the likelihood of occupational safety of the janitors. Conclusion: A significant proportion of the janitors had poor occupational safety practices. Therefore, an adequate supply of PPE and regular training and awareness creation on COVID-19 should be strengthened. Close follow-up and regular supervision of safety procedures should also be conducted as controlling strategies.

Why Does COVID-19 Vaccine Acceptance Rate Remain Low Among Patients with Chronic Diseases? Evidences from Public Hospitals of Ethiopia.

Background: Elders and patients with chronic diseases are more vulnerable to coronavirus disease 2019 (COVID-19) infection. In Ethiopia, these groups of people are given vaccination priorities amongst others. However, there is limited information on the acceptance of COVID-19 vaccine among patients with chronic diseases. Therefore, this study aimed to assess the acceptance of COVID-19 vaccine and associated factors among patients with chronic diseases visiting public hospitals in West Guji zone (Ethiopia). Methods and Materials: Facility-based cross-sectional study was employed among 408 chronic disease patients visiting two public hospitals in Ethiopia from September to October 2021. Data was collected using structured questionnaire. Multivariable logistic regression was computed to identify factors associated with acceptance of COVID-19 vaccine. Independent variables with p-value less than 0.05 were considered statistically significantly associated with the acceptance of COVID-19 vaccine. Results: The acceptance of COVID-19 vaccine among patients with chronic diseases was 39.5% (95% CI: 35-44). Factors positively associated with the acceptance of COVID-19 vaccine were age ≥40 years (AOR = 2.84; 95% CI: 1.53-5.28), urban residence (AOR = 0.6; 95% CI: 0.38-0.95), having upper respiratory tract infection (AOR = 1.32; 95% CI: 1.03-2.8), previous COVID-19 infection (AOR = 2.1; 95% CI: 1.22-3.47), having health insurance (AOR = 2.55; 95% CI: 1.23-5.28), those not drinking alcohol (AOR = 1.95; 95% CI: 1.24-3.06), those not chewing Khat (AOR = 2.01; 95% CI: 1.27-3.2), and having good knowledge (AOR = 1.55; 95% CI: 1.03-2.87) and positive attitude (AOR = 2.05; 95% CI: 1.26-3.33) towards the vaccine. Conclusion: The overall proportion of COVID-19 vaccine acceptance is low among patients with chronic diseases. Therefore, to improve the acceptance of COVID-19 vaccine, the government and health professionals should provide continuous health education.

Small Scale Enterprise Workers Require Attention: What Predicts the Level of Occupational Injuries?

Background: Occupational injuries are among the foremost public health problems that small scale enterprise workers are encountering. Most foregoing occupational injury studies focused on construction or welding industry workers which could underestimate the real level of occupational injuries recorded in small scale enterprises. Conversely, others deal with a combined level of injuries from both small scale and large scale enterprises. Therefore, this study examined the magnitude and predictors of occupational injuries among various categories of small scale enterprise workers in Ambo town (Ethiopia). Methods: An institutional-based cross-sectional study was employed among 408 small scale enterprise workers from September to October 2021. A multivariable logistic regression analysis was computed to identify factors associated with occupational injuries. Variables with P-value less than .05 were considered as significantly associated with occupational injuries. Results: The 1-year prevalence of occupational injuries was 39.5% (95% CI: 35-44). Age greater than 40 years (AOR = 2.84, 95% CI: 1.53-5.28), working for more than 8 hours per day (AOR = 2.2, 95% CI: 1.61-4.95), working during the night time (AOR = 2.1, 95% CI: 1.22-3.47), lack of workplace supervision (AOR = 2.55, 95% CI: 1.23-5.28), alcohol use (AOR = 1.95, 95% CI: 1.24-3.06), chewing khat (AOR = 2.01, 95% CI: 1.27-3.2), non-utilization of personal protective equipment (AOR = 1.55, 95% CI: 1.03-2.87), and lack of health and safety training (AOR = 2.05, 95% CI: 1.26-4.37) were important predictors of occupational injuries. Conclusions: Our findings indicated a substantial proportion of small scale enterprise workers experienced occupational injuries during the last year. Provision of health and safety training, continuous workplace supervisions, and provision and utilization of personal protective equipment are recommended.

Occupational blood exposure beyond needle stick injuries: hospital-based cross-sectional study among healthcare workers in governmental hospitals of Northern Ethiopia.

BACKGROUND: Occupational blood exposure is one of the major public health problems that healthcare workers (HCWs) are encountering. Most previous occupational blood exposure studies are delimited to needle stick injury, which could underestimate the real level of blood exposure. On the other hand, others deal with crude blood and body-fluids exposure, which possibly overestimate the magnitude of blood exposure. Therefore, this study aimed at determining the prevalence of occupational blood exposure and identifying associated factors among HCWs in the Southern Tigrai zone governmental hospitals of Northern Ethiopia considering all the potential means of blood exposure (needle stick injury, sharp medical equipment injury, and blood splash) while excluding blood-free body-fluids. METHODS: A hospital based cross-sectional study design was employed to gather data from randomly selected HCWs in three governmental hospitals from February to March, 2020. A multivariable logistic regression model was used to identify the independent factors associated with the outcome variable. RESULTS: From the total of 318 HCWs, 148 (46.5 %) were exposed to blood at least once in their lifetime. Working for more than 40 h per week (AOR= 9.4; 95 % CI: 7.61, 11.41), lack of adequate personal protective equipment (PPE) (AOR=3.88; 95 % CI: 1.64, 5.42), Hepatitis B virus vaccination (AOR=0.54; 95 % CI: 0.12,0.78), recapping used needle sticks (AOR=3.18; 95 % CI: 1.28, 8.83), and lack of infection prevention and patient safety (IPPS) training (AOR=13.5; 95 % CI: 8.12,19.11) were detected to significantly increase the likelihood of occupational blood exposure. CONCLUSIONS: As nearly half of the HCWs were exposed to blood, reducing work load below 40 h per week by employing additional staff members, supplying adequate PPE, avoiding recapping of used needle sticks, and providing IPPS training for the HCWs should be practiced.