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.

To do's after war: Priorities for acute diarrheal diseases intervention among under-five children in conflict settings of Raya Kobo district, Northeastern Ethiopia.

Introduction: Diarrheal diseases are significant causes of under-five children mortality and morbidity in developing countries. This is particularly alarming among the community living in conflict zones where less attention is given for basic services including water, food, and health. However, there are no detailed investigations on acute diarrhea among under-five children in conflict-affected areas, which impedes intervention approaches. Therefore, this study was designed to assess the prevalence of acute diarrhea and associated factors among under-five children in conflict-affected setting of Raya Kobo, Northeast Ethiopia. Methods: A community-based cross-sectional study was employed among 463 under-five children in Raya Kobo district, from February to March 2021. The study participants were selected from ten rural kebeles. Pre-tested questionnaire and observational checklist were used to collect the data. Bivariate and multivariable logistic regression analyses were computed to identify factors associated with the prevalence of acute diarrhea. Results: The prevalence of acute diarrhea among under-five children was 21% (95% confidence interval (CI): 18.50-23.91%). Unimproved drinking water source (Adjusted odds ratio (AOR) = 2.89; 95%CI: 1.38-6.06), disposal of garbage in open field (AOR = 3.33; 95%CI:1.66-6.67), having low monthly income (AOR = 5.73; 95%CI: 3.07-10.59), absence of latrine facility (AOR = 3.18; 95%CI: 1.09-8.78), poor hand washing practice at critical times (AOR = 2.52; 95%CI:1.28-4.05), not regularly cleaning food utensil before child feeding (AOR = 2.54; 95%CI:1.31-4.94), and not received Rota vaccine (AOR = 4.28; 95%CI: 1.82-10.11) were the determinant factors. Conclusions: To reduce the burden of acute diarrheal diseases, post-war intervention approaches should emphasize on advocating for Rota virus vaccination, regularly cleaning food utensils before feeding, improving hand washing practice at critical times, provision of improved drinking water source, and use of proper solid and domestic sewage discharge/disposal methods.

Personal protective equipment utilization and its association with educational status among industry workers in Ethiopia: A systematic review and meta-analysis protocol.

INTRODUCTION: Ethiopia is experiencing high prevalence of occupational morbidity and disability. One of the main contributing reasons is a low utilization of personal protective equipment (PPE). Previous studies on PPE utilization and association with educational status among industry workers were largely inconsistent. Therefore, this meta-analysis is aimed to pool the magnitude of PPE utilization and its association with educational status among industry workers in Ethiopia. METHOD: A compressive search of international databases and libraries including Scopus, PubMed, MedNar, Embase, MEDLINE, the web of science, Google Scholar, the JBI Library, African Journals Online, and Science direct will be carried out to locate published reports. Two independent reviewers will screen the records for inclusion using standardized JBI tools. Before extracting and synthesizing data, the selected studies will undergo a rigorous critical appraisal. If appropriate, a meta-analysis will be conducted. Cochrane Q-test and I2-test statistics will be used to assess the heterogeneity between studies. If necessary, meta-regression and subgroup analyses will be conducted to explore potential reasons for any inconsistency and heterogeneity. Sensitivity analysis will be performed to assess the effect of a single study on the pooled magnitude estimates. Funnel plots, along with Egger's and Begg's tests, will be used to assess the presence of publication bias. PROSPERO registration number: PROSPERO, CRD42022364562.

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.

Living in a large family and low daily water consumption substantially expose for human scabies in rural Ethiopia: a matched analysis.

BACKGROUND: Scabies has been added to the neglected tropical diseases portfolio for large-scale disease control action since 2017 and is part of the WHO roadmap for NTDs 2021-2030, targeted at ending the neglect to achieve the sustainable development goals. Previous studies have not fitted matched analysis to identify predictors of scabies infestation in Ethiopia. Information is also scarce about predictors of scabies infestation in this area. Therefore, this study aimed to identify predictors of scabies infestation in rural Aneded District, northwest Ethiopia. METHODS: A community-based matched case-control study involving 183 cases and 549 controls was undertaken from March 1 to May 31, 2021, in rural Aneded District. A two-stage sampling technique with a house-to-house census for the screening of scabies cases was employed. A structured questionnaire with questions on sociodemographics, behavior, water supply, sanitation, and hygiene, and delivery of scabies-specific interventions was used. Pretesting, training of data collectors and supervisors, and supervision were applied to keep the data quality. A multivariable conditional logistic regression model was fitted to identify predictors of scabies. RESULTS: Unmarried individuals or those in separated families (adjusted matched odds ratio (AmOR = 2.71; 95% CI 1.30-5.65); those unable to read and write or in illiterate families (AmOR = 5.10; 95% CI 1.81-14.36); those in large families (AmOR = 6.67; 95% CI 2.83-15.73); households that had longer travel times for water collection (AmOR = 2.27; 95% CI 1.08-4.76); those that had low daily water consumption (AmOR = 6.69; 95% CI 2.91-15.37); households that disposed of solid wastes in open fields (AmOR = 5.60; 95% CI 2.53-12.40); and households that did not receive scabies-specific interventions (AmOR = 2.98; 95% CI 1.39-6.39) had increased odds of scabies. CONCLUSIONS: Being unmarried, illiteracy, large family, long travel time for water collection, low daily water consumption, open dumping of solid wastes, and inaccessibility of scabies-specific interventions are predictors of scabies. This information is instrumental for redesigning improved scabies-specific interventions that consider educational status, marital status, family size, water collection time, daily water consumption, solid waste disposal, and equity and optimization in delivering existing interventions in rural Ethiopia.

Cloth sharing with a scabies case considerably explains human scabies among children in a low socioeconomic rural community of Ethiopia.

BACKGROUND: In 2020, scabies were integrated into the WHO roadmap for neglected tropical diseases, aimed at ending the negligence to realize the SDGs. Ethiopia has also introduced scabies as a notifiable disease in drought-prone localities since 2015. Many of the previous studies employed study designs that might be subject to bias. Moreover, there is no scientific evidence about scabies in this area. Hence, this study aimed to determine the prevalence and associated factors of scabies among children aged below 15 years in rural Ethiopia. METHODS: A community-based cross-sectional study was carried out among 942 children in rural kebeles of Lay Gayent District from March through May 15, 2021. A two-stage sampling technique was applied. Data on sociodemographics, housing, water supply and sanitation, children's personal hygiene, and caregivers' knowledge about scabies were collected by a structured questionnaire. Data quality was maintained through pretesting, training of data collectors and supervisors, and supervision. An adjusted binary logistic regression was modelled to identify factors associated with scabies. The Hosmer-Lemeshow goodness-of-fit test was run to check the model fitness. RESULTS: The prevalence of scabies was 21.5% (95% CI 19.0-24.3). Maternal illiteracy (adjusted odds ratio (AOR) = 1.61; 95% CI 1.07-2.43); low household wealth (AOR = 2.04; 95% CI 1.25-3.33); unimproved water source (AOR = 1.58; 95% CI 1.05-2.40); not cleaning a house daily (AOR = 2.43; 95% CI 1.63-3.62); not trimming nails (AOR = 2.21; 95% CI 1.50-3.25); cloth sharing with a scabies case (AOR = 11.77; 95% CI 6.94-19.97); and low caregiver knowledge about scabies (AOR = 2.44; 95% CI 1.64-3.63) were factors associated with scabies. CONCLUSIONS: Scabies remains a significant public health issue among children aged below 15 years in the district. Maternal illiteracy, low household wealth, unimproved water source, not cleaning a house daily, not trimming nails, cloth sharing with a scabies case, and low caregiver knowledge about scabies were factors associated with scabies. Community-wide interventions with prime emphasis on improving maternal education and caregivers' knowledge about scabies, upgrading household wealth, ensuring a safe water supply, providing healthy housing, and ensuring adequate personal hygiene are warranted.

Burden of lower respiratory infections and associated risk factors across regions in Ethiopia: a subnational analysis of the Global Burden of Diseases 2019 study.

OBJECTIVE: This analysis is to present the burden and trends of morbidity and mortality due to lower respiratory infections (LRIs), their contributing risk factors, and the disparity across administrative regions and cities from 1990 to 2019. DESIGN: This analysis used Global Burden of Disease 2019 framework to estimate morbidity and mortality outcomes of LRI and its contributing risk factors. The Global Burden of Disease study uses all available data sources and Cause of Death Ensemble model to estimate deaths from LRI and a meta-regression disease modelling technique to estimate LRI non-fatal outcomes with 95% uncertainty intervals (UI). STUDY SETTING: The study includes nine region states and two chartered cities of Ethiopia. OUTCOME MEASURES: We calculated incidence, death and years of life lost (YLLs) due to LRIs and contributing risk factors using all accessible data sources. We calculated 95% UIs for the point estimates. RESULTS: In 2019, LRIs incidence, death and YLLs among all age groups were 8313.7 (95% UI 7757.6-8918), 59.4 (95% UI 49.8-71.4) and 2404.5 (95% UI 2059.4-2833.3) per 100 000 people, respectively. From 1990, the corresponding decline rates were 39%, 61% and 76%, respectively. Children under the age of 5 years account for 20% of episodes, 42% of mortalities and 70% of the YLL of the total burden of LRIs in 2019. The mortality rate was significantly higher in predominantly pastoralist regions-Benishangul-Gumuz 101.8 (95% UI 84.0-121.7) and Afar 103.7 (95% UI 86.6-122.6). The Somali region showed the least decline in mortality rates. More than three-fourths of under-5 child deaths due to LRIs were attributed to malnutrition. Household air pollution from solid fuel attributed to nearly half of the risk factors for all age mortalities due to LRIs in the country. CONCLUSION: In Ethiopia, LRIs have reduced significantly across the regions over the years (except in elders), however, are still the third-leading cause of mortality, disproportionately affecting children younger than 5 years old and predominantly pastoralist regions. Interventions need to consider leading risk factors, targeted age groups and pastoralist and cross-border communities.

Estimating mortality and disability in Peru before the COVID-19 pandemic: a systematic analysis from the Global Burden of the Disease Study 2019.

Background: Estimating and analyzing trends and patterns of health loss are essential to promote efficient resource allocation and improve Peru's healthcare system performance. Methods: Using estimates from the Global Burden of Disease (GBD), Injuries, and Risk Factors Study (2019), we assessed mortality and disability in Peru from 1990 to 2019. We report demographic and epidemiologic trends in terms of population, life expectancy at birth (LE), mortality, incidence, prevalence, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) caused by the major diseases and risk factors in Peru. Finally, we compared Peru with 16 countries in the Latin American (LA) region. Results: The Peruvian population reached 33.9 million inhabitants (49.9% women) in 2019. From 1990 to 2019, LE at birth increased from 69.2 (95% uncertainty interval 67.8-70.3) to 80.3 (77.2-83.2) years. This increase was driven by the decline in under-5 mortality (-80.7%) and mortality from infectious diseases in older age groups (+60 years old). The number of DALYs in 1990 was 9.2 million (8.5-10.1) and reached 7.5 million (6.1-9.0) in 2019. The proportion of DALYs due to non-communicable diseases (NCDs) increased from 38.2% in 1990 to 67.9% in 2019. The all-ages and age-standardized DALYs rates and YLLs rates decreased, but YLDs rates remained constant. In 2019, the leading causes of DALYs were neonatal disorders, lower respiratory infections (LRIs), ischemic heart disease, road injuries, and low back pain. The leading risk factors associated with DALYs in 2019 were undernutrition, high body mass index, high fasting plasma glucose, and air pollution. Before the COVID-19 pandemic, Peru experienced one of the highest LRIs-DALYs rates in the LA region. Conclusion: In the last three decades, Peru experienced significant improvements in LE and child survival and an increase in the burden of NCDs and associated disability. The Peruvian healthcare system must be redesigned to respond to this epidemiological transition. The new design should aim to reduce premature deaths and maintain healthy longevity, focusing on effective coverage and treatment of NCDs and reducing and managing the related disability.

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.

Determinants of undernutrition among children aged 6-59 months during the COVID-19 pandemic: A hospital-based cross-sectional study in Ethiopia.

Background: The public health problem of undernutrition is common in Ethiopia, particularly among children aged 6-59 months. However, determinants of undernutrition among children in this age group are not well investigated particularly within the context of COVID-19 pandemic. This study was, therefore, designed to assess the magnitude and determinants of undernutrition among children aged 6-59 months at Tirunesh Beijing general hospital, Ethiopia. Methods and materials: An institutional-based cross-sectional study was conducted involving 283 children aged 6-59 months in March 2022. The data were collected using structured questionnaire and anthropometric measurements. Undernutrition was defined as a Z-score value of weight for height (WFH), height-for-age (HFA), and weight-for-age (WFA) <2SD as calculated by the world health organization plus software. A multivariable logistic regression model was used to identify the independent factors associated with undernutrition. p-values less than 0.05 were considered statistically significant. Results: The response rate in this study was 97.9%. The overall magnitude of undernutrition was 34.3%, of which 21.2%, 12.7%, and 9.5% were stunted, underweight, and wasted, respectively. Occupation of mothers [AOR = 13.64, 95% CI (4.21-14.77)], amount of meal [AOR = 14.68, 95% CI (4.09-52.81)], feeding by caregivers [AOR = 8.96, 95% CI (2.81-18.60)], and breastfeeding [AOR = 0.06, 95% CI (0.02-0.22)] were significant predictors of undernutrition. Conclusions: The prevalence of undernutrition among children under the age of five remains high. Therefore, promoting breastfeeding and motivating children to feed adequate amount of meal are recommended. Besides, counseling and/or guiding caregivers on how to feed children shall be suggested. The findings could help inform the design and prioritization of effective intervention strategies at early life stage.

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.

COVID-19 preventive practices and associated factors among high school and preparatory school students in Dessie City, Ethiopia.

Background: As the COVID-19 pandemic continues to ravage the world, the most pretentious sector besides the economy is the education system. Ethiopia is not equipped with the infrastructure and facilities to provide online classes for students at all levels. Hence, all institutions were re-opened with mandatory infection prevention and control (IPC) protocols such as the use of face masks, physical distancing, shifts in classes, and routine hand washing practices with soap and water to restrict the spread of the virus. Nevertheless, there has been no monitoring and follow- up and there is no data on IPC compliance among school children in the country. The purpose of this study was to examine the COVID-19 preventive practices and their associated factors among high and preparatory school students in Dessie City, Ethiopia. Methods: A cross-sectional study was carried out by using a pre-tested face-to-face applied structured questionnaire and direct observations from March 8 to March 20, 2021, in five high and preparatory schools in Dessie City. The sample size was proportionally allocated in each school based on the students' total number registered in the first academic semester, then stratified by grade level, and proportionally allocated to each grade and section. Finally, a simple random sampling method was used to select study participants. Variables with p-values < 0.25 in the bivariate logistic regression analysis were entered into the multivariate logistic regression model. Results: This study involved 422 students with a response rate of 98.8%. The level of good preventive practices was 43.7%. After adjusting for covariates, female, positive attitudes, received IPC training and clear accessible sharing of information and feedback with parents, students and teachers were identified as predictors of good precaution practices. Conclusion: The prevalence of good prevention practices for COVID-19 among students was relatively very low. Therefore, the Department of Health and Education of Dessie City and each school should implement environmental health programs and promote prevention practices in high schools and preparatory schools.

Urban Households' Willingness to Pay to Improve Municipal Solid Waste Collection Services and Associated Factors: A Double-Bounded Contingent Valuation Study in Harar City, Ethiopia.

Municipal solid waste collection (MSWC) service financing is a challenge for governments in developing countries, with little or no contribution from the service users. In most Ethiopian cities, residents do not pay for MSWC. This study aims to estimate households' willingness to pay (WTP) for improved municipal solid waste collection service in Harar city. A cross-sectional study was conducted among 331 households employing the contingent valuation method with a double-bounded dichotomous choice format. The hypothetical program works to collect solid waste twice a week, house-to-house, and safely dispose of it to reduce environmental and health impacts. The Tobit regression model was used to account for the determinants of households' WTP. Findings showed that 89% (95% CI: 85.4, 92.5) of households were WTP for the improved waste collection program, with an average yearly amount of US$12. The Tobit model shows that being married (ß = 6.9, 95% CI: 1.2, 13.7), having a monthly household income of >8000 ETB (ß = 31.9, 95% CI: 22.1, 41.7), attending education about MSWM (ß = 11.8, 95% CI: 5.6, 18.1), having temporary storage at household level (ß = 15.3, 95% CI: 9.5, 21.2), and recycling practices (ß = 5.5, 95% CI: 1.2, 10.8) positively influenced the WTP. Interventions like providing educational programs about waste handling and recycling and providing or encouraging households to have temporary storage at the household level are needed to enhance users' WTP. The policy implication of the finding is that community contribution through service fees could be a strategy for sustainable financing.

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.

On the use of contingent valuation method to assess factors affecting the contribution of local people for the management of water hyacinth in Lake Tana, northwestern Ethiopia.

The colonization of freshwater lakes by invasive alien species is increasingly alarming primarily owing to nutrient loads from the watersheds. For the sustainable management of invasive weeds, preventive methods, such as watershed management and sustainable agricultural practices, are recommended. Watershed protection activities by the upstream local community are believed to be effective measures to reduce nutrient loading to the receiving water bodies and hence help prevent the spread of water hyacinth. However, their willingness and potential contributions determine the effectiveness of watershed management activities. The objective of this study is, therefore, to evaluate the preferences and contributions (willingness to pay and willingness to contribute labor) of the local community for the management of water hyacinth in Lake Tana (Ethiopia). A contingent valuation method for a hypothetical market "prevention of water hyacinth infestation of Lake Tana through watershed management program" was used to collect data from 560 randomly selected households. A multivariable interval regression model was used to identify factors affecting the contribution of local people. The mean yearly willingness to pay and to contribute labor of the respondents was 435.4 Ethiopian Birr (US$ 10) and 22.4 man-days, respectively. The place of residence (rural/urban), educational level, private farm plot area, annual income, and water hyacinth-related conference participation significantly influenced the willingness to pay. Similarly, the willingness to contribute labor was strongly associated with place of residence, location, educational level, and household family size. The economic value derived from this study reflects community preferences, which could be an input for informed and evidence-based decision-making regarding the prevention of weed expansion and sustainable use of ecosystem services. Therefore, local, regional, and national authorities are advised to mobilize the local community to contribute labor and/or money so as to halt the expansion of the weed.

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.

The Need for Strengthening Health Information Dissemination Toward Indoor Residual Spraying for Malaria Prevention in Malarious Area of Ethiopia.

Introduction: Malaria remains prevalent in developing countries. This is particularly true among the community who are prone but do not apply malaria prevention and controlling strategies. In one of the malarious areas of Ethiopia (Shewa Robit), the acceptance level of indoor residual spraying (IRS) is indicated to be low as per guidelines. However, factors determining communities' acceptance of IRS are not well-investigated. Hence, this study was designed to identify the determinants for the acceptance of IRS in order to indicate priorities for malaria prevention and control. Methods: A community-based cross-sectional study design was used among 649 households in Shewa Robit town, from February to March 2021. Households were selected from five IRS-targeted kebeles. Data were collected using structured questionnaire. A multivariable logistic regression model was used to identify the independent factors associated with the acceptance of IRS. Results: The response rate in this study was 98%. The proportion of community who accepted the IRS for malaria prevention was 56.5% [95% confidence interval (CI): 52.7-60.2%]. Being male [adjusted odds ratio (AOR) = 2.21, 95% CI: 1.32-3.72], having good knowledge (AOR = 2.25, 95% CI: 1.33-3.84), did not paint/re-plaster the wall after spraying (AOR = 3.99, 95% CI: 2.36-6.76), did not perceive any side effects after spraying (AOR = 1.82, 95% CI: 1.11-2.99), effectiveness of previous IRS (AOR = 2.99, 95% CI: 1.85-4.84), non-utilization of long-lasting insecticide-treated net (LLIN) (AOR = 0.52, 95% CI: 0.33-0.84), and spraying the house at the right season (AOR: 2.14, 95% CI: 1.11-4.13) were determinant factors for the acceptance of IRS. Conclusions: To increase the acceptance level of IRS among the communities, health interventions and services should focus on the awareness creation toward the effectiveness of IRS, proper spraying time/season, and side effects of IRS. Therefore, strengthening health information dissemination could help promote the acceptance of IRS.

Management of polychlorinated biphenyls stockpiles and contaminated sites in Africa: A review of 34 countries.

Polychlorinated biphenyls (PCBs) are industrial chemicals that are designated as persistent organic pollutants. They were used for the production of multifarious products but their manufacture, and uses were banned under the Stockholm convention which took effect in 2004. The parties to the convention had prepared national implementation plans (NIPs) detailing management measures for persistent organic pollutants including PCBs. In the current review, the NIPs of 34 African countries were reviewed to assess the size of PCBs stockpiles, their storage conditions, and the management of PCBs contaminated sites. The results showed that each of the African countries examined, except Egypt, has stored PCBs stockpiles in open fields. There are several PCBs contaminated sites scattered across African countries with Malawi having the largest number of contaminated sites, 211 as of 2005. Many of these sites are not well managed and there are only few monitoring activities of the levels of PCBs. Thus, strict implementation of the Stockholm Convention and the NIPs to reduce the PCBs stockpiles size, and appropriate management of PCBs are required in Africa.