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.

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.

Household water treatment practice and associated factors in Ethiopia: A systematic review and meta-analysis.

The provision of potable water is crucial to ensuring the health and dignity of individuals. In many developing countries, including Ethiopia, waterborne disease has become a major public health problem. There is a significant gap in accessing comprehensive national-wide evidence on Household Water Treatment (HWT) practices and associated factors in Ethiopia. Therefore, this study aims to assess the pooled HWT practice and associated factors in Ethiopia. A comprehensive search of published studies before October 15, 2022, was identified using databases and other sources. Data were extracted using Microsoft Excel, and analysis was performed using STATA 14/SE software. A random-effects model was used to estimate the pooled proportion of HWT practices and the odds ratio of associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics was used to assess heterogeneity. Duval and Tweedie's "trim and fill" method was performed to adjust the pooled estimate. A subgroup analysis was also conducted to identify the sources of heterogeneity. In this study, a total of 708 articles were retrieved, and 16 eligible studies were included. The pooled proportion of HWT practice in Ethiopia was found to be 21% (95% CI: 17-24). Having a formal education (OR: 2.42, 95% CI (2.11-2.74)), being male (OR: 1.32, 95% CI (1.13-1.51)), owning radio (OR: 1.33, 95% CI (1.18-1.47)), having a higher income (OR: 1.73, 95% CI (1.41-2.04)), unimproved water source (OR: 1.71, 95% CI (1.41-2.01)), fetching water at more frequently (OR: 3.31, 95% CI (1.99-4.64)), dipping methods of water drawing (OR: 2.08, 95% CI (1.66-2.51)), and taken training of water treatment (OR: 2.15, 95% CI (1.55-2.75)) were all found to be associated with HWT practice. Based on the findings of this study, the pooled proportion of HWT practice in Ethiopia was found to be one-fifth, which indicated that it was significantly low. Therefore, the authors recommend that households could better receive adequate information about HWT practices through strengthened health education and intensive training on HWT.

Green synthesis of highly efficient and stable copper oxide nanoparticles using an aqueous seed extract of Moringa stenopetala for sunlight-assisted catalytic degradation of Congo red and alizarin red s.

Environmental pollution by organic pollutants because of population growth and industrial expansion is a global concern. Following this, the fabrication of single and efficient nanomaterials for pollution control is highly demanded. Under this study, highly efficient and stable copper oxide nanoparticles (CuO NPs) were synthesized through the green method using Moringa stenopetala seed extract. XRD, UV-vis, FT-IR, and SEM were applied to characterize the synthesized material. From XRD data, the average particle size was found to be 6.556 nm, and the nanoparticles are crystalline in nature. The formation of CuO NPs was demonstrated by FT-IR spectra of Cu-O in different bending vibration bands at 535 cm-1 and 1122 cm-1, as well as stretching vibration of Cu-O at 1640 cm-1. From UV-visible spectroscopic measurements, the energy band gap of greenly synthesized CuO NPs was found to be 1.73 eV. The SEM result shows that the nanoparticles' surfaces are rough, with some of the particles having spherically random orientation. The photodegradation efficiency of green synthesized CuO NPs photocatalyst was found to be 98.35% for Congo red at optimum experimental parameters (initial concentration, 25 mg/L; exposure time, 120 min; catalyst dose, 0.2 g; and pH, 5) and 95.4% for Alizarin Red S at optimum experimental parameters (catalyst dose, 0.25 g; initial concentration, 40 mg/L; exposure time, 120 min; and pH, 4.6). The COD values determined for the degraded product strongly support the complete mineralization of the dyes toward nontoxic materials. Reusability of the catalyst was investigated for five cycles, and the results clearly indicate the green synthesized CuO NPs are highly stable, can be used for several times, and are cost-effective as well. The degradation of Congo red and Alizarin red S on the surface of the CuO NPs follows the MBG kinetic model.

The magnitude of standard precautions practice and its associated factors among healthcare workers in governmental hospitals of northeastern Ethiopia.

Background: Non-compliance with infection control guidelines of healthcare workers may increase their risk of exposure to infectious diseases but can be prevented through adherence to standard precautionary practices in healthcare settings. Objective: This study aimed to assess the magnitude of standard precautions practice and its associated factors among healthcare workers in government hospitals of South Wollo Zone, northeastern Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 1,100 healthcare workers. Proportional sample size allocation for each selected government hospital was conducted followed by simple random sampling to select study participants using human resource records from each hospital. Data were collected using structured and self-administered pretested questionnaires. The data were analyzed using descriptive statistics, bivariable binary, and multivariable logistic regression models. Variables with a p-value <0.05 with a 95% CI were considered as having statistical significance. Results: The overall magnitude of compliance with standard precautions among healthcare workers was 19.2%. The result indicated that work experience of <5 years (AOR = 2.51; 95% CI: 1.07-5.89), absence of continuous water supply (AOR = 2.24; 95% CI: 1.95-5.29), and negative attitude (AOR = 2.37; 95% CI: 1.17-4.79) were significantly associated with poor compliance of standard precautions practice. Conclusion: The overall magnitude of compliance with standard precautions among healthcare workers was low compared to the national magnitude of infection prevention practice. Interventions including consistent and effective training on infection prevention healthcare workers should be given regularly. Providing continuous water supply and building a positive attitude toward infection prevention practices among healthcare workers are also required.

Spatial distribution of health-risky road traffic noise pollution in Dessie City, North East Ethiopia.

OBJECTIVE: Dessie is the trade center for northeast Ethiopia. High traffic flow plus overacting of promotion made the city noisy. There is a shortage of relevant evidence that enforces policy makers to design intervention plans. Therefore, this study aimed to explore the health-risky road traffic noise pollution in Dessie City, Ethiopia. METHODS: The study was conducted by purposive selection of the study area and sampling sites of the city from May 31, 2021 -June 6, 2021. Noise level recordings were taken by a digital Sound Meter and location data was collected by Global Positioning System. Residential, health facility, commercial, and mixed sites were identified by field observation. A total of 20 noise sampling points were included. The sampling points were selected by considering World Health Organization guideline. The measurements were taken twice a day at peak hours, between 8:00-11:00am and 4:00-7:00pm on all days of the week. The sound level meter was placed at a height of 1.5m and 2m from the curb. A total of 280 sound level records were conducted over one week. RESULTS: Among twenty noise recording sites, more than 50% of them registered as excessive noisy sites for all types of site categories (health facility, residential, commercial, and mixed areas). For the seven days, average noise recordings were in the range of 66-72 dB at 83% of mixed areas; 33% of health facilities; 25% of residential areas, and 86% of commercial areas. The highest levels of noise pollution were seen at the Bus-station, Buanbuawuha Square, Tekuam, Arada, Ethio General Hospital, Ersha-seble, and Menafesha areas. CONCLUSION: This study shows that the average noise level measurement within a week exceeded the permissible limits set by Ethiopia and the World Health Organization. It helps for policy development and timely actions against noise pollution and as baseline information for further investigation.

Self-Reported Food Safety Practices and Associated Factors Among Health Extension Model and Non-Model Households in Northeastern Ethiopia: A Comparative Cross-Sectional Study.

Purpose: Eating contaminated food continues to cause numerous food-borne diseases globally. Understanding the causes of poor food safety practices is key to preventing food-borne diseases. Therefore, this study aimed to assess the prevalence of food safety practices and associated factors among health extension model and non-model households in Kombolcha, Ethiopia. Methods: A comparative cross-sectional study was conducted among 327 model households and 329 non-model households in Kombolcha. Four kebeles were selected randomly from a total of 12 kebeles, followed by a systematic random sampling method to select a total of 656 households. The data were collected through face-to-face interviews with household heads and observations from April 15 to May 15, 2021. Data were entered into EpiData version 3.1 and analyzed using SPSS version 25.0. Determinants of food safety practices were determined by using multivariable logistic regression model at a p-value <0.05. Results: The overall prevalence of food safety practices was 44.7% (95% CI: 40.5-48.4%), of which 57.8% (95% CI: 53.0-63.1%) were model and 31.6% (95% CI: 26.5-36.7%) were non-model households, with significant variation among household types. Being a model household (AOR=2.99; 95% CI: 1.98-4.52), having a female household head (AOR=3.13; 95% CI: 2.13-4.59), proper solid waste management (AOR=2.32; 95% CI: 1.54-3.48), good knowledge of food safety (AOR=2.05; 95% CI: 1.43-3.03), and good attitude (AOR=1.74; 95% CI: 1.22, 2.49) were significant predictors of good food safety practices. Conclusion: The prevalence of good food safety practices was not satisfactory. Being a model household, having a female household head, proper solid waste management, good knowledge, and good attitude were significantly associated with good food safety practices. Therefore, the identified modifiable factors are potential areas of intervention to enhance good food safety practices.

Prevention Practice of COVID-19 Using Personal Protective Equipment and Hand Hygiene Among Healthcare Workers in Public Hospitals of South Wollo Zone, Ethiopia.

Objective: The use of personal protective equipment and hand hygiene are often the most recommended line of defense against coronavirus disease-19 (COVID-19). The purpose of this study is to determine the magnitude of compliance and associated factors of personal protective equipment (PPE) utilization and hand hygiene practice among healthcare workers in public hospitals of South Wollo Zone, Northeastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted among 489 healthcare workers in public hospitals of South Wollo Zone, Northeastern Ethiopia from June 15 to July 30, 2021. Proportional sample size allocation to each selected hospital followed by simple random sampling techniques were used to select the study participants using human resource records from each hospital. A pre-tested and structured self-administered questionnaire with WHO's standardized hand hygiene and PPE utilization observational checklist were used to collect data. Bivariate and multivariable analyses with 95% CI and p-value < 0.05 were employed to identify the associated factors of personal protective equipment utilization. Results: About 32 and 22.3% of healthcare workers were compliant with personal protective equipment utilization and hand hygiene practice, respectively. Feedback for safety (AOR = 2.05; 95% CI: 1.26-3.35), training on COVID-19 prevention (AOR = 3.43; 95% CI: 2.01-5.86), and perception to infection risk (AOR = 1.98; 95% CI: 1.18-3.33) were significant factors of good compliance with personal protective equipment utilization. Conclusion: The magnitude of good compliance with personal protective equipment utilization and hand hygiene was low. Interventions to promote personal protective equipment utilization and hand hygiene should focus on feedback for safety, training on COVID-19 prevention, and perception of infection risk.

Prevalence and associated factors of needle stick and sharps injuries among healthcare workers in northwestern Ethiopia.

BACKGROUND: Needle stick and sharp injuries (NSSIs) are a common problem among healthcare workers (HCWs). Although the factors related to NSSIs for HCWs are well documented by several studies in Ethiopia, no evidence has been reported about the magnitude of and factors related to NSSIs in hospitals in northwestern Ethiopia. METHODS: An institution-based cross-sectional study was carried out from January to March 2019 among 318 HCWs in three randomly-selected hospitals of the eight hospitals found in South Gondar Zone. Sample sizes were proportionally allocated to professional categories. Study participants were selected by systematic random sampling methods using the monthly salary payroll for each profession as the sampling frame. Data were collected using a self-administered questionnaire. The outcome of this study was the presence (injured) or absence of NSSIs during the 12 months prior to data collection. A binary logistic regression model with 95% confidence interval (CI) was used for data analysis. Variables from the bi-variable analysis with a p-value ≤ 0.25 were retained into the multivariable analysis. From the multivariable analysis, variables with a p-value less than 0.05 was declared as factors significantly associated with NSSIs. MAIN FINDINGS: The prevalence of NSSIs was 29.5% (95% CI: 24.2-35.5%) during the 12 months prior to the survey. Of these, 46.0% reported that their injuries were moderate, superficial (33.3%) or severe (20.7%). About 41.4% of the injuries were caused by a suture needle. Factors significantly associated with NSSIs were occupation as a nurse (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.18-4.26), disposal of sharp materials in places other than in safety boxes (AOR = 3.93, 95% CI: 2.10-5.35), recapping of needles (AOR = 2.27, 95% CI: 1.13-4.56), and feeling sleepy at work (AOR = 2.24, 95% CI: 1.14-4.41). CONCLUSION: This study showed that almost one-third of HCWs had sustained NSSIs, a proportion that is high. Factors significantly associated with NSSIs were occupation as a nurse, habit of needle recapping, disposal of sharp materials in places other than in safety boxes and feeling sleepy at work. Observing proper and regular universal precautions for nurses during daily clinical activities and providing safety boxes for the disposal of sharp materials, practicing mechanical needle recapping and preventing sleepiness by reducing work overload among HCWs may reduce the incidence of NSSIs.

COVID-19 Prevention Practices and Associated Factors among Diabetes and HIV/AIDS Clients in South-Wollo Zone, Ethiopia: A Health Facility-Based Cross-Sectional Study.

BACKGROUND: Coronavirus-2019 (COVID-19) is affecting many people. Chronic patients are highly vulnerable to contracting an infection. Most people recover within a week, but chronic patients can face severe illness or death. The increasing of cases, complications, and mortality demands compulsory preventive measures. Therefore, this study was designed to identify major preventive practices and associated factors. METHODS: A facility-based cross-sectional study was employed from November to December 2020 among diabetics and HIV/AIDS follow-up clients in Dessie referral hospital. Data were entered into EpiData manager 4.6.0 version and exported to Statistical Package for Social Science (SPSS) version 25.0 for data cleaning and analysis. Logistic regression analysis was done and an adjusted odds ratio (AOR) with its 95% confidence interval (CI) was used for determining the strength of association. RESULTS: Data were collected from 426 participants with a mean age of 46.54 years. The overall poor prevention practice rate of COVID-19 among diabetic and HIV/AIDS follow-up clients was 68.8% 95% CI (64.6-72.8%). Factors significantly associated with poor prevention practice were femaleness (AOR; 1.61; 95% CI; 1.03-2.51), illiterate [AOR; 2.59; 95% CI; 1.33-5.09]), family size greater than four (AOR; 2.06; 95% CI; 1.32-3.23), absence of health professional in the household (AOR; 1.79; 95% CI; 1.13-2.84), not having health insurance (AOR; 1.85; 95% CI; 1.18-2.89) and urban residence (AOR; 0.38; 95% CI; 0.18-0.79). CONCLUSION: The overall proportion of prevention practice towards COVID-19 among diabetic and HIV/AIDS follow-up clients was poor. Illiteracy, having a family size greater than four, not having health professionals in the household, not having health insurance and urban residency were associated with poor prevention practices. Therefore, continuous health educations about good preventive behavioral practice should be enhanced by the health professionals.

Menstrual hygiene practices among high school girls in urban areas in Northeastern Ethiopia: A neglected issue in water, sanitation, and hygiene research.

BACKGROUND: Poor menstrual hygiene practices influence school girls' dignity, well-being and health, school-absenteeism, academic performance, and school dropout in developing countries. Despite this, menstrual hygienic practices are not well understood and have not received proper attention by school WASH programs. Therefore, this study examined the extent of good menstrual hygiene practices and associated factors among high school girls in Dessie City, Amhara Region, northeastern Ethiopia. METHODS: A school-based cross-sectional study was employed to examine 546 randomly selected high school students in Dessie City, northeastern Ethiopia. Pretested interviewer-administered questionnaires and a school observational checklist were used for data collection. EpiData Version 4.6 and the Statistical Package for the Social Sciences Version 25.0 were used for data entry and analysis, respectively. Bivariate and multivariable logistics regression analyses were employed to identify factors associated with good menstrual hygiene practices. During bivariable analysis, variables with P-values less than 0.25 were retained for multivariable analysis. In the multivariable analysis, variables with a P-value less than 0.05 were declared to be significantly associated with good menstrual hygiene practices. RESULTS: Of the respondents, 53.9% (95% CI [49.6, 58.2]) reported good menstrual hygiene practices. The following factors were found to be significantly associated with good menstrual hygiene practices: age range 16-19 years (AOR = 1.93, 95% CI: [1.22-3.06]); school grade level 10 (AOR = 1.90, 95% CI: [1.18-3.07]); maternal education (primary) (AOR = 3.72, 95% CI: [1.81-7.63]), maternal education (secondary) (AOR = 8.54, 95% CI: [4.18-17.44]), maternal education (college) (AOR = 6.78, 95% CI: [3.28-14.02]) respectively]; having regular menses [AOR = 1.85, 95% CI: (1.03-3.32); good knowledge regarding menstruation (AOR = 2.02, 95% CI: [1.32-3.09]); discussing menstrual hygiene with friends (AOR = 1.79, 95% CI: [1.12-2.86]), and obtaining money for pads from the family (AOR = 2.08, 95% CI: [1.15-3.78]). CONCLUSION: We found that more than half of high school girls had good menstrual hygiene practices. Factors significantly associated with good menstrual hygiene practices include high school girls age 16-18 years, girls grade level 10, maternal education being completed primary, secondary and college level, having regular menses, good knowledge regarding menstruation, discussing menstrual hygiene with friends and obtaining money for pads from the family. Therefore, educating of high school student mothers about MHP should be a priority intervention area to eliminate the problem of menstrual hygiene among daughters. Furthermore, in order to improve the MHP among high school girls, further attention is needed to improving knowledge regarding menstruation among high school girls, encouraging high school girls' families to support their daughters by buying sanitary pads and promoting discussions among friends about menstrual hygiene. Schools need to focus on making the school environment conducive to managing menstrual hygiene by increasing awareness of safe MHP and providing adequate water/sanitation facilities.

Prevalence and associated factors of acute respiratory infection among street sweepers and door-to-door waste collectors in Dessie City, Ethiopia: A comparative cross-sectional study.

BACKGROUND: Acute respiratory infections are rising in developing countries including Ethiopia. Lack of evidence for the prevalence and associated factors of acute respiratory infection among street sweepers and door-to-door waste collectors in Dessie City, Ethiopia is a challenge for the implementation of appropriate measures to control acute respiratory infection. Thus, this study was designed to address the gaps. METHODS: A comparative cross-sectional study was conducted among 84 door-to-door waste collectors and 84 street sweepers from March to May 2018. A simple random sampling technique was used to select study participants. Data were collected by trained data collectors using a pretested structured questionnaire and on-the-spot direct observation checklist. Data were analyzed using three different binary logistic regression models at 95% confidence interval (CI): the first model (Model I) was used to identify factors associated with acute respiratory infection among street sweepers, whereas the second model (Model II) was used to identify factors associated with acute respiratory infection among door-to-door waste collectors, and the third model (Model III) was used for pooled analysis to identify factors associated with acute respiratory infection among both street sweepers and door-to-door waste collectors. From each model multivariable logistic regression, variables with a p-value <0.05 were taken as factors significantly associated with acute respiratory infection. RESULTS: The overall prevalence of acute respiratory infection among studied population was 42.85% with 95% CI (35.1, 50.0%). The prevalence of acute respiratory infection among street sweepers was 48.80% (95% CI: 37.3, 64.8%) and among door-to-door waste collectors was 36.90% (95% CI: 27.4, 46.4%). There was no statistically significant difference between the prevalence of acute respiratory infection among the two groups due to the overlapping of the 95% CI. Among the street sweepers, we found that factors significantly associated with acute respiratory infection were not cleaning personal protective equipment after use (adjusted odds ratio [AOR]: 2.40; 95% CI: 1.15, 5.51) and use of coal/wood for cooking (AOR: 3.95; 95% CI: 1.52, 7.89), whereas among door-to-door waste collectors, were not using a nose/mouth mask while on duty (AOR: 5.57; 95% CI: 1.39, 9.32) and not receiving health and safety training (AOR: 3.82; 95% CI: 1.14-7.03) were factors significantly associated with acute respiratory infection among door-to-door-waste collectors. From the pooled analysis, we found that not using a nose/mouth mask while on duty (AOR: 2.19; 95% CI: 1.16, 4.53) and using coal/wood for cooking (AOR: 2.74; 95% CI: 1.18, 6.95) were factors significantly associated with acute respiratory infection for both street sweepers and door-to-door waste collectors. CONCLUSION: The prevalence of acute respiratory infection among street sweepers and door-to-door waste collectors has no statistically significant difference. For both groups, not using a nose/mouth mask while on duty and using coal/wood for cooking fuel factors associated with acute respiratory infection. The municipality should motivate and monitor workers use of personal protective equipment including masks and gloves. Workers should use a nose/mouth mask while on duty and should choose a clean energy source for cooking at home.

Priorities for intervention to prevent diarrhea among children aged 0-23 months in northeastern Ethiopia: a matched case-control study.

BACKGROUND: The global public health problem of diarrhea is most prevalent in developing countries including Ethiopia, especially among children under two years of age. Limited information on the determinants of diarrhea among children aged 0-23 months hinders the design and prioritization of intervention strategies to address childhood diarrhea in Dessie City, northeastern Ethiopia. Therefore, this study was designed to assess the determinants of diarrhea in order to identify priority interventions for its control. METHODS: A community-based matched case-control study was conducted among children aged 0-23 months during January-February 2018. Cases defined as children with acute diarrhea, and controls defined as children without acute diarrhea, were matched by child's age (months) and place of residence (residing in the same kebele, the lowest local administrative unit, each of which has a population of approximately 5000) during the two weeks prior to data collection. Data were collected from mothers/caregivers of the 119 cases and 238 matched controls using a pre-tested structured questionnaire and an observational checklist. Data were analyzed using conditional logistic regression model with 95% confidence interval (CI); variables with p < 0.05 from multivariable analysis were considered as significantly associated with acute diarrhea among children aged 0-23 months. RESULTS: Age of mothers/caregivers (> 35 years of age) (adjusted matched odds ratio [adjusted mOR] = 2.00; 95% CI: 1.37-5.8); divorced/widowed marital status (adjusted mOR = 1.40; 95% CI: 1.26-3.3); lack of exclusive breastfeeding (adjusted mOR = 2.12; 95% CI: 1.15-3.70); presence of feces within/around latrines (adjusted mOR = 1.37; 95% CI: 1.21-3.50); lack of handwashing facility near latrine (adjusted mOR = 1.50; 95% CI: 1.30-5.30); presence of domestic sewage discharge within and/or outside the compound (adjusted mOR = 3.29; 95% CI: 1.85-7.50) and practice of handwashing at fewer than three of the five critical daily times (adjusted mOR = 4.50; 95% CI: 2.54-9.50) were significantly associated with acute diarrhea among children aged under two years. CONCLUSION: To reduce acute diarrheal disease among children under two, priority should be given to interventions that focus on improving exclusive breastfeeding practices, regular cleaning of latrines, advocating for availability of handwashing facility within/around latrines, use of proper domestic sewage discharge methods and improving handwashing practice at the five critical times each day. Strengthening communication that promotes hygiene and behavioural change may also raise awareness among mothers/caregivers and empower them to enhance handwashing practices at critical times.

Water, sanitation, and hygiene conditions and prevalence of intestinal parasitosis among primary school children in Dessie City, Ethiopia.

BACKGROUND: Intestinal parasitosis is a major public health problem that affects the health of primary school children in low- and middle-income countries where water, sanitation, and hygiene (WASH) conditions are deficient. Since there is a paucity of information on the prevalence and associated factors of this problem among primary school children in Dessie City in Ethiopia, this study was designed to address these gaps. METHODS: A school-based cross-sectional study was conducted among 407 stratified-sampled primary school children in five primary schools at Dessie City from April to June 2018. Data were collected using a pretested structured questionnaire, an observation checklist and laboratory analysis of stool samples. Stool specimen from each study participant was collected using clean, properly labeled and leak-proof stool cup. A portion of stool from each study participant collected sample was processed using saline wet mount technique and examined by microscope. The remaining specimens were preserved with 10% formalin and transported to Dessie Comprehensive Specialized Hospital laboratory to be processed by using formol-ether concentration technique. Then, slide smears were prepared from each processed stool specimen and finally, it was microscopically examined with 10x as well as 40x objectives for the presence or absence of intestinal parasites. Factors significantly associated with intestinal parasitosis were determined using binary logistic regression model at 95% CI (confidence interval). Thus, bivariate (COR [crude odds ratio]) and multivariable (AOR [adjusted odds ratio]) logistic regression analyses were carried out. From the multivariable analysis, variables having a p-value of less than 0.05 were declared as factors significantly associated with intestinal parasitosis among primary school children. MAIN FINDINGS: The overall prevalence of intestinal parasitosis was found to be 16.0% (95% CI: 12.5-19.4%), of these, 50.8% were positive for protozoa, 32.2% for helminth infections and 16.9% for double co-infections. Entamoeba histolytica was the most prevalent parasite (29.2%), followed by Giardia lamblia (21.5%), Ascaris lumbricoides (18.5%), Hymenolepis nana (9.2%) and Enterobius vermicularis (4.6%). Prevalence rates were similar among government (16.3%) and private (15.7%) school children. Water consumption was less than 5 liters per capita per day in 4 of the 5 schools. Thirty-eight (9.3%) of primary school students reported that they practiced open defecation. About two-thirds (285, 70.0%) said they always washed their hands after defecation. Mother's education (illiterate) (AOR = 3.3; 95% CI: 1.20-9.37), father's education (illiterate) (AOR = 3.9; 95% CI: 1.40-10.82), fathers who could read and write (AOR = 3.3; 95% CI: 1.25-7.86), handwashing before meal (sometimes) (AOR = 2.2; 95% CI: 1.11-4.17) and poor knowledge of WASH (AOR = 9.3; 95% CI: 2.17-16.70) were statistically associated with presence of intestinal parasitic infections. CONCLUSION: We concluded that the prevalence of intestinal parasitosis in the study area among Grades 4-8 primary school children had public health significance. Factors significantly associated with intestinal parasitosis among primary school children's were illiterate mothers and fathers, irregular handwashing of children before meals, and poor knowledge of WASH. Health education to improve students' WASH knowledge and mass deworming for parasites are recommended as preventive measures; and improvements to the quality of WASH facilities in primary schools are strongly recommended to support these measures.

Pneumonia remains a leading public health problem among under-five children in peri-urban areas of north-eastern Ethiopia.

BACKGROUND: Pneumonia is a leading cause of morbidity and mortality among children under five years of age in developing countries, including Ethiopia. However, data on this serious illness among highly susceptible and vulnerable children living in local peri-urban areas are limited. Establishing the prevalence of pneumonia and identifying the associated factors are important for proper planning and intervention. METHODS: A community-based cross-sectional study was conducted among 560 systematically selected children under the age of five years in peri-urban areas of Dessie City from January through March 2019. Data were collected using a pretested structured questionnaire, physical examination of children and direct observation of housing conditions. Pneumonia was examined using World Health Organization (WHO) guidelines as the presence of the symptoms of fast breathing or indrawn chest with or without fast breathing during the two weeks prior to the study. A principal component analysis was used to construct a household wealth index. Data were analyzed using a binary logistic regression model at 95%CI (confidence interval). The analysis involved estimating the crude odds ratio (COR) using bivariate analysis, and adjusted odds ratio (AOR) using multivariable analysis. From the multivariable analysis, variables at p-value of less than 0.05 were declared statistically significant. MAIN FINDINGS: The prevalence of pneumonia among children under five was 17.1% (95%CI: 13.9%-19.9%). Of the participating children, 113 (21.0%) had a cough, 92 (17.1%) had fast breathing, 76 (14.1%) had fever, and 40 (7.4%) of the children had chest indrawn. Domestic fuel was the most common source of cooking fuel 383 (71.1%). Majority 445 (82.6%) of children were fully vaccinated and 94 (17.4%) were not fully vaccinated. Most (481, 89.2%) of the children were got exclusive breastfeeding. Slightly more than half (284, 52.7%) of the under-five children had acute malnutrition and 27.1% of the children had a childhood history of ARI. The multivariable analysis showed using domestic fuel as the energy source for cooking (adjusted odds ratio [AOR] = 3.95, 95%CI: 1.47-10.62), cooking in the living room (AOR = 6.23; 95%CI: 1.80-21.68), overcrowding (AOR = 3.37, 95%CI: 1.56-7.27), child history of acute respiratory infection (ARI) (AOR = 6.12 95%CI: 2.77-13.53), family history of ARI (AOR = 4.69, 95%CI: 1.67-13.12) and acute malnutrition (AOR = 2.43, 95%CI: 1.18-5.04) were significantly associated with childhood pneumonia. CONCLUSION: In this study, pneumonia remains a leading public health problem among under five children in the study area and higher than national averages. Domestic fuel as the energy source for cooking, cooking in the living room, overcrowding, child history of ARI, family history of ARI and acute malnutrition were predictors of pneumonia. Community-based interventions focusing on improving housing conditions, reduced use of domestic biofuels, adequate and balanced food intake, including exclusive breastfeeding of infants, and early treatment of ARIs.

Does menstrual hygiene management and water, sanitation, and hygiene predict reproductive tract infections among reproductive women in urban areas in Ethiopia?

Reproductive tract infections (RTIs) are a public health concern in Ethiopia. However, the relationship between menstrual hygiene management (MHM) and water, sanitation, and hygiene (WASH) factors to RTIs have not been well addressed. A community-based cross-sectional study was conducted from January to March 2019 among 602 systematically selected reproductive-age women aged 15-49 years in Dessie City. Data were collected using a questionnaire and a direct observation checklist. RTIs were identified by the presence during one year before data collection of one or more signs of vaginal discharge, itching/irritation or ulcers/lesions around the vulva, pain during urination and sexual intercourse, and lower abdominal pain and lower back pain. Data were analyzed using multivariable logistic regression analysis with 95%CI (confidence interval). The self-reported prevalence of RTIs was 11.0%(95%CI:8.5-13.7%) during one year prior to the survey. The most commonly reported symptoms of RTI were burning micturition (9.1%) and vaginal discharge (6.1%). Three-fourths 443(75.0%) of households used traditional pit latrines and the majority of the study participants 527(89.2%) did not meet the basic access requirement of 20 liters of water per capita per day. The majority 562(95.1%) of the study participants did not have multiple sexual partners during the last year and 97.8% did not practiced sexual intercourse during menstruation. The most common type of blood-absorbent material used was a sanitary pad 497(84.8%) followed by cloth 89(15.2%). Factors significantly associated with RTIs were using unclean latrines (AOR: 4.20; 95%CI:2.00-8.80), not washing hands with soap before touching the genital area (AOR: 3.94; 95%CI:1.49-10.45), history of symptoms of RTIs in the past year (AOR: 5.88; 95%CI:2.30-14.98), having multiple sexual partners in the past year (AOR: 4.46; 95%CI:1.59-12.53), changing absorbent material only once per day (AOR: 8.99; 95%CI:4.51-17.92), and washing the genital area only once per day during menstruation (AOR: 5.76; 95%CI:2.07-16.05). The self-reported prevalence of RTI showed that one women experienced RTI among ten reproductive-age women. Designing a women's health policy that focuses on ensuring availability of WASH facilities and improving MHM at the community level is key for sustainably preventing RTIs.

Determinants of acute respiratory infection (ARI) among under-five children in rural areas of Legambo District, South Wollo Zone, Ethiopia: A matched case-control study.

BACKGROUND: Acute respiratory infection (ARI) leads to morbidity and mortality among under-fivechildren in developing countries, especially in rural settings. ARI ranks among the top 10 diseases in under-five children in Legambo District, South Wollo Zone, Ethiopia. The aim of this study was to evaluate determinant factors for ARI in Legambo District in 2019. MATERIALS AND METHODS: A community-based matched case-control study was conducted, involving 139 cases and 278 controls under 5 years of age, from mid-January to mid-February 2019. Data were collected using a structured questionnaire. Bivariate and multivariable conditional logistic regression analyses were performed. From the multivariable conditional logistic regression analysis, variables with a significance level of p < 0.05 were taken as significantly associated with ARI among under-five children. RESULT: ARI among children under 5 years of age was significantly associated with age of the mother/caregiver being ≥35 years, occupation of mother/caregiver being housewife, the family being of medium wealth status, the type of stove used in the house, carrying the child while preparing food, absence of windows in the house, and nutritional status of the child. CONCLUSION: The occurrence of ARI could be reduced by improving economic status, stove use, and nutrition of children, and by increasing community awareness regarding indoor air pollution and ventilation.

Scabies and its associated factors among under 15 years children in Wadila district, Northern Ethiopia, 2019.

INTRODUCTION: scabies is a contagious ectoparasite of the skin. It is caused by the mite Sarcoptes scabiei var. hominis that causes a pruritic skin eruption. It was estimated that more than 300 million cases of scabies occur worldwide every year. It remains one of the commonest skin diseases seen in developing countries including Ethiopia. Therefore, the main aim of this study is to determine scabies prevalence and its associated factors among less than 15 years children in Wadila district, Northern Ethiopia. METHODS: community based cross-sectional study was conducted on 583 participants from January 30th to February 28th 2019. Multistage sampling technique was used and data were collected using pre-tested interviewer administered questionnaire. SPSS version 23.0 was used for analysis and bivariable logistic regression was computed and variables having p < 0.25 was modelled in multi-variable logistic regression to control confounders. The level of statistical significance was set at p < 0.05. RESULTS: the prevalence of scabies infestation was 23.8% in Wadila district. Not using of soap when taking shower [AOR=2.93 (95% CI:1.72-5.00)], using unimproved water source [AOR=1.82 (95% CI:1.04-3.16)], sharing clothes from scabies cases [AOR=10.10 (95% CI: 3.37-30.23)], uncleaning of the house every day [AOR=2.28 (95% CI: 1.32-3.95)], presence of pet animals at home [AOR= 3.01(95% CI: 1.66-5.45)] and went to epidemic areas of scabies [AOR= 4.09 (95% CI: 2.37-7.06) were predictors of scabies infestation. CONCLUSION: there was higher prevalence of scabies infestation in Wadila district. Therefore, special attention should be given to under 15 years children.

Spatiotemporal variability of drinking water quality and the associated health risks in southwestern towns of Ethiopia.

The failure to provide safe drinking water services to all people is the greatest development setback of the twenty-first century including Ethiopia. Potential pollutants from various sources are deteriorating drinking water quality in different seasons, and associated health risks were not clearly known. We determined seasonal and spatial variations of urban drinking water characteristics and associated health risks in Agaro, Jimma, and Metu towns, Southwest Ethiopia. Seventy-two samples were collected during dry and rainy seasons of 2014 and 2015. The majority (87.4%) of physicochemical parameters was found within the recommended limits. However, free residual chlorine in Jimma and Agaro town water sources was lower than the recommended limit and negatively correlated with total and fecal coliform counts (r = - 0.585 and - 0.638). Statistically significant differences were observed at pH, turbidity, and total coliform between dry and rainy seasons (p < 0.05). A Kruskal-Wallis H test revealed a statistically significant difference in electrical conductivity, total hardness, fluoride, iron, and fecal coliform across the study towns (p < 0.05). The Agaro town water source was the highest in fluoride concentration (3.15 mg/l). The daily exposure level for high fluoride concentration in Agaro town was estimated between 0.19 and 0.41 mg/kg day, and the average cumulative hazard index of fluoride was > 3.13 for all age groups. Water quality variations were observed in all conventional water treatment systems in the rainy season, and further research should focus on its optimization to safeguard the public.