Air quality assessment in three East African cities using calibrated low-cost sensors with a focus on road-based hotspots

Poor air quality is a development challenge. Urbanization and industrial development along with increased populations have brought clear socio-economic benefits to Low-and Middle-Income Countries (LMICs) but can also bring disadvantages such as decreasing air quality. A lack of reliable air quality data in East African cities makes it difficult to understand air pollution exposure and to predict future air quality trends. This work documents urban air quality and air pollution exposure in the capital cities of Kampala (Uganda), Addis Ababa (Ethiopia) and Nairobi (Kenya). We build a situational awareness of air pollution through repeated static and dynamic mobile monitoring in a range of urban locations, including urban background, roadside (pavement and building), rural background, and bus station sites, alongside vehicle-based measurements including buses and motorcycle taxis. Data suggest that the measured particulate matter mass concentrations (PM 2.5, PM 10) in all studied cities was at high concentrations, and often hazardous to human health, as defined by WHO air quality guidelines. Overall, the poorest air quality was observed in Kampala, where mean daily PM 2.5 and PM 10 0.84). This link between roadside emissions and indoor air pollution within buildings located close to the road should be explored more fully. This study, through a series of case studies, provides clear evidence that roads and traffic need to be a focus for mitigation strategies to reduce air pollution exposure in East African cities. = concentrations were significantly above the WHO limits at urban background locations by 122% and 69% and at roadside locations by 193% and 215%, respectively. Trafficis clearly a major contributor to East African urban air pollution; monitoring in Kampala and Addis Ababa, on motorcycle taxis, in buses and at bus stations indicated that drivers and commuters were exposed to poor air quality throughout their commute. Road-related air pollution can also impact indoor locations near roads. Using one exemplar building located within Nairobi’s Central Business District, it is shown that measured outdoor PM concentrations significantly correlate with the indoor air quality (r = 0.84). This link between roadside emissions and indoor air pollution within buildings located close to the road should be explored more fully. This study, through a series of case studies, provides clear evidence that roads and traffic need to be a focus for mitigation strategies to reduce air pollution exposure in East African cities. </p

Lower back pain and associated factors among weavers working in Bahir Dar City, Northwest Ethiopia: A cross-sectional study

BackgroundWork-related musculoskeletal disorders are widespread among workers of informal small-scale enterprises. Specifically, lower back pain is a prevalent occupational health problem across various industries, including weaving factories. Lower back pain significantly impairs the functioning, performance, and productivity of weavers. However, information on the prevalence and associated factors of low back pain among weavers of Bahir Dar City and nationwide is scarce. Therefore, this study aimed to assess the prevalence and associated factors of lower back pain among weavers working in Bahir Dar City.MethodA multicentered institutional-based cross-sectional study was conducted on 403 weavers in Bahir Dar City, Ethiopia, from April to May 2023 using a structured face-to-face interview questionnaire. Samples were proportionally allocated to each institution, and study participants were selected using a simple random sampling technique. Variables with a P-value &lt; 0.25 in the bivariate logistic regression were adopted for the multivariate logistic regression analysis after verifying the model fitness. In the multivariate logistic regression analysis, the adjusted odds ratio (AOR) with a 95% confidence interval (CI) and a P-value &lt; 0.05 were considered to identify the associated factors of lower back pain among weavers.ResultThe results revealed that the overall annual prevalence of lower back pain was 63.5% (95% CI = 58.8–68.5). Longer working hours [AOR = 2.580 (CI = 1.517–4.384)], lack of back support [AOR = 1.938 (CI = 2.089–3.449)], repetitive movement of the back during weaving [AOR = 5.940 (CI = 2.709–13.02)], awkward posture [AOR = 2.915 (CI = 1.677–5.065), static working posture [AOR = 4.505 (CI = 2.298–8.831)], and job stress [AOR = 3.306 (CI = 1.896–5.765)] were significantly associated with lower back pain among weavers.ConclusionsLower back pain among weavers was found to be highly prevalent. Working longer hours, lack of back support, repetitive movement of the back, awkward posture, static posture, and job stress were significantly associated with lower back among weavers. The study recommends prompt interventions on weavers to ensure that they use sitting support, weave for &lt;8 h per day, change positions every 2 h, reduce job-related stress, and minimize task repetition, thereby enhancing their working conditions and minimizing the occurrence of lower back pain

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Timely Initiation of Complementary Feeding and its Associated Factors among Children 6-23 Months in Ethiopia: A Systematic Review and Meta-analysis

In Ethiopia, various studies have been done in order to determine the proportion of infants who had initiated complementary food timely and its&nbsp; associated factors. The results of these studies were not consistent and had a big variability. Hence, the aim of this systematic review and meta-&nbsp; analysis is to estimate the pooled prevalence of timely initiation of complementary feeding and its associated factors among children 6-23 months&nbsp; in Ethiopia. Different databases were systematically searched. Studies reporting the proportion and associated factors of timely initiation of&nbsp; complementary feeding in Ethiopia were considered. The Cochrane Q test statistic and I2 test were used to assess the heterogeneity between the&nbsp; studies. A random effect model was computed to estimate the pooled prevalence of timely initiation of breastfeeding. In addition, the association&nbsp; between timely initiation of complementary feeding and Antenatal Care follow-up, place of delivery, postnatal checkup, women’s education,&nbsp; mother’s occupation, father’s education, marital status, child sex, place of residence was determined. Eighteen studies were finally included in this&nbsp; meta-analysis. The findings of this meta-analysis revealed that, the pooled prevalence of timely initiation of complementary feeding in Ethiopia was&nbsp; 55.64% (95% Confidence interval: 50.35, 60.93%). In this study, timely initiation of complementary feeding in Ethiopia was significantly low compared&nbsp; to the current global recommendation on complementary feeding. Women from rural area were less likely to initiate complementary&nbsp; feeding at six months as compared with women from urban areas. Mothers who give birth at home were less likely to initiate complementary&nbsp; feeding timely.&nbsp;&nbsp

Functional disability and its associated factors among community- dweller older adults living in Gondar Town, Ethiopia: a community-based cross-sectional study

Abstract Background Functional disability is an emerging public health concern that has an impact on the health and quality of life of older adults. If functional disability recognized early, it will be possible to support them to live independently. Although functional disability is extensively researched in developed countries; studies are scarce in Sub-Saharan Africa, particularly Ethiopia. Therefore, this study aims to assess the prevalence and associated factors of functional disability in activities of daily living among older adults in Gondar town, Ethiopia. Methods A community-based cross-sectional study was conducted from April to June 2022. Multistage sampling techniques were used to recruit 607 older adults aged 60 years and older. A pre-tested interview-administered questionnaire was used to assess functional disability in basic activities of daily living and instrumental activities of daily living using the Katz Index and Lawton scale, respectively. Bivariate and multivariable logistic regression models were employed. The findings of the study were presented by descriptive statistics and an adjusted odds ratio with 95% CI was used to determine statistical significance. Results The prevalence of functional disability in basic activities of daily living and instrumental activities of daily living among older adults was 34.5% and 54.4, respectively. Age 80 and older [AOR = 2.41, CI (1.41–4.10)], low-income status [AOR = 2.58, CI (1.50–4.46)], multimorbidity [AOR = 2.97, CI (1.92–4.60)], depression [AOR = 2.97, CI (1.63–5.40)], and low level of physical activity [AOR = 3.31, CI (2.11–5.17)] were associated with basic activities of daily living. Age 80 and older (AOR = 3.11, CI = 1.94-5.00), multimorbidity [AOR = 3.06, CI (2.10–4.46)], and depression [AOR = 3.52, CI (2.10–4.46)] were associated with instrumental activities of daily living. Conclusion and recommendations Our study finding revealed that functional disability affects a large number of older adult residents. The age group of 80 years and older, low-income status, a low level of physical activity, multimorbidity, and depression were associated with basic and instrumental activities of daily living. Therefore, health interventions designed to increase older adults’ level of physical activity, management of multimorbidity, and depression, more care for elders 80 years and older, and supporting older adults financially for health insurance coverage could be an important strategy to reduce functional disability among older adults

Additional file 1 of Functional disability and its associated factors among community- dweller older adults living in Gondar Town, Ethiopia: a community-based cross-sectional study

Supplementary Material

Determinants of vaccine acceptance, knowledge, attitude, and prevention practices against COVID‐19 among governmental healthcare workers in Addis Ababa and Adama, Ethiopia: A cross‐sectional study

Abstract Background and Aims COVID‐19 vaccines are vital tools for infection prevention and control of the pandemic. However, coronavirus immunization requires acceptance among healthcare workforces and by the community. In Ethiopia, studies focused on determinants of vaccine acceptance, knowledge, attitude, and prevention practices (KAP) contrary to the novel coronavirus among healthcare staff are limited. Hence, closing this gap requires research. Methods A cross‐sectional study was conducted on 844 governmental healthcare workers. A stratified, simple random sampling technique was used to select the respondents. Data were collected using a structured questionnaire. Binary and multivariable logistic regression statistical models were used to analyze the data. Results This study indicated that only 57.9% of the participants had good COVID‐19 vaccine acceptance, meaning they took at least a dose of the vaccine themselves. We found that 65%, 60.9%, and 51.3% of the participants had good knowledge, prevention practices, and attitude against the pandemic. The novel coronavirus vaccine acceptance rate was 2.19 times more likely among females (adjusted odds ratio [AOR] = 2.19 with 95% confidence interval [CI]: 1.54–3.10) than among male participants. Further, respondents who did not report having any chronic diseases were 9.40 times higher to accept COVID‐19 vaccines (AOR = 9.40 with 95% CI: 4.77, 18.53) than those who reported having a chronic condition. However, healthcare workers who had a habit of chewing khat at least once per week were 4% less likely to take the vaccine (AOR = 0.04 with 95% CI: 0.01, 0.32) than those who had no habit of chewing khat. Conclusion Many core factors influencing COVID‐19 vaccine acceptance were identified. A significant number of participants had poor vaccine acceptance, KAP against COVID‐19. Therefore, the government should adopt urgent and effective public health measures, including public campaigns to enhance public trust in COVID‐19 vaccines. In addition, continuous, timely, and practical training should be provided to healthcare workers

Level of JMP ladders for water, sanitation, and hygiene (WASH) services among healthcare facilities of Bishoftu Town, Ethiopia: An implication of healthcare-associated infection prevention status

This study aimed to assess the level of JMP ladders for WASH services. A cross-sectional study was conducted. Forty-four healthcare facilities were enrolled. From each healthcare facility, water samples were collected directly from water storage facilities. In addition to the interview, an observational checklist was used. Descriptive statistics and a chi-square test were conducted to analyze the data. The coverage of advanced and basic drinking water services in healthcare facilities was 4.6 and 70.4%, respectively. However, the healthcare facilities’ access to advanced and basic sanitation services was nil. Similarly, 61.4 and 88.6% of the healthcare facilities had no hygiene and waste disposal services, respectively. While 2.6, 4.5, and 75% of healthcare facilities had advanced, basic, and limited environmental cleaning services, 18.2% lacked environmental cleaning services. Water samples of 15.9, 11.4, and 6.8% of the healthcare facilities were found positive for total coliforms, fecal coliforms, and E. coli, respectively. The WASH services of the healthcare facilities were very low and not on track to achieve the Sustainable Development Goal target. Healthcare facilities could be sources of healthcare-associated infections. Hence, the government and other concerned bodies should take urgent action to improve WASH services. HIGHLIGHTS 4.6 and 70.4% of the healthcare facilities used advanced and basic water services, respectively.; The healthcare facilities’ access to advanced and basic sanitation services was nil.; The majority of the healthcare facilities had no hygiene and waste disposal services.; 18.2% of the healthcare facilities lacked environmental cleaning services.; Bacteria and chemical contaminants contaminated many water samples.

Access to water, sanitation and hygiene (WASH) services and drinking water contamination risk levels in households of Bishoftu Town, Ethiopia: A cross‐sectional study

Abstract Background and Aims Access to safe drinking water, sanitation, and hygiene is a fundamental human right and essential to control infectious diseases. However, many countries, including Ethiopia, do not have adequate data to report on basic water, sanitation, and hygiene (WASH) services. Although contaminated drinking water spreads diseases like cholera, diarrhea, typhoid, and dysentery, studies on drinking water contamination risk levels in households are limited in Ethiopia. Therefore, closing this gap needs investigation. Methods A community‐based cross‐sectional study was conducted. A total of 5350 households were included. A systematic, simple random sampling technique was used to select the participants. The information was gathered through in‐person interviews using a standardized questionnaire. Furthermore, 1070 drinking water samples were collected from household water storage. Results This investigation revealed that 9.8%, 83.9%, and 4.9% of households used limited, basic, and safely managed drinking water services, respectively. Besides, 10.2%, 15.7% and 59.3% of households used safely managed, basic and limited sanitation services, respectively. Yet, 10.6% and 4.2% of households used unimproved sanitation facilities and open defecation practices. Also, 40.5% and 19.4% of households used limited and basic hygiene services. On the other hand, 40.1% of households lacked functional handwashing facilities. In this study, 12.1%, 26.3%, and 42% of households’ drinking water samples were positive for Escherichia coli, fecal coliforms, and total coliforms, respectively. Also, 5.1% and 4.5% of households’ drinking water samples had very high and high contamination risk levels for E. coli, respectively. We found that 2.5% and 11.5% of households and water distributors had unacceptable fluoride concentrations, respectively. Conclusion The majority of households in Bishoftu town lack access to safely managed sanitation, drinking water, and basic hygiene services. Many households’ water samples had very high and high health risk levels. Hence, the government and partner organizations should implement water and sanitation safety plans