Ecological Status of Hot Springs in Eastern Amhara Region: Macroinvertebrates Diversity

 Springs are the places where ground water is discharged at specific locations. They vary dramatically as to the type of water they discharge. Hot springs is having the temperature of the water lies significantly above the mean of annual air temperature of that region. Temperature is one of the most important factors that govern species abundance and distribution. The objective of this study is to examine the relationship between biological parameters (macroinvertebrate diversity) with physicochemical water and habitat quality of hot springs in Easter Amhara Region. A cross-sectional study of physical, chemical and biological components of the hot springs was carriedout to assess their ecological status. Samples were collected from March to May 2013. Biological samples were collected to provide a qualitative description of the community composition at each sampling site. Water samples were collected for analysis of selected physicochemical parameters following water quality assessment protocols. A total of 1095 macroinvertebrates classified into 10 orders and 31 families of macroinvertebrates were collected from the 12 sampling sites. The most abundant orders were Diptera 49.90%, Odonata 15.53%, Coleopteran 12.97%, and Ephmeropetra 9.5% represented by 14 families. Macroinvertebrate taxa were absent at B1 and H1 sites with the temperature of 72 0C and 70 0C respectively. However, in this study, the macroinvertebrate taxa (Chironomidae and Hydrobiidae) were found within a temperature of 52 oC at S1 and H1 sites. The results are also revealed that as the temperature gradient declines, the macroinvertebrate diversity flourished.Due to this fact, both macroinvertebrate diversity and family biotic index were negatively correlated with temperature and the correlations were significant. Human disturbance and habitant conditions varied considerably among sites in the study area. Although human disturbance and water pollution are among the factors influencing ecological quality, the strong correlations between water temperature and species diversity suggest that temperature is the major environmental gradient affecting aquatic biodiversity in hot springs

Organoleptic and palatability properties of drinking water sources and its health implications in Ethiopia: a retrospective study during 2010-2016

Background: This retrospective study aimed to investigate the physicochemical properties of drinking water sources in Ethiopia and compare the water quality with the health-based target. For this purpose, the water quality database of Ethiopian Public Health Institute (EPHI) from 2010 to 2016 was used. Methods: The concentration and other properties of the water samples were analyzed according to the Standard Methods of Water and Wastewater analysis. Quality control and quality assurance were applied in all stages following our laboratory standard operation procedures (SOPs). Results: The concentration of the selected parameters varied based on the type of water sources. The mean concentration of turbidity was higher in spring water (21.3 NTU) compared to tap (12.6 NTU) and well (3.9 NTU) water sources. The mean concentration of total dissolved solids (TDS), electrical conductivity (EC), sodium (Na+), and sulfate (SO4 -2) was found to be higher in spring water sources than tap and well water sources. Comparably, the concentration of hardness, calcium, and magnesium was found to be higher in well water sources than spring and tap water sources. The bivariate analysis indicated that out of 845 analyzed water samples, more than 50% of the samples from Oromia region had turbidity, pH, TDS, hardness, Ca++, K+, and Na+ within an acceptable limit. In addition, the logistic regression analysis showed that water quality parameters were strongly associated with the type of water sources and regional administration at P < 0.05. Conclusion: More than 80% of the samples analyzed from drinking water sources were in agreement with WHO guidelines and national standards. However, the remaining 20% specifically, pH (25%), calcium (20%), hardness (18.1%), TDS (15.5%), and turbidity (13.3%) analyzed from improved water sources did not comply with these recommendations. Due to objectionable or unpleasant taste, people may force to look for alternative unprotected water sources that lead to health concerns. Keywords: Drinking water, Water quality, Water sources, Taste, Physicochemical properties, Retrospective study, Ethiopia, Logistic model

Biomedical waste disposal systems of health facilities in Ethiopia

Background: Biomedical waste generated from health and health-related activities can be grouped as general waste and hazardous waste. This remains true if and only if there is proper on-site handling, such as the segregation and separation of waste based on the type and nature of the source. Methods: A stratified random sampling design was used to provide representative results for Ethiopia, for various types of facility and management authorities, and for each of the 11 regions. Totally, 1327 health facilities were assessed using the World Health Organization (WHO) inventory tools. Results: Nationally, medical waste in 32.6% of the studied health facilities was stored in covered containers, and in about 27% of them it was stored in another protected environment. About 40% of health facilities stored their medical waste in unprotected areas. Twenty-eight (2.6%) and 420 (39.3%) health facilities used 2-chamber industrial incinerators and 1-chamber drum incinerators, respectively. About 58% of health facilities used unsafe waste treatment methods. The proportion of using safe medical waste disposal method was high in referral hospitals (87.9%). This shows the utilization of safe medical waste disposal methods is in decreasing order from higher to lower levels of organization in health facilities. Conclusion: The present study showed a preliminary finding on the waste disposal systems of health facilities at the national level. Dumping biomedical waste outside the health facility is common, and access to common waste facilities is limited. Therefore, a holistic approach to safe medical waste management practices, including the collection process (handling, sorting, and segregation), storage, treatment and final disposal is crucial in all types of health facilities, regardless of the level of organization, ownership, or geographic distribution. Keywords: Health Facility, Biomedical Waste, Disposal, Incinerator, Ethiopi

Pattern and Trend of Medical Admissions of Patients of Chronic Non-Communicable Diseases in Selected Hospitals in Addis Ababa, Ethiopia

Although chronic non-communicable diseases (NCDs) have been of major importance in developed countries for several decades, currently it is becoming recognized as a major public health threats in the developing world too.The increasing NCDs burden is compounded by failure in provision of clear and up-to-date evidence on the burden for key decision makers. The present study is designed to collect retrospective secondary data from selected Government and Private Hospitals in Addis Ababa that offer services to out-patients of NCDs through special referral clinics. The Objective of this research is to depict the patterns and trends of common NCDs in Government and Private Hospitals in Adds Ababa, and provide decision makers with  information on the burden of NCDs at  health facility level.In order to collect retrospective data, four Governments and five Private owned Hospitals in Addis Ababa that offer referral clinic for NCD were selected. Data of NCD out-patients from 2007 to 2011 were considered for present study. Records of cardiovascular diseases, diabetes mellitus, cancer, chronic kidney diseases and chronic pulmonary obstructive diseases including asthma were collected. The data were collected from Hospital registration and patient records anonymously by respective Hospital staff members assigned in the referral clinics.Records of 46,565 patients were collected and more than 60% data were obtained from TikurAnbessa Specialized Teaching Hospital and International cardiac center. Majority of the clients (77 %) were from urban areas while 23% from rural areas. With regard to gender, 56% of the patients are females and 44% males.  As age increases the proportion of patients with NCDs increased and there was a decline after 54 years. Among the patients who were attending outpatient clinics, the vast majority about 40% were patients were with cardiovascular diseases while diabetes and cancer each independently accounts 20% of the proportion. Patients with chronic pulmonary obstructive diseases including asthma, and chronic kidney diseases were 6% and 5%, respectively. Information regarding the status of patients while making follow-up was also collected. It resulted in about 56% of all NCDs out-patients were actively following their health condition by making   frequent visit to their respective out-patient referral clinics, about 2% were deceased and 1% referred to other hospitals, about 41.2% of all NCDs patients were found to be drop-out for unknown reasons. This research reveals that NCDs are becoming public health problems in Addis Ababa. Therefore, there is a need for population-based representative survey to quantify the burden with risk factors for policy formulation and interventions against this emerging epidemic. Moreover, further study is recommended to investigate the reasons of patients why they discontinue care &amp; treatment offered at facility level

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Organoleptic and palatability properties of drinking water sources and its health implications in Ethiopia: a retrospective study during 2010-2016

Background: This retrospective study aimed to investigate the physicochemical properties of drinking water sources in Ethiopia and compare the water quality with the health-based target. For this purpose, the water quality database of Ethiopian Public Health Institute (EPHI) from 2010 to 2016 was used. Methods: The concentration and other properties of the water samples were analyzed according to the Standard Methods of Water and Wastewater analysis. Quality control and quality assurance were applied in all stages following our laboratory standard operation procedures (SOPs). Results: The concentration of the selected parameters varied based on the type of water sources. The mean concentration of turbidity was higher in spring water (21.3 NTU) compared to tap (12.6 NTU) and well (3.9 NTU) water sources. The mean concentration of total dissolved solids (TDS), electrical conductivity (EC), sodium (Na+), and sulfate (SO4-2) was found to be higher in spring water sources than tap and well water sources. Comparably, the concentration of hardness, calcium, and magnesium was found to be higher in well water sources than spring and tap water sources. The bivariate analysis indicated that out of 845 analyzed water samples, more than 50% of the samples from Oromia region had turbidity, pH, TDS, hardness, Ca++, K+, and Na+ within an acceptable limit. In addition, the logistic regression analysis showed that water quality parameters were strongly associated with the type of water sources and regional administration at P < 0.05. Conclusion: More than 80% of the samples analyzed from drinking water sources were in agreement with WHO guidelines and national standards. However, the remaining 20% specifically, pH (25%), calcium (20%), hardness (18.1%), TDS (15.5%), and turbidity (13.3%) analyzed from improved water sources did not comply with these recommendations. Due to objectionable or unpleasant taste, people may force to look for alternative unprotected water sources that lead to health concerns

Assessing the effect of sunlight exposure on physicochemical properties of bottled water in Addis Ababa, Ethiopia: An experimental observational study

Bottled water is potable water that is manufactured, distributed, or offered for sale and intended for human consumption. However, bottled water retailers usually expose bottled water to direct sunlight at the point of sale, and store it for extended periods. Therefore, this study aimed to investigate the effects of sunlight exposure and storage time on the physicochemical properties of bottled water. An experimental observational study design was employed to assess the effect of direct sunlight exposure on selected physicochemical parameters in four water brands (40 samples for both control and exposed) for 28 days in Addis Ababa, Ethiopia. The study's average sunlight intensity and sunshine hours from 3 October to 30/2020 were 197.7 ± 31.8 W/M2 and 7. 3 ± 2. 7 h, respectively. The mean values of the physicochemical parameters of bottled water before and after exposure to sunlight were compared using a paired sample t-test and Wilcoxon signed-rank test with a significance level of 0.05. Approximately 80% of the analysed parameters did not match the labelled value of bottled water. This study showed that the values of pH, F-, and NO3− were decreased from 7.31 to 7.02; 0.20 to 0.15 mg/L, and 3.95 to 3.52 mg/L, respectively. Whereas the level of NO2−, TDS, and turbidity was increased with increasing sunlight exposure from 0.00 to 0.02 mg/L, 82.82 to 85.24 mg/L, and 0.00 to 0.57 NTU, respectively. Statistically significant differences in pH, F−, NO2−, and turbidity levels were found between the exposed and non-exposed groups of bottled water. Apart from the increase or decrease in chemical concentration after sunlight exposure, the physicochemical parameters of the exposed bottled waters were within the recommended standards, except for fluoride and turbidity. However, the fluoride concentration was below the recommended level in both exposed and unexposed samples, with a further reduction in sunlight-exposed bottled water samples. Therefore, regulators should ensure that bottled water is protected against long-term direct exposure to sunlight to provide safe water to consumers

Evaluation of Hookworm Diagnosis Techniques from Patients in Debre Elias and Sanja Districts of the Amhara Region, Ethiopia

Background. Inappropriate diagnosis could intimidate the prevention and control of hookworm infection. Thus, this study was aimed at evaluating the performance of hookworm diagnosis methods. Methods. An institution-based cross-sectional study was conducted from patients in Debre Elias and Sanja districts of the Amhara region, Ethiopia, from November 2019 to January 2020. The study subjects were selected conveniently. After the data was entered into Statistical Package for the Social Sciences (SPSS), sensitivity, specificity, predictive values, test accuracy, and agreement of the different hookworm diagnosis methods, namely, test tube flotation technique (TFT), McMaster (MM), formol-ether concentration (FEC), Kato-Katz (KK), and direct wet mount microscopy (DWMM), were calculated by using SPSS software. The composite reference standard (CRS) was used as the gold standard method. The kappa (κ) test was used to measure the level of agreement between diagnosis tests. Result. A total of 389 stool samples were collected from patients in the study. The overall prevalence of hookworm was 63.24%. The test tube flotation technique (TFT) was found to be the highest both in terms of sensitivity and diagnostic accuracy (100%). McMaster (MM) was the second most sensitive test (68.7%), followed by FEC (44.3%) and KK (38.2%). On the other hand, DWMM had the lowest sensitivity (37.4%), and its diagnostic accuracy was also the least (60%). Only TFT had a perfect agreement (agreement=100%, kappa=1) with the CRS. The sensitivity of DWMM, KK, and FEC showed a kind of linear function with the intensity of infection, but TFT and MM methods were not affected by the infection intensity. Conclusion. Hookworm is still a public health problem in the study area. TFT is by far more sensitive than MM, FEC, KK, and DWMM techniques

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

Knowledge and attitude toward evidence-based medicine and associated factors among health science students in Mettu University southwest Ethiopia: A cross-sectional study

Introduction: Evidence-based medicine (EBM) is “the process of systematically seeking, examining, evaluating, and utilizing current research findings as the basis for clinical decision-making by combining both individual clinical competence and client choice”. Objective: This study aimed to assess the knowledge and attitude toward EBM and its associated factors among health science students in Mettu University. Methods: A cross-sectional survey was conducted using a random sample of health science students in Mettu University from November to December 2022. Multivariable logistic regression analyses were used to identify the factors associated with the knowledge and attitude toward EBM. Adjusted odds ratio (AOR) with 95% confidence interval and P ≤ 0.05 was used to quantify strength of association between variables. Results: Out of 423 health science students 415 completed the questionnaire (with a 98.1% response rate). Overall, 49.4% (205/415) of respondents had a favorable attitude toward EBM and 50.6% (208/415) had good knowledge of EBM. The majority 61.1% (253/415) of participants had internet access. Only 12.0% (50/415) of respondents had received EBM-related training. Respondent's EBM training was associated with knowledge of EBM were 2.7 times (AOR 2.70, 95% CI 1.38, 5.31), those who understood sensitivity were 3.0 times (AOR 3.09, 95% CI 1.76, 3 0.60), those who understood odds ratio were 2.0 times (AOR 2.08, 95% CI 1.35, 2.38), Aware of PubMed were 1.9 times (AOR 1.96, 95% CI 1.03, 3.73), and Owned smart-phone or PC were 3.6 times (AOR 3.67, 95% CI 3.20, 4.31). Good EBM knowledge was 3.0 times (AOR 3.01, 95% CI 2.05, 3.12), Aware of PubMed resources to make clinical decisions was 2.9 times (AOR 2.99, 95% CI 3.20, 3.61), and Participants owned a smartphone or personal computer were 3.2 times (AOR 3.23, 95% CI 3.05, 3.57) were predictors of positive attitude. Conclusions: This study demonstrates a lack of formal EBM training and awareness of basic concepts of EBM among health science students. Health science students' attitude toward EBM were 49.4% to enhance EBM knowledge and skills, formal teaching of EBM courses should be integrated into medical education