Level of faecal coliform contamination of drinking water sources and its associated risk factors in rural settings of north Gondar Zone, Ethiopia: a cross-sectional community based study

Background: Today, close to a billion people mostl living in the developing world do not have access to safe and adequate water. Several studies in Ethiopia indicate that the majority of the drinking water sources had coliform count beyond the WHO standard. Therefore, Regular quality control mechanisms need to be in place. The objective of this study is therefore to determine the level of faecal coliform contamination of drinking water and its associated factors in North Gondar Zone, Ethiopia.Methods: A community-based cross-sectional study was conducted in rural parts of North Gondar Zone from April to July, 2016. Water samples were taken from water sources using standardized water sampling techniques. Face-to-face interview with structured questionnaires were used to collect socio-economic and behavioral data. Univariate and multivariate analyses were done using logistic regression models.Results: A total of 736 households participated in the study. The prevalence of positive faecal coliform at water sources in North Gondar Zone was found to be 56.5% (n=416) with [95% CI (53-60)]. In multivariate analysis, educational status [(AOR): 0.28, 95% CI (0.1-0.8], sanitary risk of contamination [AOR): 513,95%CI (51-511)] and water shortage experience [AOR: 0.25, 95% CI (0.12-0.5)] are variables identified as predictors for faecal coliform contamination of water in the source.Conclusion: In this study, the prevalence of positive faecal coliform at water source was high. Educational status, sanitary Risk of contamination at the water source, water shortage experience had significant associations with the presence of faecal coliform in drinking water sources.Keywords: Water quality, Risk factors, Colifor

Foodborne disease hazards and burden in Ethiopia: A systematic literature review, 1990–2019

Background: Foodborne disease (FBD) affects millions of people each year, posing a health burden similar to malaria, tuberculosis or HIV. A recent World Bank study estimated the productivity losses alone attributed to unsafe food within Africa at $20 billion in 2016, and the cost of treating these illnesses at an additional$3.5 billion. Ethiopia faces multiple food safety challenges due to lack of infrastructure and basic pre-requisites for food safety such as clean water and environment, washing facilities, compounded by limited implementation of food safety regulations, and a lack of incentives for producers to improve food safety. A consolidation of our understanding and evidence of the source, nature and scale of FBD in Ethiopia is needed to inform policy and future research. We performed a Systematic Literature Review (SLR) of publications on FBD occurrence in Ethiopia including hazard presence and impact. Method: The SLR followed Cochrane and PRISMA guidelines. We searched PubMed and CAB-Direct for relevant publications between 1990 and 2019 (inclusive). Observational studies and reviews were included. Two reviewers screened titles and abstracts, and retained publications were reviewed in full for quality and data extraction. Result: In total 128 articles met the inclusion criteria. Most articles focused on the identification of biological hazards in food. High levels of microbial contamination in different food value chains were often found in the small, ad hoc, observational studies that dominated the literature. Raw milk (22/128, 17.0%) and raw beef (21/128, 16.4%) were the most studied food products. Foodborne (FB) parasites were often found at higher rates in food than bacterial and viral pathogens, possibly due to differences in ease of identification. High levels of bacterial contamination on the hands of food handlers were widely reported. There were no reports on the incidence of human FBDs or resulting health and economic impacts. Conclusion: Our findings reflect existing concerns around food safety in Ethiopia. A lack of substantial, coordinated studies with robust methodologies means fundamental gaps remain in our knowledge of FBD in Ethiopia, particularly regarding FBD burden and impact. Greater investment in food safety is needed, with enhanced and coordinated research and interventions

Effective coverage of antenatal care services in Ethiopia: a population-based cross-sectional study.

BACKGROUND: Antenatal care (ANC) is a principal component of safe motherhood and reproductive health strategies across the continuum of care. Although the coverage of antenatal care visits has increased in Ethiopia, there needs to be more evidence of effective coverage of antenatal care. The 'effective coverage' concept can pinpoint where action is required to improve high-quality coverage in Ethiopia. Effective coverage indicates a health system's performance by incorporating need, utilization, and quality into a single measurement. The concept includes the number of contacts, facility readiness, interventions received, and components of services received. This study aimed to measure effective antenatal care coverage in Ethiopia. METHODS: A two-stage cluster sampling method was used and included 2714 women aged 15-49 years and 462 health facilities from six Ethiopian regions from October 2019 to January 2020. The effective coverage cascade was analyzed among the targeted women by computing the proportion who received four or more antenatal care visits where the necessary inputs were available, received iron-folate supplementation and two doses of tetanus vaccination according to process quality components of antenatal care services. RESULTS: Of all women, 40% (95%CI; 38, 43) had four or more visits, ranging from 3% in Afar to 74% in Addis Ababa. The overall mean health facility readiness score of the facilities serving these women was 70%, the vaccination and iron-folate supplementation coverage was 26%, and the ANC process quality was 64%. As reported by women, the least score was given to the quality component of discussing birth preparedness and complication readiness with providers. In the effective coverage cascade, the input-adjusted, intervention-adjusted, and quality-adjusted antenatal coverage estimates were 28%, 18%, and 12%, respectively. CONCLUSION: The overall effective ANC coverage was low, primarily due to a considerable drop in the proportion of women who completed four or more ANC visits. Improving quality of services is crucial to increase ANC up take and completion of the recommended visits along with interventions increasing women's awareness

Factors associated with adherence to iron folate supplementation among pregnant women in West Dembia district, northwest Ethiopia: a cross sectional study

Abstract Objective In Ethiopia, iron folate tablets are prescribed for all pregnant mothers during their antenatal visits and given for free; however, only limited data are available on their adherence. Therefore, the aim of this study was to assess adherence to iron folate supplementation and its associated factors among pregnant women in West Dembia district, northwest Ethiopia. An institution based cross-sectional study was conducted on 348 pregnant women that had at least one antenatal care visit. Bivariate and multivariate logistic regressions were employed to identify the predictors at p-value < 0.2 and 0.05 respectively. Results Adherence to iron folate supplementation in this study was 52.9% [95% CI (47.7, 58.0%)]. Women who had good knowledge about anemia (AOR: 2.63, 95% CI 1.51, 4.59), knowledge about iron folate supplementation (AOR: 2.82, 95% CI 1.52–5.23), four and more ANC visits (AOR: 6.97, 95% CI 3.25, 14.96), and anemia history during current pregnancy (AOR: 13.87, 95% CI 3.75, 51.35) were significantly associated with adherence to iron folate supplementation. Therefore, preventing prenatal anemia, improving knowledge of women about anaemia and iron folate supplementation, and increasing ANC services are essential to increase adherence

Perceived quality of essential newborn care implementation among health facility deliveries in North Gondar Zone, Northwest Ethiopia: a cross-sectional study

Plain language summary Essential newborn care is a set of practices provided by healthcare workers and mothers to every newborn during delivery. Studies are scarce regarding the quality of newborn care implementation. Therefore, this study aimed to measure the magnitude and factors associated with essential newborn care implementation perceived quality among health facility deliveries in Northwest Ethiopia. A facility-based cross-sectional study design was employed to collect data from 370 randomly selected deliveries in 11 health facilities. A pre-tested interviewer-administered structured questionnaire was adopted from different kinds of literature and guidelines. A binary logistic regression model was fitted to assess the strength and significant level of the association at p-value < 0.05. The overall implementation perceived quality of essential newborn care was found to be 66.3%. The implementation perceived quality of cord care, breast-feeding and thermal care was 75.4, 72.2 and 66.3% respectively. Newborn immunization and vitamin K administration had the lowest implementation perceived quality i.e. 22.4 and 24.3% respectively. Friendly care during delivery (AOR = 5.1, 95% CI: 2.4, 11.0), partograph uses (AOR = 3.0, 95% CI: 1.1, 8.6), child immunization service readiness (AOR = 2.9, 95% CI: 1.5, 5.7), BEmEONC service readiness (AOR = 2.1, 95% CI: 1.2, 3.9) and facing no neonatal illness at all (AOR = 4.2, 95% CI: 1.6, 10.9) were significantly associated with good essential newborn care implementation qualities. The perceived quality of essential newborn care implementation was low in the study area. This is associated with poor readiness on BEmEONC and child immunization services, unfriendly care and not using partograph during delivery. Hence, availing the BEmEONC and child immunization service inputs, continuous training and motivation of healthcare workers for friendly care are vital for improving essential newborn care implementation perceived quality

Prevalence of common symptoms of neonatal illness in Northwest Ethiopia: A repeated measure cross-sectional study.

BackgroundThe neonatal period is the most vulnerable stage of life. In Ethiopia, neonatal illness is common and the reduction in neonatal mortality is not as significant as for under-five mortality.ObjectivesTo determine the prevalence and factors associated with neonatal illness symptoms reported by mothers delivering in health facilities in Northwest Ethiopia.MethodsA repeated measure cross-sectional study design was employed to collect data from 358 randomly selected deliveries in 11 health facilities from November 2018 to March 2019. A pretested and interviewer-administered structured questionnaire adapted from the literature was employed to record neonatal outcomes (illnesses and/or deaths) at birth, 24 hours, 7th, 14th and 28th day from birth. Cleaned data was exported to STATA version 14 software for analysis. Multilevel analysis was used to identify individual and facility-level characteristics associated with neonatal illness symptoms.ResultsThe prevalence of neonatal illness symptoms was 27.8% (95% CI; 23.2, 32.8) of the 338 babies born alive and the neonatal mortality rate was 41/1000 live births (14/338). The most common symptoms or conditions of neonatal illness reported by mothers' in the study area were possible serious bacterial infections (95.8%, 90/94), localized bacterial infections (43.6%, 41/94), low birth weight (23.4%, 22/94), diarrhea (18.1%, 17/94), prematurity (14.9%, 14/94), and jaundice (7.5%, 7/94). Among the babies who died, neonates who had possible serious bacterial infections, low birth weight, localized bacterial infections, and prematurity took the highest proportions with 100% (14/14), 64.3% (9/14), 50% (7/14), and 42.9% (6/14), respectively. Having a maximum of 3 children (AOR = 1.96; 95% CI = 1.1-3.6), having twins or triplets during pregnancy (AOR = 2.43; 95% CI = 1.1-6.1), and lack of antenatal counseling (AOR = 1.83; 95% CI = 1.1-3.3) were among the maternal factors associated with neonatal illness. Having low birth length (AOR = 7.93; 95% CI = 3.6-17.3), and having a poor breastfeeding quality (AOR = 2.37; 95% CI = 1.4-4.0) were found to be the neonatal factors associated with neonatal illness.ConclusionsThis study indicated a high prevalence of neonatal illness symptoms in Northwest Ethiopia. Therefore, early detection, referral and better management of symptoms or conditions with a high mortality, like sepsis and low birth weight are compulsory to save the lives of many neonates. Strengthening the health extension programme to improve antenatal care service utilization and breastfeeding quality of neonates among postpartum women is crucial

Environmental factors of diarrhea prevalence among under five children in rural area of North Gondar zone, Ethiopia

Abstract Background In the sub-Saharan countries, many of the children including found in health facilities are not having sufficient care of diarrhea. Diarrheal disease in these countries is one of the main causes of deaths for under-five children. Methods A community-based cross-sectional study design was used to collect data from May–June, 2016 to determine environmental factors of diarrhea prevalence among under five children in North Gondar Zone. Structured interview questionnaire and observational checklist were used to collect data. Using probability proportion to size, number of households was determined in each district. The multivariable binary logistic regression analysis with a 95% confidence interval and p < 0.05.was used to identify environmental factors associated with childhood diarrheal disease. Results Of the total 736 individuals surveyed from 736 households, a total of 163 (22.1%) with [95% CI (19.1–25.1)] under –five children had 2 week period diarrhea prevalence. Roof material [AOR: 1.99, 95% CI (1.1–3.82)], hand washing facility [AOR: 0.52, 95%CI (0.33–0.82)], presence of Latrine facility [AOR: 1.65, 95% CI (1.01–2.72)], presence of feces around the pit hole [AOR: 1.65, 95% CI (1.01–2.72)], presence of feces around the house compound [AOR: 1.65, 95% CI (1.01–2.72)] and risk of contamination of household storage had significant associations with diarrheal morbidity. Conclusion The prevalence of childhood diarrheal disease among under – five children in rural settings of northwest Ethiopia was high. Type of roof material, hand washing facility, presence of Latrine facility, presence of feces around the pit hole, presence of feces around the house compound and risk of contamination of household storage had significant associations with diarrheal morbidity