Book Review: "Water Resources Management in Ethiopia: Implications for the Nile Basin."

Water Resources Management in Ethiopia: Implications for the Nile Basin.Edited by: Helmut Kloos and Worku Legesse (With 17 contributors)Cambria Press: Amherst: New York; 2010Hard Cover, 415 pages (with 14 chapters and Index

Sanitary conditions of food establishments in Mekelle town, Tigray, North Ethiopia

No Abstract. The Ethiopian Journal of Health Development Vol. 21 (1) 2007: pp. 3-1

Assessment of occupational injuries in Tendaho Agricultural Development S.C, Afar Regional State

Background: The status of occupational injuries in workplaces in general and agriculture sectors in particular is ill defined in Ethiopia. Pocket studies in developing countries indicate that occupational injury due to an unsafe working environment is increasing.Objectives: To determine the magnitude of occupational injury and describe factors affecting its happening among workers of Tendaho State Farm located in Afar Region.Methods: Cross-sectional study design was employed to assess  occupational injuries among randomly selected 810 workers in August, 2006. A structured questionnaire based interviews, work environment observation, physical examination of study subjects for injury, and reviewing medical records for injury were used to collect the data.Results: The overall occupational injury prevalence rate was 783 per 1000 exposed workers per year. Seventy (11%) injured workers were hospitalized. Most (90%) of hospitalization was for more than 24 hours. Only one death was reported in the preceding 12 months prior to the study. A total of 6153 work-days were lost, at an average of 11.4 daysper an injured worker per year. Working more than 48 hours per week [AOR: 8.27, 95% CI:(4.96-13.79)], absence of health and safety training [AOR: 2.87, 95% CI: (1.02-8.06)], sleeping disorder [AOR: 1.64, 95% CI: (1.12-2.41)], alcohol consumption [AOR: 1.72, 95% CI: (1.06-2.80)], job dissatisfaction [OR: 1.83, 95% CI: (1.30-2.58)] and absence of protective devices [OR: 3.18, (1.40-7.23)] were significant factors that contributed to the prevailing occupational injuries.Conclusion: Multiple factors related to the work organization and  employee’s behavior increased the risk of occupational injuries. Continued on the job training, sustained work place inspections and proving occupational health and safety services should get emphasis in work places

Assessment of the impact of latrine utilization on diarrhoeal diseases in the rural community of Hulet Ejju Enessie Woreda, East Gojjam Zone, Amhara Region

Background: The construction of latrine is a relatively simple technology that is used to prevent the spread of infectious diseases. While household access is important, community sanitation coverage is even more important to improve health through the regular use of well-maintained sanitation facilities.Objective: Assessing the impact of latrine utilization on diarrhoeal diseases in the rural community in the district of Hulet Ejju Enessie Woreda, East Gojam.Method: A community based descriptive cross-sectional study was conducted in a randomly selected 824 households that had 90% latrine coverage at the time data collection in 2006. A structured and pre-tested questionnaire complemented with observation was used to collect data. The study area is found in one of the districts of East Gojjam where the health services extension program was actively underway. Trained data collectors and supervisors were involved in the study. Data entry and cleaning was done using EPI INFO 6.04d, while SPSS version 11 was used for data analysis.Results: Most (61%) households with traditional pit latrines had latrine utilization. In a bivaraite analysis, the extent of latrine utilization was significantly associated with presence of primary or secondary school children in the house [AOR: 1.47, 95% CI: (1.04-2.06)], perceived reasons for latrine construction [AOR: 2.89, 95% CI: (1.24-6.72)] and learning from neighborhoods [AOR: 10.07, 95% CI: (1.97-51.56)], ecology of ‘Kolla’ [AOR: 0.47, 95% CI: (0.29-0.74) and ‘Woyna-Dega’ [AOR: 0.55, 95% CI: (0.38-0.81), and owning latrines for >2 years [AOR: 2.13, 95% CI: (1.57-2.89)]. The occurrence of childhood diarrhoea was not statistically associated with the extent of latrine utilization [AOR: 0.63, 95% CI: (0.22-1.81)]; however, only owning latrines for >2 years remained significant in a multivariate analysis [AOR: 0.28, 95% CI: (0.12-0.66)]. Conclusion: Utilization of latrine facilities was common among the majority of households. The duration of having latrines had impacted the occurrence of childhood diarrhea. [Ethiop. J. Health Dev. 2010;24(2);110-118

The status of school sanitation facilities in some selected primary and secondary schools in Dessie City Administration, South Wello Zone, Amhara Region

Background: There is a growing demand on school hygiene and sanitation facilities given the growing number of school enrolment in Ethiopia. A safe school environment plays a key role in facilitating education and enduring pupils with improved life skills. Although there is much attention given for the expansion of schools to reach all school aged children in Ethiopia, the concern on focusing school hygiene and sanitation remains to be a challenge.Objectives of the study: A assessing the status of water and sanitary facilities in selected schools of Dessie Town with the intention of obtaining exploring baseline to serve for implementation of an Urban Health Extension Program in the region.Methods: This study was done in May 2010 in Dessie City Administration. Questionnaire-based interviews with school principals and record reviews supplemented by physical observation were used to collect the necessary data. Descriptive statistics was used to present the findings.Results: The overall latrine to school population ratio was (1:64), which was about twice less than the recommended one. The ratio for female students was significantly lower than that for males. The access to drinking water facilities (water taps) and hand washing facilities were very much limited to the extent not conforming to the standard. The presence of school-based water, sanitation, and hygiene committee and clubs was unheard.Conclusion: The inadequate sanitation facility in schools poses a health risk that would impact students’ potential to attend education. Hence, a coordinated effort among all concerned school to safeguard the school environment should be considered as one part of the path for reaching the MDG goals with respect to at least sanitation

Assessment of demographic, health and nutrition related factors to a school performance among school children in Arb-Gebeya Town, Tach-Gaynt Woreda, South Gondar, Ethiopia

Background: Intestinal parasite and malnutrition are prevalent among children in general and school aged children in particular, in the Ethiopian context. There is limited information how these factors are associated with school performance.Objective: This study assessed the effect of intestinal parasitic infection and nutritional status on academic performance of school children.Methods: A school-based cross-sectional survey was conducted among randomly selected 601 school childrenattending grades 5th-8th. Data was collected using standardized, closed ended and coded questionnaire. Physical health assessment, parasitological laboratory examinations and anthropometric measurements were the means used to assess the presence of parasitic infections and nutritional status. Grade scores were used to evaluate school performance. Graduate nurses and laboratory technicians were involved in the data collection. EPO INFO version 6.04 and SPSS version 13.0 were used for data management and analysis, respectively.Results: Out of the 601 students, who had stool examination, 216 (35.9%) had at least one parasite. Of those, the dominant parasite was E-histolytica, 80 (13.3%), followed by ascariasis, 50 (8.3%). The prevalence of underweight (BMI value below the 5th percentile) in the area was 30(5%) in all age groups.The mean of the students’ grade is 62.25% (SD±9.25). Three hundred twenty-eight (54.6%) of the students had scored below the mean. The rate of absenteeism in the group below five days was 540 (74.9%) students who had parasitic infection were less likely to achieve higher academic performance than those who had not (AOR=0.58, 95% CI: 0.41-0.83). Nutritional status as measured by BMI did not shows an association with academic performance.Conclusion: Even though the prevalence of intestinal parasites in the area seemed low, it affected school performance in the Arb-Gebeya school. However, nutritional status did not affect academic performance according to this study

Assessment of health hazards and associated factors among the returned migrants living at Bati Woreda, Oromia Zone, Amhara National Regional State

Background: Migration is a demographic event which serves as a coping mechanism of poverty alleviation in developing countries, including Ethiopia. The living condition of migrants in economically attractive countries, however, is having a devastating effect. The health risk of Ethiopian migrants to neighboring countries is not well documented.Objective: This study aimed to assess hazards and associated factors among returned migrants living at Bati Woreda, Amhara National Regional State.Methods: A quantitative cross-sectional survey with a sample size of 390 returnees was made in five kebeles of the woreda using a structured questionnaire in April 2011. Health hazard was defined as a health outcome that occurred during the process of migration involving travelling, staying in the destination, or getting back home. The quantitative data was entered and cleaned using Epi Info Version 3.5.1. Descriptive statistics was performed to present socio-demographic data. Multivariate logistics regression analysis using AOR with 95% CI was used to assess the relative importance of associated factors. The qualitative data was collected using focus group discussions and in-depth interviews using semi-structured question guide. Open Code Version 3.4 was used to select codes, categories and themes for the qualitative data using the thematic analysis.Results: The overall magnitude of health hazards was 41%: diarrhea 31.6% and malaria 10.5% were the leading acute illnesses. After controlling the possible confounders in binary multivariate logistic regression, push factors related to age ≥35 years [AOR (95%CI) =3.48 (1.73,7.02)], the ability to read and write in educational status [AOR (95%CI) = 2.49 (1.17,5.30)], being jobless and a housewife [AOR (95%CI) = 2.17(1.29,3.64)] and AOR (95%CI) =5.28 (2.17,12.83)], respectively, and presence of better employment opportunities and living conditions as a pull factors [AOR (95%CI) = 8.61(3.16,23.47) and [AOR (95%CI) = 6.35 (1.89,21.36)], respectively, were determinants of health hazards.Conclusion: Migrants were highly exposed to health hazards because of the illegal routes of the movement. Socio-economic variables with respect to age, education and unemployment were predictors of the migration phenomenon. Providing safety protection from potential health hazards before leaving the country, proper social and psychological rehabilitation of returnees is recommended

Healthcare waste generation and its management system: the case of health centers in West Gojjam Zone, Amhara Region, Ethiopia

Background: Healthcare service providers generally aim at controlling and preventing diseases such as communicable ones. However, in the course of activities, the generation of hazardous and non hazardous waste is a concern of an environmental risk to health care workers, the public and the environment at large.Objective: To assess healthcare waste type, generation rate, and its management system in health centers in West Gojjam Zone.Methods: Cross-sectional study was employed to estimate waste generation rate and evaluate its management system in ten public health centers from March 2007 to April 2007. Observational checklist, key informant interview guide and weighing scale were data collection tools that were used to characterize waste generation. Weighing of healthcare waste was done for eight consecutive days in each health center. Data were entered and analyzed using EPI Info version 6.04d and SPSS version 13.0.Results: The daily mean ( ± SD) healthcare waste-generation rate was 1.79 ± 0.54 kg, which was equivalent to 0.035 ± 0.05 kg/outpatient/day. About 0.93 ± 0.3 kg/day (52.0%) was general and 0.86 ± 0.33 kg/day (48.0%) was hazardous waste. The mean healthcare waste generation rate among health centers did not significantly vary. Segregation of wastes and pre treatment of infectious wastes were not properly practiced by any of the health centers. Only four out of ten health centers used local type of incinerators, while others used open burning for the final handling of healthcare wastes. Biological wastes such as placenta were generally disposed and buried in nonwatertight disposal pits. Operational guidelines were not found in all assessed health centers. Nine out 70 (13%) interviewed healthcare workers had needle injuries during the last 12 months prior this study. Conclusion: The unit generation rate was relatively small in magnitude when compared with similar health facilities that are found in developing countries. The indiscriminate handling and disposal of biological wastes is a concern. [Ethiop. J. Health Dev. 2010;24(2):119-126

Prevalence and factors affecting work-related injury among workers engaged in Small and Medium-scale industries in Gondar wereda, North Gondor zone, Amhara Regional State, Ethiopia

No Abstract. The Ethiopian Journal of Health Development Vol. 21 (1) 2007: pp. 25-3

Assessment of the magnitude and associated factors of immunological failure among adult and adolescent HIV-infected patients in St. Luke and Tulubolo Hospital, Oromia Region, Ethiopia

Introduction: The use of antiretroviral therapy (ART) has become a standard of care for the treatment of HIV infection. However, cost and resistance to ART are major obstacles for access to treatment especially in resource-limited settings. In this study, we aimed to assess the magnitude and associated factors of Immunological failure among adult and adolescent HIV infected Patients (with age '15yrs) on Highly Active Antiretroviral Therapy (HAART) in St. Luke and Tulu Bolo Hospitals, Oromia Region, Ethiopia. Methods: A retrospective follow-up study was conducted among HIV-infected patients initiated 1st line ART at St. Luke and Tulu Bolo Hospitals, South West Shoa Zone, Oromia, Ethiopia. Results: A total of 828 patient charts were reviewed. 477(57.6%) were female and the median age was 32 years. The median baseline CD4 count was 148cells/mm3. The most common prescribed ART was TDF based (36.7%). Out of 828 patients chart reviewed 6.8% (56) were developed immunological failure. Out of them only 20 (2.4%) were detected and put on second line regimen. The incidence of immunological failure was 1.8 cases per 100 person years of follow-up. Patients who had not disclosed their HIV status to any one had high risk of immunological failure compared with patients those who had disclosed their HIV status (AHR, 0.429; 95% CI 0.206 - 0.893; P-value=0.024). Conclusion: Non disclosures of HIV status and with ambulatory of baseline functional status were found to be predictors of immunological failure. Most of the immunological failure cases were not detected early and not switched to second line ARV regimen. So patients with the above risk factors should be considered for a timely switch to second line HAART