Water Supply and Health: Drinking water and Sanitation Coverage in Ethiopia 1990 - 2015 Review

Background: Human health, incorporating physical, social and psychological well-being, depends on an adequate supply of potable water and a safe environment sections. Waterborne infections are one of the commonest problems in developing countries. Access to safe drinking water and basic sanitation needs will eliminate vast part of water-borne disease cases. Objectives: to assess the trends safe water coverage and sanitary conditions in Ethiopia together with the challenges of the sector. Methods: In depth literature survey from online published peer reviewed articles, publications from International organization and Ethiopia ministry of health was used to assess the trend and access of improved water and sanitation coverage since 1990 to 2015 in Ethiopia. Results: Among 93 articles, 45 of them have important information and included in the quantitative review. To this end Ethiopia has reached the Millennium Development goal of access to safe water and the national coverage reached to 68.5% and 33% for sanitation facilities. Ethiopia is not on the right track to reach for sanitation target (47%) of 2015. The development trend for water coverage and sanitation facilities shows that urban dwellers (16% of the population) are more benefited than the rural (84%) citizens. Poor access of sanitation and improved drinking water in rural part is resulted due to improper planning, malfunction water scheme utilities, and other factors. Conclusions: Despite, the efforts made to increase the access to safe drinking water and sanitation facilities to the population in the last 15 years; water related diseases are still one of the top ten diseases in the country. Protecting the source alone is not sufficient enough to reduce waterborne diseases unless point of use treatments and hygienic handling of water is practiced. Additional commitments and efforts are required post 2015 to assure the sustainability, access to the basic human right, water

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century