Hand hygiene practices during the COVID-19 pandemic and associated factors among barbers and beauty salon workers in Ethiopia.

Coronavirus disease-2019 (COVID-19) is still causing morbidity and mortality all over the world. Preventive measures such as wearing a facemask, social distancing and hand hygiene continue to be the only options available in countries such as Ethiopia where vaccines are not yet widely available. Hand hygiene is one of the easiest and cheapest preventive measures, and one that is especially important for barbers and beauty salon workers who are widely exposed to the virus due to their contact with many customers. Therefore, measuring the proportion of good hand hygiene practices and associated factors among barbers and beauty salon workers may provide essential guidance in the development of effective interventions to improve COVID-19 prevention measures. A facility-based cross-sectional study was conducted among 410 barbers and beauty salon workers in Dessie City and Kombolcha Town from January 5 to February 10, 2021. The study participants were selected using a simple random sampling technique. A structured questionnaire and an observational checklist were used to collect the data. The collected data were entered into EpiData version 4.6 and analysed using Statistical Package for Social Sciences (SPSS) version 25.0. Logistic regression analysis using bivariate and multivariable logistic regression models was employed. From the bivariate analysis, variables with p <0.25 were retained into multivariable logistic regression analysis. Finally, from the multivariable analysis, variables that had a p-value < 0.05 were declared as factors significantly associated with good hand hygiene practices. Of the total 410 barbers and beauty salon workers, 52.9% [95% CI: 48.3-57.6] had good hand hygiene practices whereas 47.1% [95% CI: 42.4-51.7] had poor hand hygiene practices. From the total respondents, more than half 250 (61%) were male and 160 (39%) were female, with a mean age of 27.42 ±7.37 years. Out of 410 barbers and beauty salon workers, 73.7% had good knowledge about COVID-19 and 59.5% had a positive attitude towards taking precautions against COVID-19. Female sex (AOR = 2.17, 95% CI:1.29-3.65), educational level of college or above (AOR = 5.53, 95% CI:2.85-10.71), positive attitude towards taking precautions against COVID-19 (AOR = 2.4, 95% CI:1.46-4.17), belief in the effectiveness of hand hygiene practices (AOR = 3.78, 95% CI:2.18-6.55) and presence of a hand-washing facility with soap and water (AOR = 5.55, 95% CI:3.28-9.40) were factors significantly associated with good hand hygiene practices among barbers and beauty salon workers. The proportion of good hand hygiene practice was not sufficient to combat the virus. Good hand hygiene practice was higher among those with higher educational level, positive attitude towards taking precautions against COVID-19, belief in the effectiveness of hand hygiene practices, presence of a hand-washing facility with soap and water and those of female sex. Thus, improving hand hygiene practices through continued training, especially for those with a lower educational level and for male workers, is recommended. Moreover, government and non-government organizations should work together to provide alcohol-based hand sanitizer at a low cost to those barbershops and beauty salons if there is no access to water and soap

Facemask wearing to prevent COVID-19 transmission and associated factors among taxi drivers in Dessie City and Kombolcha Town, Ethiopia.

BackgroundThe World Health Organization (WHO) has pointed out that urban taxi drivers and their passengers are at higher risk of transmitting coronavirus disease 19 (COVID-19) due to frequent contact among many people. Facemask wearing is one of the preventive measures recommended to control the transmission of the virus. A lack of evidence of the proportion of facemask wearing among taxi drivers and associated factors in Ethiopia, including Dessie City and Kombolcha Town, hinders the design of targeted interventions to advocate for facemask use. This study was designed to address this gap.MethodsA cross-sectional study was conducted among 417 taxi drivers in Dessie City and Kombolcha Town from July to August, 2020. The study participants were selected using a simple random sampling technique after proportionally allocating the sample size from the total number of taxi drivers working in Dessie City and Kombolcha Town. The data were collected by trained data collectors using a structured questionnaire and an on-the-spot observational checklist. The collected data were checked, coded and entered to EpiData version 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 25.0 for data cleaning and analysis. Bivariate (Crude Odds Ratio [COR]) and multivariable (Adjusted Odds Ratio [AOR]) logistic regression analyses were employed using 95% CI (confidence interval). From bivariate logistic regression analysis, variables with p-value Main findingsThe proportion of taxi drivers who wore a facemask was 54.68% [95%CI: 50.10-59.7%]. The majority (58.3%) of drivers were using cloth facemasks, followed by N95 facemasks (24.5%) and surgical facemasks (17.3%). Out of the total 417 taxi drivers, more than two-thirds (69.8%) of them had a good knowledge about COVID-19 and 67.6% of taxi drivers had a positive attitude towards taking precautions against transmission of COVID-19. Three-fourths (74.1%) of the taxi drivers believed that wearing a facemask could prevent COVID-19. More than half (52.5%) felt discomfort when wearing a facemask. Almost three-fourths (72.2%) of taxi drivers felt that the presence of local government pressure helped them to wear a facemask. We found that marital status [AOR = 3.14, 95%CI: 1.97-5.01], fear of the disease [AOR = 2.1, 95%CI: 1.28-3.47], belief in the effectiveness of a facemask [AOR = 5.6, 95%CI: 3.1-10.16] and feeling government pressure [AOR = 3.6, 95%CI: 2.16-6.13] were factors significantly associated with wearing a facemask.ConclusionWe found that the proportion of facemask wearers among taxi drivers was relatively low in Dessie City and Kombolcha Town. In order to increase that number, government bodies should work aggressively to encourage more taxi drivers to wear a facemask. We also recommend that government and non-government organizations work very closely together to implement strategies that promote facemask use, including increasing the availability of inexpensive facemasks, and monitoring and controlling facemask use

Access to and challenges in water, sanitation, and hygiene in healthcare facilities during the early phase of the COVID-19 pandemic in Ethiopia: A mixed-methods evaluation.

BackgroundInadequate water, sanitation, and hygiene (WASH) in healthcare facilities (HCFs) have an impact on the transmission of infectious diseases, including COVID-19 pandemic. But, there is limited data on the status of WASH facilities in the healthcare settings of Ethiopia. Therefore, this study aimed to assess WASH facilities and related challenges in the HCFs of Northeastern Ethiopia during the early phase of COVID-19 pandemic.MethodsAn institution-based cross-sectional study was conducted from July to August 2020. About 70 HCFs were selected using a simple random sampling technique. We used a mixed approach of qualitative and quantitative study. The quantitative data were collected by an interviewer-administered structured questionnaire and observational checklist, whereas the qualitative data were collected using a key-informant interview from the head of HCFs, janitors, and WASH coordinator of the HCFs. The quantitative data were entered in EpiData version 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 25.0 for data cleaning and analysis. The quantitative data on access to WASH facilities was reported using WHO ladder guidelines, which include no access, limited access, and basic access, whereas the qualitative data on challenges to WASH facilities were triangulated with the quantitative result.ResultsFrom the survey of 70 HCFs, three-fourths 53 (75.7%) were clinics, 12 (17.2%) were health centers, and 5 (7.1%) were hospitals. Most (88.6%) of the HCFs had basic access to water supply. The absence of a specific budget for WASH facilities, non-functional water pipes, the absence of water-quality monitoring systems, and frequent water interruptions were the major problems with water supply, which occurred primarily in clinics and health centers. Due to the absence of separate latrine designated for disabled people, none of the HCFs possessed basic sanitary facilities. Half (51.5%) of the HCFs had limited access to sanitation facilities. The major problems were the absence of separate latrines for healthcare workers and clients, as well as female and male staffs, an unbalanced number of functional latrines for the number of clients, non-functional latrines, poor cleanliness and misuse of the latrine. Less than a quarter of the HCFs 15 (21.4%) had basic access to handwashing facilities, while half 35 (50%) of the HCFs did not. The lack of functional handwashing facilities at expected sites and misuse of the facilities around the latrine, including theft of supplies by visitors, were the two most serious problems with hygiene facilities.ConclusionDespite the fact that the majority of HCFs had basic access to water, there were problems in their sanitation and handwashing facilities. The lack of physical infrastructure, poor quality of facilities, lack of separate budget to maintain WASH facilities, and inappropriate utilization of WASH facilities were the main problems in HCFs. Further investigation should be done to assess the enabling factors and constraints for the provision, use, and maintenance of WASH infrastructure at HCFs

Knowledge, attitude, and preventive practices towards COVID-19 and associated factors among adult hospital visitors in South Gondar Zone Hospitals, Northwest Ethiopia.

BackgroundCoronavirus disease 2019 (COVID-19) is currently the critical health problem of the globe, including Ethiopia. Visitors of healthcare facilities are the high-risk groups due to the presence of suspected and confirmed cases of COVID-19 in the healthcare setting. Increasing the knowledge, attitude, and practices towards COVID-19 prevention among hospital visitors are very important to prevent transmissions of the pandemic despite the lack of evidence remains a challenge in Ethiopia. Therefore, this study was designed to investigate the status of knowledge, attitude, and preventive practice towards COVID-19 and associated factors among hospital visitors in South Gondar Zone Hospitals, Northwest Ethiopia.MethodsA facility-based cross-sectional study design was employed during August 1 to 30, 2020 from randomly selected 404 adult hospital visitors in South Gondar Zone Hospitals, Northwest Ethiopia. The data was collected using interviewer-administered questionnaire. The outcome of this study was good or poor knowledge, positive or negative attitude and good or poor preventive practice towards COVID-19. Three different binary logistic regression models with 95% CI (Confidence interval) was used for data analysis. For each mode, bivariable analysis (crude odds ratio [COR]) and multivariable analysis (adjusted odds ratio [AOR]) was used during data analysis. From the bivariable analysis, variables with a p-value Main findingsAbout 69.3% of the respondents had good knowledge, 62.6% had a positive attitude, and 49.3% had good preventive practice towards the prevention of COVID-19. We found that factors significantly associated with good knowledge about COVID-19 were educational status who can read and write (AOR = 2.78; 95%CI: 1.18-6.56) and college and above (AOR = 6.15; 95%CI: 2.18-17.40), and use of social media (AOR = 2.96; 95%CI: 1.46-6.01). Furthermore, factors significantly associated with a positive attitude towards COVID-19 includes the presence of chronic illnesses (AOR = 5.00; 95%CI; 1.71-14.67), training on COVID-19 (AOR = 3.91; 95%CI: 1.96-7.70), and peer/family as a source of information (AOR = 2.45; 95%CI: 1.06-5.63). Being a student (AOR = 7.70; 95%CI: 1.15-15.86) and participants who had a good knowledge on COVID-19 (AOR = 4.49; 95%CI: 2.41-8.39) were factors significantly associated with good practice towards COVID-19.ConclusionWe found that knowledge, attitude, and preventive practices towards prevention of COVID-19 among adult hospital visitors were low. Therefore, we recommended that different intervention strategies for knowledge, attitude and preventive practices are urgently needed to control the transmission of COVID-19 among adult hospital visitors. Health education of those who could not read and write about COVID-19 knowledge issues and advocating use of social media that transmit messages about COVID-19 are highly encouraged to increase the good knowledge status of adult hospital visitors. Furthermore, providing training about COVID-19 prevention methods and using various sources of information about COVID-19 will help for improving positive attitude towards COVID-19 prevention, whereas for increasing the status of good preventive practices towards COVID-19, improving the good knowledge about COVID-19 of adult hospital visitors are essential

Menstrual hygiene practices among high school girls in urban areas in Northeastern Ethiopia: A neglected issue in water, sanitation, and hygiene research.

BackgroundPoor menstrual hygiene practices influence school girls' dignity, well-being and health, school-absenteeism, academic performance, and school dropout in developing countries. Despite this, menstrual hygienic practices are not well understood and have not received proper attention by school WASH programs. Therefore, this study examined the extent of good menstrual hygiene practices and associated factors among high school girls in Dessie City, Amhara Region, northeastern Ethiopia.MethodsA school-based cross-sectional study was employed to examine 546 randomly selected high school students in Dessie City, northeastern Ethiopia. Pretested interviewer-administered questionnaires and a school observational checklist were used for data collection. EpiData Version 4.6 and the Statistical Package for the Social Sciences Version 25.0 were used for data entry and analysis, respectively. Bivariate and multivariable logistics regression analyses were employed to identify factors associated with good menstrual hygiene practices. During bivariable analysis, variables with P-values less than 0.25 were retained for multivariable analysis. In the multivariable analysis, variables with a P-value less than 0.05 were declared to be significantly associated with good menstrual hygiene practices.ResultsOf the respondents, 53.9% (95% CI [49.6, 58.2]) reported good menstrual hygiene practices. The following factors were found to be significantly associated with good menstrual hygiene practices: age range 16-19 years (AOR = 1.93, 95% CI: [1.22-3.06]); school grade level 10 (AOR = 1.90, 95% CI: [1.18-3.07]); maternal education (primary) (AOR = 3.72, 95% CI: [1.81-7.63]), maternal education (secondary) (AOR = 8.54, 95% CI: [4.18-17.44]), maternal education (college) (AOR = 6.78, 95% CI: [3.28-14.02]) respectively]; having regular menses [AOR = 1.85, 95% CI: (1.03-3.32); good knowledge regarding menstruation (AOR = 2.02, 95% CI: [1.32-3.09]); discussing menstrual hygiene with friends (AOR = 1.79, 95% CI: [1.12-2.86]), and obtaining money for pads from the family (AOR = 2.08, 95% CI: [1.15-3.78]).ConclusionWe found that more than half of high school girls had good menstrual hygiene practices. Factors significantly associated with good menstrual hygiene practices include high school girls age 16-18 years, girls grade level 10, maternal education being completed primary, secondary and college level, having regular menses, good knowledge regarding menstruation, discussing menstrual hygiene with friends and obtaining money for pads from the family. Therefore, educating of high school student mothers about MHP should be a priority intervention area to eliminate the problem of menstrual hygiene among daughters. Furthermore, in order to improve the MHP among high school girls, further attention is needed to improving knowledge regarding menstruation among high school girls, encouraging high school girls' families to support their daughters by buying sanitary pads and promoting discussions among friends about menstrual hygiene. Schools need to focus on making the school environment conducive to managing menstrual hygiene by increasing awareness of safe MHP and providing adequate water/sanitation facilities

Water, sanitation, and hygiene conditions and prevalence of intestinal parasitosis among primary school children in Dessie City, Ethiopia.

BackgroundIntestinal parasitosis is a major public health problem that affects the health of primary school children in low- and middle-income countries where water, sanitation, and hygiene (WASH) conditions are deficient. Since there is a paucity of information on the prevalence and associated factors of this problem among primary school children in Dessie City in Ethiopia, this study was designed to address these gaps.MethodsA school-based cross-sectional study was conducted among 407 stratified-sampled primary school children in five primary schools at Dessie City from April to June 2018. Data were collected using a pretested structured questionnaire, an observation checklist and laboratory analysis of stool samples. Stool specimen from each study participant was collected using clean, properly labeled and leak-proof stool cup. A portion of stool from each study participant collected sample was processed using saline wet mount technique and examined by microscope. The remaining specimens were preserved with 10% formalin and transported to Dessie Comprehensive Specialized Hospital laboratory to be processed by using formol-ether concentration technique. Then, slide smears were prepared from each processed stool specimen and finally, it was microscopically examined with 10x as well as 40x objectives for the presence or absence of intestinal parasites. Factors significantly associated with intestinal parasitosis were determined using binary logistic regression model at 95% CI (confidence interval). Thus, bivariate (COR [crude odds ratio]) and multivariable (AOR [adjusted odds ratio]) logistic regression analyses were carried out. From the multivariable analysis, variables having a p-value of less than 0.05 were declared as factors significantly associated with intestinal parasitosis among primary school children.Main findingsThe overall prevalence of intestinal parasitosis was found to be 16.0% (95% CI: 12.5-19.4%), of these, 50.8% were positive for protozoa, 32.2% for helminth infections and 16.9% for double co-infections. Entamoeba histolytica was the most prevalent parasite (29.2%), followed by Giardia lamblia (21.5%), Ascaris lumbricoides (18.5%), Hymenolepis nana (9.2%) and Enterobius vermicularis (4.6%). Prevalence rates were similar among government (16.3%) and private (15.7%) school children. Water consumption was less than 5 liters per capita per day in 4 of the 5 schools. Thirty-eight (9.3%) of primary school students reported that they practiced open defecation. About two-thirds (285, 70.0%) said they always washed their hands after defecation. Mother's education (illiterate) (AOR = 3.3; 95% CI: 1.20-9.37), father's education (illiterate) (AOR = 3.9; 95% CI: 1.40-10.82), fathers who could read and write (AOR = 3.3; 95% CI: 1.25-7.86), handwashing before meal (sometimes) (AOR = 2.2; 95% CI: 1.11-4.17) and poor knowledge of WASH (AOR = 9.3; 95% CI: 2.17-16.70) were statistically associated with presence of intestinal parasitic infections.ConclusionWe concluded that the prevalence of intestinal parasitosis in the study area among Grades 4-8 primary school children had public health significance. Factors significantly associated with intestinal parasitosis among primary school children's were illiterate mothers and fathers, irregular handwashing of children before meals, and poor knowledge of WASH. Health education to improve students' WASH knowledge and mass deworming for parasites are recommended as preventive measures; and improvements to the quality of WASH facilities in primary schools are strongly recommended to support these measures