Environmental degradation and its severe impact on human health has revealed the necessity for effective educational interventions. Given the importance of “Environment,” “Health,” and “Education,” as key pillars for the achievement of sustainable development, the education for environmental health is evolving into a main component of current strategies against environmental health threats, such as climate change and urban air pollution. Environmental Health Education, which must be considered as a strategical response against environmental degradation, offers vast capacity for innovation alongside every educational stage. For instance, the application of new technologies, such as virtual and augmented reality applications, the adoption of innovative interdisciplinary educational approaches, and the incorporation of Arts are evolving into a new era’s educational perspectives. All the new trends in formal, non-formal and informal Environmental Health Education should be captured and assessed, in favor of protecting both local and global natural environment, human and animal health, and promoting sustainability.

No studies have investigated the cancer outcomes from high level medium duration coal mine fire fine particulate matter ⩽2.5 µm in diameter (PM_2.5) exposure. We included 2208 Morwell residents (exposed) and 646 Sale residents (unexposed) who participated in the Hazelwood Health Study Adult Survey. Competing risk regression models were used to evaluate relationships between coal mine fire exposure and cancer incidence, adjusting for known confounders. There were 137 cancers in the exposed and 27 in the unexposed over 14 849 person-years of follow-up. A higher risk of cancer incidence was observed for Morwell participants (HR = 1.67 [95% CI 1.05-2.67]), but no evidence to suggest associations between PM_2.5 exposure and incidence of all cancers (HR = 1.02 [95% CI 0.91-1.13]), or site-specific cancers. There is no strong evidence that exposure to high concentrations of mine fire-related PM_2.5 over a prolonged period could explain the higher risk in exposed population in this study.

INTRODUCTION: Household flooring has been associated with diarrhea, but few studies have examined the association between childhood diarrhea and type of household flooring considering the individual and community level characteristics. We aimed to determine if household flooring was associated with childhood diarrhea among children 0 to 23 months of age in Ethiopia.

METHODS: Data from the fourth round of the Ethiopian Demographic and Health Survey (EDHS) conducted in 2016 is used to carry out the analysis. The EDHS was large, cross-sectional by design and nationally representative. In the current analysis, we included children 0 to 23 months of age (n = 4552) with their mother and 636 community clusters. To get information about the occurrence of diarrhea, mothers/caregivers were asked, “Has (NAME) had diarrhea in the last 2 weeks?” The response to this question was recorded as, “yes” or “no.” A multilevel binary logistic regression model was fitted to identify factors associated with childhood diarrhea.

RESULTS: The overall prevalence of diarrhea among children 0 to 23 months of age in Ethiopia was 15.5% (95% CI [confidence interval] 14.4-16.5). No association was found between childhood diarrhea and type of household flooring (adjusted odds ratio [AOR] 1.05, 95% CI 0.59-1.88). The adjusted odds also showed that the age of the child, having an acute respiratory infection (ARI), and size of the child at birth were associated with diarrhea.

CONCLUSION: We found no association between childhood diarrhea and the type of household flooring. Further research with strong research design is needed to determine the effect of household flooring on childhood diarrhea.

BACKGROUND: Household water treatment practice or managing water at the point-of-use provides a means of improving drinking water quality and preventing diarrheal diseases. However, evidence regarding household water treatment practice and associated factors in Ethiopia, particularly in Southern Ethiopia are limited. This study was, therefore, designed to assess household water treatment practice and associated factors among households in Southern Ethiopia.

METHODS: A community-based cross-sectional study design was conducted among 627 households in Southern Ethiopia. A stratified random sampling technique was used in this study and a pre-tested structured questionnaire was used to collect data about household water treatment practice and associated factors among selected households through face-to-face interviews. The data were analyzed using descriptive statistical tests and binary logistic regression was performed to assess the association between independent and dependent variables. Odds ratio with 95% confidence intervals were used to determine the level of association.

RESULTS: This study revealed that the level of household water treatment practice was 34.3% with 95% CI (30.7-38.1) and boiling was the most common method of household water treatment in the study area. Educational status of having formal education (AOR = 2.01, 95% CI = 1.34-3), withdrawing water from storage vessel by dipping (AOR = 1.86, 95% CI = 1.2-2.87) and frequency of fetching water 3 or more times and above a day (AOR = 2.65, 95% CI = 1.45-4.88) were significantly associated with household water treatment practice.

CONCLUSION: Household water treatment practice is low in the study area. Educational status of having a formal education, drawing water by dipping, and those who collect their drinking water 3 or more times a day were predictors of household water treatment practice. Thus, efforts should be made to increase the level of household water treatment practice especially among those with no formal education and further studies should be conducted to understand the behavioral factors associated with household water treatment practice.

It is generally accepted that industrial wastewater like tannery effluent is high strength wastewater. The aim of this study was to examine the capacity of Vetiver grass for the treatment of high strength wastewater in a constructed wetland. Two constructed wetland beds were designed and one of them was not planted used as a control group. The grass was planted with 20 cm by 20 cm distance from each seedling. The biometric characteristics of Vetiver grass was evaluated by taking randomly selected clusters of the grass. The concentration of chromium in the extract of parts of the grass was determined by atomic absorption spectrophotometer. The Chromium bioaccumulation and Translocation factor was estimated. Composite samples before and after treatment of 4 different hydraulic retention time was collected. The physiochemical analysis of the wastewater has been carried out. The constructed wetland bed with Vetiver grass performed that, BOD, COD, NH₄-N, NO₃-N, TN, PO₄-P, and TP were reduced at the retention time of 9 days by 91.9%, 96.3%, 62%, 86%, 88.7%, 96.3%, and 92.2% respectively. Chromium was also reduced by 97% at retention time of both 7 and 9 days over the planted bed. The bed with plant performs significantly better than without plant at P-value <.01. Therefore, Vetiver grass has a capacity to reclaim high strength industrial wastewater in tropical areas.

BACKGROUND: A high percentage of the richest households in Bangladesh lack soap at their handwashing places, a problem that is typically considered to be one of the poor.

OBJECTIVE: We investigated toilet sharing practices, locations of water sources, and relevant sociodemographic factors associated with the observed handwashing places that lack soap in the richest (ninth wealth decile) households in Bangladesh.

METHODS: We used data from the 2017-18 Bangladesh Demographic and Health (BDHS) Survey.

Logistic regression technique was used to investigate how toilet sharing practices, water source locations, and different sociodemographic factors were associated with observed handwashing places without soap.

RESULTS: We found that 25.8% of the richest households were observed to have no soap at their handwashing places. Of these households, those that shared their toilets with another household were 4.6 times (95% CI 3.15-6.60) more likely to observe handwashing places without soap as compared with those that did not share their toilets. Further, the richest households were 4.2 times (95% CI 2.38-7.33) more likely to observe handwashing places without soap if they collected water from their own yard or plot, and 7.1 times (95% CI 3.61-13.97) more likely to observe handwashing places without soap if they collected water from elsewhere in comparison to the reference group that collected water from their own dwelling.

CONCLUSION: Sharing toilet with other households and location of main water source are associated with handwashing places without observed soap in the richest households in Bangladesh. These results can inform discussions of water availability and soap-handwashing-related policy and program development.

BACKGROUND: Maternal handwashing practice is an important measure to prevent the spreading of childhood disease. Handwashing is still being practiced to a very low extent especially at critical times since the global prevalence of handwashing with soap was estimated at 19% by a systematic review after compiling 42 studies all over the world.

OBJECTIVE: To assess the handwashing practice and its predictors among mothers of children aged 0 to 23 months in Mareka District, south Ethiopia, 2020.

METHOD: A community-based cross-sectional study was conducted with a multistage sampling technique on 520 women having children aged 0 to 23 months in Mareka District. Data were collected by using interviewer-administered pre-tested structured questionnaires. Data were checked for completeness and entered into Epi data entry 4.6.2. The data were exported into SPSS version 22 for analysis with multivariate logistic regression analysis at P < .05.

RESULT: Mothers wash their hands with soap and water after visiting the latrine (27.1%), after cleaning the child’s bottom (28.5%), before cooking (6.2%), before eating (6.9%), and before feeding the child (21.2%). The most important predictors were water availability near the handwashing location with an adjusted odds ratio (AOR) 5.26 (95% CI 1.99-13.69) and soap availability near the handwashing location with AOR 0.40 (95% CI 0.18-0.89) for good handwashing practice.

CONCLUSION: The handwashing practice at critical times was low. The presences of water and soap near the handwashing location were the most important predictors. It is necessary to increase the provision of both water and soap near the handwashing location for improving handwashing with soap and water at key times.

In Ethiopia, most of the coffee processing plants are generating large amounts of wastewater with high pollutant concentrations and discharge directly into the water bodies untreated or partially treated. The main objective of this study was to assess the effects of coffee wastewater discharged to river water quality using physicochemical parameters and macro-invertebrate indices. This study was conducted from November to the end of December 2019. Ten wastewater and river water samples were taken from coffee the processing plant and river. The macro-invertebrate samples were collected by kick sampling technique using a standard hand net. Shannon and Simpson diversity indices were examined at 3 sampling stations. The Pielou evenness index was also determined. It was found that except for TDS all the parameters of the raw wastewater and river water did not comply with the international discharge limit. The mean concentration of Faro coffee processing plant wastewater were BOD₅ (2409.6 ± 173.1 mg/L), COD (4302 ± 437 mg/L), TSS (2824.6 ± 428.4 mg/L), TDS (3226 ± 623.6 mg/L), and TS (4183.3 ± 432.9 mg/L). Whereas from Bokaso coffee processing plant were BOD₅ (3770 ± 604.4 mg/L), COD (4082.6 ± 921.9 mg/L), TSS (2766 ± 501.7 mg/L), TDS (3017 ± 747.6 mg/L), and TS (3874 ± 471.1 mg/L). A total of 392 macroinvertebrates belonging to 24 families and 7 orders were collected. The benthos assemblage communities in this river were 40, 56, and 296 at downstream 1, downstream 2, and upstream respectively. The value of the Simpson diversity index varies from 0.4 to 0.75. In the same manner, the value of the Shannon diversity index also varied from 0.5 to 1.36. Most of the physicochemical parameters of the raw wastewater were beyond the national and international discharge limits. The quality of Orsha river water downstream was more adversely affected compared to upstream.

BACKGROUND: Food-borne diseases represent a widespread and growing public health problem, both in developed and developing countries. However, this problem has more impact on health and economy in developing countries than in developed countries but reliable data is not available.

METHODS: A cross-sectional study was done in 2019 at Debarq town, Amhara region, Northwest Ethiopia. A questionnaire prepared in English after adapted from previous studies then translated in to local language Amharic was used in order to collect the data. Data were checked manually for completeness, coded, and entered in to Epi Info version 7.1 and then exported in to SPSS version 26 statistical package for analyze. Descriptive statistics, percentage, frequency, standard deviation, and mean were analyzed. Likewise, bivariable and multivariable binary logistic regression analysis were done to know the relationship between the independent variables and attitude of food safety among mothers. The variables found having a P-value <.2 in the bivariable analysis were further analyzed in multivariable binary logistic regression. The variables with P-value <.05 were considered as significantly associated with food safety attitude of mothers.

RESULTS: About 423 mothers of under-5 children were involved in this study. The mean age of the participants was 39.844 ± 11.02. In this study, educational status (primary education (Adjusted Odds Ratio [AOR]: 2.66; 95% Confidence Interval [CI] [1.42-4.97]), secondary education (AOR: 2.66; 95% CI [3.35-14.05]), and diploma and above (AOR: 4.07; 95% CI [1.65-10.06])), higher income (AOR: 3.58; 95% CI [1.54-8.29]), good food safety knowledge (AOR: 3.08; 95% CI [1.51-6.242]) and good food hygiene practice (AOR: 3.97; 95% CI [2.33-6.75]) were factors associated with food safety attitude in the current study.

CONCLUSION: Significant proportion of participants in the study area had poor food safety attitude. Educational status, income, food safety knowledge, and food safety practice were significantly associated with food safety attitude among mothers. Food hygiene practice, knowledge, and level of education should be increased in order to improve food safety attitudes among mothers who were responsible in food processing at household level.

BACKGROUND: Despite the fact that Iran has been exposed to severe dust storms during the past 2 decades, few studies have investigated the health effects of these events in Iran. This study was conducted to assess the association between dust storms and daily non-accidental, cardiovascular, and respiratory mortality in Dezful City (Khuzestan Province, Iran) during 2014 to 2019.

METHODS: In this study, mortality, meteorological, and climatological data were obtained from the Dezful University of Medical Sciences, Iranian Meteorological Organization, and Department of Environment in Khuzestan Province, respectively. Days of dust storm were identified based on the daily concentration threshold of particulate matter with an aerodynamic diameter of less than 10 µm (PM₁₀) according to Hoffmanns҆ definition, and then an ecological time-series was used to estimate the short-term effects of dust storms on daily mortality. Statistical analysis was performed using a distributed lag linear model (DLM) and a distributed lag non-linear model (DLNM) packages by R software and the study results were reported as excess mortality.

RESULTS: During the study period, 15 223 deaths were recorded, and 139 dust storms occurred in Dezful city. In addition, there was statistically significant excess risk of mortality due to dust storms in Dezful City (mortality in the group under 15 years of age, lag₄: 34.17% and 15-64 years of age groups, lag₅: 32.19%, lag₆: 3.28%), also dust storms had statistically significant effects on respiratory mortality (lag₆: 5.49%).

CONCLUSION: The findings of the current study indicate that dust storms increase the risk of mortality with some lags. An evidence-based early warning system may be able to aware the people of the health effects of dust storms.

Solid waste disposal is one of the challenging components in integrated solid waste management. Particularly the problem is prominent in cities with rapid population growth and waste generation. Harar, a capital city of Harari regional state located in the eastern part of Ethiopia, covers an area of 19.5 km² and has a total population of 270 000. Despite the fastest population growth of the city, it doesn’t have a landfill site to accommodate the waste generated and open dumping is in full practice. As an integral part of a solid waste management plan, the construction of a landfill has been suggested by the city municipality. However, the multi-dimensional and conflicting aspect of landfill sitting, which involves environmental, social, technical, and economic considerations, challenges the location of a suitable landfill site. In the current study, we have applied geographic information system (GIS) and analytical hierarchy process (AHP) multi-criteria decision analysis to select a landfill site through minimizing conflicting interests. Environmental and socio-economic factors including well water, distance from residence, land use and land cover, elevation, slope, and wind direction were weighted to develop a suitability index for landfill siting. Experts’ opinion was obtained to rank the aforementioned factors. The required landfill size was determined based on population growth, waste generation rate, and waste volume/year. Accordingly, the suitability index resulted in 3% of the area as highly suitable, and the rest 0.29%, 14.18%, 52.75%, and 29.8% classified as unsuitable, least suitable, moderately suitable, and suitable, respectively. Considering the future trend of waste generation, 16 ha of land located in the eastern part of the city was selected as a candidate landfill site with all the required suitability. The results of this study can be used as an input for decision making in siting landfill for Harar city.

Olive Mill Solid Residue (OMSR) can be utilized as a bio-sorbent in wastewater treatment. Even though several studies on OMSR as a bio-sorbent were carried out, there is still a need to investigate a simple and relatively inexpensive OMSR treatment that increases pollutant removal. In this study; OMSR is used in batch experiments to remove toxic heavy metals from aqueous solutions including Cd²⁺, Cu²⁺, and Pb²⁺ ions. The effect of OMSR treatment (untreated; OMSR-U, treated with n-hexane; OMSR-H, and treated with water; OMSR-W) was investigated by chemical oxygen demand and cation exchange capacity. It was confirmed by both tests that OMSR-W was the best treatment. The same result was re-confirmed by batch uptake experiments of the heavy metal ions. Using OMSR-W as a bio-sorbent; the effect of several parameters such as pH, contact time, bio-sorbent concentration, metal ions concentration, and the presence of other metal species were studied to figure their influence on the metal ions uptake. The optimum conditions for single metal systems were found to occur at pH 5.5, an initial metal concentration of 50 mg/L, a shaking time of 60 minutes, a bio-sorbent concentration of 20 g/L. In binary metal ions solutions; Cd²⁺ uptake was increased in presence of Cu²⁺ or Pb²⁺. However, the uptake of Cu²⁺ and Pb²⁺ was decreased in presence of other metals. The equilibrium sorption data for single metal systems were described by the Langmuir isotherm model. The highest value of maximum uptake was found for Pb²⁺ (4.587 mg/g) followed by Cd²⁺ (4.525 mg/g) and Cu²⁺ (4.367 mg/g). These results show that OMSR-W, which has a very low economical value, could be used for the treatment of wastewater contaminated with heavy metals.

BACKGROUND: Diarrhea is one of the health problems contributing to Nigeria’s under-5 mortality rate, ranked as the eighth highest globally. As our search is concerned, there is limited evidence on the spatial distribution of childhood diarrhea in Nigeria. Therefore, this study aimed to examine the spatial distribution and predictors of diarrhea among under-5 children in Nigeria.

MATERIALS AND METHODS: Using data from the child’s recode file of the 2018 Nigeria Demographic and Health Survey, a sample of 28 583 children of women of reproductive age was considered as the sample size for this study. The outcome variable used in this study was childhood diarrhea. We employed both multilevel and spatial analyses to ascertain the factors associated with childhood diarrhea as well as its spatial clustering.

RESULTS: The regional distribution of the prevalence of diarrhea among children in Nigeria ranged from 0% to 62%. The hotspots for childhood diarrhea were in Yobe, Bauchi, Gombe, Kano, Sokoto, Imo, and Taraba. The likelihood of a child having diarrhea in Nigeria was higher among women whose partners have secondary education and above [aOR = 1.18; 95%CI = 1.05-1.33], women currently working [aOR = 1.24; 95%CI = 1.13-1.35], women practicing Islam [aOR = 1.24; 95%CI = 1.04-1.46], and women who were exposed to mass media [aOR = 1.29; 95%CI = 1.18-1.42], compared to women whose partners had no formal education, women not currently working, women practicing Christianity, and those who were not exposed to mass media. Children born to mothers who reside in North East [aOR = 2.55; 95%CI = 2.10-3.10], and communities with medium socioeconomic status [aOR = 1.44; 95%CI = 1.09-1.91] were more likely to experience diarrhea compared to those born to mothers residing in the North Central and in communities with low socioeconomic status.

CONCLUSION: High proportions of childhood diarrhea among under-5 children in Nigeria were located in Yobe, Bauchi, Gombe, Kano, Sokoto, Imo, and Taraba. Policies and interventions that seek to reduce or eliminate diarrhea diseases among under-5 children in Nigeria should take a keen interest in the factors identified as predictors of childhood diarrhea in this study as this will help in achieving the aims of WASH, ORT corners, and SDG 3 by the year 2030.

BACKGROUND: Long-term consumption of water containing an excessive amount of fluoride causes dental and skeletal fluorosis. De-fluoridation options differ in terms of scale, efficacy, long-term viability, and user acceptance. Therefore, this study aimed to identify the challenges of using fluoride-filtered water and its associated factors among households.

METHODS: A cross-sectional study was conducted from April to May, 2018 among 405 randomly selected households in Dugda Woreda of Ethiopia Rift Valley East Shewa Zone, Oromia Region. A structured interviewer-administered questionnaire was used to collect the data. SPSS version 20 was used to enter and analyze the collected data. Logistic regression analysis was used to identify association between dependent and independent factors and explained by odds ratio with 95%CI.

RESULTS: A total of 228 (56.3%) households were found to utilize fluoride filtered water from community water supply schemes for drinking and cooking purposes. No family history of fluorosis (AOR = 44.4, 95%CI: 18.8, 104.74), monthly income of less than 1000 ETB (AOR = 0.03, 95%CI: 0.004, 0.23), good knowledge of community fluoride filter schemes (AOR = 5.93, 95%CI: 1.30, 26.9), and not afford to pay bill of ⩾0.50 ETB [AOR = 0.4, 95%CI: 0.20, 0.91] were factors significantly associated with utilization of community-level fluoride-filtered water.

CONCLUSION: In this study, more than half of the households used fluoride filtered water. Family monthly income, affordability, presence of family members with the history of fluoride exposure, and knowledge about community fluoride filter schemes were factors significantly associated with utilization of community-level fluoride-filtered water.

This paper applies an organizational learning framework to explore attitudes towards failure in the water, sanitation and hygiene (WASH) development sector. It draws on 35 key-informant interviews, contextualized by organizational theory and existing scholarship on failure in development, to understand the challenges faced by WASH practitioners in identifying failure, analyzing failure, and deliberate experimentation. Through interrogating past and present initiatives for publicizing failure in development, this paper digs deeper into the successes, obstacles, and lessons learnt from mainstreaming failure into organizational practices. It then synthesizes these findings to advance a 3-tier conceptual map for organizations to build an enabling environment for learning from failure in development.

BACKGROUND: The presence of agricultural pesticide residue can cause adverse health effects.The main objective of this study was to evaluate the level of pesticides in the blood of small-scale farmers (SSFs) and associated risk factors in western Ethiopia.

METHODS: Across sectional study was conducted in June 2020 using 240 blood samples, 140 from the exposed small-scale farmers (ESSFs) and 100 from non-exposed small-scale farmers (NESSFs). The blood sample analysis was mad for 5 organochlorines (OCs) and 3 synthetic pyrethroids (SPs) pesticides by gas-liquid chromatography with an electron capture detector (GC-ECD) methods. Extraction, and clean up of the samples were made by using standard analytical methods. To define the relationships between the outcomes and explanatory variables, logistic regression models were used.

RESULTS: The results shows that p,p’-DDT, heptachlor and deltamethrin were the most frequently detected pesticides with 96.4%, 95%, and 100% in both ESSFs and NESSFs, respectively. The ESSFs blood samples have shown the highest mean concentrations of permethrin and p,p'-DDT(1.26 ± 0.15) and (0.28 ± 0.4) mgL⁻¹, respectively. SSFs under the age of 40 were 21% less likely to be exposed to permethrin than those above the age of 40 (Adjusted Odd Ratio, AOR, 0.21; 95% CI: 0.1-0.44). Male SSFs were 17 times more likely to be exposed to heptachlor than females (AOR, 17.36; 95%CI: 7.34-41.09) and farmers with no formal education were 18 times more likely to be exposed to deltamethrin than those with primary schools and beyond (AOR, 18.1; 95 %CI: 4.53-72.06). Furthermore, SSFs that did not use PPE appropriately were 3.6 and 6.21 times more likely to be exposed to cypermethrin (AOR, 3.6; 95%CI: 1.94-6.54) and p,p'-DDE(AOR, 6.21; 95%CI: 3.38-11.41) blood levels than those who did, respectively. SSFs that perform different activities like eating and drinking (11%), chewing (10%), and diverse activities (8%) were more likely to be exposed to p,p′-DDT than those farmers who didn’t use pesticides.

CONCLUSIONS: This study identified a high concentration p,p'-DDE, p,p'-DDT, heptachlor, cypermethrin, permethrin, and deltamethrin in the blood of small scale farmers. The older age, less education, and farmers with inappropriate PPE use are more likely exposed to pesticides.

BACKGROUND: Meat safety is important for public health. As part of the meat chain abattoirs are required to give attention to meat hygiene and safety in order to minimize hazards. Therefore, the current study was conducted to evaluate the bacteriological quality of sheep carcasses, knowledge and hygienic practices of workers in a selected abattoir and to determine the effect level of 2.5% citric acid spray on total coliforms and aerobic bacteria load of raw sheep carcasses surfaces.

METHODS: A cross-sectional study design with structured questionnaire and observational checklists observation were used. A systematic random sampling technique was employed. A total of 50 sample swabs (25 swabs before citric acid spray and 25 after citric acid spray) were randomly taken from brisket, flank and rump of sheep’s carcasses. Swabs were moistened with buffered peptone water (BPW) and samples were taken by rubbing 100 cm² (10 cm × 10 cm) area delineated by sterile aluminum template. In addition, we administered a structured questionnaire and an observational checklists to assess knowledge and hygienic practices of workers. Bacteriological quality of sheep carcasses were analyzed using the methods described by the US bacteriological analytical manual.

RESULTS: The mean count for aerobic bacteria of the sheep carcasses before and after citric acid spray were 7.2log₁₀ CFU/ml and 6.4log₁₀ CFU/ml, respectively. The test results also showed that 21 (84%) and 15 (60%) of the swab samples were positive before and after spraying citric acid, respectively. The mean counts for coliform bacterial of the sheep carcasses before and after citric acid spray were 3.5log₁₀ CFU/ml and 2.9log₁₀ CFU/ml, respectively. The mean total aerobic and coliform counts before and after citric acid spray were significantly different (P < .05). Regarding the hygiene condition of workers, all the respondents reported that they always washed their hands with soap before and after entering the slaughtering room and 23 (53.5%) of the workers reported that they used hot water. Thirty-one (72.1%) of the workers reported that they do not used soap to wash hands after visiting toilet. Thirty-five (81.4%) of the production workers did not wear mouth mask while handling and distribute meat/carcass. On the other hand, all of the workers wore capes, gowns and boots at the time of the observation and only 18 (18.6%) of the production workers wore gloves at the time of the survey.

CONCLUSION: The current study revealed that significant proportion of sheep carcasses were positive for total aerobic bacteria and total coliform. Moreover, the study also showed that spraying of sheep carcasses with 2.5% citric acid significantly reduced the total coliform and aerobic counts. However, we did not assessed how much spray results to this effect. Therefore, we recommended further studies to determine how much spray of 2.5% citric acid significantly reduce bacterial contamination of sheep carcasses. In addition, the abattoir has to follow the food hazard analysis critical control point (HACCP) system to minimize meat contamination during harvesting and processing. The abattoir has to also implement strict operation laws to improve hygiene conditions of the workers. In addition, the abattoir can minimize meat contamination using 2.5% citric acid as a decontaminant.

The occurrence of several disinfectant byproducts has been investigated in swimming pools. Until now, there are only a few studies on nitrosamine, particularly N-nitrosodimethylamine in swimming pool water. This could be due to the lack of a suitable method that is sensitive enough for the measurement of N-nitrosodimethylamine in pool waters. Other disinfectant byproducts formed in pool water widely documented are trihalomethanes, haloacetic acids, halonitromethanes, and chloramines but inadequate information on N-nitrosodimethylamine. This paper provides a review of the nitrogenous disinfectant byproduct in swimming pools and its health implications. Anthropogenic substances introduced by swimmers such as sweat, lotions, and urine contribute to the formation of N-nitrosodimethylamine. The reaction of secondary amines such as dimethylamine with mono/dichloroamines produced dimethyl hydrazine and further undergo oxidation to form N-nitrosodimethylamine. The reaction of chlorine and other disinfectants with these anthropogenic sources in swimming pools cause cancer and asthma in human tissues. Thus, the assessment of N-nitrosodimethylamine in the swimming pool is less well documented. Therefore, the health consequences, mutagenic, and genotoxic potentials of N-nitrosodimethylamine should be the focus of more research studies.

BACKGROUND: In order to protect public health during the outbreaks of infectious diseases including the pandemic COVID-19, provision of Water, Sanitation, and Hygiene (WASH) services is important. The challenges of inaccessible WASH services along with the pandemic COVID-19 in low-income countries can lead to a devastating problem.

METHOD: A systematic search of published articles was identified using PubMed, Web of Science, and Google Scholar, on relevant studies of COVID-19 and WASH services. Published articles were identified using abstracts and titles of the articles, followed by assessed for eligibility, and screening of the full text reports of relevant studies.

RESULTS: Electronic database search identified 798 articles from which 28 full text articles were included in the systematic review. A lack of access to WASH services in households, schools, health care facilities, and other public spaces were the main identified COVID-19 related public health risks. A lack of adequate data and financial shortages were the challenges for mitigating the problems of COVI-19 and WASH services.

CONCLUSION: This systematical review identified the impacts and challenges of COVID-19 in the provision of WASH services. The results implied that COVID-19 has significant impacts on WASH services that can affect the health of the public. Therefore, strengthening and ensuring access to WASH services are important for preventing COVID-19 and realizing human rights. Community engagement also can be used to support for prevention and control of COVID-19. Countries need to be expand their investment in WASH services as an important mechanism for mitigating COVID-19.

BACKGROUND: Occupational skin diseases are the second leading occupational disease, accounting for almost 25% of all missed workdays. Occupational contact dermatitis (OCD) accounts for 70% to 90% of all skin disorders in the workplace. Only a few occupational epidemiology studies have looked into the prevalence and risk factors of occupation-induced dermatitis among narcotic crop farm workers around the world. Related studies in Ethiopia are even fewer.

METHODS: A cross-sectional survey was conducted in the Dirashe district of Southern Ethiopia from March 23 to April 12, 2021. Data was collected using a standardized interviewer-administered questionnaire. The history of contact dermatitis was determined using the standardized Nordic Occupational Skin Questionnaire version 2002 (NOSQ-2002). A total of 578 farm laborers took part in the study, which was conducted using a systematic random sampling. Descriptive statistics and multivariable regression were used to characterize the data and identify factors associated with occupational contact dermatitis.

RESULT: The prevalence of self-reported occupational contact dermatitis in the past 12 months among workers of large-scale Khat farms was (AOR: 67.80%, 95% CI [61.00, 76.23]). In the multivariable regression, being older (AOR: 5.51, 95% CI [1.79, 7.24]), working as a bundle binder (AOR: 5.74, 95% CI [2.12, 15.55]), not wearing personal protective equipment (PPE) (AOR: 2.50, 95% CI [1.64, 3.81]), and having poor knowledge of pesticides use, storage, and disposal methods (AOR: 2.50, 95% CI [1.64, 3.81]) were associated with occupational contact dermatitis.

CONCLUSION: Contact dermatitis caused by work is very common among Khat farm laborers. Measures to promote safe practices and reduce exposure to hazards, such as removing expired and/or banned chemicals, purchasing alternative pesticides that meet legislative requirements, job rotation and routine training of staff on safe practices, increasing safety signage, and performing risk assessments, as well as improving the quantity and quality of institutional protective equipment supplies may thus contribute to the enhancement of safe work practices.

BACKGROUND: Understanding of healthcare utilisation during foodborne illness is vital for public health practice, and healthcare planning. Present study aims to identify patterns and determinants of healthcare-seeking behaviour in response to foodborne illness among students of Saudi Arabia.

METHODS: A cross-sectional survey was conducted among 252 students of Saudi Electronic University located in four major cities (Riyadh, Abha, Dammam and Jeddah) of Saudi Arabia. Study participants were students who reported a foodborne illness within 1 month prior to the survey. A multivariate logistic regression models were used to analyse association of healthcare-seeking behaviour with knowledge and attitude about food poisoning of participants.

RESULTS: Of the 252 participants who experienced foodborne illness symptoms, 69.8% visited doctor for seeking care, while 7.5% visited pharmacy, 9.1% got treated by the family and peers and 13.4% did not do anything. Healthcare-seeking behaviour of participant showed association with knowledge of the cause of food poisoning (AOR: 1.98; 95% CI 1.04-3.78, P = .036); and attitude of participant that food poisoning illnesses is a serious health problem and may lead to death (AOR: 2.15; 95% CI 1.33-2.71, P = .014).

CONCLUSIONS: In this study, majority of the participants used healthcare for treatment during the food poisoning episode, and healthcare-seeking behaviour depended on perceived severity of the disease consequences. Knowledge on food poisoning was found to be an important determinant in utilisation of healthcare services. Health promotion and educational programmes are recommended to further increase the healthcare utilisation for foodborne illness.

BACKGROUND: Globally, Africa is one of the continents that uses the lowest quantity of agrochemicals in farming. However, unsafe chemical use practices are high among farmers in Africa, posing serious health and environmental consequences. This study seeks to address three questions: (1) What factors motivate/compel smallholder farmers in Ghana to use agrochemicals? (2) What safety precautions or unsafe chemical use practices can be found in the communities? (3) What are the health implications of agrochemical use among smallholder farmers in Ghana?

METHODOLOGY: The study used purposive and simple random sampling techniques to select 136 individuals for the survey, out of which 31 individuals were eliminated, and 105 participants were selected for in-depth interviews and focus group discussions. Additionally, participants’ observations were collected, workshops were facilitated, and documents analyses were conducted. Qualitative data were analyzed using NVivo software and the quantitative data were analyzed using SPSS version 23.0.

FINDINGS: The study found that environmental challenges, activities of NGOs, government policy, lack of or high cost of labor, and competition among farmers were major factors influencing farmers’ decisions to use agrochemicals. Present agrochemical use in Ghana poses a risk to health and the environment. Finally, the study discovered chemical poisoning and low self-reported health quality as major health implications of agrochemical use in the communities.

BACKGROUND: Human illnesses caused by parasites, viruses, and bacteria that are transmitted by vectors are called vector-borne diseases. Vector-borne diseases usually affect the poorest populations, particularly where there is a lack of access to adequate housing, safe drinking water, and sanitation. This community-based cross-sectional study was, conducted to assess the prevalence of self-reported vector-borne diseases and associated factors in the rural communities of northwest Ethiopia.

METHODS: A community-based cross-sectional study design with structured observation was conducted among 1191 randomly selected rural households in northwest Ethiopia from April to June 2017. Data were collected by using a structured questionnaire; and observation checklist. Multivariable binary logistic regression analysis was used to identify variables associated with the prevalence of self-reported vector-borne diseases on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and P-values <.05.

RESULTS: In the current study, 216 (18.1%) of the rural households reported one or more vector-borne diseases. Scabies (9.5%) were the most reported vector-borne disease followed by Malaria (6.9%). The prevalence of self-reported vector-borne diseases was statistically associated with the head of the family (mother) (AOR = 0.13, 95% CI = 0.02-0.72), regular cleaning of the living environment (AOR = 0.51, 95% CI = 0.36-0.74), poor cleanness of the living rooms (AOR = 1.77, 95% CI = 1.03-3.03), and moderate cleanness of the floor (AOR = 1.64, 95% CI = 1.06-2.52).

CONCLUSION: The prevalence of self-reported vector-borne diseases was high in the rural communities of northwest Ethiopia. The low prevalence was associated with family head; regular cleaning of living environment and cleanness of the floor. Designing and strengthening an intervention strategy for environmental sanitation, regular cleaning of living house, and keeping personal hygiene shall be considered.

BACKGROUND: Ectoparasites are organisms which inhabit the skin or outgrowths of the skin of another organism (the host). Many ectoparasites are known to be vectors of pathogens, which the parasites typically transmit to hosts. Though, ectoparasites are common in the vulnerable groups and economically disadvantaged communities, there is limited evidence on its magnitude in Ethiopia. This community-based cross-sectional study was, therefore, conducted to assess the prevalence and associated factors of ectoparasites in the rural communities of northwest Ethiopia.

METHODS: A community-based cross-sectional study design with structured observation was conducted among 1191 randomly selected rural households in northwest Ethiopia in May 2016. Data were collected using structured interviewer administered interview questionnaire and structured observation checklist. Prevalence of human ectoparasites in the rural communities was defined as the presence of one or more lice, fleas, bed bugs, mites, and ticks and the presence of these ectoparasites were observed by trained environmental health experts. Multivariable binary logistic regression analysis was used to identify variables associated with prevalence of ectoparasites on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and P values <.05.

RESULTS: Of a total of 1191 rural households, human or hair lice were observed in one or more of the family members in 186 (15.6%) rural households. Similarly, fleas were observed in more than half, 609 (51.1%) of rural households and bed bugs were observed in 441 (37%) rural households. Furthermore, mites and ticks were reported in 113 (9.5%) and 130 (10.9%) of the households respectively. Accordingly, one or more ectoparasites were observed in 865 of 1191 rural households. The presence of one or more ectoparasites was, therefore, found to be 72.6% (95% CI = 70%-75.1%). The prevalence of ectoparasites was statistically associated with educational status of the female head being not educated (AOR = 1.476, 95% CI = 1.001, 2.177) and absence close supervision by health extension workers (AOR = 2.151, 95% CI = 1.205, 3.843).

CONCLUSION: The prevalence of one or more ectoparasites was high in the rural communities of northwest Ethiopia. The high prevalence was associated with education status of the female head and close supervision of households by health extension workers. Disseminating health information about intervention strategies of ectoparasites and closely supervising the rural households need to be considered.

BACKGROUND: Providing safe and adequate Water, Sanitation and Hygiene (WASH) services in response to emergencies is a major problem. Globally, few studies have investigated the bacteriological quality of drinking water at the IDP sites. Therefore, the objective of this study was to evaluate the bacteriological quality of drinking water and associated factors at the IDP sites of Gedeo zone.

METHODS: A cross-sectional study was conducted on 213 water samples collected from November to December 2018. The membrane filter technique was used to retain bacteria and lauryl sulphate broth media was used to detect faecal coliforms. After incubation of 14 hours at 44°C, faecal coliforms with yellow colonies were counted and expressed in terms of CFU/100 ml of water. The data were entered into Epi data version 3.1 and exported to STATA version 14 for analysis. Binary logistic regression analysis with 95%CI and P ⩽ .05 was used to identify factors associated with an outcome variable.

RESULTS: Out of 213 water samples collected, 107 (50.2%) samples were tested positive for faecal coliforms. The presence of latrines in uphill (AOR: 6.7, 95%CI: 1.0-42.9), other sources of pollution (AOR: 5.0, 95%CI: 1.1-22.3), inadequate fencing (AOR: 7.1, 95%CI: 1.3-40.2) and lack of diversion ditch (AOR: 6.3, 95%CI: 1.0-37.6) were factors significantly associated with faecal contamination of springs. Dug wells that had a latrine within 10 m (AOR: 11.4, 95%CI: 1.8-72.1), other pollution sources within 10 m (AOR: 7.9, 95%CI: 1.9-32.4), inadequate fencing (AOR: 2.8, 95%CI: 1.0-7.9), drawing water using a bucket with rope (AOR: 7.3, 95%CI: 1.6-33.4) and unsanitary well cover (AOR: 3.4, 95%CI: 1.1-10.4) were factors significantly associated with faecal contamination of wells.

CONCLUSIONS: The majority of the water sources in internally displaced people sites were tested positive for faecal coliforms. The presence of latrine in uphill, other sources of pollution, inadequate fencing, lack of diversion ditch, drawing water using a bucket with rope and unsanitary well cover were factors associated with the presence of faecal coliforms. Therefore, adequate fencing, proper diversion ditch construction and hygiene promotion should be done to protect water sources from faecal contamination. Furthermore, latrines and other point sources of contamination should be located at least 10 m away or at a lower elevation from water sources.

ObjectiveThe aim of this study was to assess the chemical and physical work conditions in hair salons and to analyze health risk of exposure to VOCs for the hairdressers of hair salons. Methods: This study was carried out at 4 selected hair salons close to universities in Surat Thani province, Thailand. VOCs were collected by area sampling using charcoal tubes (9 samples per salon). The air samples were analyzed using GC/FID. The noise levels, illumination, and temperature were measured by using sound level meter, lux meter, and WBGT, respectively. Results: Toluene, cyclohexanone, xylene, and hexane were the most frequently found across the hair salons. All of the VOCs concentration was highest in the mixing area. All of hair salons had cancer risk exceeding 1 × 10⁻⁶ and HI > 1.0, indicating that indoor air pollution may affect hairdresser’s health. The average VOCs concentrations after installation of local exhaust ventilation and open the door for 30 minutes before closing the hair salon, was significantly lower than before and after installation of the local exhaust ventilation. The WBGT indoors varied within 22 to 28°C, sound pressure levels within 71 to 76 dBA, and illumination within 70 to 400 lux. The noise levels and temperature in the hair salons were satisfactory on the scale of the Ministry of Labor (Thailand). Conclusions:Installing and using proper ventilation in hair salon are recommended to eliminate health effects. Hairdresser worked in poor lighting that should be improved to appropriate levels (>1000 lux).

BACKGROUND:Determinants of childhood diarrhea in households with improved WASH (ie, households with improved drinking water sources, improved sanitation facilities, and those who practiced safe child stool disposal) are limited. This study aimed to identify the determinants of diarrhea among under-five children exclusively in households with improved Water, Sanitation, and Hygiene (WASH).

METHODS: A repeated cross-sectional study design was followed, and data from the Demographic and Health Survey (DHS) conducted between 2005 and 2016 in Ethiopia was used. A total of 1,975 child-mother pairs (257 children with diarrhea and 1718 children without diarrhea) in households with improved WASH were included in this study. Hierarchical conditional logistic regression models were used. Adjusted odds ratios (AOR) with corresponding 95% confidence intervals (CI) were estimated to determine the strength of association.

RESULTS: Children aged 13 to 24 months (Adjusted Odds Ratio [AOR] = 2.70, 95%CI: 1.69-4.32), children who did not receive the measles vaccine (AOR = 2.33, 95%CI: 1.60-3.39), and those residing in the agrarian region (AOR = 1.66, 95%CI: 1.10-2.49) were significantly more likely to develop diarrheal morbidity. The size of the child at birth was also found to be significantly associated with diarrheal morbidity.

CONCLUSION: In this study, child factors (age of the child, vaccinated for measles, and the size of a child at birth), and household-related factors (contextual region) had a significant effect on the risk of childhood diarrheal morbidity in households with improved WASH in Ethiopia.

The challenges faced in sanitation and hygiene programmes are numerous and complex. Failures are inevitable. From our experience of working on rapid action learning and research in this sector we have found that when mistakes are shared they are usually those which were uncontrollable and unanticipated i.e. somebody else’s fault. In this perspectives piece we propose a typology of failure alongside criteria for research and learning processes that prioritises timeliness, relevance and actionability. We argue that these can be used together to identify and reflect on failures (and successes) quickly. We provide some practical suggestion for different stakeholders to support a shift towards a more open and reflexive sector, where all types of failures can be shared broadly.

The aim of this study is to determine associations between ambient air pollution and the number of emergency department (ED) visits for diseases of the genitourinary tract in Toronto, Canada. We used the National Ambulatory Care Reporting System (NACRS) database to obtain the related ED visits and developed statistical models using daily data on ED visits, temperature, relative humidity, and outdoor air pollution concentration levels. The NACRS database contains data on hospital-based and community-based ambulatory care. The environmental data were retrieved from the National Air Pollution Surveillance (NAPS) program. The NAPS is the main source of ambient air quality data in Canada. We considered 2 air quality health indexes and 6 air pollutants: daily means of fine particulate matter PM_2.5, O₃, CO, NO₂, SO₂, and also maximum 8-hour average ozone. For every air pollutant, we fit 270 models (15 lags × 18 strata). We found that same-day air pollution concentrations have the highest number of statistically significantly positive associations with ED visits for genitourinary health outcomes. A total of 133 positive associations were identified over the 14 days lag. In subgroup (strata) analysis, females older than 60 years of age were found to have the most positive associations. In particular, nitrogen dioxide was found to be highly associated with ED visits for females over 60; an increase in NO₂ was associated with an increased relative risk (RR) of ED visits when lagged over 0, 1, and 2 days (RR = 1.040 [95% confidence interval: 1.028, 1.052], 1.020 [1.009, 1.032], and 1.025 [1.013, 1.036], respectively). The values of risks are reported for a 1 interquartile range increase in concentration (8.8 ppb). Our results suggest that urban ambient air pollution affect the number of ED visits due to genitourinary system conditions.

Resistance to antimicrobial agents is a growing concern in public health. It has been reported in wildlife from several places in the world though wild animals are not normally exposed to clinically used antimicrobial agents. Despite this, very little research has been done in Ghana to determine antimicrobial resistance in wild animals, particularly those in protected areas. In this study, the presence of colistin resistant and multidrug resistant (MDR) gram-negative bacteria in cloacal swabs of wild birds captured in a Ghanaian forest protected area were evaluated. A total of 195 isolates from 138 individual birds were obtained, identified and tested for resistance to colistin. The colistin-resistant isolates were subsequently tested for multidrug resistance to 4 other antimicrobial agents (Oxytetracycline, Streptomycin, Ampicillin and Ciprofloxacin). Colistin resistance was observed in 6.5% (9/138) of the birds and this was seen in only birds that were sampled close to the reception area of the protected area. About 50% of the colistin-resistant isolates were multidrug resistant. AMR isolates were obtained from birds that have been documented to show an insectivorous or omnivorous feeding preference. Data obtained from the study suggests that AMR and MDR occurred in wild birds from the Conservation Area and supports the claim that proximity to human impacted habitats (settlements/farmlands) increased the likelihood of carriage of AMR. Though the routes of transmission remain unclear, there is potential for spread from the wild birds to other wild/domestic animals and possibly back to humans.

Diversity, Equity, and Inclusion in the global sanitation sector have not been the subject of extensive investigation or scrutiny. However, without diverse leadership, the sector will continue to experience failure, inefficient use of dwindling resources, and overall low sanitation coverage rates, with 2 billion people lacking sanitation access. This research presents the first quantitative study of sanitation leadership demographics. The results revealed that older, white males from High-Income Countries comprised over a third of all leadership positions. This research found that two-thirds of all sanitation leaders were white, with white leaders 8.7 times more likely to hold multiple positions across different organizations than Black, Indigenous, or other People of Color. Eighty-eight out of one hundred organizations were headquartered in a High-Income Country, and western institutions dominated education data. Black, Indigenous, and other Women of Color were the least represented group, highlighting the importance of an intersectional perspective when discussing gender and racial equality. These issues must be urgently addressed if the Sustainable Development Goal 6.2 targets are to be met effectively. Institutional reform, inclusive hiring policies, and transforming individual attitudes are starting points for change. More organizational data should be made available, and further research needs to be conducted on these topics if a change is to be seen in time for 2030.

Due to the increasing adoption of nutrient discharge regulations, many research groups are stepping into new territory with phosphorus (P) measurements. Accurate reporting of P concentrations in effluent from novel wastewater treatment technologies is critical for protecting both environmental and human health. Analysis of P in wastewater is prone to pitfalls because of the (1) variety of chemical forms of P in wastewater (orthophosphate, condensed P, and organic P), (2) availability of different chemical assays for measuring different P forms, and (3) different conventions in the units for reporting P. Here, we present a case study highlighting how these pitfalls affect analysis and interpretation of P measurements. We show that, when used appropriately, commercially-available kits are indeed accurate tools for evaluating reactive P and total P concentrations. For both standard solutions and real wastewater, we systematically remove steps from the total P protocol to show how protocol deviations affect the results. While standard solutions are important for validating analytical methods, commercially-available wastewater standard solutions only contain P as orthophosphate (reactive P). We therefore demonstrate options for making a mixed-P standard solution containing acid-hydrolyzable and/or organic P compounds that can be used to validate both reactive P and total P assays.

To monitor safely managed drinking water services, an increasing number of countries have integrated water quality testing for Escherichia coli into nationally-representative household surveys such as the Multiple Indicator Cluster Surveys (MICS). However, plastic waste generated during such water quality testing programs, mostly through the use of pre-sterilized disposable materials, is non-negligible. The objective of this study was to evaluate several re-use protocols for disposable filter funnels used by the MICS water quality test kits. Decontamination and re-use protocols were assessed in centralized laboratory and decentralized field settings and neither yielded positive results. Re-use of 100 mL sterile funnels decontaminated with an alcohol wipe resulted in a higher incidence of false positive results (i.e., positive contamination when processing sterile water), both in the laboratory and field; therefore, a higher proportion of positives tests can be expected if these components are re-used. Further improvements to the decontamination technique and training are needed before material re-use can be reliably adopted. Autoclaving the funnels for re-use is feasible, provided that there is capacity to re-package and distribute funnels in a sterile manner.

BACKGROUND: The emergence of Methicillin resistant Staphylococcus aureus (MRSA) poses a serious public health threat. Strains of Staphylococcus aureus resistant to β-lactam antibiotics are known as MRSA. MRSA has gained attention as community pathogen. MRSA has been increasingly reported as emerging problem in veterinary medicine. However, little is known in Ethiopia. This study was, therefore, conducted to identify MRSA, to determine its drug susceptibility patterns, and mastitis infection in dairy cattle in and around Adama town, Central Ethiopia.

METHODS: A cross-sectional study was conducted to estimate the occurrence of MRSA in mastitic dairy cows in and around Adama town, central Ethiopia. A total of 384 lactating cows were included from the conveniently selected dairy farms in the study area. Approximately 10 ml of milk was aseptically collected from clinical and subclinical mastitic cows into sterile universal bottles after discarding the first 3 milking streams. Then, Staphylococcus aureus was isolated using the conventional bacteriological procedure. Resistance to methicillin was detected using the Kirby-Bauer disc diffusion antibiotic susceptibility method. Oxacillin disc was used to detect methicillin resistant Staphylococcus aureus strains. Antimicrobial susceptibility test was conducted against MRSA strains using streptomycin (S, 10 µg), amoxicillin (Am, 25 µg), kanamycin (k, 30 µg), nalidixic acid (NA, 30 µg), oxytetracycline (OT, 30 µg) sulphonamide (S, 300 µg) and ceftriazole (CRO, 30 µg).

RESULTS: The study found that the prevalence of mastitis was 121(31.5%). Among this 37(30.6%) were clinical mastitis and 84 (69.4%) of them were sub-clinical mastitis. Of 121 mastitis cases, Staphylococcus aureus was isolated in 37 (30.6%) of mastitic cow milk samples. The prevalence of mastitis was significantly affected by breed, age, floor type and hygienic status of the milkers (P < .05). Moreover, 32.4% of Staphylococcus aureus isolates were resistant to oxacillin. A total of 75% percent of MRSA isolates were resistant to amoxicillin, 66.7% were resistant to oxytetracycline, and 50% were resistant to sulphonamide. However, 75% of MRSA isolates were susceptible to kanamycin, 58.3% were susceptible to streptomycin, and 50% were susceptible to nalidixic acid.

CONCLUSION: The study revealed that relatively high number of strains are resistant to the antibiotics commonly used in the therapeutic protocol of many human and animal infections. Therefore, antimicrobial susceptibility test should be carried out at a regular basis and proper hygienic practices should be introduced at farm level. Creating public awareness about transmission, prevention and control of MRSA should also be considered.

BACKGROUND: Dust storms and their impacts on health are becoming a major public health issue. The current study examines the health impacts of dust storms around the world to provide an overview of this issue.

METHOD: In this systematic review, 140 relevant and authoritative English articles on the impacts of dust storms on health (up to September 2019) were identified and extracted from 28 968 articles using valid keywords from various databases (PubMed, WOS, EMBASE, and Scopus) and multiple screening steps. Selected papers were then qualitatively examined and evaluated. Evaluation results were summarized using an Extraction Table.

RESULTS: The results of the study are divided into two parts: short and long-term impacts of dust storms. Short-term impacts include mortality, visitation, emergency medical dispatch, hospitalization, increased symptoms, and decreased pulmonary function. Long-term impacts include pregnancy, cognitive difficulties, and birth problems. Additionally, this study shows that dust storms have devastating impacts on health, affecting cardiovascular and respiratory health in particular.

CONCLUSION: The findings of this study show that dust storms have significant public health impacts. More attention should be paid to these natural hazards to prepare for, respond to, and mitigate these hazardous events to reduce their negative health impacts.

Registration: PROSPERO registration number CRD42018093325

From preventing cholera and diarrhea by reducing exposure to human waste, to reducing transmission of COVID-19 through handwashing, water, sanitation and hygiene (WASH) can save lives. Numerous global health initiatives have been created to combat the spread of infectious diseases. However, according to the Sanitation and Hygiene Fund, “decades of under investment in sanitation and hygiene have made this sector the weakest link in our efforts to achieve the [Sustainable Development Goals (SDGs)].” There appear to be various reasons for the lag in global attention to, funding toward, and innovation around WASH-related diseases. Firstly, WASH is comprised of three interrelated components, water, sanitation, and hygiene, each of which has its own subset of indicators, priorities, and infrastructure, thus making streamlined communications and impact measurement within the sector incredibly complex. Secondly, WASH is a field that bridges many sectors, and there has historically been a lack of understanding of where responsibility lies to consistently fund and execute WASH interventions, programming, and policymaking. Additionally, public health research and funding tend to favor evaluations using randomized controlled trials (RCTs), which are often referred to as the “gold standard.” RCTs, like all single evaluative methods, have limitations which may not effectively capture the complexity of WASH interventions and their subsequent multi-sectoral outcomes. In some cases “it may be infeasible (or unethical) to randomize communities to a [WASH] intervention” which would prohibit the research from reaching the current “gold standard” threshold for academic rigor and subsequent funding. A new concept called “Transformative WASH” has recently emerged in the WASH sector as a result of three RCTs and calls for a “comprehensive package of WASH interventions” to effectively improve health and social outcomes. We believe that the current definition of the “gold standard” in academic research is failing the WASH sector and does not align with “Transformative WASH.” Rather, the “gold standard” should instead be a mixed methods research toolkit that utilizes Human-Centered Design (HCD) practices, and proxy methods such as “participatory design” or “Behavior Centered Design theory” to better design and evaluate WASH interventions.

Ventilating indoor spaces helps prevent COVID-19 transmission. We investigated self-reported rates of opening windows to improve ventilation in the home, perceived effectiveness of opening windows, and confidence that if you wanted to, you could open windows. One in 6 people reported rarely, if ever, opening windows in their home in the last week. Three in 4 people knew that opening windows to improve ventilation was an effective way to prevent the spread of COVID-19 and 5 in 6 were confident that they could open windows in their home. Official messaging should continue to seek to improve knowledge about the effectiveness of ventilation for reducing COVID-19 transmission, and increase the frequency of window opening.

INTRODUCTION: Coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV2). COVID-19 is highly contagious, potentially fatal, and a global public health concern. Combining optimized personal protective equipment (PPE) use and hand hygiene is the best strategy for preventing COVID-19 in health care workers (HCWs).

METHODS: We conducted a national cross-sectional web-based survey of HCWs in the infection control program (IPC) in Thailand between May 5, 2020 and May 15, 2020. The primary objective was the prevalence of optimized PPE use amongst HCWs. The secondary objective was identification of the independent predictors of optimized PPE use.

RESULTS:We received a response from 46% of HCWs (756/1650), and all those who responded were nurse or HCWs who were registered in the IPC network. Five HCWs were excluded because of missing data, and 751 were included in the final analysis. The prevalences of PPE use were 22% (168/751) for optimized PPE use, 78% (583/751) for non-optimized PPE use, 35% (263/751) for PPE overuse, and 43% (320/751) for PPE underused. In univariate analysis, optimized PPE use was significantly associated with age, education level, knowledge of appropriate negative pressure room selection, and knowledge of apparently milder symptom severity in children than adults. In multivariate analysis, independent predictors of optimized PPE use were knowledge of appropriate negative pressure room selection (aOR = 1.95, 95% CI = 1.18-3.22), the difference in symptom severity between children and adults (aOR = 0.55, 95% CI = 0.37-0.81), and education level (aOR = 1.54, 95% CI = 1.04-2.27).

CONCLUSION: The prevalence of optimized PPE use amongst HCWs was 22%. Independent predictors of optimized PPE use were COVID-19 knowledge-based factors and education level. Therefore, the continued education training program should be implemented to ensure maintenance of appropriate practices during the COVID-19 pandemic.

Globally, harmful algal blooms (HABs) are on the rise, as is evidence of their toxicity. The impacts associated with blooms, however, vary across Nation states, as do the strategies and protocols to assess, monitor, and manage their occurrence. In Canada, water quality guidelines are standardized nationally, but the management strategies for HABs are not. Here, we explore current strategies to understand how to better communicate risks associated with HABs to the public. Our team conducted an environmental scan on provincial and territorial government agency protocols around HABs. Results suggest that there are variations in the monitoring, managing, and communicating of risk to the public: British Columbia, Manitoba, New Brunswick, and Quebec have well-established inter-agency protocols, and most provinces report following federal guidelines for water quality. Notably, 3 northern territories have no HABs monitoring or management protocols in place. More populous provinces use a variety of information venues (websites, social media, on site postings, and radio) to communicate risks associated with HABs, whereas others’ communications are limited. To induce more collaboration on HABs monitoring and management and reduce the associated risks, creating a coherent system with consistent messaging and inter-agency communication is suggested.

Urban air pollution is a major problem with known negative health implications, such as respiratory and cardiovascular diseases. Lockdown measures have caused the reductions of various urban pollutants, such as nitrogen dioxide (NO₂), particulate matters (PMs), and polycyclic aromatic hydrocarbons (PAHs). COVID-19 pandemic has also established remote-working as an antidote to declining economic activity due to lockdown measures. The environmental health implications of the new hybrid-working model, which drastically reduces the number of circulating vehicles, appear to be positive enough to reveal an emerging opportunity. Since this hybrid model may have started becoming a widely accepted working model, the current situation has revealed the opportunity of remote-working arrangements to serve as a supplementary mitigative and adaptive measure against urban environmental deterioration. Also, a remote-working carbon-saving footprint may be introduced in order to evaluate a firm’s carbon footprint reduction due to remote-working arrangements. These workings arrangements may be accompanied by improvements and expansions of urban green spaces and with broader use of electric vehicles, transforming our cities into more sustainable, safe, healthy, and worth-living environments.

BACKGROUND: Childhood diarrhea is the major contributor to the deaths of children under the age of 5 years in Ethiopia, but evidence at the national level to identify the contributing factors associated with diarrhea by considering the clustering effects is limited. Hence, this study aimed to identify factors associated with childhood diarrhea at the individual and community levels.

METHODS: A secondary data analysis was conducted using the 2011 and 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of 23 321 children with their mothers were included in this study, and multilevel logistic regression models were applied for the data analysis.

RESULTS: The odds of diarrhea among female children were 13% lower (AOR = 0.87; 95% CI: 0.79-0.94) compared with male children. The odds of diarrhea among children aged between 13 and 24 months were 31% higher than (AOR = 1.31; 95% CI: 1.17-1.47) their younger counter parts. Children aged ⩾25 months (AOR = 0.50; 95% CI: 0.45-0.56), those whose mothers were unemployed (AOR = 0.79; 95% CI: 0.73-0.87), and children live in households between 2 and 3 under-5 children (AOR = 0.87; 95% CI: 0.79-0.96) were associated with lower odds of experiencing diarrhea. The odds of diarrhea among children whose mother had no formal education were 49% higher than (AOR = 1.49; 95% CI: 1.08-2.07) their counterparts. Besides, children residing in city administrations (AOR = 0.69; 95% CI: 0.58-0.82) had lower odds of experiencing diarrhea than children living in agrarian regions.

CONCLUSIONS:At the individual level (sex and age of the child, mother’s employment status, and educational level, and the number of under-5 children) and the community-level (contextual region) were found to be significant factors associated with childhood diarrhea in Ethiopia.

COVID-19 pandemic, as another disease emerging in the interface between animals and humans, has revealed the importance of interdisciplinary collaborations such as the One Health initiative. Environmental Health, whose role in the One Health concept is well established, has been associated with COVID-19 pandemic via various direct and indirect pathways. Modern lifestyle, climate change, environmental degradation, exposure to chemicals such as endocrine disruptors, and exposure to psychological stress factors impact human health negatively. As a result, many people are in the disadvantageous position to face the pandemic with an already impaired immune system due to their exposure to environmental health hazards. Moreover, the ongoing pandemic has been associated with outdoor and indoor air pollution, water and noise pollution, food security, and plastic pollution issues. Also, the inadequate infrastructure, the lack of proper waste and wastewater management, and the unequal social vulnerability reveal more linkages between Environmental Health and COVID-19 pandemic. The significant emerging ecological risk and its subsequent health implications require immediate risk analysis and risk communication strategies.

BACKGROUND: Diarrheal disease is one of the leading causes of death in children under the age of 5. Access to and use of improved water and sanitation services is associated with this, but there is little country-level evidence for this relationship in Ethiopia. Therefore, associations between improved water supply and sanitation usage and childhood diarrhea in Ethiopia have been identified as the objective of this study.

METHODS: This study was a cross-sectional study using data from Ethiopia’s 2016 Demographic and Health Survey. Through interviews with mothers/caregivers who had children under the age of 5 years, data was collected. The outcome of this study was the response of the mothers/caregivers interviewed to the 2-week occurrence of diarrhea. Logistic regression analysis was used to examine the relationship between dependent and independent variables.

RESULTS: The survey results found that the use of improved drinking water and latrine facilities was 59.3% (95% CI: 58.36-60.31) and 17.3% (95% CI: 16.59-18.09), respectively. With respect to the handling practices of child feces, 24.8% (95% CI: 23.8-25.70) of the child feces of the interviewed mothers/caregivers were disposed of safely. The prevalence of childhood diarrhea in the preceding 2 weeks was 11% (95% CI: 10.36-11.61). Residence of Somali Region (AOR = 1.81, 95% CI: 1.25-2.61), having more than 2 under-5 children (AOR = 1.21, 95% CI: 1.01-1.46), having more than 5 family members (AOR = 1.18, 95% CI: 1.03-1.36), sex of the indexed child (AOR = 0.88, 95% CI: 0.77-0.99) and unsafe child feces disposal practices (AOR: 1.32; 95% CI: 1.14-1.54) were significantly associated with childhood diarrhea.

CONCLUSION: Residing in the Somali region, having more than 2 children under the age of 5 and having more than 5 household members, indexed child sex, and safe disposal of child feces were significantly associated with diarrhea. Therefore, in Ethiopia, the prevention of childhood diarrhea should concentrate on eliminating household crowding and encouraging the safe disposal of child feces.

BACKGROUND: Inadequate water supply, sanitation, hygiene practices, and diarrhea are related to malnutrition, but there is limited evidence in Ethiopia about their association. Thus, the objective of this study was to describe childhood malnutrition and the association with diarrhea, water supply, sanitation and hygiene practices.

METHODS: A case-control study design was performed from December 2018 to January 2019 in Kersa and Omo Nada districts of the Jimma Zone, Ethiopia. Both children aged 6 to 59 months were chosen randomly from malnourished and well-nourished children in 128 cases and 256 controls, respectively. Bodyweight, length/height, mid-upper arm circumference, and presence of edema of the children were measured according to the WHO references. Then, the nutritional status of the children was identified as a case or control using the cutoff points recommended by the WHO. To see the association-dependent and independent variables, logistic regression analysis was used.

RESULTS: A total of 378 children were included in this study (98.44%). Malnutrition was significantly increased among children who delayed breastfeeding initiation(AOR = 3.12; 95% CI: 1.62-6.00), had diarrhea (AOR = 9.22; 95% CI: 5.25-16.20), were living in households indexed as the poorest (AOR = 2.50; 95% CI: 1.12-5.62), defecated in a pit latrine without slab/open pit (AOR = 2.49; 95% CI: 1.17-5.30), collecting drinking water from less than/equal to 1 km distance (AOR = 4.77; 95% CI: 1.01-22.71) and sometimes practiced hand washing at the critical times (AOR = 2.58; 95% CI: 1.16-5.74) compared with their counterparts. However, lactating during the survey (AOR = 0.35; 95% CI: 0.18-0.67), water collection from unprotected sources (AOR = 0.22; 95% CI: 0.05-0.95) and collection and disposal of under-5 children feces elsewhere (AOR = 0.06; 95% CI: 0.01-0.49) significantly reduced the likelihood of malnutrition.

CONCLUSIONS: Early initiation of exclusive breastfeeding, diarrhea prevention, and the use of improved latrine and handwashing practices at critical times could be important variables to improve the nutritional status of children.

Introduction: Environmental health (EH) services have a long history in Ethiopia, but data on environmental health services quality and the magnitude of environmental health professionals’ engagement has never been addressed. This study was conducted to assess the quality of environmental health services in different sectors and professionals’ level of engagement in Eastern Ethiopia.

Methods: Institution based cross-sectional mixed study design was implemented. A cluster sampling technique was employed to select 83 participants. Data were collected using a pretested questionnaire and an interview guide. Descriptive, bivariate, multivariate, and thematic analysis was carried out.

Results: Professionals’ performance in most services were reported to be average or low. Only 19.5% of participants responded as having good satisfaction in their job. The multiple logistic regression analysis showed factors associated with selected environmental health services. The odds of identifying environmental problems was associated with profession (adjusted odds ratio (AOR): 4.1; 95% confidence interval (CI): 1.3-7.6) and level of education (AOR: 3.1; 95%CI: 0.9-5.9). The factors contributing to introducing innovative solutions to EH problems were type of institution (AOR: 3.1, 95%CI = 1.6-9.3), profession (AOR: 3.4, 95%CI = 1.1-12.2), and level of support and emphasis offered (OR: 5.6, 95% CI = 2.2-11.9). Level of job satisfaction was also associated with the above-mentioned independent variables.

Conclusion: The current study showed low level of professionals’ engagement and factors associated with the quality of environmental health services in different sectors. Therefore, Ethiopian Federal Ministry of Health and other concerned ministries, agencies, and authorities should intervene accordingly to improve the service and level of professionals’ engagement.

BACKGROUND: Long-Lasting Insecticidal Nets (LLINs) efficacy could be compromised due to a lot of influences together with user compliance and vector population insecticide resistance status. Thus, this study was to assess the biological efficacy of DuraNet® with the help of the World Health Organization cone bioassay and field experimental hut.

METHODS: A laboratory and a semi-field conditions experimental huts against Anopheles Mosquitoes were conducted in southwestern Ethiopia from September 2015 to January 2016. The bio efficacy of DuraNet® was evaluated using the WHO cone bioassay test and then its field efficacy was evaluated using experimental huts against the malaria vector population.

RESULTS: World Health Organization cone bioassay tests against pyrethroid-resistant An. arabiensis led to mean percent mortality and knockdown of 78% and 93%, respectively. Washing of DuraNet® successively reduced its efficacy from 93% knockdown (0 wash) to 45% knockdown (20 washes). Similarly, mean mortality decreased from 84% (0 wash) to 47% (20 washes). A total of 1575 female mosquitoes were collected over 40 nights out of which 1373(87.8%) were An. gambiae s.l., 116 (7.4%) were Anopheles coustani and 107 (6.8%) were An. pharoensis. The mean blood-feeding rate was significantly lower (P < .001) in hut containing unwashed DuraNet® when compared to hut containing untreated DuraNet®. The mean mortality rate was significantly higher (P < .001) in hut containing DuraNet® when compared to hut containing untreated DuraNet®. Unwashed DuraNet® showed the highest personal protection 88.7% and 100% against An. Arabiensis and An. pharoensis, respectively.

CONCLUSION: Both DuraNet® and PermaNet 2.0 moderate efficacy against a pyrethroid-resistant population of An. arabiensis from Ethiopia. The bio efficacy of DuraNet® was found below the WHO recommendation. Therefore, the real impact of the observed insecticide resistance against DuraNet® to be further studied under phase-III trials, the need for new alternative vector control tools remains critical.

When waste management infrastructure is built, there can be resistance from the local affected populations, often termed the Not in My Backyard (NIMBY) phenomenon. This study aims to understand the forms of resistance that may develop in such contexts, focusing on 2 solid waste and 1 liquid waste management site within Mzuzu City, Malawi. At the newest solid waste site, community resistance had grown to the extent that the site was reportedly destroyed by the local community. Interviews and observations of the sites are complemented by examining historic and recent satellite images. It was found that, at the new solid waste site, community engagement had not been conducted effectively prior to construction and as part of ongoing site operations. This was compounded by poor site management and the non-delivery of the promised benefits to the community. In contrast, at the liquid waste site, the community could access untreated sludge for use as fertilizer and were happier to live within its vicinity. While NIMBYism is a frustrating phenomenon for city planners, it is understandable that communities want to protect their health and well-being when there is a history of mismanagement of waste sites which is sadly common in low-income settings. It is difficult for government agencies to deliver these services and broader waste management. In this study, an unsuccessful attempt to do something better with a legitimate goal is not necessarily a failure, but part of a natural learning process for getting things right.