Unprotected Sources Research Articles

Animal Handling Practice Among Rural Households in Northwest Ethiopia Increases the Risk of Childhood Diarrhea and Exposure to Pathogens From Animal Sources.

In Ethiopia, domestic animals and their feces are not properly contained. However, the risk of exposure to zoonotic pathogens is not well documented. This study was conducted to assess animal handling practices and the risk of childhood diarrhea among rural households in northwest Ethiopia. This study was done among 403 randomly selected households. Information on animal handling was collected using a questionnaire and spot-check observation. The occurrence of childhood diarrhea in 14 days prior to the survey was assessed based on the reports of female head of households. Multivariable binary logistic regression analysis was performed to identify the association between animal handling practices and childhood diarrhea. All the female head of households had contact with animal feces when preparing fuel disks and plastering the house components with animal dung. Domestic animals shared a corral within the living space of the humans in 20% of the households. Animals entered the human living quarters and accessed foods in 32% of the households. Moreover, 24% of the children aged 24 to 59 months had diarrhea in a 2-week period prior to the survey. Childhood diarrhea was associated with domestic animals sharing the same house as humans (AOR: 3.3, 95% CI: 1.3, 8.6), presence of animal excreta in child playing areas (AOR: 2.4, 95% CI: 1.2, 4.6), contact of domestic animals with stored foods (AOR: 3.5, 95% CI: 2.0, 5.9), trapped dirt under fingernails of female heads (AOR: 3.7, 95% CI: 1.9, 7.5), open defecation (AOR: 3.24, 95% CI: 1.8, 5.9), and unprotected sources (AOR: 4.2, 95% CI: 1.1, 15.3). Domestic animals and their excreta are not hygienically contained in the area. Animal handling practices including their excreta and the hygiene behavior of female head of households (eg, handwashing and food handling practices) should be improved to prevent childhood diarrhea.

Functional data analysis to characterize disease patterns in frequent longitudinal data: application to bacterial vaginal microbiota patterns using weekly Nugent scores and identification of pattern-specific risk factors

BackgroundTechnology advancement has allowed more frequent monitoring of biomarkers. The resulting data structure entails more frequent follow-ups compared to traditional longitudinal studies where the number of follow-up is often small. Such data allow explorations of the role of intra-person variability in understanding disease etiology and characterizing disease processes. A specific example was to characterize pathogenesis of bacterial vaginosis (BV) using weekly vaginal microbiota Nugent assay scores collected over 2 years in post-menarcheeal women from Rakai, Uganda, and to identify risk factors for each vaginal microbiota pattern to inform epidemiological and etiological understanding of the pathogenesis of BV.MethodsWe use a fully data-driven approach to characterize the longitudinal patters of vaginal microbiota by considering the densely sampled Nugent scores to be random functions over time and performing dimension reduction by functional principal components. Extending a current functional data clustering method, we use a hierarchical functional clustering framework considering multiple data features to help identify clinically meaningful patterns of vaginal microbiota fluctuations. Additionally, multinomial logistic regression was used to identify risk factors for each vaginal microbiota pattern to inform epidemiological and etiological understanding of the pathogenesis of BV.ResultsUsing weekly Nugent scores over 2 years of 211 sexually active and post-menarcheal women in Rakai, four patterns of vaginal microbiota variation were identified: persistent with a BV state (high Nugent scores), persistent with normal ranged Nugent scores, large fluctuation of Nugent scores which however are predominantly in the BV state; large fluctuation of Nugent scores but predominantly the scores are in the normal state. Higher Nugent score at the start of an interval, younger age group of less than 20 years, unprotected source for bathing water, a woman’s partner’s being not circumcised, use of injectable/Norplant hormonal contraceptives for family planning were associated with higher odds of persistent BV in women.ConclusionThe hierarchical functional data clustering method can be used for fully data driven unsupervised clustering of densely sampled longitudinal data to identify clinically informative clusters and risk-factors associated with each cluster.

Evaluation of factors that influence Reoccurrence of Cholera epidemics in Bwera Hospital, Kasese District

Cholera is an acute enteric infection characterised by sudden onset of profuse, painless watery diarrhoea and vomiting. Transmission of the disease is by faecal-oral route and from man to man via faecal contaminated water, ingestion of contaminated foods and drinks, and bottle feeding in infants. Globally, an estimated 1.4 to 4.3 million cholera cases and 28,000 to 142,000 cholera related deaths occur every year and the highest deaths rates occur in developing countries. The aim of this study was to explore the factors influencing reoccurrence of cholera outbreaks in Bwera hospital-Kasese district, Uganda. The study was a descriptive cross-sectional where quantitative strategy was applied on health workers and households within Bwera hospital. The study targeted 73 respondents; random sampling procedure was used. Three broad themes were based on to obtain results namely; sources of water for home use, environmental sanitation and the role of climate change. It emerged that water was mainly collected from unprotected sources using rudimentary methods and it was made safe by boiling. Hand washing was seen as a common practice done though occasionally. Generally solid wastes were poorly managed including human waste and reinforcing reforestation was seen as a remedy to avert effects of climate change. The commonest source of water for home consumption was from open water surfaces mainly rivers/streams. Boiling was seen as one of the commonest methods of making water safe for home consumption but the numbers of house hold that boils water are very few thereby making them prone to infection. Washing hands was the commonest practice especially before eating but still some children do ignore washing of their hands before eating if their caretakers are not around them; however, it was not consistently after visiting latrine. Poor waste disposal was seen present in the communities whereby bushes and river banks were seen as places where human waste is deposited. Keywords: Cholera, Deaths, Households, Bwera hospital, contaminated Water.

Community and individual level determinants of infant mortality in rural Ethiopia using data from 2016 Ethiopian demographic and health survey

The infant mortality rate remains unacceptably high in sub-Saharan African countries. Ethiopia has one of the highest rates of infant death. This study aimed to identify individual-and community-level factors associated with infant death in the rural part of Ethiopia. The data for the study was obtained from the 2016 Ethiopian Demographic and Health Survey. A total of 8667 newborn children were included in the analysis. The multilevel logistic regression model was considered to identify the individual and community-level factors associated with new born mortality. The random effect model found that 87.68% of the variation in infant mortality was accounted for by individual and community level variables. Multiple births (AOR = 4.35; 95%CI: 2.18, 8.69), small birth size (AOR = 1.29; 95%CI: 1.10, 1.52), unvaccinated infants (AOR = 2.03; 95%CI: 1.75, 2.37), unprotected source of water (AOR = 1.40; 95%CI: 1.09, 1.80), and non-latrine facilities (AOR = 1.62; 95%CI: 1.20) were associated with a higher risk of infant mortality. While delivery in a health facility (AOR = 0.25; 95%CI: 0.19, 0.32), maternal age 35–49 years (AOR = 0.65; 95%CI: 0.49, 0.86), mothers receiving four or more TT injections during pregnancy (AOR = 0.043, 95% CI: 0.026, 0.071), and current breast feeders (AOR = 0.33; 95% CI: 0.26, 0.42) were associated with a lower risk of infant mortality. Furthermore, Infant mortality rates were also higher in Afar, Amhara, Oromia, Somalia, and Harari than in Tigray. Infant mortality in rural Ethiopia is higher than the national average. The government and other concerned bodies should mainly focus on multiple births, unimproved breastfeeding culture, and the spacing between the orders of birth to reduce infant mortality. Furthermore, community-based outreach activities and public health interventions focused on improving the latrine facility and source of drinking water as well as the importance of health facility delivery and received TT injections during the pregnancy.

Suggested two layers container for shielding the low and intermediate activity gamma-ray sources

Due to the advantages of using gamma-ray radiation sources in various fields, the average equivalent dose received due to the exposure to these sources increases. The wrong handling or direct exposure to these sources give raises the equivalent dose for the receiver. Thus, a container made up of two layers (metal and glass layers) was suggested to decrease the recorded equivalent dose received from the gamma-ray radioactive sources to an acceptable limit. The Monte Carlo MCNP simulation code was utilized to predict the equivalent dose around the container's outer surface and at 100 cm from the center of the outer container's faces. For example, the simulation study illustrated that the equivalent dose rate received at 100 cm from an unprotected 137Cs source with an activity of 3.7E+8 Bq is 26.30 μSv/h. This equivalent dose rate from an unprotected source is reduced to 22.75 μSv/h using the inner layer of the stainless steel with a thickness of 0.5 cm. After that, the equivalent dose rate reduced from 22.75 to 7.60 μSv/h, raising the WO3. Simultaneously, the equivalent dose rate from an unprotected Co-60 source reaches 50.51 μSv/h. It is reduced to 23.56 μSv/h by using a container consisting of an inner layer of stainless steel with a thickness of 0.5 cm and an outer glass layer of BaWP7 glass sample with WO3 content of 60 mol % and thickness of 5 cm.The present study showed the suggested container's ability in reducing the absorbed dose and equivalent dose rate for intermediate activity gamma-ray sources used in laboratories and nuclear medicine.

Prevalence of intestinal parasitic infections and associated factors among pregnant women attending antenatal care at Yirgalem General Hospital, Sidama, Ethiopia

BackgroundIn poor countries like Ethiopia, the burden of intestinal parasitic infections (IPIs) is high. Thus, this study was aimed to assess the prevalence of IPIs and associated factors among pregnant women attending antenatal care clinics at Yirgalem General Hospital, Sidama, Ethiopia. MethodsA cross-sectional study was conducted among systematically selected 400 pregnant women. Trained data collectors administered the questionnaire. The stool samples were collected and analyzed. SPSS version-25 was used for data analysis. Descriptive statistics, bivariable and multivariable logistic regression analysis were done. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to measure the presence and strength of association. A p-value ≤0.05 was considered to declare statistical significance. ResultsThe prevalence IPI was 35.8% (95% CI: 31.1, 40.5%). Increased odds of IPIs observed among pregnant women who lived in the rural area, ate unwashed fruits/vegetables, drank water from the unprotected source, drank untreated water, not washed hands by soap, and had a history of previous IPI. ConclusionPrevalence of IPIs was high. Thus, strengthening health education on the appropriate handling of foods, keeping personal and environmental hygiene, and protecting the source of drinking is crucial. Further, therapeutic and prophylactic intervention according to the World Health Organization deworming protocol is also important to tackle this problem.

Prevalence And Associated Factors of Thinness Among Adolescent Girls Attending High School In Soro District, Hadiya Zone, Southern Ethiopia

Background: Despite the government of Ethiopia is striving to reduce the prevalence of the undernutrition, thinness among adolescents is one of the challenging nutritional issues in lifecycle approach in Ethiopia. Therefore, this study was aimed on determining the prevalence of thinness and its associated factors among adolescent girls attending high schools in Soro District, Hadiya Zone, Southern Ethiopia. Methods: Institution based comparative cross sectional study design was employed. The study was conducted from March 15 to April 15, 2019 in high schools of rural and urban settings of Sorro District, Hadiya Zone. Both binary and multivariable logistic regression analysis were done to identify the factors associated with thinness among adolescent girls. Result: A total of 414 adolescent girls were participated in this study making the response rate of 100%. The mean age were (17.01± 1.55) and 16.90 ± 1.48, P = 0.437) among adolescent girls in rural and urban high schools respectively. The overall prevalence of the thinness among female adolescents attending high schools in Soro district, Hadiya Zone was 6.8%. There was no statistically significant difference in thinness among adolescent girls in rural and urban high schools. Household wealth tertile AOR: 4.19; 95% C.I: 1.13-15.47, P <0.05, source of drinking water AOR: 2.31; 95% C.I: 1.01- 5.30, P <0.05, dietary diversity AOR: 3.99; C.I: 1.15-13.82, P <0.05 and skipping breakfast AOR: 2.97; C.I: 1.28-6.92, P <0.05 were found to be independent factors associated with thinness. Conclusion: Being low in household wealth tertile, unprotected source of drinking water, inadequate dietary diversity and skipping breakfast were those factors identified to be independently associated with thinness among female adolescents. Attention should be given from government and nongovernmental organizations by empowering household economic capacity, extending access for pure drinking water and increasing nutrition sensitive agriculture focusing on maintaining food varieties.

Small and Medium Enterprise ERP Platform Based on Windows Azure Cloud Computing

ERP is an important way and tool for enterprises to implement informatization construction, and it is an important foundation and strong support for enterprises to carry out e-commerce business. The purpose of this paper is to design an ERP platform for small and medium enterprises based on Azure Windows cloud computing. On the basis of in-depth understanding of the basic concepts and principles of cloud computing, e-commerce and ERP systems, the ERP platform of e-commerce cloud e-commerce system is designed and completed. Use cloud computing to reduce the cost of writing business information, reduce business risks, and provide personalized business services. And using the proposed reliability model in a cloud computing environment, the reliability value is 0.66, while exposure to high unprotected power sources triggers a reliability review. In the multi-tenant architecture area, the data between the application area and the tenants is separated to ensure that different tenants and different modules in the same tenant do not affect each other, and the security of the application system is ensured.

Selective Code Duplication for Soft Error Protection on VLIW Architectures

Very Long Instruction Word, or VLIW, architectures have received much attention in specific-purpose applications such as scientific computation, digital signal processing, and even safety-critical systems. Several compilation techniques for VLIW architectures have been proposed in order to improve the performance, but there is a lack of research to improve reliability against soft errors. Instruction duplication techniques have been proposed by exploiting unused instruction slots (i.e., NOPs) in VLIW architectures. All the instructions cannot be replicated without additional code lines. Additional code lines are required to increase the number of duplicated instructions in VLIW architectures. Our experimental results show that 52% performance overhead as compared to unprotected source code when we duplicate all the instructions. This considerable performance overhead can be inapplicable for resource-constrained embedded systems so that we can limit the number of additional NOP instructions for selective protection. However, the previous static scheme duplicates instructions just in sequential order. In this work, we propose packing-oriented duplication to maximize the number of duplicated instructions within the same peroformance overhead bounds. Our packing-oriented approach can duplicate up to 18% more instructions within the same performance overheads compared to the previous static duplication techniques.

Factors associated with childhood diarrheal in Ethiopia; a multilevel analysis

BackgroundDiarrhea is the second cause of child deaths globally. According to World Health Organization reports, in each year it kills more than 525,000 children under-5 years. More than half of these deaths occur in five countries including Ethiopia. This study aimed to identify both individual and community-level risk factors of childhood diarrheal in Ethiopia.MethodsEthiopian demography and health survey of 2016 data were used for the analysis. A total of 10,641 children aged 0–59 months were included in the analysis. A multi-level mixed-effect logistic regression model was used to identify both individual and community-level risk factors associated with childhood diarrheal.ResultThe incidence of childhood diarrheal was 12% (95%CI: 11.39, 12.63). The random effect model revealed that 67% of the variability of childhood diarrhea explained by individual and community level factors. From the individual-level factors, children aged 36–59 month (AOR = 3.166; 95% CI: 2.569, 3.900), twin child (AOR = 1.871; 95% CI: 1.390, 2.527), birth order 5 and above (AOR = 2.210, 95% CI: 1.721, 2.839), not received any vaccination (AOR = 1.197; 95% CI: 1.190,1.527), smaller size of child at birth (AOR = 1.303;95% CI: 1.130,1.504) and never breastfed children (AOR = 2.91;95%CI:2.380,3.567) associated with the higher incidence of childhood diarrhea. From the community-level factors, living in a rural area ((AOR = 1.505; 95%CI: 1.233, 1.836)), unprotected source of drinking water (AOR: 1.289; 95% CI: 1.060, 1.567) and availability of unimproved latrine facilities (OR: 1.289; 95% CI: 1.239, 1.759) associated with the higher incidence of childhood diarrhea. Besides, Children live in Afar, Amhara, Benishangul-Gumuz, Gambella, SNNPR and Dire Dawa regions had higher incidence of childhood diarrhea.ConclusionThe incidence of childhood diarrhea was different from cluster to clusters in Ethiopia. Therefore, integrated child health intervention programs including provisions of toilet facility, access to a clean source of drinking water, educate parents about the importance of breastfeeding and vaccination have to be strongly implemented in order to reduce the high incidence of childhood diarrhea among children in Ethiopia.

Households' reluctance to collect potable water from improved sources, Ethiopia

Abstract Water resources development and management are central to economic growth and poverty reduction. Despite considerable efforts, many households still rely on unimproved water sources. This research aimed to understand the reasons behind household reluctance to collect potable water from improved sources in urban and rural settings. Sixteen water points were selected purposively and a household survey conducted on the selected improved water source users. The result shows that in the urban areas people were satisfied with the water services provided. However, the poor could not afford the high cost of water and households sought unprotected alternative sources. Seventy-seven per cent of the urban and 65% of the rural households collect water from unimproved sources. Family size was the determinant factor for household water consumption from improved sources. Reliability, queuing time, high quality, and distance were associated with households' reluctance to collect potable water from improved sources. In conclusion, households' dependency on unprotected sources had a direct impact on the sustainability of schemes. Social factors are also fundamental when thinking about the sustainability of schemes.

Assessment of Water Supply and Sanitation in Bishan Guracha Sub-City in West Arsi Zone

It is well known that water is a natural resource without which all living things cannot exist. It is a natural requirement for all living things to have access to water if they have to be alive. It seems so why the 70 percent of our planet, earth, covered by water though the world population is facing water scarcity. Such scarcity of water is urging people to use water from unprotected sources which the world urban poor and rural population are highly affected by. As it is known ‘water is life’ because it gives life for all, on the contrary many are dying as a result of unsafe drinking water. The objective of this study was to assess the water supply and sanitation situation in the Bishan Guracha. By conducting an assessment one can determine water supply and sanitation coverage and identify water supply and sanitation problems in the sub-city and then propose solutions to improve water supply and sanitation coverage. In this research finding the main defined objective ideas are current water supply coverage, distribution system, water quality, demand analysis at present and future forecasting, analysis the sanitation status, and finally sate the solution for every weak part of the research results specifically. Water supply coverage status 20% water supply fulfills from the water points and the rest 80% of water supply requirement is fulfilled by hand dug well and in some extent rain fall collecting. The quality condition of water supply as WHO and Ethiopian drinking water quality standard both water points and hand dug well water are evaluated. Sanitation coverage is defined as the percentage of the population with access to adequate (improved) sanitation facilities that hygienically separate human excreta from human contact. Keywords: Design period, population forecasting, peak demand, peak hour DOI: 10.7176/CER/13-4-03 Publication date: June 30 th 2021

Challenges of Potable Water Supply in Assosa Town, Benishangul Gumuz Region, Ethiopia

Assosa town has been through a problem of sustainable potable water supply because the demand is not satisfied and large numbers of people do not have access to adequate amount of potable water. As a result, residents are forced to get water from unprotected sources which are far from their homes. Besides, they also buy water frequently from illegal persons and incur additional cost. In line with these the main objective of this study was to assess the challenges inadequate water supply in Assosa town. A survey was conducted on a randomly selected 97 House Holds and interviews with purposefully selected key informants in the year 2019. Emphasis was put on examining the nature of the problems of water supply and challenges the service providers and households faced. The study has confirmed that the town water supply service could not cover the demand of it with present existing capacity and based on the research outcome only 36.1% of the respondents get water through their own private taps. As the majority of respondents were agreed that in the study area, many respondents expressed that population size, budget problemsand insufficient and poor distribution of water were the main challenges for potable water supply system. That is, the water supplying service in the town is unsustainable; it is socially inequitable, economically inefficient and environmentally unsound. This study presents the following recommendations to ensure sustainable water supply in the study area including providing different water sources, conserving water sources, family planning, demand management, demand oriented supply, participating different actors, mobilizing financial resources, and staffing organizational structure with skilled personnel and equipping it with material facilities. Keywords: Water sources, production, accessibility, potable water supply, Assosa. DOI: 10.7176/JRDM/75-03 Publication date: May 31 st 2021

Serviceability Assessment of Water Supply & Its Infrastructure and Associated Challenges for providing Safe Drinking Water in Ethiopia-Gimbi Town

The development of infrastructure is fundamental to economic growth and development of countries. The objective of this study was to assess the serviceability of water supply & its infrastructure and associated challenges for providing safe drinking water in Ethiopia-Gimbi town. The research design was descriptive type and the related data was both primary and secondary sources. Primary data was obtained from sample of 219 households, 7 officials and professionals of water office. Samples were drawn, using simple random from the sample frame. Moreover, the water supply infrastructure were observed and photographed and included. Analyses were done by using SPSS and presented by percentage, tables, and charts. The study has confirmed that Gimbi town is facing water supply service problem. The survey result showed that the water produced only covers 30.39% of the demand. Even if private meter connection is taken as best standards of water supply, the connection for residential consumer is only 22.57%. Furthermore, all areas could not get equal and proportional service. As a result, they are exposed to unprotected sources. The cumulative effect of the existing situations decreased the daily average consumption of pipe water to 6.08 liters per person per day. The study also identified population growth, inadequate source, frequent interruption, unaccounted-for water (41.25%), lack of sufficient funding and capacity, lack of standby diesel generator and limited stakeholders’ participation as challenges. The paper recommends interventions to overcome water scarcity. These include: exploring additional source, redesigning distribution system, encouraging capacity building for staffs, having standby diesel generator, carrying out appropriate operation and maintenance, introducing rainwater harvesting program, launching appropriate water infrastructural assets management, using water reservoir, promoting stakeholders’ participation to improve the problems. Keywords : Accessibility; Affordability; Adequate Water Supply; Infrastructure; Interruption; Meter Connection; Pipe Water; Safe Drinking Water; Unaccounted-for Water. DOI: 10.7176/DCS/11-5-02 Publication date: May 31 st 2021

Infectious diseases in India: assessing the role of household amenities and socio-demographic determinants

Infectious diseases continue to be a significant impediment in the attainment of sustainable development goals related to health. A lack of essential household amenities and social determinants are the primary cause behind the outbreak of infectious diseases in LMICs. The current study aimed to examine the socio-demographic determinants of infectious diseases vis-a-vis basic household amenities in India. This study was based on nationally representative data of ‘Key indicators of Social Consumption in India: Health’ conducted by the National Sample Survey Organisation between July 2017 and June 2018. The study measured the inicidence of various infectious diseases across basic household amenities and socio-demographic variables. Multivariate logistic regression is employed to analyse the association between the likelihood of a particular infectious disease and various intersectional variables. The study findings reveal that the lack of household amenities such as access to a toilet, clean drinking water, garbage disposal and socio-economic determinants such as area of residence, gender, poverty and age have a significant impact on the incidence of infectious diseases in India. Among various infectious diseases jaundice, malaria and others, including tuberculosis and typhoid, dengue fever and chikungunya, have a relatively higher incidence. Approximately 22.32% of the population do not have proper toilet facility, 45.56% have proper tap water facility, while 50% either use water from spring/well or other unprotected sources and about half of the population do not have any arrangement for garbage disposal. Among socio-demographic determinants, incidence of infections is relatively higher in rural areas, other backward classes (OBCs), males, children, and adults. The study findings outlined that there is a need for better government interventions towards reducing the burden of infectious diseases in India, particularly in rural areas.

Individual- and Community-Level Risk Factors Associated with Childhood Diarrhea in Ethiopia: A Multilevel Analysis of 2016 Ethiopia Demographic and Health Survey.

Background Diarrhea is the second cause of child deaths globally. According to World Health Organization reports, in each year, it kills more than 525,000 children under 5 years. More than half of these deaths occur in five countries including Ethiopia. This study is aimed at identifying both individual- and community-level risk factors of childhood diarrhea in Ethiopia. Methods Ethiopian demography and health survey of 2016 data were used for the analysis. A total of 10,641 children aged 0–59 months were included in the analysis. A multilevel mixed-effects logistic regression model was used to identify both individual- and community-level risk factors associated with childhood diarrhea. Result The incidence of childhood diarrhea was 12% (95% CI: 11.39, 12.63). The random-effects model revealed that 67% of the variability of childhood diarrhea was explained by individual- and community-level factors. From the individual-level factors, children aged 36–59 months (AOR = 3.166; 95% CI: 2.569, 3.900), twin child (AOR = 1.871; 95% CI: 1.390, 2.527), birth order 5 and above (AOR = 2.210, 95% CI: 1.721, 2.839), not received any vaccination (AOR = 1.197; 95% CI: 1.190, 1.527), smaller size of child at birth (AOR = 1.303; 95% CI: 1.130, 1.504), and never breastfed children (AOR = 2.91; 95% CI: 2.380, 3.567) associated with the higher incidence of childhood diarrhea. From the community-level factors, living in a rural area (AOR = 1.505; 95% CI: 1.233, 1.836)), unprotected source of drinking water (AOR = 1.289; 95% CI: 1.060, 1.567), and availability of unimproved latrine facilities (OR: 1.289; 95% CI: 1.239, 1.759) associated with the higher incidence of childhood diarrhea. Besides, children who live in Afar, Amhara, Benishangul-Gumuz, Gambella, SNNPR, and Dire Dawa regions had higher incidence of childhood diarrhea. Conclusion The incidence of childhood diarrhea was different from cluster to cluster in Ethiopia. Therefore, integrated child health intervention programs including provisions of toilet facility, access to a clean source of drinking water, educate parents about the importance of breastfeeding, and vaccination have to be strongly implemented in order to reduce the high incidence of childhood diarrhea among children in Ethiopia.

Detection Of Fecal Coliforms In Water Used In Formal And Informal Food Outlets In Kasungu District, Malawi

Poor sanitary practices are common amongst many food handlers posing a health risk to consumers. Maintenance of high quality water is one of the most important aspects of ensuring consumer safety. Therefore, regular water testing is critical in public food outlets where bacterial contamination may cause outbreak of disease. The study aimed at analyzing water samples obtained from the formal and informal food outlets for the presence of fecal coliforms that are indicative of poor sanitation that result in foodborne infections amongst consumers. Using a cross-sectional design, water samples from participating food outlets (N=40) were analyzed using the membrane filtration method. Samples were filtered, under vacuum, through a cellulose acetate membrane of 0.45 μm pore size. Fecal coliforms exceeding permissible range were detected in 15 test samples (N=40). The median (IQR) concentrations of fecal coliforms (FC/100ml) in dishwashing water was 1(136) and 145(340) for the formal and informal food outlets respectively. The median (IQR) for drinking water was 0(0) with a minimum and maximum range of 0 and 14 FC/100mls. The study established a positive correlation between fecal coliforms and electrical conductivity, and total dissolved solids (p<0.05) in dish washing water used at both formal and informal food outlets. Contamination was attributed to lack of running water, poor pest control and unwholesome practices in many food outlets. Based on the study findings, it is concluded that electrical conductivity, total dissolved solids and turbidity values may be used to deduce the presence of fecal coliforms in water. The study recommends that water drawn from unprotected sources must be boiled or treated at the point of use before it can be safely used in food outlets. Periodic water testing and sanitary supervisions for all food outlets must be mandatory to ensure compliance with minimum set standards.

Chemical and in vitro bioanalytical assessment of drinking water quality in Manhiça, Mozambique

The chemical quality of drinking water is widely unknown in low-income countries. We conducted an exploratory study in Manhiça district (Mozambique) to evaluate drinking water quality using chemical analyses and cell-based assays. We measured nitrate, fluoride, metals, pesticides, disinfection by-products, and industrial organochlorinated chemicals, and conducted the bioassays Ames test for mutagenicity, micronuclei assay (MN-FACS), ER-CALUX, and antiAR-CALUX in 20 water samples from protected and unprotected sources. Nitrate was present in all samples (median 7.5 mg/L). Manganese, cobalt, chromium, aluminium, and barium were present in 90-100% of the samples, with median values of 32, 0.6, 2.0, 61, 250 μg/l, respectively. Manganese was above 50 μg/l (EU guideline) in eight samples. Arsenic, lead, nickel, iron, and selenium median values were below the quantification limit. Antimony, cadmium, copper, mercury, zinc and silver were not present. Trihalomethanes, haloacetic acids, haloacetonitriles and haloketones were present in 5-28% samples at levels ≤4.6 μg/l. DDT, dieldrin, diuron, and pirimiphos-methyl were quantified in 2, 3, 3, and 1 sample, respectively (range 12-60 ng/L). Fluoride was present in one sample (0.11 mg/l). Trichloroethene and tetrachloroethene were not present. Samples were negative in the in vitro assays. Results suggest low exposure to chemicals, mutagenicity, genotoxicity and endocrine disruption through drinking water in Manhiça population. High concentration of manganese in some samples warrants confirmatory studies, given the potential link to impaired neurodevelopment.

Childhood Malnutrition and the Association with Diarrhea, Water supply, Sanitation, and Hygiene Practices in Kersa and Omo Nada Districts of Jimma Zone, Ethiopia.

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.

The Potential for Citizen Science to Improve the Reach of Sanitary Inspections

To achieve Sustainable Development Goals (SDGs) 6, universal and equitable access to safe and affordable drinking-water quality and sanitation for all, and 10, to reduce inequality within and among countries, additional and urgent work is required. Efforts to achieve these Goals in the context of small drinking-water supplies, which are the furthest behind in regards to progress, are of particular need. Reasons for this disparity in progress include the remoteness of access to small drinking-water supplies and the lack of technical and financial capacity for monitoring supplies. The World Health Organization promote the use of Sanitary inspection (SI) as an on-site assessment of risk. Despite the potential to increase the body of knowledge and information on supplies in a region, there has been limited research into the role of citizen science and SIs. To meet SDG targets, we need to improve the reach of SIs. This study uses a mixed methods approach of quantitative on-site SI data collection and remote SI data collection via photographic images, together with qualitative data collection, collected by non-expert students, who are citizens of Malawi, as well as a panel of experts in the field of SI. Results indicate that, although further research into the topic is required prior to widescale implementation, the potential exists for citizens to conduct SI, with remote expert verification of the results using photographic images of supplies. Further documentation or guidance is required to support citizens in this process. The results highlight a critical gap in the availability of appropriate documentation for unprotected spring sources which is urgently required. The use of citizen science for SI data collection is in its infancy. However, this study indicates that there is potential to explore the use of citizen science in this area, which will contribute to achieving SDGs 6 and 10.