BACKGROUND: Household air pollution from biomass fuels burning in traditional cookstoves currently appeared as one of the most serious threats to public health with a recent burden estimate of 2.6 million premature deaths every year worldwide, ranking highest among environmental risk factors and one of the major risk factors of any type globally. Improved cookstove interventions have been widely practiced as potential solutions. However, studies on the effect of improved cookstove interventions are limited and heterogeneous which suggested the need for further research. METHODS: A cluster randomized controlled trial study was conducted to assess the effect of biomass-fuelled improved cookstove intervention on the concentration of household air pollution compared with the continuation of an open burning traditional cookstove. A total of 36 clusters were randomly allocated to both arms at a 1:1 ratio, and improved cookstove intervention was delivered to all households allocated into the treatment arm. All households in the included clusters were biomass fuel users and relatively homogenous in terms of basic socio-demographic and cooking-related characteristics. Household air pollution was determined by measuring the concentration of indoor fine particulate, and the effect of the intervention was estimated using the Generalized Estimating Equation. RESULTS: A total of 2031 household was enrolled in the study across 36 randomly selected clusters in both arms, among which data were obtained from a total of 1977 households for at least one follow-up visit which establishes the intention-to-treat population dataset for analysis. The improved cookstove intervention significantly reduces the concentration of household air pollution by about 343 μg/m CONCLUSIONS: The biomass-fuelled improved cookstove intervention significantly reduces the concentration of household air pollution compared to the traditional method. This suggests that the implementation of these cookstove technologies may be necessary to achieve household air pollution exposure reductions. TRIAL REGISTRATION The trial project was retrospectively registered on August 2, 2018, at the clinical trials.gov registry database ( https://clinicaltrials.gov/ ) with the NCT03612362 registration identifier number.
Air Pollutants/analysis* ; Air Pollution, Indoor/prevention & control* ; Biomass ; Cluster Analysis ; Cooking/methods* ; Ethiopia

BACKGROUND: Globally, dental caries may be a major public health issue which may be preventable. Many studies have been conducted on dental caries in Ethiopia which present inconsistent results. OBJECTIVE: This meta-analysis was expected to consolidate the findings conducted in various regions of the country and generate country representative information on the burden and its associated factors of dental caries in Ethiopia. METHODS: Our systematic review and meta-analysis was carried out to estimate the pooled prevalence of dental caries and its associated factors in the Federal Democratic Republic of Ethiopia. Medical specialty databases like ScienceDirect, HINARI, Embase, PubMed, Google Scholar, and Cochrane Library were consistently and exhaustively searched. To determine the aggregate prevalence, studies delineating the prevalence of dental caries and associated factors were included. Important data were extracted employing a standardized data extraction tool ready in Microsoft Excel and imported to the STATA version-13 statistical software package for analyses. To assess non-uniformity, the Cochrane Q test statistics and I RESULTS: The result of thirteen studies disclosed that the overall prevalence of dental caries in the Federal Democratic Republic of Ethiopia was found to be 40.98 (31.62, 50.34). Within the subgroup analysis, the uppermost prevalence was determined in Tigray region (46.59% (24.64, 68.54)) whereas the bottom prevalence was determined in Addis Ababa (34.20% (8.42, 59.97)). Dental caries prevalence was considerably high among study subjects who consumed sweet food (OR= 2.4 (95% CI (1.91, 3.01))). But the presence of dental plaque (OR = 5.14 (95% CI (0.67, 39.39))) and habit of tooth- cleaning (OR = 0.71 (95% CI (0.17, 2.96))) were not statistically significant with the outcome of interest. CONCLUSION Our meta-analysis found that the prevalence of dental caries was comparatively high, and sweet food consumption was the most risk issue for dental caries in Ethiopia. The Ethiopian Federal Ministry of Health ought to offer a lot of attention to strengthen the oral health care system and also the implementation of community-level interference programs.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Dental Caries/etiology* ; Ethiopia/epidemiology* ; Humans ; Middle Aged ; Prevalence ; Risk Factors ; Young Adult

INTRODUCTION: The survival of HIV/AIDS patients on antiretroviral therapy (ART) is determined by a number of factors, including economic, demographic, behavioral, and institutional factors. Understanding the survival time and its trend is crucial to developing policies that will result in changes. The aim of this study was to compare the survival estimates of different subgroups and look into the predictors of HIV/AIDS patient survival. METHODS: A retrospective cohort study of HIV/AIDS patients receiving ART at the University of Gondar teaching hospital was carried out. To compare the survival of various groups, a Kaplan-Meier survival analysis was performed. The Cox proportional hazards model was used to identify factors influencing HIV/AIDS patient survival rates. RESULTS: In the current study, 5.91% of the 354 HIV/AIDS patients under ART follow-up were uncensored or died. Age (HR = 1.051) and lack of formal education (HR = 5.032) were associated with lower survival rate, whereas family size of one to two (HR = 0.167), three to four (HR = 0.120), no alcoholic consumption (HR = 0.294), no smoking and chat use (HR = 0.101), baseline weight (HR = 0.920), current weight (HR = 0.928), baseline CD4 cell count (HR = 0.990), baseline hemoglobin (HR = 0.800), and no TB diseases were associated with longer survival rate. CONCLUSIONS Fewer deaths were reported in a study area due to high patient adherence, compared to previous similar studies. Age, educational status, family size, alcohol consumption, tobacco and chat usage, baseline and current weight, baseline CD4 cell count, baseline hemoglobin, and tuberculosis (TB) diseases were all significant predictors of survival of HIV/AIDS patients.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-HIV Agents/therapeutic use* ; Cohort Studies ; Ethiopia/epidemiology* ; Female ; HIV Infections/mortality* ; Hospitals ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Young Adult

BACKGROUND: International Labour Organization (ILO) report indicates more than 2.4 million workers die from work-related diseases and accidents each year. Work-related respiratory ailments related to airborne particulate matter such as flour dust are responsible for about 386,000 deaths and 6.6 million illness-adjusted life years. Even though exposure to flour dust together with the extreme expansions of flour mill sectors is a priority health concern, extent of the problem is little investigated in Ethiopia. The aim of this study was to evaluate the magnitude and risk factors of work-related respiratory symptoms among flour mill workers in Bahir Dar City, Ethiopia. METHODS: This study employed a comparative cross-sectional survey of 560 samples (280 exposed group from flour mill workers and 280 unexposed group from office workers) with a stratified random sampling technique. The study was conducted from March to April 2019 in Bahir Dar City, Northwest Ethiopia. We used the British Medical Research Council (BMRC) questionnaire to assess work-related respiratory symptoms. The questionnaire was pretested and interview administered to collect data. Binary logistic regression analysis was fitted to evaluate significant factors of respiratory symptoms at a < 0.05 p value. Adjusted odds ratio (AOR) with a confidence interval (CI) of 95% was calculated to determine a strength of association. RESULTS: All the sampled participants had fully responded to the interview. The median age of exposed and unexposed groups was 28.5 interquartile range (IQR, 20) and 31 (IQR, 15) years, respectively. The prevalence of work-related respiratory symptoms among flour mill workers was substantially higher than that of among controls, 63.9% and 20.7%, respectively (Χ CONCLUSION Respiratory symptoms emanating from exposure to various flour dusts were significantly higher among flour mill workers than among the control group. Therefore, we recommend the need to effectively implement health and safety programs that account for the reduction of dust at a source, use of engineering controls (e.g., provision of adequate ventilation systems), use of administrative measures (e.g., training program and health surveillance) and provision of a suitable personal protective equipment (PPE). Furthermore, it is vital to integrate workplace health and safety programs to the wider public health policies and strategies to effectively mitigate the burden of work-related respiratory conditions. We also encourage future studies to evaluate concentration of flour dusts combined with physical examinations to establish plausible associations of respiratory symptoms with dusts of flour mill-related origin.
Adult ; Air Pollutants, Occupational/adverse effects* ; Cross-Sectional Studies ; Dust ; Ethiopia/epidemiology* ; Female ; Flour ; Humans ; Male ; Occupational Diseases/epidemiology* ; Particulate Matter/adverse effects* ; Prevalence ; Respiration Disorders/epidemiology* ; Risk Factors ; Surveys and Questionnaires ; Workplace ; Young Adult

BACKGROUND: Substance abuse is a worldwide problem that primarily affects adolescents, resulting in chronic health complications as well as psychosocial challenges and economic losses. However, the magnitude of the problem and the factors that contribute to it are not well studied in Ethiopia, particularly in the study area. As a result, this study was carried out to determine the prevalence and associated factors of substance use among preparatory school students in the Kolfe-Keraniyo sub-city of Addis Ababa, Ethiopia. METHODOLOGY: An institution-based cross-sectional study of 383 randomly selected preparatory school students in the Kolfe-Keraniyo sub-city was conducted. The data were gathered using a pretested self-administered structured questionnaire. Multivariable binary logistic regression analysis was employed to identify factors associated with substance use based on the adjusted odds ratio (AOR) and 95% confidence interval (CI) with p values less than 0.05. RESULT: This study revealed that the lifetime prevalence of substance use among preparatory students in Kolfe-Keraniyo sub-city, Addis Ababa, Ethiopia, was 26.5% (95% CI, 22.2, 30.7%). Specifically, 16% drunk alcohol, 9.6% smoked cigarette, and 9.4% chewed khat. The 16.3% were current users, of which 8.3% were drinkers, 6.4% were smokers, and 5.9% were khat chewers. Substance use was significantly associated with being male (AOR, 3.3; 95% CI, 1.284, 8.613), having alcohol drinking family member (AOR, 4.0; 95% CI, 1.704, 9.196), having khat chewing family member (AOR, 2.87; 95% CI, 1.161, 7.070), poor school substance use controlling rule (AOR, 6.64; 95% CI, 1.863, 23.687), availability of substance retailing shops in residential areas (AOR, 2.9; CI, 1.303, 6.606), strong relationship with parents (AOR, 0.005; 95% CI, 0.001, 0.026), and being member of school mini-media (AOR, 0.177; 95% CI, 0.048, 0.657). CONCLUSION According to the findings of this study, one-quarter of the study participants were substance users. Alcohol, khat, and cigarettes were all commonly used substances. Gender, parent-child relationship, family member substance use history, school substance use controlling rules, school mini-media and pro-social involvement, and the availability of substance retailing shops were all strongly associated with substance use. Strengthening school rules on substance use, controlling substance retailing shops near schools and residential areas, and providing students with health education are all strategies for reducing substance use among students.
Adolescent ; Cross-Sectional Studies ; Ethiopia/epidemiology* ; Female ; Humans ; Male ; Prevalence ; Risk Factors ; Schools ; Students/statistics & numerical data* ; Substance-Related Disorders/epidemiology* ; Surveys and Questionnaires ; Young Adult

Bilharziasis is a tropical parasitic disease caused by different species of the genus Schistosoma. One species, S. haematobium, is widely spread in Sudan. There is a scarcity of information about S. haematobium infection among the fishermen in the country. Therefore, this study was designed to determine the prevalence of S. haematobium infection among fishermen, and the immune status among non-infected fishermen in two villages, El Hadib and Hawer-Ajowel at the White Nile state in Sudan. A cross-sectional survey was conducted among 119 fishermen in addition to 20 samples from non-endemic area which were included as a control group. Urine samples were examined by sedimentation method and faecal samples were examined by the Kato Katz method and formalin-ether concentration technique. Blood samples were examined for enumeration of IgE antibody and cytokines, interferon Gamma (IFN-γ), Tumor Necrosis Factor (TNF) and Interleukin10 (IL–10) levels using ELISA. The result of the study indicated that the overall prevalence of S. haematobium among the fishermen was 35 (29.41 %). Of the 35 positive participants, 23 (65.71 %) were infected for the first time, and 12 (34.29 %) for the second time (re-infection). Twenty-four candidates of the non-infected fishermen were included in the immunological study. The total IgE mean titer was 282.90 ±70.93 iu/ml, IFN-γ mean level was 9.62±4.60 pg/ml. TNF, 114.64±46.63 pg/ml and the IL–10 was 1.51±0.58 pg/ml. High prevalence of S. haematobium exists among fishermen and the non-infected fishermen from the endemic area showed high immune response similar to those exposed to the infection.
Cytokines ; Allergy and Immunology ; Sudan

BACKGROUND: Improved water sources are not equally available in all geographical regions. Populations dependent on unsafe water sources are recommended to treat their water at point-of-use using adequate methods to reduce associated health problems. In Ethiopia, the spatial distribution of households using unimproved water sources have been incomplete or ignored in most of the studies. Moreover, evidence on the point-of-use water treatment practice of households dependent on such water sources is scarce. Therefore, the current study is intended to analyze the spatial distribution of unimproved water sources by wealth quintiles at country level and point-of-use treatment (POU) practices using nationally representative data. METHOD: The data of 2016 Ethiopian Demographic and Health Survey (EDHS) conducted on 16650 households from 643 clusters were used for the analysis. For spatial analysis, the raw and spatially smoothed coverage data was joined to the geographic coordinates based on EDHS cluster identification code. Global spatial autocorrelation was performed to analyze whether the pattern of unimproved water coverage is clustered, dispersed, or random across the study areas. Once a positive global autocorrelation was confirmed, a local spatial autocorrelation analysis was applied to detect local clusters. The POU water treatment is analyzed based on reported use of either boiling, chlorine (bleach), filtration, or solar disinfection (SODIS). RESULTS: There were 5005 households using unimproved water sources for drinking purposes. Spatial variation of unimproved water coverage was observed with high coverage observed at Amhara, Afar, Southern Nations Nationalities and People and Somalia regions. Disparity in unimproved water coverage between wealth quintiles was also observed. The reported point-of-use water treatment practice among these households is only 6.24%. The odds of POU water treatment among household heads with higher education status is 2.5 times higher (95% CI = 1.43-4.36) compared to those who did not attend education. CONCLUSION An apparent clustering trend with high unimproved water coverage was observed between regions and among wealth quintiles hence indicates priority areas for future resource allocation and the need for regional and national policies to address the issue. Promoting households to treat water prior to drinking is essential to reduce health problems.
Drinking Water/analysis* ; Ethiopia ; Socioeconomic Factors ; Spatial Analysis ; Water Purification/methods* ; Water Supply/statistics & numerical data*

Aims: The study aimed at determining the antimicrobial activities and cytotoxicity properties of medicinal plants collected from southwestern Kenya. Methods and results: A total of 23 ethanol extracts of selected medicinal plants were bio-assayed against Gramnegative bacterial strains (Escherichia coli NU14, Helicobacter pylori ATCC 700824, and Porphyromonas gingivalis ATCC 33277). Cytotoxicity tests were also carried out on mammalian cell lines (AGS, KB, and TR146). Preliminary type of phytochemical compounds present in the extracts was determined by thin-layer chromatography. Cassia didymobotrya plant extract (1 mg/mL) had strong antimicrobial activity against P. gingivalis (average zone of inhibition of 21.70 ± 0.88 mm, MIC 0.13 ± 0.00 mg/mL and MBC 0.50 ± 0.00 mg/mL). Escherichia coli was resistant to all the extracts bioassayed. Leonotis nepetifolia (15.80 ± 0.20 mm) and Clerodendrum myriacoides (14.20 ± 0.44 mm) showed only moderate activity against H. pylori. Cell cytotoxicity results indicated a dose-dependent response against KB, TR146 and AGS cell lines with C. didymobotrya having IC50 values of 47.64 and 704.00 µg/mL on KB and TR146 cell lines, respectively. L. nepetifolia and C. myriacoides did produce IC50 of 0.1883 mg/mL and 0.1061 mg/mL against the AGS cell line respectively. Conclusion, significance and impact of the study Most of the extracts had no or weak activity against test isolates, but C. didymobotrya leaves extracts showed strong activity against P. gingivalis. C. didymobotrya can offer alternative medicare to P. gingivalis conditions.
Plants, Medicinal--adverse effects ; Kenya (Southwestern)

BACKGROUND: Petrol is the non-specific term for petroleum which is used for inside combustion of engines. Petrol filling workers are highly vulnerable to occupational exposure to these harmful substances which lead to hemato-toxicity and blood disorders such as leukemia, aplastic anemia, and dysplastic bone marrow. Thus, this study was aimed to assess hematological parameters of petrol filling workers in Gondar town, Northwest Ethiopia. METHODS: A comparative cross-sectional study was conducted from January to March 2019 in Gondar town, Northwest Ethiopia. A total of 110 study participants comprising 55 study groups and 55 controls group were recruited by a convenient sampling technique. Socio-demographic data were collected using a structured questionnaire, and 3 ml of venous blood was collected for the determination of hematological parameters. The data were entered into Epi info 7.2.0.1 and analyzed by SPSS version of 20. Mean, standard deviation, median, and interquartile ranges were used to present the data. Independent t test and Mann-Whitney U test were used to compare the mean or median difference between parametric and non-parametric hematological parameters, respectively. Moreover, Pearson product-moment and Spearman's rank-order bivariable correlations analyses were used to describe the correlation between hematological parameters and duration of exposure to petrol. A P value of ≤ 0.05 was considered statistically significant. RESULTS: The study revealed that mean red blood cell count and hemoglobin level as well as the median hematocrit, mean cell hemoglobin concentration, platelet count, absolute lymphocytes count, and red cell distribution width values of petrol filling workers showed a significant increment compared with the control group. On the other hand, the mean cell hemoglobin value of petrol filling workers showed a significant decrement compared with healthy controls. Moreover, the duration of exposure to petrol showed a significant positive correlation with red blood cell count and mean cell hemoglobin concentration; however, a significant negative correlation was observed with mean cell volume. CONCLUSION This study showed that the majority of hematological parameters of petrol filling workers showed an increment compared with healthy controls which might be associated with exposure to petrol chemicals. However, further longitudinal study with a larger sample size should be conducted to explore the impact of petrol exposure on hematopoiesis.
Adult ; Cross-Sectional Studies ; Erythrocyte Count ; Erythrocyte Indices ; Ethiopia ; Female ; Hematocrit ; Humans ; Lymphocyte Count ; Male ; Middle Aged ; Occupational Exposure ; analysis ; Oil and Gas Industry ; Platelet Count ; Time Factors ; Young Adult

BACKGROUND: World Health Organization (WHO) recommends that viral load ([VL) is a primary tool that clinicians and researchers have used to monitor patients on antiretroviral therapy (ART), an antiviral drug against retroviruses. Whereas, CD4 cell counts can only be used to monitor clinical response to ART in the absence of VL testing service. Therefore, this study is aimed to assess the level of immunological status and virological suppression, and identify associated factors among human immunodeficiency virus ([HIV)-infected adults who were taking antiretroviral drugs of combination regimen know as highly active antiretroviral therapy (HAART). METHODS: A hospital-based cross-sectional study was conducted at the University of Gondar comprehensive specialized referral hospital from February to April 2018. A total of 323 adult participants on HAART were selected using a systematic random sampling technique and enrolled into the study. Blood samples for viral load determination and CD4 cell count were collected. Binary logistic regression analysis was used to determine factors associated with immunologic status and virological suppression in HIV patients on HAART. Odds ratio with 95% CI was used to measure the strength of association. RESULTS: Virological suppression (VL level < 1000 copies/ml) was found in 82% (95% CI 77.7, 86.1) of study participants, and it has been associated with CD4 cell count between 350 and 499 cells/mm (adjusted odds ratio (AOR) = 2.56; 95% CI 1.14, 5.75) and > 499 cells/mm (AOR = 7.71; 95% CI 3.48, 17.09) at VL testing and current age > 45 years old (AOR = 5.99; 95% CI 2.12, 16.91). Similarly, favorable immunological status (≥ 400 cells/mm for male and ≥ 466 cells/mm for female) was observed in 52.9% (95% CI 47.4, 58.8) of the study participants. Baseline CD4 cell count of > 200 cells/mm, age at enrollment of 26 through 40 years old, and urban residence were significantly associated with favorable immunological status. CONCLUSION Though the majority of HIV-infected adults who were on HAART had shown viral suppression, the rate of suppression was sub-optimal according to the UNAIDS 90-90-90 target to help end the AIDS pandemic by 2020. Nonetheless, the rate of immunological recovery in the study cohort was low. Hence, early initiation of HAART should be strengthened to achieve good virological suppression and immunological recovery.
Adult ; Aged ; Antiretroviral Therapy, Highly Active ; statistics & numerical data ; CD4 Lymphocyte Count ; Cross-Sectional Studies ; Disease Susceptibility ; immunology ; Ethiopia ; Female ; Humans ; Male ; Middle Aged ; Viral Load ; Young Adult