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Abstract Background Street foods are any foods or drinks prepared or sold by street vendors in an open space. The purpose of this study was to determine the Bacteriological safety and antibiotic resistance patterns of Staphylococcus aureus and Enterobacteriaceae isolated from street foods. Method A laboratory-based cross-sectional study was used from December 2022 to February 2023 on street foods of Addis Ababa, Hawassa, Dire Dawa, and Jimma towns of Ethiopia. 525 street foods and 175 water samples were taken from 175 street food vending stalls. Proportional allocation to the total town population and stratified sampling techniques were used to select vending stalls. Samples were analyzed for the presence of bacteria following the standard microbiological methods used for the isolation, enumeration, and identification of bacteria. Pour plate technique was used to transfer the suspension to MacConkey agar, Mannitol Salt Agar, and Salmonella Shigella Agar. The antibiotic susceptibility test was performed using the Kirby-Bauer disk diffusion method. SPSS software was used to analyze the data. Result Out of 525 food samples, 279 (53%) were contaminated by bacteria. From 175 water samples, 95 (54.3%) were contaminated with Escherichia coli. From both samples in total, eleven bacterial species were isolated. Staphylococcus aureus was the most frequently isolated species. Shigella, Klebsiella, and Salmonella group A have statistically significant with the type of food. Erythromycin (54%), Streptomycin (17%), and Amoxicillin (14%) were the most resistant antibiotics. Least resistance was observed to Ciprofloxacin (5%). Conclusion Street foods of the selected towns were highly contaminated with various antibiotic-resistant organisms. Hence, the relevant authorities ought to ensure the proper handling of street food by enforcing safety measures. Additionally, they should initiate a widespread awareness campaign promoting the prudent use of antibiotics among both street food vendors and the broader population.

Dereje Esubalew,1 Mihret Melese,2 Melese Belete,3 Adugnaw Ambelu,2 Bezawit Mulat,2 Tadegew Adane,4 Wubet Tazeb Wondie,5 Mengistie Diress2 1Department of Human Physiology, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia; 2Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Human Physiology, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 4Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 5Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Ambo University, Ambo, EthiopiaCorrespondence: Dereje Esubalew, Tel +251942868674, Email derejeesubalew13@gmail.comBackground: Generally, people with type 2 diabetes mellitus in various countries experience a significant rate of sensorineural hearing impairment. Nonetheless, there is scant evidence of sensorineural hearing impairment among type 2 diabetes mellitus patients in Northwest Ethiopian. Therefore, the objective of this study was to evaluate the occurrence rate and contributing factors of sensorineural hearing impairment in type 2 diabetics at comprehensive and specialized referral hospitals in Northwest Ethiopia.Methods: A facility-based cross-sectional study design was carried out from May 3, 2022, to June 14, 2022, on 846 study participants in Ethiopia, with a response rate of 99.65%. The research subjects were chosen by simple random sampling techniques. Data was gathered by using audiometric measurements and structured interview-administered questionnaires and then entered into EPI data version 4.6. Finally, it was exported to STATA 14 for analysis. Binary logistic regression, chi-square test, and odds ratio were done to verify the assumptions and degree of association. Ultimately, factors exhibiting a p-value < 0.05 with a 95% CI were regarded as significant predictors of hearing impairment.Results: The magnitude of sensorineural hearing impairment in this investigation was 50.49% (95% CI: 45.67%, 55.26%). Factors significantly associated with sensorineural hearing impairment were age (AOR=1.10, 95% CI: 1.07, 1.14), hyperlipidemia (AOR=2.86, 95% CI: 1.05, 7.82), duration of diabetes (AOR=2.26, 95% CI: 1.26, 4.06), hypertension (AOR=1.94, 95% CI: 1.02, 3.69) and regular physical exercise (AOR=0.25, 95% CI: 0.09, 0.68).Conclusions and Recommendations: In this study, relatively high rates of sensorineural hearing impairment were observed. Stakeholders should establish routine hearing screening, and participants will advise to incorporate regular physical exercise into their routines.Keywords: hearing loss, impairment, audiometer, diabetes, Ethiopia

Background: Street foods are ready-to-eat foods prepared and/or sold by vendors and hawkers in public places such as streets and plazas. Despite being widely available and affordable, they pose a significant public health risk. Objective: This study aims to assess the hygienic practices of street food vendors, sanitary condition of their stalls and associated factors in selected towns of Ethiopia. Method: Community-based Cross-sectional study design was used from December 2022 to January 2023 in Addis Ababa, Dire Dawa, Hawassa, and Jimma towns of Ethiopia. A total of 1168 street food-vending stalls were determined using a single population proportion formula. Proportional allocation to the total population of the towns was used to assign the number of street food vending stalls to each town and sub cities. The interviewer-administered questionnaire and an observational checklist were used to collect data. Bivariate and multivariate analyses were run using statistical Package for Social Sceinces (SPSS) V-23. Result: The study included 926 street food vendors from Addis Ababa, 84 from Dire Dawa, 99 from Hawassa, and 59 from Jimma. The majority of respondents (86%) were female, with a mean age of 31.26. 60% of respondents were married, and 57% had completed primary school. 18% of street food vendors prepared their food on the street, with no shelter or shade. The overall good hygienic practices of the street food vendors were 16% while the good sanitary status of the vending stalls was 6.8 %. Sex, work experience, receiving training on food safety, having medical checkup, availability of hand washing facilities, and having good knowledge on food safety were predictors of good hygienic practice. Conclusion: Most of the street food vendors had poor hygienic practices as well as their vending stalls had poor sanitary conditions. Hence, encouragement and support for street food vendors to have improved water, sanitation, and hygiene facilities in the vicinity, along with strict regulations, will help the vendors provide safe food to consumers, thereby protecting the public's health.

Introduction: Street foods are foods and beverages as either ready for direct consumption or minimally processed, prepared, and/or sold by vendors and handlers. The objective of this study was to explore the condition and governance of street foods in Ethiopia. Method: A qualitative exploratory study was employed from December 2022 to January 2023 in Addis Ababa, Hawassa, Dire Dawa, and Jimma, cities of Ethiopia. Twelve respondents comprised key informants from selected governmental sectors were interviewed. The purposive sampling method was used to recruit study participants. The number of participants interviewed was determined by the information saturation criterion, and data were collected at the interviewee’s offices. Data were collected by using key informant interview technique and audio recorded. An interview guide was used to facilitate interviews and thematic analysis was employed. The Overall data management process was conducted using Atlas-ti V 8 software. Result: The result revealed there were 4 thematic areas these were street food vendors and vending process, policy content and implementation, integration and coordination of sectors, and the way forward. The street food vendors prepared their food in an insanitary manner, absence of common working places for the vendors, lack of due emphasis for the street food vendors in the national food and nutrition policy, lack of formalization and legalization of street food vendors, poor coordination among sectors and institutions work on street food governance, and weakness on the implementation of rules and regulations in controlling street food vendors were the prominent gaps that were identified in the policy. Conclusion: Though Ethiopia has a national food and nutrition policy, the policy doesn’t adequately address the street food vending sector. Besides, it is not well communicated to the implementers resulting in poor policy implementation. Quantifying socio-economic benefits of street food vending activities in Ethiopia needs further investigation.

Tadegew Adane,1 Mihret Melese,2 Ephrem Tesfaye,3,&ast; Adugnaw Ambelu,2,&ast; Mihret Getnet,2,&ast; Deresse Sinamaw,1,&ast; Dereje Esubalew,4,&ast; Yibeltal Yismaw2 1Department of Biomedical Science, School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Biomedical Sciences, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale- Goba, Southeast Ethiopia; 4Department of Biomedical Science, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia&ast;These authors contributed equally to this workCorrespondence: Tadegew Adane Abebe, Email tadegeada0975@gmail.comBackground: Epilepsy is a brain disease that is associated with electrocardiographic (ECG) abnormalities. However, this evidence is limited in Ethiopia. Studying ECG abnormality in epileptic patients could help minimize the cardiac problems and death of epileptic patients by early screening. This study was aimed to assess electrocardiogram abnormalities and associated factors among people with and without epilepsy at referral hospitals in Amhara Regional State (ARS), northern Ethiopia, 2022.Methods: Institutional-based comparative cross-sectional study was conducted from April 20 to June 20, 2022. Three referral hospitals in ARS were selected by simple random sampling. Epileptic patients were selected by systematic random sampling, and 403 age- and sex-matched participants were selected from attendants of patients in the outpatient department. Interviewer-administered questionnaire and digital electrocardiograph were used for data collection. Data were entered to EpiData version 4.6 and exported to stata version 14 for analysis. Variables with P value < 0.25 in bivariable analysis were entered to multivariable binary logistic regression. Strength of association was determined by adjusted odds ratio with a 95% confidence interval (CI).Results: The prevalence of ECG abnormality was 40.0% (95% CI = 34.7– 46.8) and 29.0% (95% CI = 23.2– 34.3) in epileptic and non-epileptic subjects, respectively. The odds of ECG abnormality was 58% higher among epileptic patients. Divorce, duration of epilepsy, uncontrolled epilepsy, former/current smoker, adequate physical activity, hypertension, and overweight/obesity were associated with ECG abnormality among epileptic patients.Conclusion and Recommendations: The proportion of ECG abnormality was higher among the epileptic than the non-epileptic group. This should be a wake-up call for stakeholders to establish appropriate measurements to reduce cardiac issues of epileptic patients.Keywords: electrocardiographic abnormality, epilepsy, Ethiopia

Mihret Melese, Ayechew Adera, Adugnaw Ambelu, Yibeltal Yismaw Gela, Mengistie Diress Department of Human Physiology, School of Medicine, University of Gondar, Gondar, EthiopiaCorrespondence: Mengistie Diress, University of Gondar, P. O. Box 196, Gondar, Ethiopia, Email mengistiediress@gmail.comIntroduction: Cardiovascular disorders are one of the commonly recognized occupational diseases in the developed world. Individuals chronically exposed to noise at workplaces had a higher risk of developing elevated arterial blood pressure. There are limited studies in Ethiopia regarding this topic and thus this study determined the prevalence and determinant factors of occupational noise-induced pre-hypertension among metal manufacturing workers in Gondar city administration, Northwest Ethiopia.Methods: An institution-based cross-sectional study design was carried out. In this study, 300 study participants were recruited by census sampling method. A sound level meter was used to measure the working area noise level. A semi-structured pre-tested interviewer-administered questionnaire was used to collect sociodemographic and clinical data. Blood pressure was measured in a quiet room in the morning using a mercurial sphygmomanometer. Both bivariable and multi-variable binary logistic regressions were used to identify factors associated with noise-induced prehypertension. Adjusted odds ratio with 95% confidence interval was reported, and variables with p < 0.05 were considered as statistically associated factors with pre-hypertension.Results: The prevalence of noise-induced pre-hypertension was 27.7% (95% CI: 22.7– 32.7). In multivariable logistic regression, working area noise level (AOR = 3.8, 95% CI: 6.8– 8.9), 45– 65 years’ age (AOR = 9.8, 95% CI: 5.4– 12.9), years of work experience ((6– 10 years (AOR = 2.8, 95% CI: 1.98– 5.90 and > 10 years (AOR = 4.8, 95% CI: 7.8– 9.75)), being a cigarette smoker (AOR = 3.6, 95% CI: 1.36– 9.77), and alcohol consumption (AOR = 2.4, 95% CI: 1.06– 1.04) were significantly associated with noise-induced prehypertension.Conclusion: Workers in metal manufactures who were exposed to noise levels > 85 dB developed elevated blood pressure. The odds of having prehypertension were increased by years of work experience, advanced age, smoking, and alcohol consumption. Our findings recommended that the real-world preventive strategies should be taken to lower the risk of noise-induced pre-hypertension hastened by occupational noise exposure.Keywords: noise, pre-hypertension, metal manufacturing workers, Ethiopia

Yibeltal Yismaw Gela,1 Ayechew Adera Getu,1 Aynishet Adane,2 Bezawit Mulat Ayal,1 Yonas Akalu,1 Adugnaw Ambelu,1 Mengistie Diress,1 Yigizie Yeshaw1,3 1Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Internal Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Yibeltal Yismaw Gela Email yibeltalyismaw7@gmail.comBackground: Cognitive impairment is one of the public health problems affecting 50 million people in the world. Chronic kidney disease (CKD) patients are at high risk to develop cognitive impairment which leads to poor quality of life, difficulty in adhering to medications, increased risk of mortality, and health resource utilization. However, there is no study done on the prevalence of cognitive impairment and associated factors among chronic kidney disease patients in Ethiopia.Objective: This study aimed to assess the prevalence of cognitive impairment and associated factors among chronic kidney disease patients at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals in 2020, Northwest Ethiopia, 2020.Methods: An institution-based comparative cross-sectional study was conducted at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals in 2020. A systematic random sampling technique was used to select the study participants. Data were collected using standard tools. Data were checked for its completeness and entered into Epi data version 3.0 then exported into STATA 14. Multi-variable logistic regression analysis was employed to identify associated factors of cognitive impairment among CKD patients, and variables having a p-value of ≤ 0.05 were declared as significant.Results: In this study, 116 CKD patients and 116 age, sex, and educational level matched controls were included with a response rate of 100%. The prevalence of cognitive impairment was 49.1% [95% CI (40%, 58.3%)] among CKD patients and 28.4% [95% CI (20.9%, 37.5%)] among controls. Independent predictors of cognitive impairment among CKD patients were estimated glomerular filtration (eGFR) < 60mL/min/m2 [AOR=3.9, 95% CI (1.1– 14.74)], proteinuria [AOR=6.0, 95% CI (1.83– 20.3)], age greater than 65 years [AOR=4.0, 95% CI (1.12– 14.64)], and educational level of grade 8 and less [AOR= 4.7, 95% CI (1.22 -18.47)].Conclusion: The prevalence of cognitive impairment among CKD patients was higher than healthy controls. Cognitive impairment was higher among CKD patients with eGFR < 60mL/min/m2, proteinuria, educational level of grade 8 and less, and age greater than 65 years. Therefore, there is a need to have a regular evaluation and follow-up of CKD patients for cognitive impairment.Keywords: cognitive impairment, chronic kidney disease, SMMSE

Bezawit Mulat,1 Adugnaw Ambelu,1 Sewbesew Yitayih,2 Yibeltal Yismaw Gela,1 Ayechew Adera,1 Yigizie Yeshaw,1 Yonas Akalu1 1Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Bezawit Mulat Email mulatbezawit@gmail.comBackground: Cognitive impairment is a common complication of hypothyroidism that affects the patient’s quality of life in different aspects. In Ethiopia, though the prevalence of hypothyroidism is high the magnitude of cognitive impairment among these patients is not known. Therefore, the current study is aimed at determining the prevalence of cognitive impairment and associated factors among adult hypothyroid patients.Methods: An institution-based cross-sectional study was employed from February 24 to May 22, 2020, to assess the prevalence of cognitive impairment and associated factors among adult hypothyroid patients. Data was collected by a pretested interviewer-administered structured questionnaire and standardized Mini-mental state examination (SMMSE) tool. A cluster sampling technique was used. Data was entered into Epidata version 4.6 and exported into a statistical package for social science (SPSS) version 25 for further analysis. Both bivariable and multivariable logistic regression analyses were done. A 95% confidence interval and P-value < 0.05 were used to declare statistical significance.Results: A total of 216 adult hypothyroid patients were included with a response rate of 98.6%. The mean age was 42.5 (± 11) years. The prevalence of cognitive impairment was 27.3% (95% CI (21.7, 33.8)) and it was significantly associated with increased age (AOR = 1.23, 95% CI (1.11, 1.34)), increased duration of illness (AOR = 1.48, 95% CI (1.14, 1.90)) and high thyroid-stimulating hormone (TSH) level (AOR = 1.3, 95% CI (1.1, 1.6)).Conclusion: The prevalence of cognitive impairment among hypothyroid patients was high. Increased age, increased duration of illness and high TSH levels were significantly associated with cognitive impairment. Hence, early screening of cognitive impairment among hypothyroid patients with increased age, increased duration of illness and high TSH level should be given due emphasis to increase patients quality of life.Keywords: cognitive impairment, hypothyroidism, SMMSE, Ethiopia

BackgroundAssessments of disease burden are important to inform national, regional, and global strategies and to guide investment. We aimed to estimate the drinking water, sanitation, and hygiene (WASH)-attributable burden of disease for diarrhoea, acute respiratory infections, undernutrition, and soil-transmitted helminthiasis, using the WASH service levels used to monitor the UN Sustainable Development Goals (SDGs) as counterfactual minimum risk-exposure levels.MethodsWe assessed the WASH-attributable disease burden of the four health outcomes overall and disaggregated by region, age, and sex for the year 2019. We calculated WASH-attributable fractions of diarrhoea and acute respiratory infections by country using modelled WASH exposures and exposure-response relationships from two updated meta-analyses. We used the WHO and UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene public database to estimate population exposure to different WASH service levels. WASH-attributable undernutrition was estimated by combining the population attributable fractions (PAF) of diarrhoea caused by unsafe WASH and the PAF of undernutrition caused by diarrhoea. Soil-transmitted helminthiasis was fully attributed to unsafe WASH.FindingsWe estimate that 1·4 (95% CI 1·3-1·5) million deaths and 74 (68-80) million disability-adjusted life-years (DALYs) could have been prevented by safe WASH in 2019 across the four designated outcomes, representing 2·5% of global deaths and 2·9% of global DALYs from all causes. The proportion of diarrhoea that is attributable to unsafe WASH is 0·69 (0·65-0·72), 0·14 (0·13-0·17) for acute respiratory infections, and 0·10 (0·09-0·10) for undernutrition, and we assume that the entire disease burden from soil-transmitted helminthiasis was attributable to unsafe WASH.InterpretationWASH-attributable burden of disease estimates based on the levels of service established under the SDG framework show that progress towards the internationally agreed goal of safely managed WASH services for all would yield major public-health returns.FundingWHO and Foreign, Commonwealth & Development Office.

BackgroundEstimates of the effectiveness of water, sanitation, and hygiene (WASH) interventions that provide high levels of service on childhood diarrhoea are scarce. We aimed to provide up-to-date estimates on the burden of disease attributable to WASH and on the effects of different types of WASH interventions on childhood diarrhoea in low-income and middle-income countries (LMICs).MethodsIn this systematic review and meta-analysis, we updated previous reviews following their search strategy by searching MEDLINE, Embase, Scopus, Cochrane Library, and BIOSIS Citation Index for studies of basic WASH interventions and of WASH interventions providing a high level of service, published between Jan 1, 2016, and May 25, 2021. We included randomised and non-randomised controlled trials conducted at household or community level that matched exposure categories of the so-called service ladder approach of the Sustainable Development Goal (SDG) for WASH. Two reviewers independently extracted study-level data and assessed risk of bias using a modified Newcastle-Ottawa Scale and certainty of evidence using a modified Grading of Recommendations, Assessment, Development, and Evaluation approach. We analysed extracted relative risks (RRs) and 95% CIs using random-effects meta-analyses and meta-regression models. This study is registered with PROSPERO, CRD42016043164.Findings19 837 records were identified from the search, of which 124 studies were included, providing 83 water (62 616 children), 20 sanitation (40 799 children), and 41 hygiene (98 416 children) comparisons. Compared with untreated water from an unimproved source, risk of diarrhoea was reduced by up to 50% with water treated at point of use (POU): filtration (n=23 studies; RR 0·50 [95% CI 0·41-0·60]), solar treatment (n=13; 0·63 [0·50-0·80]), and chlorination (n=25; 0·66 [0·56-0·77]). Compared with an unimproved source, provision of an improved drinking water supply on premises with higher water quality reduced diarrhoea risk by 52% (n=2; 0·48 [0·26-0·87]). Overall, sanitation interventions reduced diarrhoea risk by 24% (0·76 [0·61-0·94]). Compared with unimproved sanitation, providing sewer connection reduced diarrhoea risk by 47% (n=5; 0·53 [0·30-0·93]). Promotion of handwashing with soap reduced diarrhoea risk by 30% (0·70 [0·64-0·76]).InterpretationWASH interventions reduced risk of diarrhoea in children in LMICs. Interventions supplying either water filtered at POU, higher water quality from an improved source on premises, or basic sanitation services with sewer connection were associated with increased reductions. Our results support higher service levels called for under SDG 6. Notably, no studies evaluated interventions that delivered access to safely managed WASH services, the level of service to which universal coverage by 2030 is committed under the SDG.FundingWHO, Foreign, Commonwealth & Development Office, and National Institute of Environmental Health Sciences.

Abstract Background In Ethiopia, although there are numerous small-scale and medium industries which use lead-based raw materials that may pose health risks to workers, there are no workplace regulations for lead exposure. Moreover, there are no studies carried out on the blood lead levels (BLLs) of workers or on the contribution of common workplace practices to lead poisoning. Method A cross-sectional study on the BLLs of 45 automotive garage workers and 40 non-garage workers was carried out in the town of Jimma, Ethiopia. In addition to BLL analysis, data on some risk factors such as smoking, and chewing ‘khat’ (the leaves of Catha adulis) were gathered through structured questionnaires and interviews and data analysis was performed using SPSS (version 16). The t-test was used to compare mean BLLs of study groups. The analysis of variance (ANOVA), Kruskal-Wallis, Pearson chi-square and odds ratio tests were used to investigate the associations between specific job type, smoking and/or ‘khat’ chewing, service years and occurrence of non-specific symptoms with BLLs. Results The mean BLL of the automotive-garage workers was found to be significantly greater than that of the controls. The BLLs of all the lead-exposed individuals were found to be over 10 μg/dL, and 53% of them had BLLs ranging 12 – 20 μg/dL, with the remaining 47% having over 20 μg/dL. The BLL of the workers increased with the duration of working in an automotive garage. Individuals involved in manual car painting comprise a larger percentage (58%) of those with the highest BLLs (≥ 20 μg/dL). Lead accumulation in individuals who chew ‘khat’ in the work place was found to be faster than in those who are not used to chewing ‘khat’. ‘Khat’ is an evergreen shrub native to tropical East Africa, with dark green opposite leaves which are chewed when fresh for their stimulating effects. Conclusion The findings of the study have clearly demonstrated that the BLLs of automotive-garage workers in Jimma town are considerably high with a range of 11.73 – 36.52 μg/dL and the workers are in danger of impending lead toxicity. The BLLs of the workers are influenced by their occupational practices, chewing Catha adulis leaves at the workplace, and the time spent working in an automotive garage.

Background: Wastewater treatment is crucial to protecting public health and the environment by removing Biohazards. In Ethiopia, however, significant research gaps limit progress, especially regarding the efficiency of Biohazard removal in existing treatment facilities. This review evaluates the effectiveness of current treatment methods for Biohazard removal, highlights key challenges, and offers recommendations. Methods: This scoping review followed PRISMA guidelines, systematically searching databases like NLM. Science Direct, HINARI and Scopus for Biohazard removal studies in Ethiopia, with independent reviewers screening and analyzing relevant data to identify key challenges. Results: Out of 1218 studies initially recorded by title and abstract, only 11 articles were selected for analysis. The Activated Sludge Process emerged as a highly effective system, achieving 85% to 95% removal of antimicrobial resistance (AMR) and total coliforms. Other methods, such as the Conventional Activated Sludge, and Anaerobic-Aerobic Reactors, demonstrated promising results but were found only in select locations. However, the widely adopted Oxidation Ponds, Ethiopia's most common wastewater treatment system, showed the lowest AMR removal efficiency, at just 30% to 50%. Significant challenges, including inadequate infrastructure, high operational costs, and weak regulatory enforcement. Conclusions and recommendations: The review underscores the need for affordable wastewater treatment in Ethiopia, highlighting challenges such as inadequate infrastructure and high costs. To enhance effectiveness and reduce public health risks from Biohazards like AMR, recommendations include adopting cost-effective treatment technologies, strengthening regulatory frameworks, increasing public awareness, promoting corporate responsibility, and investing in infrastructure for sustainable wastewater management. Plain language summary: This scoping review highlights the Activated Sludge Process and Anaerobic-Aerobic Reactors as effective methods, achieving 85% to 95% AMR removal. In contrast, Oxidation Ponds, commonly used in Ethiopia, show only 30% to 50% efficiency. Addressing challenges like inadequate infrastructure and costs is crucial, necessitating low-cost technologies for sustainable wastewater management. [ABSTRACT FROM AUTHOR]

Background: Schoolgirls in resource-limited settings encounter significant challenges in maintaining proper menstrual hygiene management practices. Studies on associated factors in menstrual hygiene management practices among schoolgirls in Bahir Dar City are limited. Objectives: The study aimed to evaluate the menstrual hygiene practices of schoolgirls and identify factors that influence these practices in the limited settings of Bahir Dar City. Design: This study was a school-based, analytical, cross-sectional study conducted among schoolgirls between the ages of 11 and 25. Methods: A total of 701 schoolgirls, selected at random based on their consent, participated in this school-based, analytical, cross-sectional study. The data collection process was comprehensive, involving a self-administered questionnaire and 5 rounds of observations at 10 schools using the Joint Monitoring Program for Water, Sanitation, and Hygiene monitoring tool. The study used a binary logistics regression model to determine the strength of the association between predictor and outcome variables, ensuring a rigorous analysis with a p -value < 0.05. Results: In this study, 375 (53.50%) participants were found to have good menstrual hygiene practices. Factors such as the mothers' education (diploma and above vs not read and write (AOR = 26.29, 95% CI: 11.69–59.12), fathers' education (diploma and above vs not read and write (AOR = 19.21, 95% CI: 8.51–43.32), having access to basic water service (AOR = 14.62, 95% CI: 5.12–41.73), having access to basic sanitation services (AOR = 21.02, 95% CI: 7.87–56.15), being older among the schoolgirls (AOR = 19.69, 95% CI: 10.18–38.07), having private work (AOR = 15.58, 95% CI: 6.99–34.73), having open discussions with sisters (AOR = 27.01, 95% CI: 11.45–63.73), having friendly discussions about menstrual hygiene with schoolgirl friends (AOR = 18.67, 95% CI: 8.45–41.24), and residing in urban areas (AOR = 6.43, 95% CI: 3.52–11.73)) were significantly associated with good menstrual hygiene practices. Conclusion: The schoolgirls in the study area had good menstrual hygiene practices. However, uneducated parents, inadequate facilities, limited access to absorbent materials, and lack of support were challenges that affected proper menstrual hygiene management practice. To improve menstrual hygiene practices, it is crucial to address these identified modifiable factors and consider education programs, better facilities, community support, and policy changes that prioritize menstrual hygiene management in schools for schoolgirls to manage menstruation. Plain language summary: Menstrual hygiene management practices among schoolgirls Menstruation poses challenges for schoolgirls in resource-limited settings. Cultural norms, lack of proper infrastructure, limited access to affordable products, and insufficient education hinder the practice of proper menstrual hygiene practices. These challenges can lead to health risks, absenteeism, and decreased academic performance. For instance, in the Oromia region, only 35% of the schoolgirls used sanitary pads, while in the Amhara region, 44.9%–33% used sanitary pads. A school-based analytical cross-sectional study was conducted in Bahir Dar City from March 2022 to August 2023 to evaluate the menstrual hygiene practices of schoolgirls and identify the factors that influence these practices in the schools of Bahir Dar City, located in Northwest Ethiopia. The mean age of schoolgirls was 16.82 years (SD = ±1.60), and the age of 8 years was the first menarche experience in 7 (1%) schoolgirls. The overall practices showed that 375 (53.50%) schoolgirls exercised good MHM, and the remaining 326 (46.50%) exercised poor MHM. The study revealed that schoolgirls whose mothers' and fathers' had a college education and above, older schoolgirls, schoolgirls with parents working in private, those attending schools with basic water and sanitation facilities, and those who openly discussed menstruation with their sisters and friends tended to have better MHM practices. Parental education levels, WASH facilities, and schoolgirls' residence areas have been identified as factors affecting schoolgirls' menstrual hygiene practices. The identified modifiable factors are the areas of intervention to increase proper menstrual hygiene practices. Concerned bodies should create a supportive and safe environment to help schoolgirls manage their monthly menstruation safely and comfortably. [ABSTRACT FROM AUTHOR]

Background: The challenges of safe menstrual hygiene management practices in low-income settings, including the study areas are pressing. However, Studies specifically focusing on barriers that schoolgirls face in managing monthly menstruation in schools of Bahir Dar are inadequate and scarce. Method: To ensure the robustness of the findings, a comprehensive study was conducted among schoolgirls and boy students aged 12–20 in three schools. This study employed focus group discussions and in-depth interviews with students and leaders of the school gender club. A word cloud generator was used to visually represent frequently mentioned keywords, and the data generated from interviews were analyzed using the Open Code 4.03 tool. Results: The findings, derived from focus group discussions and in-depth interviews, revealed several significant barriers that schoolgirls face in practicing safe menstrual hygiene management. These barriers, including sociocultural factors (133), inadequate use of menstrual hygiene management facilities (73), inadequate knowledge before menarche (59), and a general lack of support (35), underscore the multifaceted nature of the issues. Importantly, these findings emphasize the urgent need for targeted interventions to address these barriers and improve menstrual hygiene management among schoolgirls. Conclusion: Schoolgirls in Bahir Dar encounter numerous challenges in maintaining safe menstrual hygiene practices. Addressing the identified modifiable barriers represents crucial areas for intervention, requiring collaborative efforts from school communities and other relevant stakeholders to create an environment conducive to promoting and enhancing safe menstrual hygiene practices. [ABSTRACT FROM AUTHOR]

Lead (Pb) in drinking water is a serious concern due to its adverse health impacts. Aiming to identify sources and contributing factors of waterborne Pb, this study tracked Pb at different locations in Addis Ababa's (capital of Ethiopia) water distribution system, successively from 3 water sources, 15 storage reservoirs and 88 taps. The mean Pb concentration at sources was 2.6 µg/L, significantly varying from the concentration at taps, 15.9 µg/L (ANOVA Post Hoc, P = 0.02). A significant variation of Pb was also observed among the city's water distribution sub-systems and source waters (ANOVA Post Hoc, P = 0.006). Surface waters exhibited a negative Langelier saturation index (LSI) and higher corrosivity. Analysis from first-drop and flushed water samples showed that water stagnation for 6–8 hours would increase Pb leaching by 11.5 Points (95% CI [6.23, 16.78]). Metal plumbing releases more Pb compared to plastics (t30 = −4.358, P < 0.001), where the leaching is higher from new faucets than the old (r = −0.368, P < 0.05). A multiple linear regression (R2 = 0.61, F5, 80 = 24.617, P < 0.001) predicted that a 1% increase of Fe in the water can raise the Pb concentration by 0.35% (t80 = 7.033, P < 0.001), while 1% increment of Zn can raise Pb by 0.21% (t80 = 4.45, P < 0.001). The analysis suggests that leaded-brass and galvanised-steel could be important Pb sources. In conclusion, Pb contamination in Addis Ababa's drinking water system chiefly arises from the plumbing and pipelines, where the main portal of entry lies between storage reservoirs and taps. Water properties (hardness, tendency to scale formation and corrosivity), water stagnation time in pipelines, and material types and age of premise plumbing were significant contributing factors. [ABSTRACT FROM AUTHOR]

The sanitary revolution of the 19th century in much of Europe and North America marked a milestone of public health progress. During this era, transmission dynamics of disease were only [...]