Browsing by Author "Kumie, Abera(PhD)"
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Item Assessing the Effect of Water PH on Turbidity Removal and Bacterial Load Reduction Using Moringa Olifeira for Water Treatment(Addis Ababa University, 2015-09) Mekonnen, Tamrat; Kumie, Abera(PhD); Kaba, Mirgissa(PhD)Background: Among all liquids, water is a unique substance and one of the most important natural resources. In the absence of safe and adequate drinking water supplies, diseases such as diarrhea, skin and eye infections are common. Treatment methods were thus required in order to protect the health of consumers. Currently seed of tropical plant Moringa Olifeira is being recommended as cost effective technology for water treatment in developing countries. The pH at which coagulation occurs is the most important parameter for proper coagulation performance as it affects the surface charge of colloids. Objective: The present study was carried out to determine effect of water pH on turbidity removal and bacterial load reduction using Moringa Olifeira for water treatment. Methods: During this study, ground water from open well and tap water were collected for treatment by Moringa Olifeira seeds in powdered form. Primarily the minimum dose of Moringa Olifeira for effective treatment was identified. Then coagulation ability of Moringa Olifeira seed extract was assessed at different pH values (4, 5, 6, 7, 8, and 9) of water. Parameters which may influence coagulation effectiveness of Moringa Olifeira were kept under control during experimental procedure. Result: The result showed that 60mg of Moringa Olifeira is the optimum dose to treat water with 167NTU initial turbidity and 310 total coliforms. The effect of water PH on total coliforms reduction and turbidity removal effectiveness of Moringa Olifeira was studied and its removal effectiveness is also found to be 90.32% and 90.34% respectively. The pH evaluated has statistically significant effects on the turbidity removal and total coliform reduction with the p-values much lower than 0.05(1.2*10-11). Conclusion: Effectiveness of Moringa Olifeira in reducing turbidity and bacterial load is significantly affected by water pH values. Therefore effect that could arise from variation in the pH of water should be considered. Sequentially, since Moringa Olifeira does not guarantee impurity removal as World Health Organization guidelines, additional disinfection of coagulated water to remove pathogens is necessary in order to achieve standard quality before the water is drunkItem Assessing the Prevalence of Work Musculoskeletal Disorders and Assocaiated Factors among Workers in Selected Garments in Addis Ababa, Ethiopia(Addis Ababa University, 2016-06) Girma, Zenebe; Kumie, Abera(PhD); Gezu, MeazaBackground:-Musculoskeletal disorders are serious problems that every human being would face through the process of his/her life. Studies show that these problems frequently occur in work place. The problem is growing in textile specifically among garment workers in many developing countries. In Ethiopia there is little evidence on the ergonomic exposure for development of musculoskeletal disorder in garment industries. Objective:-This study was to determine prevalence of work related musculoskeletal disorders and its associated factors among garment worker in Addis Ababa, Ethiopia. Methods:-Institutional based cross-sectional study design was implemented from March – April /2016 among 422 garment workers in selected Garments in Addis Ababa. An Amharic version pre tested Standard Nordic Musculoskeletal questionnaire and Quick Exposure Check tool were used to collect data using six data collectors and two supervisors. Data was entered in EPI info version 7 and analyzed using SPSS version 20. Frequency tables, graphs and descriptive summaries were used to describe the study variables. Model fitness and collinearity test were done. To control the effect of confounding variables, multiple logistic regression models with hierarchical entry of variables was done. Variables with p-value less than 0.05 under 95% CI in final model were considered as having significant association with dependent variable. Result: The response rate of this study was 100%. Three hundred and fifty five (84%) of them were female. The median age of the study subject was 29 years inter quartile range of (25-35). The one year prevalence of work related musculoskeletal disorders was 65.4% with 95% C.I: (60.9, 69.7). Among behavioral factors, habits of not doing physical exercise and alcohol consumption were significantly associated with development of musculoskeletal disorders [AOR: 1.96, 95% CI (1.03-3.72)] and [AOR: 9.4, 95% CI (1.15-76.7)], respectively. Among psychosocial factors, job stress and job satisfaction were associated with higher odds of MSDs [AOR: 4.6, 95% CI (2.55-8.4)] and [AOR: 3.9, 95% CI (2.18-7.07)], respectively. Work environment related factors like work hour per week [AOR: 7.9, 95% CI (3.2-19.5)] and working department had significant association after adjusting all others factors. Conclusion and Recommendation:-Based on findings of this study, there is significant prevalence and associated factors of musculoskeletal disorders in garment workers. Owners and governmental bodies should focus on preventive strategies and safety guidelines in order to prevent workers from occupational hazards. Key words: - Ethiopia, Garment worker, Work related musculoskeletal disordersItem Assessment of Environmental Health Status of Dukam Town, Oromia Region(Addis Ababa University, 2010-06) Mekonnen, Tesfaye; Kumie, Abera(PhD)Back ground: Access to healthfully housing, improved water supply, sanitation and hygienic practices in general and urban sanitation in particular is one of the major issues in public health protection and survival of human being. The ever increasing unplanned urbanization and poor access to safe water supply, sanitation and unhealthful living and working environment leads to tremendous communicable & none communicable diseases. Objective of the study: The general objective of the study was to assess environmental health status of Dukam town and generate relevant information for informed decision making process of town officials and concerned stakeholders. Methods: A community based cross-sectional study was conducted in Dukam town from March to May, 2010. Using systematic random sampling methods a total of 409 households were selected for quantitative information while physical observation was made to see sanitary status of municipal water system, solid and liquid waste management and housing condition of the town. Quantitative data collected using pretested and standardized questionnaire was entered using EPI-Info version 6.04 and exported to SPSS 16.0 window version for cleaning and analysis. Frequencies, proportions and summary statistics were employed to describe the study population in relation to the objective of the study. Logistic regression analysis was also employed to examine association among major dependent and independent variables. Result: The findings of this study revealed that over all access to healthful- housing, improved water sources, latrine facility and appropriate solid and liquid waste management system were found very low and significantly associated to educational status, income and ownership of the households. Conclusions and Recommendations: Given that Dukam is currently expanding, considerable portion of inhabitants are currently living in poor housing condition and out of access to safe and adequate water supply, improved sanitation and hygienic conditions. Hence, considering existing challenges and opportunities to community at large, the town administration should plan upgrading or slum clearance of seriously affected old housing structures and put in place sanitary housing enforcements. Furthermore, with good private and public sector involvements, municipal water supply, solid and liquid waste system must be made accessible to all residents of the town hand in hand with promotion of participatory hygiene and sanitation information. Key words: Environmental health, healthful housing, improved water supply, sanitation, Solid and liquid waste mgt and hygiene practicesItem Assessment of Healthcare Waste Generation Rate, Composition and Its Management System in Menellik Ii Referral Hospital, Addis Ababa, Ethiopia(Addis Abeba Universty, 2015-06) Debalkie, Desta; Kumie, Abera(PhD)Background: Healthcare facilities provide health service and prevent the public from health risk such as communicable disease. However, hospitals by virtue of handling patients generate hazardous waste which is potentially harmful to the environment if not handled and disposed properly. The amount and type of waste generated from the healthcare facilities is not well documented and managed in Ethiopia. Objective: The objective of this study is to assess the health care waste generation rate, composition and its management system in Menellik II referral hospital, Addis Ababa. Methods: An institutional based descriptive cross-sectional study design using both quantitative and qualitative methods was employed to assess the waste generation rate and management system in Menellik II referral hospital in Addis Ababa City. Standard weighing scale was used to quantify the generation rate of healthcare waste for seven days and observational check list for participatory walk through survey. The key informant interview guide also conducted to assess healthcare waste management practice. Data collectors and supervisor were recruited and trained. Data was entered in to Microsoft office excel version 2007 and transported to SPSS version 20 for analysis. Mean generation rates were determined based on important factors, the type of case teams. Patient flow, healthcare waste and its type generation rate among case teams were compared using Kruskal Wallis test and relation of visitors and amount of healthcare waste were determined by Pearson correlation. Results: The mean waste generation rate was found to be 1.94 Kg/bed/day±0.335, comprised of 40.9% general and 59.1% hazardous wastes. The amount of waste generated was significantly increased as the number of patient flow increased (r=0.835, p<0.05). Inpatients generated high proportion of total healthcare wastes than outpatient case teams (t=4.353, p<0.01). The mean waste generation rate was significantly varied among case teams (X2=56.558, p<0.0001). The staff wrong attitude, resistance to wards waste segregation, collection and treatment practice, and lower managerial commitment resulted in poor healthcare waste management system. Conclusions: The mean generation rate in the hospital is comparable to other studies in Ethiopia but higher than Sub Saharan African countries and the management of healthcare waste was poor. The composition of hazardous waste was 1.5 that of general waste (t=2.8, P<0.05) and the generations vary with patient load. The hospital should audit generation of waste to develop and implement effective and efficient waste management systems and conduct periodical surveillance of health care waste management practices.Item Assessment of Infant Feeding Practices among HIV Positive Mothers Receiving ARV/ART and HIV Status of Their Infants with its Determinants in South and North Wollo Zone, Amhara Region, Ethiopia(Addis Ababa University, 2012-06) Ali, Yeshimebet; Kumie, Abera(PhD)Back ground: Infant feeding practice is one of the challenging issues on prevention of MTCT of HIV particularly in developing countries due to the benefits and risks of replacement and exclusive breast feeding practice. Breast feeding by an infected mother increases the risk of transmission and provision of ARV prophylaxis for both mothers and her exposed infant with recommended infant feeding practice for HIV positive mothers reduces MTCT of HIV. Objective: To assess the infant feeding practices of HIV Positive mothers receiving ARV/ART and HIV status of their infants with its determinants in South and North Wollo Zone. Methods: Institution based cross sectional study with both quantitative and qualitative methods was conducted among 373 HIV positive mothers with their exposed infants. The study subjects were drawn from 21 health institutions in South and North Wollo Zone in the order of their arrival starting from January to April 2012 till the sample size was fulfilled. Quantitative data were collected using pre-tested structured questionnaire where as qualitative data were obtained from selected HIV positive mothers through in-depth interview with semi-structured interview guide. Results: The prevalence of HIV among infants was 7.8% with the following feeding practice Exclusive replacement feeding (ERF), exclusive breastfeeding (EBF) and mixed feeding (MF) were13.4 %, 74.8 %, and 11.8% respectively. The predictors for HIV status of infants were infant illness [AOR=7.23, 95%CI =(2.64, 19.78)], maternal illness [AOR=4.61, 95% CI=(1.52, 13.96)], maternal knowledge on PMTCT [AOR = 3.35, 95%CI = (1.22, 9.15)], place of delivery [AOR =5.00, 95%CI = (1.45, 17.17)], mode of delivery [AOR=5.20, 95%CI = (1.60, 16.95)] and, infant feeding practice with exclusive breast feeding [AOR=0.23, 95%CI=(0.08, 0.68)] . Conclusions: In this study HIV status of the infant was determined by infant feeding practice, maternal and infant illness, and mother’s knowledge on PMTCT. Educating mothers focusing on PMTCT, early seeking of treatment during their illness and behavioral change on infant feeding practice with proper ARV/ART service are important interventions for PMTCT of HIVItem Assessment of Insecticide Treated Nets (ITNs) Utilization among Children under five years of age and Pregnant women of Adama Woreda, Oromia Regional State, Ethiopia(Addis Abeba Universty, 2007-01) Felema, Bogale; Kumie, Abera(PhD)Background: East Shoa Zone is one of the 14 Zones in Oromia Regional States accounting more than half of malaria burden annually. Among 12 Woreda in the Zone Adama Woreda is highly malarious, almost 95% of the land malarious and 91% of population at risk. Over 20,000 bed ITNs were distributed in the area. Additionally, the role of Social marketing is not negligible. Despite the efforts to achieve the goal, locally there is critical lack of information about ITNs ownership by households, utilization among under 5 children and pregnant women and factors affecting utilization. Objective: The study is aimed to assess the proportion of Insecticide Treated Nets ownership by households, utilization among under 5 children and pregnant women and factors affecting ownership and utilization of Adama Woreda. Method: Community based cross- sectional survey was conducted during September 2006. Primarily, the malarious villages were stratified as rural, suburban kebeles and factory camps. The existing households were identified using registration list available at Woreda health office. Study units were identified by multistage random sampling technique. A total sample of 845 households was proportionally selected. Both self-reported information and direct observations were used to collect data. Data was entered to the computer using EpiinfoVersion6 and analyzed in SPSS 11.0 version statistical software. Tables and figures were used to present the data. Frequency distribution, percentages and Odds Ratio with 95% level of confidence were calculated and interpreted accordingly. Result: A total of 826 households were assessed, among which 494 and 116 households were assessed with children under 5 years of age and pregnant women, respectively. Four hundred and ninety seven (59.7%) households were observed owning at least one ITN. Three hundred and four (61.5%) children and 73 (62.9%) pregnant women were living in the household owning at least one mosquito net. Direct observation of household has confirmed that only 20.2% and 14.7% of children and pregnant women respectively, were utilizing properly mounted ITNs. Self-reported utilization was over reported compared to direct observation. Regarding a factor for non-owning of ITNs, high price and Locating for free distribution were among the major once. Among major factors for none utilizing, absence of mosquito in the house (53.8%), and forget to mount net (34.6%). In general, knowledge and practice of ITNs were significantly associated with place of residences, educational status and health information of the respondents. Conclusion and Recommendation The coverage of ITNs in the area is highly encouraging, although the significant proportion of households was not covered. Not all mosquito nets owned by households were being properly utilized used by young children and pregnant women. Significant proportions of vulnerable groups were not covered. Hence, prioritizing vulnerable groups during distribution, household education on careful and consistent utilization of bed net with great emphasis to high risk and priority groups and district level educational monitoring and regularly ongoing survey were recommended.Item Assessment Of Knowledge And Hygeinic Practices Towards Bacteriological Quality Of Drinking Water At Dobe Toga Kebele, Shebedino Woreda, SNNPR(Addis Ababa University, 2007-08) Abegaz, Teferi; Kumie, Abera(PhD)Background: Drinking Water becomes contaminated with faecal matter due to inadequate protection of the source, unhygienic practices of the community at the source and household level Objectives: The aim of this study was to assess the impact of knowledge and hygienic practices of the community on bacteriological quality of drinking water at the source and point of use Methods: A community- based cross-sectional study was conducted using intervieweradministered questionnaire, inspection check list to observe the condition of water sources, and bacteriological water quality examination of sources and household containers. The study was conducted during August 2006-June 2007 in Dobe Toga kebele of Shebedino wereda. SNNPR. Four hundred twenty households were selected using systematic random sampling method to assess the knowledge and hygienic practices of the community and gathered by health extension worker under strict supervision of principal investigator and supervisors. Bacteriological examination of six protected springs and eighty four systematically selected household containers was carried out by using Oxfam DelAgua water testing kit. Results: Almost all of the springs were subjected to contamination of faecal coliform with high sanitary risk score. There is a significant variation between the bacteriological analysis of source water and household drinking water with a mean of 10.3 and 32.1CFU/ 100 ml of water samples respectively. Educational status was the only variables which was significant after adjustment of other socio demographic, Knowledge and practices variables [AOR: 6.64, 95% CI=1.028-42.927). However other variables like: types of household containers, washing of containers before transferring, methods of water withdrawal, duration of stored water and cover of container during transportation and storage were significant in bivariate analysis but not in multivariate analysis. This may be due to confounding effects of different variables Conclusion and Recommendation: Protected springs with high sanitary risk score were highly subjected to bacteriological contamination and its load of feacal coliform almost tripled at household level, because of poor household management system. Proper protection of water sources, regular monitoring of water quality and hygiene education on water and sanitation, are very important strategies to improve the bacteriological water quality. Key words: Knowledge, practice and bacteriological contaminationItem Assessment of Magnitude and Factors of Occupational Injure among Workers in Large scale Metal Manufacturing Industries in Addis Ababa(Addis Ababa University, 2010-06) Habtu, Yitagesu; Kumie, Abera(PhD)Background: The burden of occupational injury in most developing countries including Ethiopia is becoming a public health problem. Therefore, information that shows the magnitude and predictors of occupational injury in most risky work places in Ethiopia such as metal processing and working industries is indispensable to inform proper intervention programs to have healthy workforce and sound economic development. Objective: This study is intended to assess the magnitude and factors affecting occupational injuries among workers engaged in large scale metal manufacturing industries in Addis Ababa. Method: Institutional cross sectional study was conducted in Addis Ababa from February to March 2010. 50% of large scale metal manufacturing industries were selected by simple random sampling after stratification. Then, calculated sample size was allocated for each industry by PPS. And then, Study subjects were stratified by working sections and those who were directly engaged in the work were selected from each stratum by simple random sampling after preparing a frame from payroll of those industries. Structured questionnaire was designed to collect information on outcome variables and factors. Observational checklist and in-depth interview with key informants was held to triangulate the information with quantitative findings. Result: The overall prevalence of occupational injury was 489 per 1000 exposed workers per year. 119(29.4%) of injured workers were hospitalized or stayed at home bed with 98(82.4%) for 24 or more working hours and one death was reported in 12 months. Sex of workers [AOR:3.32, 95%CI: (1.88,5.85)],Safety and health supervision [AOR: 1.60,95%CI:(1.03,2.60)], Hours worked per week [AOR: 2.37,(95%CI:(1.55,3.61)], Cigarette smoking [AOR: 3.36,95%CI: (1.73,6.50) ] and presence of functional danger signs/ posts [AOR: 2.65,(95%CI: (1.67,4.19)] were significantly associated factors with magnitude of occupational injury. Conclusion and Recommendation: The burden of occupational injury in metal manufacturing industry is really significant public health problem. So continues health and safety information, basic occupational health services and additional cohort study for factors should be undertaken. Key words: occupational injury, large scale metal manufacturing industriesItem Assessment of occupational injuries and illness symptoms among Addis Ababa city solid waste collectors(Addis Abeba Universty, 2012-01) Bogale, Daniel; Kumie, Abera(PhD)Background: Municipal solid waste workers are highly exposed to health and environmental safety risks due to exposure to heavy workloads, bio-aerosols, volatile compounds, potentially hazardous or even infectious materials. In our country, like many developing countries, municipal solid waste is collected manually and collection of household waste is also a job which requires repeated heavy physical activities such as lifting, carrying, pulling, and pushing. Objective: To assess occupational injuries and illness symptoms and factors affecting injuries among solid waste collectors in Addis Ababa city. Methods: Cross-sectional study design was employed to assess occupational injuries and illness symptoms among household solid waste collectors. There were 280 household solid waste collector unions in five randomly selected sub-cities. A total of 876 workers from 92 unions which were proportionally allocated to each sub-city were participated in the study. A structured questionnaire based face to face interviews and observational check list for personal protective device status and utilization pattern were used to collect data. Results: The response rate of this study was 97.9% and female respondents were account 71.2%. The median age of the study subjects was 33 years (ranging from18 to 70 years). The overall occupational injury prevalence rate in the last 12 months was 383 (43.7%). None use of personal protective equipments while being on duty [AOR: 2.62, 95%CI: (1.48-4.63)] and as compared to those who had five and more children, odds of injuries for those who had 3-4 children was reduced by around half [AOR: 0.52, 95%CI: (0.30-0.93)]. The prevalence of dermal illness symptoms; itching and eczema among study participants were 27.7% and 33.6% respectively. In this study total of 311 (35.5%) participants reported that they had been troubled with musculoskeletal symptoms (joint and back pain) during the last 12 months. Conclusion: There are injuries and illness symptoms among this group of workers in a level that need immediate measure. So, implementation of basic occupational health and safety services like training on occupational health and safety with the provisions of personal protective devices and follow up of their appropriate utilization among this group of workers are highly advisable.Item Assessment of Prevalence of Work Related Injuries among Small and Medium Scale Industrial Workers in North Gondar Zone, Amahara Regional State(Addis Ababa University, 2005-06) Tadesse, Takele; Kumie, Abera(PhD)Background: Throughout the world, work related injuries continue to cause serious public health problems and are leading cause of death, disability and disease. In developing countries including Ethiopia, the risk of having work related injury is 10 to 20 times higher than that of developed countries. Objectives: This study investigated the magnitude and extent of work-related injuries among small and medium scale industrial workers in Gondar Woreda. Methods: Stratified random sampling technique was employed to identify the industries. A total of 962 workers at production site were interviewed from both industries. Three hundred twenty one from small and 641 from medium scale industries were selected proportionate to population size. Workers from each industry were selected using simple random sampling technique. Trained data collectors administered a standardized questionnaire through face- toface interview. Physical examination, record review and workplace observation were done to ascertain the self- reported information. Data were analysed by stepwise binary logistic regression model. Results: The over all annual prevalence rate of work related injury was 335/1000 exposed workers, with 355/1000 and 324/1000 among small and medium sale industrial workers, respectively. Fifty five (17.1%) of the injured respondents were hospitalised, accounting for 40% hospitalisation more than 24 hours. One hundred and three (53.9%) of the injured respondents were absent from work for more than 3 days. There were 2 deaths as result of work related injuries in the last 12 months. The significant contributing factors for work related injuries in both industries were young age(<30 years) [adjusted OR: 1.41, 95 % CI: (1.03-1.93)],job categories, 5 years or less in the present job [OR: 1.53, 95 % CI: (1.12-2.08)] , working 48 hours or less per week [OR: 0.68, 95 % CI: (0.49, 0.94)] ,workplace supervision [OR: 0.61, 95 %CI: (0.45, 0.83)] ,sleep disorder[OR: 1.49, 95 %CI: (1.04,2.14)] and job satisfaction [OR: 0.59, 95 %CI: (0.43,0.83)] . Conclusion: Young age, job category, lack of experience, and sleep disorders were increased the risk of work-related injuries. Working 48 hours or less, workplace supervision, and job satisfaction decreased the occurrence of work-related injuries. Preventive measures concerning health and safety training, regular workplace supervision and the establishment of active and functional occupational health and safety programmes are essential to safeguard the health and safety condition of workforce in small and medium scale industries.Item Assessment of Radiation exposure of Diagnostic x-rays among Patients and Personnel(Addis Abeba Universty, 2005-07) Tesfahun, Alemu; Kumie, Abera(PhD)Background: Medical diagnostic radiation is manmade sources of exposure in medical practices. Ionizing radiation yields known health hazard that may vary from skin burn to cancer or death. In Ethiopia, health facilities are growing in number with the increasing facility of radiology services. However, the number of personnel, the provision of spare part of machine, quality assurance and other aspect has not grown with demand of safety. Objectives: The study was designed to assess the status of radiation exposure due to diagnostic xrays among patients and personnel. Methods: Cross-sectional study was carried out in 43 functional diagnostic x-ray institutions from January to February 2005 in Addis Ababa. A total of 215 patients who were examined for chest posterior-anterior (PA) were randomly selected. In addition, all radiology personnel who had dose report of the year 2004 were the study subjects. National Radiation Protection Authority completed radiation surveillance and quality control records of institutions were also considered. Results: The mean (SD) skin entrance dose of patients was 1.877(1.546) mSv. Out of the total 215 patients, 206(95.8%) of patients’ shallow dose and 191(88.8%) patients entrance deep dose were greater than 0.4mSv. The annual mean (SD) skin entrance dose for radiology personnel was found to be 0.407(0.225) mSv. According to records analysis of the National Radiation Protection Authority quality control, 15(19.2%), 13(16.7%) and 17(21.8%) of institutions machines were deviated with in unacceptable range in their generator voltage, the machines timer and, their collimation and beam alignment respectively. Multi variate analysis indicated that exposure setting v i i i greater than 25mAS [OR= 3.141; 95% CI = (1.170-8.432)] had impact on patients’ received dose to be high. Conclusion: Adult patients examined for chest-PA entrance dose was abnormally high. Thus, great efforts will be expected from different sectors of the country in order to bring the patients received dose for specified radiological procedure to minimum level.Item Assessment of the Impact of latrine Utilization on Diarrhoeal Diseases in the rural community of Hulet Ejju Enessie District, Amhara Regional State(Addis Abeba Universty, 2007-02) Anteneh, Andualem; Kumie, Abera(PhD)Background: While household access is important, community sanitation coverage is even more important to improve health around the world. This is best achieved through regular use of a well-maintained sanitation facility. The proper use of latrines can reduce the risk of diarrhea to almost the same extent as improved water supplies. Objective: The study was designed to assess the impact of latrine utilization on diarrhoeal diseases in the rural community of Hulet Ejju Enessie district. Method: A community based cross- sectional study was conducted. All 824 households with latrines from 10 selected kebeles were interviewed about latrine utilization and 370 households with < 5 children were interviewed about diarrhoeal diseases. A structured and pre-tested questionnaire and checklist were used to collect data. Results: Most (60.7%) households observed that their latrine utilization was satisfactory. The extent of latrine utilization was significantly associated with presence of primary or secondary school children in the house [AOR: 1.47, 95%CI: (1.04-2.06), perceived reasons for latrine construction like self initiation [AOR: 2.89, 95%CI: (1.24-6.72) and seeing others [AOR: 10.07, 95%CI: (1.97-51.56), Climatic zone of ‘Kolla’ [AOR: 0.47, 95%CI: (0.29-0.74) and ‘Woyna-Dega’ [AOR: 0.55, 95%CI: (0.38-0.81), and duration of owning latrines by the households [AOR: 2.13, 95%CI: (1.57-2.89). The occurrence of childhood diarrhoea was statistically associated with the extent of latrine utilization in the bivariate analysis [AOR: 0.38, 95%CI: (0.17-0.87) but not significant in the multivariate analysis [AOR: 0.63, 95%CI: (0.22-1.81). The occurrence of childhood diarrhoea was also significantly associated with the duration of owning latrines by the households both in the bivariate [AOR: 0.29, 95%CI: (0.13-0.65) and final step of multivariate analysis [AOR: 0.28, 95%CI: (0.12-0.66). Conclusions and recommendations: The presence of primary or secondary school children in the house, perceived reasons for latrine construction and duration of owning latrines are factors affecting latrine utilization. Rather than the extent of latrine utilization, duration of owning latrines had impacts on the occurrence of childhood diarrhoea. Using role model sanitation intervention, well maintained and functional latrines, target oriented and regular hygiene education promotion programs are very important strategies to bring about behavioral change on latrine utilization as well to reduce the risk of the occurrence of childhood diarrhoea. vi Keywords: Impact, latrine utilization, extent of latrine utilization, childhood diarrhoeal disease, factors affecting latrine utilizationItem Assessment of the Utilization of Personal Protective Equipment among Textile Industry Workers in Dukem Town(Addis Abeba Universty, 2017) Demeke, Aklilu; Kumie, Abera(PhD)Background_: Utilization of personal protective equipment is one of the most important measures to protect workers from exposure to occupational hazards, especially in developing countries. However, there is a limited studies describing personal protective equipment utilization in our country Objectives_: To assess the utilization of personal protective equipment and associated factor in textile industry workers, in Dukem town Methods_: Institutional based cross-sectional study was conducted among two textile industries (Almehadin and Alasr) from June- Dec, 2016 in Dukem town. Stratified sampling followed by simple random sampling technique was used to select a total of 456 textile industry workers. Information regarding participants Practice, work-related and socio-demographic factors was collected by face to face interview using structured questionnaire. Data were checked for its completeness, cleaned, coded and entered into Epinfo version7 and exported to SPSS version 21 for analysis. Data analysis were done using logistic regression. Strength of association was measured using odds ratio, at 95% confidence intervals. Results: The utilization of personal protective equipment were 62.3 % (95%CI) at the time of data collection. The study showed availability of personal protective equipment[AOR(1.817, 95%CI(.82-4.05)], ventilation [AOR(2.25,95%CI (1.4-3.6)], 0rientation given[AOR[(0.56, 95%CI(0.32-0.95.)] and Sex [AOR1.67,95%CI(1.02-.2.71)].were independent predictors of personal protective equipment utilization on multivariate analysis. Conclusion: The proportion of PPE utilization was found 62.3%.(95%CI) unavailability of PPE, poor ventilation, orientation given, and sex were significantly predictors of PPE utilization Recommendation: The use of PPE by workers at workplace is essential element to prevent their exposure to work hazard, injuries, illness, and death. Both governmental and private sectors found in Dukem town and managers of industries should address the problem of unavailability of PPE, poor ventilation, and orientation for workers.. viItem Assessment on the Environmental Health Conditions and Associated Health Threats in Kebribeyhae Refuge Camp Somali National Regional State, Ethiopia(Addis Abeba Universty, 2010-07) Kibret, Feleke; Kumie, Abera(PhD)8 7 6 < =$)>& !()*&* =$ ! 9 & # ! $ & ! # * < ? /040 ! , 9 # , @*( $ < + 6 8 4A ! ( ! ! @!(!! 44 48A , , 9 7 6 7 9 66B 48 9 ! ( C ! 9 ' D /11 @;1 /BA =$)>& 7 6 9 =$)>& ! C " 9 E ! ! !Item Capstone Intervention Project: Skilled Delivery Attendence Rate at Gindeberet Hospital, Oromia, Ethiopia(Addis Ababa University, 2012-05) Debebe, Tadele; Kumie, Abera(PhD); Harin-Yale, Jeph(PhD)Introduction: Maximizing skilled birth attendance rate is one of the proven intervention that positively influence the maternal mortality rate of a given country or community. Skilled birth attendance is also the chosen indicator to monitor progress towards MDG 5, which is reduction of MMR by three fourth and it is a priority area of HSDP IV, Ethiopia. Design: Pre and post-intervention design (Pre-intervention base-line assessment, Intervention, Post intervention result assessment) Setting: Gindeberet district hospital, West Shewa of Oromia Regional State, Ethiopia. Participants: The primer investigator (PI), Maternity department staffs, Gynecologist &Obstetrician, and finance department staffs. Implementation: Group health education of ANC mothers on safe delivery, Individual counseling for ANC attendant mothers at MCH unit, Fulfilling medical equipments and furniture needed for hospital deliver, Improve staff capabilities and staff coverage, consensus on referral take-over between the hospital & catchment HFs, and Charge free maternity service & pregnancy related cases of illness were selected strategic intervention implemented. Main Outcome Measure(s): Increased delivery attendance, Evaluation: Comparison of baseline and end-line assessment is used to verify the outcome of the capstone intervention, (T-test, P-value<0.05 at 95% CI). Keywords: capstone intervention, skilled delivery attendance, Gindeberet Results: The number of total deliveries attended in Gindeberet Hospital had been increased from15/month at pre-intervention period to 53/month during the postintervention period (T-statistics=26.83, with p-value<0.00001Epi Info 16.04 at 95% CI), Lessons Learned: This capstone intervention project demonstrated the possibility of improving the quality, access and acceptability and utilization of skilled birth attendance at rural hospital level through focused and simple interventionItem Healthcare Waste in Ethiopia a Study of Waste Generation, Composition and Management in the Amhara National Regional State, Ethiopia(Addis Abeba Universty, 2015-07) Tesfahun, Esubalew(PhD); Kumie, Abera(PhD)Background: Hospitals are among the complex institutions which generate a broad range of hazardous waste materials in the course of healthcare activities. The hazardous and toxic parts of wastes from healthcare establishments consists of infectious, bio-medical, chemical, sharps and radioactive material pose serious environmental and public health risks, if they are not properly treated and disposed. Despite the great potential for environmental hazards and public health risks of healthcare waste, its proper handling and management is substantially undermined in many developing countries. The hazardous waste has a small portion of healthcare waste, but the absence of appropriate waste segregation practices leads mixing hazardous waste with general (non-hazardous) waste results the entire bulk of waste becoming potentially hazardous. In Ethiopia, there is a continued growth in the number of hospitals and other health facilities to meet the healthcare demand of the alarming population growth. Increasing the number of health institution and development of technology combined with an increase in the use of disposable medical products has contributed to the large amount and diversity in composition of healthcare waste being generated. The high generation rate compounded by poor handling and disposal practices has been increasing the risk of environmental contamination and disease transmission. To establish proper healthcare waste management system, it is crucial to know the current practice, healthcare waste composition and predicting the generation rate. The actual amount of healthcare waste generated and its composition in Ethiopia is not well defined; consequently, estimating different figures in healthcare waste management is becoming very problematic. Therefore, a comprehensive research is required for the development of effective healthcare waste management system that can minimize the health and environmental risks. Objectives: This study aimed to determine the composition and generation rate of healthcare wastes with a predictive model and assess the current practices of healthcare waste management system. Methods: The study was conducted using random selection method. Accordingly, the hospitals were selected using lottery method from private and government hospitals that are found in Amhara National Regional State, Ethiopia. Nine hospitals were selected for the study. A longitudinal study design was conducted to investigate the healthcare waste composition, and generation rate. Based on the seasonal variability data, generation rate predictive models were selected. A cross-sectional study design was used to assess the current practice of healthcare waste management system using interviews and observation. Comparative cross-sectional study xiii design was used to evaluate the effect of segregation practice on hazardous healthcare waste generation rate before and after intervention. The quantity of waste generated was estimated by collecting and weighting healthcare waste from all departments of the sampled hospitals using a calibrated sensitive weight scale every day at 6:00 PM for seven consecutive days (Monday to Sunday) for two seasons. The data were entered, compiled and analysed using EPI info version 7 and Statistical Package for Social Science (SPSS) version 16 statistical software packages. The important variables that affect the quantity of waste generated from the hospitals were identified using regression analysis. Simple and multiple linear regression models were applied to estimate or predict the hospitals healthcare waste generation rate. The analysis were done first separately for each of the 9 hospitals and then grouped by ownership and level of hospitals as well as by the categories of healthcare waste. Data description was made using mean, Standard Deviation (SD), frequency, and percentage. Data from key informant interviews and observation were analysed by theme. Results: The mean healthcare waste generation rate of hospitals was for inpatients 1.5 kg/ bed/day and outpatients 2.5 kg/outpatient/day. The average generation rate estimated in kg/bed/day and kg/outpatient/day has a statistical significance difference (P < 0.03). The generation rate of general healthcare waste in private hospitals was 1.85kg/bed/day and a public hospital was 0.78 kg/bed/day. The generation rate kg/bed/day in private and public hospitals also has a statistical significance difference (P < 0.02). The compositions of healthcare waste in public hospitals were 46.4%, 34.3%, 3.8%, 9.1%, 6.2% and 0.2% for general, infectious, sharps, pharmaceutical, pathological and radioactive wastes respectively. The compositions of healthcare waste in private hospitals were 45.3%, 29.7%, 6.7%, 17.3%, 0.5% and 0.5% for general, infectious, sharps, pharmaceutical, pathological and radioactive wastes respectively. The compositions of healthcare waste in public and private hospitals were almost similar except for pathological and pharmaceutical wastes. There were no clear local guidelines to facilitate segregation of healthcare waste in both public and private hospitals; segregation was not practiced in all hospitals. The common waste treatment method used by hospitals was incineration; all the incinerators were found to be inefficient because of faulty design, construction and operation. All public hospitals had open pits in their backyards that were used for the final disposal as burial or open incineration, while private hospitals were mixing their healthcare waste with the municipal solid waste. xiv The healthcare waste generation rate has a strong positively correlation with the number of inpatients R2= 0.935, 0.908 and 0.936 for public referral, public district and private general hospitals respectively. Similarly, the waste generation rate has positively correlated with the number of outpatients R2= 0.57, 0.868 and 0.456 for public referral, public district and private general hospitals respectively. The implementation of segregation practice was able to reduce the generation rate from 61.04 % to 42.2 % of hazardous healthcare waste. Nevertheless, with this reduction rate, the total percentage of hazardous waste (44%) was higher than that of the range (10-25%) reported by World Health Organization (WHO). Conclusions: The effect of number of inpatients and outpatients treated in the hospitals on healthcare waste generation rate varied from hospital to hospital (private general, public district and public referral hospitals). The rate also varied by ownership where private hospitals were produced significantly higher (kg/bed/day) total and hazardous waste than government-run hospitals. It was observed that as the number of inpatients and outpatients increase, the healthcare waste generation rate will also increase. The results indicated that both measurement units (kg/bed/day and kg/outpatient/day) should be used in order to precisely quantify the waste generation rates for different types of wastes at each hospital. With the current malpractices of healthcare waste management the percentage of hazardous waste was estimated to be very high (61.04%) and considering the segregation practice alone can reduce the percentage of hazardous waste by 17%. Overall, proper waste management system was almost not yet instituted in all sampled hospitals. Recommendations: A number of gaps exist regarding proper hospital healthcare waste management in the Region. Therefore, there is an urgent need for raising awareness among healthcare workers and supporting staff on healthcare waste management issues (segregation, storage, collection, transport, treatment and disposal) and their relevance in addressing public health and environmental risks. Keywords Hazardous, hospital, healthcare waste, generation rate, waste composition, waste management, private, public, EthiopiaItem Hospital Acquired Infections and Infection Prevention Practice in Teaching Hospitals in the Amhara Regional State, Ethiopia(Addis Ababa University, 2017-05) Worku, Walelegn; Kumie, Abera(PhD); Moges, Feleke(Professor)Background: Hospital acquired infections are major public health concerns throughout the world, contributing to increased morbidity, mortality, and health cost. Hospitals are the main sources for the risk of acquiring infection during health care delivery. There is little evidence concerning the burden of unsafe care in developing countries, where the risk of harm to patients is likely to be greater, due to low infrastructure, technologies, and human resources. Limited researches to specific infections show that a significant number of inpatients acquire infections in hospital set ups in Ethiopia. There is limited information that indicate magnitude, barriers and factors for prevention and control practice of hospital acquired infections in teaching hospitals. Objective: The overall objective of this study was to assess the magnitude and risk factors of hospital acquired infections and barriers and health care workers practice of infection prevention and control in Amhara Regional state teaching Hospitals, Ethiopia. Methods: Mix of quantitative and qualitative methods were employed. A repeated cross-sectional and matched case control study designs were employed between April and July 2015 at the University of Gondar and Felege-Hiwot medical teaching hospitals. All eligible inpatients admitted for at least 48 hours on the day of the survey were included. Trained physicians and nurses collected data according to the Centers for Disease Control and Prevention(CDC) definitions of hospital acquired infections. A total of 908 patients for the prevalence survey, 545 patients, 109 cases and 436 controls for the matched case control study and 422 health care workers for the practice of infection prevention and control were included in this study. The collected data were cleaned, coded and entered into Epi-Info software version 3.5.3 and analysis was done using STATA 13. Univariate and multivariable Conditional logistic regression were used for the analysis. Odds ratios with the corresponding 95% confidence intervals were estimated and p values were determined. Variables with P < 0.05 in the multivariable conditional logistic regression analysis were considered as significant independent predictors in this study. For the qualitative study, a phenomenological approach was used to explore the lived experience of healthcare workers and management staffs towards infection prevention practice and control. XII Data were collected from ten in-depth interviews and four focus group discussions, by face to face interviews using open ended interview guides in safe and quiet places. Data were managed using open code software version 4.03 and contents were analyzed thematically. Results: The overall point prevalence of hospital acquired infection was 14.9 % (95% CI: 12.7- 17.1). Klebsiella spp (22.44%) and Staphylococcus aureus (20.4%) were the most commonly isolated hospital acquired infections causing pathogen in these hospitals. Patients admitted in wards with medical waste containers the room had 82% less chance of developing hospital acquired infections (AOR 0.18: 95% CI, 0. 03-0.98). The odds of developing hospital acquired infections among immune deficient patients were 2.34 times higher than non-immuno- compromised patients, with 95% CI: (1.17-4.69). Patient received antimicrobials, central vascular catheter and surgery since admission had 8.63, 6.91 and 2.35 higher odds of developing hospital-acquired infection, respectively. The proportion of infection prevention practice towards hospital acquired infection was 55% with 95% CI: (50.1-59.6). In the past one year 234 (56.7%) and 150 (36.3%) health care workers were exposed to blood and body fluids and sharp or needle sticks injury, respectively. Nurses practice 2.09 times more compared to physicians to infection control with (95% CI: 1.27-3.43). In the qualitative assessment, a total of ten different barriers were identified: such as lack of availability of facilities, shortage of material supply, lack of maintenance of facilities and equipment’s, high patient flow, lack of experience, emergency situation, healthcare worker behavior and healthcare worker’s knowledge, low awareness of patients and visitors and large number of families and visitors to the hospital. Conclusions: High prevalence of hospital acquired infection was observed in teaching hospitals. Surgical site infection and pneumonia were the most common type of infections. Infection prevention and control practice were low in the study setting. High proportion of healthcare workers were exposed to risks. Nursing professionals practiced prevention better than physicians. Important barriers for infection prevention were identifiedItem Information Needs and Seeking Behavior among Health Professionals Working at Governmental Hospital and Health Centers in Bahir Dar Town, Amhara Region, Ethiopia.(Addis Ababa University, 2012-06) Andualem, Mulusew; Kumie, Abera(PhD); Kebede, Gashaw(PhD)Background: Universal access to information for health professionals is a pre requisite for meeting the MDGs and achieving health for all strategy. In developing countries, a large proportion of the population, including health professionals have no or only poor access to health information resources due to poor infrastructures, economic related, poor attention, etc Objective: The purpose of this study is to assess information needs and seeking behavior of health professionals working at Governmental Hospitals and Health Centers in Bahir Dar town, Amhara Region, Ethiopia. Methods: A cross sectional study design using quantitative and qualitative approaches was carried out to achieve the research objectives using 350 study participants. Self-administered questionnaire and observation checklist were instruments to collect the required data. Manually edited data were entered in to computer using Epi-info version 3.5.1; further cleaned and exported to SPSS statistics version19; then cleaned again and analyzed as needed. Frequencies, cross tabulation, chi-square, Odds ratio with 95%CI, and Binary logistic regression analysis were done to describe and assess associations among variables of interest. Results: Nearly all (97.3%) of respondents reported that they need health information to update themselves and support daily activities. More than half (54%) encountered problems on their daily activities due to information limitation. Major barriers to access information were geographical, organizational, personal, economic related, educational status and time. Only 145 (42.8%) respondents have access to internet at different places with various frequencies and have shown statistically significant association (p <0.05) with age, sex, monthly income, computer literacy and access, patient seen per day, working experience, and working site. Majority of study participants have too much limited access to different information resources,especially library and internet. More than half (57.7%) respondents seek information by consulting their hard copies when there is a need. About 151(44.5%) respondents prefer to access on job trainings and soft copies next to hardcopies. Conclusions and recommendations: Almost all respondents need to access health information and more than 80% of study areas have no library, internet and computer services. Therefore, great attentions and efforts must be done to help those starved health professionals working at those areas.Item Measuring Unmet Family Planning Need Differences and Levels of Agreement between Husband and Wife, Gedeo Zone, SNNPR(Addis Ababa University, 2011-05) Tsehaye, Yoseph; Kumie, Abera(PhD)Background: - The total fertility rate of Ethiopia was 5.4 with 34 percent unmet needs for family planning. Although the contraceptive prevalence rate among women of reproductive age (15-49 years) has doubled during the last ten years, it still remains very low. This may indicate the existence of some barriers that prohibit couples from using family planning even if they desire to limit or delay births in 2005 in Ethiopia. Objective: - To assess the magnitude of unmet family planning need differences and levels of agreement between husband and wife, Gedeo Zone, Southern Nation and Nationality People Region. Methods: - A cross-sectional comparative, community based study was conducted in Gedeo zone. The data were collected between 20 January and 15 February 2011. Wonago wereda and Yirgacheffe town administration were selected by simple random sampling method. Using random sampling technique, a total of 254 wives and 254 husbands in six rural and three urban kebeles were selected for the study. A structured pre-tested standard questionnaire was used for data collection. Data entry, cleaning and analysis were done using the EPI INFO version 3.5.1 and SPSS version 19 statistical package. Statistical tests such as Chi -square, logistic regression was used and also level of agreement amongst spouses was analyzed using Kappa statistics. Results: Unmet need for family planning was 39.4% for wives and 11.4% for husbands. The difference was seen both in unmet need for spacing (28.8% for wives vs. 8.3% for husbands) as well as limiting family size (10.6% for wives vs. 3.1% for husbands). Overall, the observed concordance was 51.49% for contraceptive use, 72.05% for unmet need, 92.9% for ideal number of children and 96.85% for contraceptive attitude. The kappa statistic varied from a low of 0.062 (P<0.004) for ever use of contraception to a high of 0.887 for ideal number of children with contraceptive attitude 0.802 (P<0.000), unmet need 0.331 (P<0.000) and current use of contraception 0.122 (P<0.000). Conclusion: Unmet need for family planning was significantly higher for wives compared to husbands and overall, a greater degree of agreement was observed regarding reproductive health events, family planning attitudes and unmet need. It is also evident that increasing awareness and acceptance of contraceptive use among women is not enough, the study recommends developing an effective family planning program intervention to involve men in the Reproductive Health/Family Planning (RH/FP) programs and raise awareness among both men and womenItem Prevalnce of Work Related Lower Back Pain and Assocaiated Factors among Welders in Selected Metal and Engineering Industries in Addis Ababa and Surrounding Towns(Addis Ababa University, 2017-06) Assefa, Tamirat; Kumie, Abera(PhD)Background: - Work related lower back pain is one of the commonest musculoskeletal disorders affecting all age groups including adults in work place. Welding Workers in Metal and engineering industry are commonly exposed to lower back pain. There is limited information on the prevalence and associated factors that leads to work related lower back pain. Objective: -The aim of this study is to determine the prevalence of work related Lower Back Pain and to identify associated factors among welding workers Methods:- - Cross-sectional study design was implemented from March – April /2017 among 422 welders in selected metal and engineering industries in Addis Ababa and surrounding towns. An Amharic version adapted and pre tested Standard Nordic Musculoskeletal questionnaire was used to collect data using four data collectors and two supervisors. Data was entered in EPI info version 7 and analyzed using SPSS version 21. Frequency tables, graphs and descriptive summaries were used to describe the study variables and co-linearity test were done. To control the effect of confounding variables, multivariate logistic regression models with hierarchical entry of core variables was done. Variables with p-value less than 0.05 under 95% CI in final model were considered as significant Results: - The twelve month prevalence of work related lower back pain among this working group was 62.1 % with 95% C.I: (57.5, 66.7%). longer service years for more than 20 years [AOR (95% C.I): 3.58 (1.14-4.36), repetitive task within < 30 second [AOR (95% C.I): 2.26 (1.18-4.32)], not get training on OSHA [AOR (95% C.I): 4.4 (2.68 -7.20), not doing physical exercise regularly [AOR: 2.17, 95% CI ((1.36-3.46)], extended working hours for more than 8 hours [AOR (95% CI : 3.66 (2.06-6.51) were predictors for work related lower back pain. Conclusion and Recommendation: -The prevalence of work related lower back pain was higher among welding workers. Working for longer years, not performing repetitive tasks, extended working hours, absence of training on OSHA and regular physical exercise, were the most contributing factors in increasing lower back pain. Therefore the factory managers should under gone job rotation for those with higher service years to less loaded area, workers should done regularly physical exercises, get training on OSHA for all existing and new hired workers and MOLSA should enforce factory management to stick to ILO proclamation on healthy working hours to reduce risk of developing low back pain among welders Key words: - Welders, Work related lower back pain, Ethiopia