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This study aims to assess hand hygiene compliance and associated factors among healthcare providers in Dessie referral hospital (Ethiopia) using the gold standard WHO's observational checklist and self-administered questionnaire. Hand hygiene practices of 230 healthcare providers from ten hospital wards were observed over 24 hours period. The required numbers of sample were proportionally allocated among the different professions and wards. The overall observed hand hygiene compliance was only 17.6%. Hand hygiene training , availability of functional sink , knowledge about hand hygiene , attitude towards hand hygiene , availability of water and soap , and availability of alcohol-based hand rub were positively associated with hand hygiene compliance. As lower levels of compliance were observed for indications that have potential risk for patients, healthcare providers need to follow the WHO's multimodal hand hygiene improvement strategies. This study also indicated the important prerequisites that could help improve hand hygiene.

Gete Berihun,1 Zebader Walle,2 Daniel Teshome,3 Leykun Berhanu,1 Masresha Abebe,1 Ayechew Ademas,1 Adinew Gizeyatu,1 Awoke Keleb,1 Asmamaw Malede,1 Getaneh Atikilt,2 Abraham Teym,4 Metadel Adane1 1Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 2Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 3Department of Anatomy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 4Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Gete Berihun Email geteberihun@gmail.comIntroduction: COVID-19 has been a global public health problem since December 2019. Higher education institutions are risky areas for the transmission of COVID-19. But, still there is insufficient information on the prevention of the disease in this setting.Objective: To assess knowledge, attitude, and prevention practices towards COVID-19 among students of Ethiopian higher education institutions.Methods: Institutin -based cross-sectional study design was conducted from December 1 to 30, 2020 among randomly selected 407 undergraduate students from higher education institutions in Ethiopia. The outcome variables were knowledge, attitude, and practices towards COVID-19. Binary logistic regression models at 95% confidence interval (CI) were used to determine the factors affecting knowledge, attitude, and practices towards COVID-19. In multivariable analysis, variables with a p-value of less than 0.05 were considered statistically significant and independently associated with outcome variables at 95% CI.Results: About 75.9% (95% CI: 72.2– 79.9%) of University students had a good knowledge, 62.4% (95% CI: 58.2– 67.1%) had a positive attitude, and 56.8% (95% CI: 52.6– 61.9%) had a good COVID-19 prevention practices. Students over the age of 30 (AOR=5.8; 95% CI: 1.5, 10.6), third-year students (AOR=3.1; 95% CI: 1.1, 8.9), and being health science students (AOR=4.4; 95% CI: 2.2, 8.9) were significantly associated with a good knowledge towards COVID-19. Urban residents (AOR=0.6; 95% CI: 0.3– 0.9), having an average family monthly income of $75USD (AOR=3.5; 95% CI: 1.8– 6.7), use of at least one type of social media (AOR=4.7; 95% CI: 1.7– 12.9), and having a positive attitude (AOR=2.2; 95% CI: 1.3– 3.5) were significantly associated with COVID-19 prevention practices.Conclusion: Despite three-fourths of the participants had a good knowledge, the attitude and prevention practices were low. Age, study year, College of study, presence of chronic illnesses, use of social media, family income, and residence were factors of knowledge, attitude, and prevention practices towards COVID-19. Hence, multiple information dissemination strategies using multiple media outlets should be implemented continuously.Keywords: COVID-19, Knowledge, Attitude, Practice, Higher education, Ethiopia

Background Needle stick and sharp injuries (NSSIs) are a common problem among healthcare workers (HCWs). Although the factors related to NSSIs for HCWs are well documented by several studies in Ethiopia, no evidence has been reported about the magnitude of and factors related to NSSIs in hospitals in northwestern Ethiopia. Methods An institution-based cross-sectional study was carried out from January to March 2019 among 318 HCWs in three randomly-selected hospitals of the eight hospitals found in South Gondar Zone. Sample sizes were proportionally allocated to professional categories. Study participants were selected by systematic random sampling methods using the monthly salary payroll for each profession as the sampling frame. Data were collected using a self-administered questionnaire. The outcome of this study was the presence (injured) or absence of NSSIs during the 12 months prior to data collection. A binary logistic regression model with 95% confidence interval (CI) was used for data analysis. Variables from the bi-variable analysis with a p-value ≤ 0.25 were retained into the multivariable analysis. From the multivariable analysis, variables with a p-value less than 0.05 was declared as factors significantly associated with NSSIs. Main findings The prevalence of NSSIs was 29.5% (95% CI: 24.2–35.5%) during the 12 months prior to the survey. Of these, 46.0% reported that their injuries were moderate, superficial (33.3%) or severe (20.7%). About 41.4% of the injuries were caused by a suture needle. Factors significantly associated with NSSIs were occupation as a nurse (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.18–4.26), disposal of sharp materials in places other than in safety boxes (AOR = 3.93, 95% CI: 2.10–5.35), recapping of needles (AOR = 2.27, 95% CI: 1.13–4.56), and feeling sleepy at work (AOR = 2.24, 95% CI: 1.14–4.41). Conclusion This study showed that almost one-third of HCWs had sustained NSSIs, a proportion that is high. Factors significantly associated with NSSIs were occupation as a nurse, habit of needle recapping, disposal of sharp materials in places other than in safety boxes and feeling sleepy at work. Observing proper and regular universal precautions for nurses during daily clinical activities and providing safety boxes for the disposal of sharp materials, practicing mechanical needle recapping and preventing sleepiness by reducing work overload among HCWs may reduce the incidence of NSSIs.

Background Poor menstrual hygiene practices influence school girls’ dignity, well-being and health, school-absenteeism, academic performance, and school dropout in developing countries. Despite this, menstrual hygienic practices are not well understood and have not received proper attention by school WASH programs. Therefore, this study examined the extent of good menstrual hygiene practices and associated factors among high school girls in Dessie City, Amhara Region, northeastern Ethiopia. Methods A school-based cross-sectional study was employed to examine 546 randomly selected high school students in Dessie City, northeastern Ethiopia. Pretested interviewer-administered questionnaires and a school observational checklist were used for data collection. EpiData Version 4.6 and the Statistical Package for the Social Sciences Version 25.0 were used for data entry and analysis, respectively. Bivariate and multivariable logistics regression analyses were employed to identify factors associated with good menstrual hygiene practices. During bivariable analysis, variables with P-values less than 0.25 were retained for multivariable analysis. In the multivariable analysis, variables with a P-value less than 0.05 were declared to be significantly associated with good menstrual hygiene practices. Results Of the respondents, 53.9% (95% CI [49.6, 58.2]) reported good menstrual hygiene practices. The following factors were found to be significantly associated with good menstrual hygiene practices: age range 16–19 years (AOR = 1.93, 95% CI: [1.22–3.06]); school grade level 10 (AOR = 1.90, 95% CI: [1.18–3.07]); maternal education (primary) (AOR = 3.72, 95% CI: [1.81–7.63]), maternal education (secondary) (AOR = 8.54, 95% CI: [4.18–17.44]), maternal education (college) (AOR = 6.78, 95% CI: [3.28–14.02]) respectively]; having regular menses [AOR = 1.85, 95% CI: (1.03–3.32); good knowledge regarding menstruation (AOR = 2.02, 95% CI: [1.32–3.09]); discussing menstrual hygiene with friends (AOR = 1.79, 95% CI: [1.12–2.86]), and obtaining money for pads from the family (AOR = 2.08, 95% CI: [1.15–3.78]). Conclusion We found that more than half of high school girls had good menstrual hygiene practices. Factors significantly associated with good menstrual hygiene practices include high school girls age 16–18 years, girls grade level 10, maternal education being completed primary, secondary and college level, having regular menses, good knowledge regarding menstruation, discussing menstrual hygiene with friends and obtaining money for pads from the family. Therefore, educating of high school student mothers about MHP should be a priority intervention area to eliminate the problem of menstrual hygiene among daughters. Furthermore, in order to improve the MHP among high school girls, further attention is needed to improving knowledge regarding menstruation among high school girls, encouraging high school girls’ families to support their daughters by buying sanitary pads and promoting discussions among friends about menstrual hygiene. Schools need to focus on making the school environment conducive to managing menstrual hygiene by increasing awareness of safe MHP and providing adequate water/sanitation facilities.

Background Acute respiratory infections are rising in developing countries including Ethiopia. Lack of evidence for the prevalence and associated factors of acute respiratory infection among street sweepers and door-to-door waste collectors in Dessie City, Ethiopia is a challenge for the implementation of appropriate measures to control acute respiratory infection. Thus, this study was designed to address the gaps. Methods A comparative cross-sectional study was conducted among 84 door-to-door waste collectors and 84 street sweepers from March to May 2018. A simple random sampling technique was used to select study participants. Data were collected by trained data collectors using a pretested structured questionnaire and on-the-spot direct observation checklist. Data were analyzed using three different binary logistic regression models at 95% confidence interval (CI): the first model (Model I) was used to identify factors associated with acute respiratory infection among street sweepers, whereas the second model (Model II) was used to identify factors associated with acute respiratory infection among door-to-door waste collectors, and the third model (Model III) was used for pooled analysis to identify factors associated with acute respiratory infection among both street sweepers and door-to-door waste collectors. From each model multivariable logistic regression, variables with a p-value Results The overall prevalence of acute respiratory infection among studied population was 42.85% with 95% CI (35.1, 50.0%). The prevalence of acute respiratory infection among street sweepers was 48.80% (95% CI: 37.3, 64.8%) and among door-to-door waste collectors was 36.90% (95% CI: 27.4, 46.4%). There was no statistically significant difference between the prevalence of acute respiratory infection among the two groups due to the overlapping of the 95% CI. Among the street sweepers, we found that factors significantly associated with acute respiratory infection were not cleaning personal protective equipment after use (adjusted odds ratio [AOR]: 2.40; 95% CI: 1.15, 5.51) and use of coal/wood for cooking (AOR: 3.95; 95% CI: 1.52, 7.89), whereas among door-to-door waste collectors, were not using a nose/mouth mask while on duty (AOR: 5.57; 95% CI: 1.39, 9.32) and not receiving health and safety training (AOR: 3.82; 95% CI: 1.14–7.03) were factors significantly associated with acute respiratory infection among door-to-door-waste collectors. From the pooled analysis, we found that not using a nose/mouth mask while on duty (AOR: 2.19; 95% CI: 1.16, 4.53) and using coal/wood for cooking (AOR: 2.74; 95% CI: 1.18, 6.95) were factors significantly associated with acute respiratory infection for both street sweepers and door-to-door waste collectors. Conclusion The prevalence of acute respiratory infection among street sweepers and door-to-door waste collectors has no statistically significant difference. For both groups, not using a nose/mouth mask while on duty and using coal/wood for cooking fuel factors associated with acute respiratory infection. The municipality should motivate and monitor workers use of personal protective equipment including masks and gloves. Workers should use a nose/mouth mask while on duty and should choose a clean energy source for cooking at home.

Background In Ethiopia, malaria has declined in the last decade; only a small number of cases have been reported, primarily from hotspots. The contribution of house proximity to water bodies and the role of migration in malaria transmission has not yet been examined in detail in northwest Ethiopia. Individual and household-level environmental and socio-demographic drivers of malaria heterogeneity were explored contextually in meso-endemic villages around Lake Tana, northwest Ethiopia. Methods A health facility-based paired age-sex matched case–control study involving 303 matched pairs was undertaken from 10 October 2016, to 30 June 2017. Geo-referencing of case households, control households, proximate water bodies, and health centres was carried out. A pretested and structured questionnaire was used to collect data on socio-demography, household assets, housing, travel history, and malaria intervention measures. Medians (interquartile range) were computed for continuous variables. Pearson’s Chi square/Fisher’s exact test was used to detect significant differences in proportions. Principal component analysis was performed to estimate household wealth. Stratified analysis was used to confirm confounding and interaction. A multivariable conditional logistic regression model was used to detect risk factors for malaria. Results Of 303 malaria cases, 59 (19.5% [15.4–24.3]) were imported malaria cases whereas 244 (80.5% [75.7–84.6]) were locally acquired malaria cases. In bivariate analysis, marital status, educational status, and bed net ownership were significantly associated with malaria cases. In multivariable adjustment, travel to malarious lowlands in the preceding month (adjusted mOR = 7.32; 95% CI 2.40–22.34), household member’s travel to malarious lowlands (adjusted mOR = 2.75; 95% CI 1.02–7.44), and inadequate health information on malaria (adjusted mOR = 1.57; 95% CI 1.03–2.41) were predictors of malaria. Stratified analysis confirmed that elevation of households and travel to malarious lowlands were not effect modifiers. Travel to malarious lowlands had a confounding effect on malaria but elevation of households did not. Conclusions In this study, travel to farms in the lowlands and inadequate health information on malaria were risk factors for malaria in villages around Lake Tana. This evidence is critical for the design of improved strategic interventions that consider imported malaria cases and approaches for accessing health information on malaria control in northwest Ethiopia. Electronic supplementary material The online version of this article (10.1186/s12936-018-2434-y) contains supplementary material, which is available to authorized users.

Background Malaria remains a major public health problem in Ethiopia. The use of LLINs is an effective approach to reducing transmission. Persistent use of LLINs is determined by numerous factors. Quantitative studies have assessed LLIN ownership and utilization, but the behavioral, socio-cultural, socioeconomic and net distribution contexts that impact their use have not been examined in depth. This study aimed to explore barriers of persistent LLIN use among communities around Lake Tana. Methods Twenty-three community residents who owned LLINs (15) or not (8) during the study period and 38 key informants were interviewed from April to June 2017. Phenomenological study was employed to explore the local contexts and factors that influence persistent use of LLINs. Individuals were purposefully selected to capture different views. Community residents were selected based on their permanent residence and LLIN use experience. Key informants were health extension workers, local leaders, students, and health professionals. The data were managed using QSR International NVivo Version 10 software and coded, and themes were identified. Results Killing ability of nets against arthropods other than mosquitoes reportedly made use of LLINs a favored malaria prevention method despite their ineffectiveness after 3 months. Conical nets were preferred due to their compatibility with varied sleeping structures. Numerous factors influenced persistent use, notably erroneous perceptions about LLINs, malaria and mosquitoes; bedbug infestation; inconvenience; unintended uses; distribution problem of nets; and socio-cultural and economic factors. Unintended uses were often associated with local needs and seldom linked with social issues and deficiencies in information about malaria and LLINs. Collateral benefits were considered important, principally in terms of disinfestation of bedbugs. Conclusions Non-persistent LLIN use was associated with inconvenient bed net design and early damage; non-potency of the insecticide against other arthropods; facilitation of bedbug infestation; unintended uses; wrong perceptions about malaria, mosquitoes, and LLINs; and inadequate follow-up regarding LLINs utilization. Distribution of conical nets and provision of adequate information on LLINs and malaria may promote persistent use. Using an insecticide that also kills arthropods other than mosquitoes may reduce unintended uses and increase persistent use.

Objective Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis. Smear positive tuberculosis patients are responsible for up to 90% of transmission occurring in the community. However, little is known about pulmonary tuberculosis preventive practices among bus users in Ethiopia. This study aimed to assess the level of Pulmonary Tuberculosis (PTB) preventive practices and associated factors among bus users at Addis Ababa. Results Community based cross-sectional study was conducted among bus users at Addis Ababa. Participants were selected using systematic sampling technique. Overall, 50.5% of bus users had good practices on prevention of PTB at Addis Ababa. The odds of practicing prevention of PTB among participants who were attended secondary school (AOR = 4.63; 95% CI 2.62, 11.17) and higher education (AOR = 2.86: 95% CI 1.13, 7.73), resided at Addis Ababa (AOR = 2.51; 95% CI 1.61, 5.21), knowledgeable about PTB (AOR = 4.12; 95% CI 3.14, 5.70), and using mass media (AOR = 2.14; 95% CI 1.78, 4.27) as a source of information were higher than the odds of their respective counterparts. The overall practice of pulmonary tuberculosis prevention among city bus users in the study area was low. Therefore, enhancing educational opportunity and increase community awareness about the causes, risk factors and means of transmission using mass media might improve the practices of PTB prevention during bus transportation. Electronic supplementary material The online version of this article (10.1186/s13104-019-4135-1) contains supplementary material, which is available to authorized users.

Background: Ethiopia introduced directly observed therapy short-course (DOTS) strategy for TB in 1995; reaching its full coverage in 2005. Treatment success rate (TSR) was 84% in 2009 and dropped to 83% in 2010. Despite the progress made in tuberculosis control throughout Ethiopia, risk factors leading to poor treatment outcome have not been assessed in Dessie and Woldiya town health institutions. Therefore, this study aimed to determine treatment outcome of TB patients and risk factors for poor treatment outcome in Dessie and Woldiya town health institutions, Northeast Ethiopia. Methods: A three years (September 2010 to August 2012) retrospective study was conducted from medical records of 1511 TB patients at Dessie and Woldiya town health institutions. Data were collected using a questionnaire that consists of patients’ age, sex, weight, TB history, TB type, HIV status, availability of supporter, availability of mobile number, drug type and TB treatment outcomes in treatment cards and TB logbook from February, 2013 to April, 2013. Pearson chi-square test and logistic regression were employed for data analysis. Results: From 1511 TB patients, 1,331(88.1%) were successfully treated, 123 (8.1%) died, 45 (3.0%) defaulted and 12 (0.8%) failed from treatment. In terms of TB type, 57.4% were pulmonary TB, 40.5% were extra pulmonary TB and 2.1% were both smear negative pulmonary and extra pulmonary TB. In addition, TB-HIV co-infection rate was 42.9% in 2010, with significant reduction in 2012 (33.7%) (P