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Amensisa Hailu Tesfaye,1 Tesfaye Hambisa Mekonnen,1 Belay Desye,2 Dawit Getachew Yenealem1 1Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Amensisa Hailu Tesfaye, Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia, Tel +251-934-803-290, Fax +251-58-114-1240, Email amensisahailu@gmail.comBackground: Healthcare-associated infections are a global health problem and are more prevalent in developing countries such as Ethiopia, but there is a paucity of research on the infection prevention practices of cleaning staff. Therefore, this study aimed to assess infection prevention and control practices and associated factors among cleaners working in healthcare facilities in Gondar City, Ethiopia.Methodology: A cross-sectional survey was conducted among healthcare cleaning staff from May to June 2022. A total of 428 cleaners took part in the survey. Data were collected using a semi-structured interviewer-administered questionnaire. The data were entered into EpiData version 4.6 and analyzed using Stata version 14 software. A multivariable binary logistic regression analysis was used to ascertain the significance of associations at < 0.05 p-value and the adjusted odds ratio (AOR) with a 95% confidence interval (CI).Results: Among the 390 study participants included, 294 (75.1%) were female. Of the surveyed participants, 186 (47.7%) had good knowledge of infection prevention and control practices. This study revealed that out of the 390 healthcare cleaners, 204 (52.3%) had good infection prevention and control practices with 52.3% [95% CI (47.2, 56.4)]. Good knowledge of infection prevention and control [AOR: 1.56, 95% CI (1.03, 2.37)] and the availability of infection prevention and control guidelines in the workplace [AOR: 1.54, 95% CI (1.01, 2.33)] were significant factors associated with infection prevention and control practice.Conclusion: The present study found that almost half of the healthcare cleaners had poor IPC practices. The finding underlines the importance of good IPC knowledge and the accessibility of IPC guidelines to improve IPC practices among healthcare cleaning staff. The findings of this study also highlight that behavioral change interventions and paying attention, particularly to nonclinical staff such as cleaners in health care settings, are critical to reducing infection in health care settings.Keywords: healthcare-associated infection, infection prevention, healthcare cleaners, Ethiopia

Introduction: Drinking contaminated water is a significant cause of mortality and morbidity in Sub-Saharan Africa, where access to safe drinking water is limited. Although numerous studies have investigated the bacteriological quality of drinking water in Ethiopia, their findings have been inconsistent and varied, hindering the implementation of effective water quality monitoring. Moreover, there is a lack of nationwide assessment of the bacteriological quality of drinking water in Ethiopia. Therefore, this systematic review and meta-analysis aimed to determine the bacteriological quality of drinking water and its associated factors in Ethiopia., Methods: An international electronic database, including PubMed, Science Direct, Global Health, CINAHL, African Journals Online, HINARI, and Google Scholar was employed to retrieve the relevant articles. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) guidelines. A random-effects model was used to estimate the pooled effect size, and the Egger regression model was employed using STATA 14 software to assess potential publication bias., Results: A total of 26 studies involving 7,962 water samples met the eligibility criteria for meta-analysis. The pooled prevalence of at least one bacteriological contamination of drinking water was 52.26% (95%CI: 39.09-65.43), with extreme heterogeneity (I2 = 99.7%; p-value < 0.001). The pooled prevalence of total and fecal coliform in drinking water was 49.55% (95% CI: 34.88-64.23) and 44.27% (95%CI: 34.36-54.19), respectively. 14.13% of the water source was at a very high sanitary risk level (unfit for drinking), with significant heterogeneity (I2 = 94.1%, p< 0.001). The absence of household-level water treatment (OR = 3.3; 95%CI: 1.28-5.32) and drawing water using dipping methods (OR = 4.52; 95%CI: 1.71-7.34) were determinant factors for bacteriological contamination of drinking water., Conclusion: We found that the bacteriological quality of drinking water did not comply with the World Health Organization and Ethiopia's standard guidelines for drinking water, which call for urgent intervention. One out of seven water sources was at a high sanitary risk level, which could increase the risk of infectious disease in the country. The absence of household-level water treatment and drawing water using dipping was a significant factor in the bacteriological quality of drinking water. Based on these findings, the water supply and sewerage authority should prioritize regular monitoring of the bacteriological quality of drinking water., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Daba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Antimicrobial resistance is a major global public health concern, especially in low-resource settings. In low- and middle-income countries, the existing evidence about antimicrobial resistance in drinking water is inconsistence and not comprehensive. Therefore, this study aimed to estimate the pooled prevalence of antimicrobial resistance profiles of Escherichia coli from drinking water in low- and middle-income countries., Methods: This study was conducted using comprehensive literature searches using various databases such as PubMed, Scientific Direct, HINARI, and Google Scholar. Data extraction was performed using Microsoft Excel and exported to STATA 14/SE software for analysis. We used the Joanna Briggs Institute's quality appraisal tool to ensure the quality of the included studies. A random effects model was employed to estimate the pooled prevalence. Publication bias was evaluated using funnel plots and Egger's regression test. Subgroup and sensitivity analysis were also conducted in this study., Results: The study found that the pooled prevalence of Escherichia coli isolates in drinking water was 37.94% (95% CI: 26.73-49.13). The prevalence of multidrug resistance was 43.65% (95% CI: 31.15-56.15). Regarding specific antimicrobials, the pooled resistance levels of Escherichia coli were 54.65% (95% CI: 41.35-67.96) against contrimoxazole, followed by 48.64% (95% CI: -3.6-101) against amoxicillin and 48% (95% CI: -18.1-114.2) against cefuroxime., Conclusion: The findings indicated a significant prevalence of antimicrobial resistance of Escherichia coli isolated from drinking water and its multidrug resistance. To address this issue, it recommends focusing on improving basic hygiene and sanitation practices and enhancing water and wastewater treatment systems., Systematic Review Registration: Identifier CRD42024533592., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Desye, Woldetsadik Mawugatie, Asmare, Tsega, Melak, Endawkie and Daba.)

Background: The increasing use of pesticides has become a global public health concern. The problem is more devastating in developing countries, which deters the implementation of effective intervention strategies. Moreover, the existing evidences are inconsistent and not comprehensive. Therefore, this study aimed to determine the pooled pesticide safe use practices and acute health symptoms, and identify factors among farmers in developing countries., Methods: A comprehensive search using databases such as PubMed, HINARI, Google Scholar, and Epistemonikos, as well as grey literature, was searched up to June 30, 2023. The updated preferred reporting items for systematic reviews and meta-analysis guidelines were used. Data were extracted using Microsoft Excel, and it was exported to STATA 14/SE software for analysis. The Joanna Briggs Institute's quality appraisal tool was used to assure the quality of the included articles. A random-effects model was used during analysis. The funnel plot and Egger's regression test were used to assess the publication bias, and sensitivity analysis was conducted to assess the effect of a single study., Results: The pooled pesticide safe use practice was 43.1% (95% CI: 31.01-55.2), and the prevalence of acute health symptoms was 30.36% (95% CI: 19.61-41.1). Farmers with good knowledge (OR = 3.83, 95% CI: 2.36-5.29), good attitudes (OR = 2.16, 95% CI: 1.46-2.86), being educated (OR = 5.11, 95% CI: 2.96-7.26), and having more than five years of experience (OR = 6.13, 95% CI: 2.56-9.71) were found to be the identified factors associated with pesticide safe use practice., Conclusions: This study highlighted a significant gap in pesticide safe use practices and a high prevalence of acute health symptoms among farmers. Therefore, comprehensive intervention measures such as providing educational and safety training programs are required for pesticide users among farmers., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: Visceral Leishmaniasis, also known as kala-azar, is a potentially fatal, neglected tropical disease caused by the protozoan parasite Leishmania and transmitted through infected sandflies. It is one of the major global public health problems and contributors to economic crisis among people. Though different studies investigated human visceral leishmaniasis in Eastern Africa, the findings were inconsistent and inconclusive enough, and there is no representative data on this devastating public health concern. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence and risk factors associated with human visceral leishmaniasis in Eastern Africa., Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 2020) guidelines were followed for this study. Databases such as PubMed/MEDLINE, CINAHL, LIVIVO, African Journals Online, African Index Medicus (AIM), HINARI, Science Direct, Web of Science, Cochrane Library, Google Scholar, Semantic Scholar, and Google were used to retrieve all the relevant articles. The search was carried out from 23 May 2024 to 17 July 2024. Data were analyzed using STATA 17 software to determine the pooled prevalence of human visceral leishmaniasis with a 95% confidence interval using a random-effects model., Result: In this meta-analysis, thirty-nine articles with 40,367 study participants were included. The overall pooled prevalence of human visceral leishmaniasis in Eastern Africa was 26.16% [95%; CI: 19.96, 32.36%; I 2  = 99.67%; p  = 0.00]. Gender, age, family size, presence of termite hill/mound, presence of cattle/domestic animals, outdoor sleeping, presence of VL infected family member/s, and presence of water source/pathway near home were the risk factors significantly associated with human visceral leishmaniasis., Conclusion: The recorded pooled prevalence of human visceral leishmaniasis in Eastern Africa underscores the urgent need for comprehensive intervention strategies. This includes rigorous health education for residents, covering the disease's cause, transmission, vector breeding sites, and prevention mechanisms., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Geto, Berihun, Berhanu, Desye and Daba.)

Background: Pesticide exposure is a major public health issue among farmers affecting make it their health, economic stability, and agricultural productivity. This study aimed to investigate the magnitude and determinants of farmers' knowledge of health risks, safety practices, and acute pesticide poisoning in the South Wollo Zone, Ethiopia., Methods: A community-based cross-sectional study was conducted in the South Wollo Zone's irrigation areas from July to August 2022. Using a multistage sampling technique, five out of ten irrigation districts were randomly selected, and three kebeles (the smallest administrative unit) from each district (15 total) were chosen based on intensive irrigation activities. A proportional sample size was allocated across the selected kebeles according to the number of farmers. Trained data collectors conducted face-to-face interviews using a pretested structured questionnaire. Crude and adjusted odds ratios with 95% confidence intervals at a p -value of 0.05 identified statistically significant factors., Result: The study found that 55.2% of farmers had below mean knowledge of health risks, 63.7% practiced below mean safety practices, and 47.9% experienced acute pesticide poisoning. Significant factors for below mean knowledge included no formal education (AOR = 2.32; 95% CI: 1.27-4.23) and lack of pesticide training (AOR = 2.07; 95% CI: 1.33-3.21). Below mean safety practices were associated with age > 47 years (AOR = 2.07; 95% CI: 1.06-4.04), below mean retailer actions (AOR = 1.97; 95% CI: 1.34-2.89), and below mean attitude (AOR = 1.79; 95% CI: 1.23-2.62). Acute pesticide poisoning was significantly associated with over 10 years of exposure (AOR = 4.34; 95% CI: 2.55-7.39), below mean knowledge (AOR = 2.17; 95% CI: 1.23-2.62), lack of training (AOR = 3.73; 95% CI: 2.33-5.98), and below mean safety practices (AOR = 4.40; 95% CI: 2.86-6.78)., Conclusion: Farmers' knowledge of health risks and safety practices was not satisfactory. Low educational status, lack of training, and minimal government involvement were associated with below mean knowledge. Below mean knowledge and below mean safety practices, low education, lack of training, and minimal government involvement were associated with acute pesticide poisoning. Young farmers, limited retailer involvement, and below mean attitudes contribute to unsafe practices., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Keleb, Ademas, Abebe, Berihun, Desye and Bezie.)

Introduction: Air pollution is a significant global public health concern. However, there is a lack of updated and comprehensive evidence regarding the association between exposure to ambient air pollution and adverse birth outcomes (preterm birth, low birth weight, and stillbirth). Furthermore, the existing evidence is highly inconsistent. Therefore, this study aims to estimate the overall association between ambient air pollution and adverse birth outcomes., Methods: In this study, initially a total of 79,356 articles were identified. Finally, a total of 49 articles were included. We conducted compressive literature searches using various databases, including PubMed, Scientific Direct, HINARI , and Google Scholar. Data extraction was performed using Microsoft Excel, and the data were exported to STATA 17 software for analysis. We used the Joanna Briggs Institute's quality appraisal tool to ensure the quality of the included studies. A random effects model was employed to estimate the pooled prevalence. Publication bias was assessed using funnel plots and Egger's regression test., Results: In this study, the pooled prevalence of at least one adverse birth outcome was 7.69% (95% CI: 6.70-8.69), with high heterogeneity ( I 2  = 100%, p-value  < 0.001). In this meta-analysis, high pooled prevalence was found in preterm birth (6.36%), followed by low birth weights (5.07%) and stillbirth (0.61%). Exposure to PM 2.5 (≤10 μg/m 3 ) throughout the entire pregnancy, PM 2.5 (≤10 μg/m 3 ) in the first trimester, PM 10 (>10 μg/m 3 ) during the entire pregnancy, and O 3 (≤10 μg/m 3 ) during the entire pregnancy increased the risk of preterm birth by 4% (OR = 1.04, 95% CI: 1.03-1.05), 5% (OR = 1.05, 95% CI: 1.01-1.09), 49% (OR = 1.49, 95% CI: 1.41-1.56), and 5% (OR = 1.05, 95% CI: 1.04-1.07), respectively. For low birth weight, exposure to PM 2.5 (≤10 μg/m 3 ) and PM 2.5 (>10 μg/m 3 ) throughout the entire pregnancy was associated with an increased risk of 13% (OR = 1.13, 95% CI: 1.05-1.21) and 28% (OR = 1.28, 95% CI: 1.23-1.33), respectively., Conclusion: This study highlighted a significant association between ambient air pollution and adverse birth outcomes. Therefore, it is crucial to implement a compressive public health intervention., Systematic Review Registration: The review protocol was registered with the record ID of CRD42024578630., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Desye, Berihun, Geto, Berhanu and Daba.)

Introduction: The public health concern of tobacco smoking is more prevalent in low- and middle-income countries including Ethiopia. Various studies have investigated tobacco smoking in various parts of Ethiopia. However, the findings have been inconsistent and characterized by significant variability. Besides, there is no nationally representative data on the subject, which could deter the design of effective intervention strategies to reduce tobacco-related problems. Therefore, this study aimed to estimate the pooled prevalence of tobacco smoking and associated factors among adults in Ethiopia., Methods: The study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Guideline. A detailed search was conducted from international databases including PubMed, Cochrane Library, Science Direct, CINAHL, African Journals Online, HINARI, Global Health, and Google Scholar. The extracted data was analyzed using STATA 14 software. A random-effects model was used to estimate the effect size. The Egger regression test and I 2 statistics were used to determine potential publication bias and heterogeneity among the reviewed articles, respectively., Results: A total of 32 studies with 69,897 study participants were included in this systematic review and meta-analysis. The pooled prevalence of lifetime tobacco smoking among adults in Ethiopia was 16.0% (95% confidence Interval (CI): 13.6-18.39) and there was significant heterogeneity among the included studies (I 2  = 99.1%, p  < 0.001). Male adults were three times more likely to smoke tobacco as compared with females [OR = 3.22 (95% CI: 2.06-5.03)]. Being an alcohol user [OR = 3.78 (95%CI: 1.27-11.24)] and having tobacco-smoking friends [OR = 7.21 (95%CI: 5.56-9.35)] are potential determinant factors for tobacco smoking., Conclusion: The pooled prevalence of lifetime and current tobacco smoking among adults in Ethiopia was high, which calls for urgent intervention. Therefore, prioritization of tobacco control strategies, such as creating awareness about the public health importance of tobacco smoking, can help prevent and mitigate the effects of tobacco smoking. Alcohol control law enforcement should also be strengthened., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Daba, Atamo, Debela, Dagne, Desye and Gebrehiwot.)

Introduction: Musculoskeletal disorders are the leading cause of illness, disability, and poor quality of life. Lack of access to potable water in the backyard forces women to take water from off-plot sources every day, which may expose them to various health risks. However, there has been little investigation on the musculoskeletal disorders' health effects on water-carrying women., Objective: This study aimed to assess musculoskeletal disorders symptoms and associated factors among water-carrying women in the Legambo district, Northeastern Ethiopia., Materials and Methods: A community-based cross-sectional study was done with 618 water-carrying women chosen using simple random and systematic random sampling techniques. The data were collected using face-to-face interviews with the standard Nordic Musculoskeletal Questionnaire. Data entry were carried out using Epi-data version 4.6 and exported to SPSS version 25.0 for analysis. A binary logistic regression was used to determine the factors associated with self-reported musculoskeletal disorder symptoms at a 95% confidence interval (CI). In the multivariate model, variables with a p -value ≤0.05 and a 95% CI were declared as factors of self-reported musculoskeletal disorder symptoms. The model's fitness was assessed using Hosmer and Lemeshow, and it was found to be fit., Results: The prevalence of self-reported MSD symptoms was 72.5% during the previous 12 months. MSD symptoms were significantly elevated among women who carried water from a distance of 501-1,000 m [adjusted odds ratio (AOR) = 5.39, 95% CI = 3.64-9.69] and >1,000 m (5.93, 2.84-12.40), carried a water load of >15 kg during pregnancy (8.29, 2.97-23.09), and carried a water load of >15 kg when not pregnant (1.59, 1.44-2.68)., Conclusion: Three-fourths of the participants had self-reported musculoskeletal disorder symptoms in the past 12 months. Distance of water sources from their house, carrying the same amount of water during pregnancy, and weight of the water load carrying were factors associated with the self-reported musculoskeletal disorder symptoms. Hence, health professionals should raise awareness of the association between carrying high water loads and the development of MSDs, especially during pregnancy. Improvement in water supply infrastructure and enhancing behavioral intervention should be done. Furthermore, Future researchers should assess MSDs using objective measurements and cohort studies should be implemented., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Berihun, Gasheya, Abebaw, Abebe, Gizeyiatu, Berhanu, Dagne, Desye, Walle, Zewdu and Wondim.)

Introduction: Cigarette smoking is a persistent public health problem as it is a risk factor for many diseases. Previous studies on the role of illegal drug use in cigarette smoking have yielded disparate and inconclusive results, hindering the development of effective intervention strategies to address this issue. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of cigarette smoking and its associated factors, with a specific focus on the influence of illegal drug use among students in Ethiopia., Methods: We conducted a comprehensive search of international databases, including PubMed, Cochrane Library, Science Direct, CINAHL, African Journals Online, HINARI, Global Health, and Google and Google Scholar. Grey literature was also identified from various university digital libraries. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA) guidelines. Due to the high heterogeneity among the included studies (I2 = 98.6%; p-value <0.001), we employed a random-effects model with a 95% confidence interval (CI) to estimate the pooled effect using STATA 14 software. The publication bias was assessed using a statistical Egger regression test., Results: A total of 22 studies involving 18,144 students met the eligibility criteria for this systematic review and meta-analysis. The pooled prevalence of lifetime and current cigarette smoking among students in Ethiopia was 13.8% (95% CI: 9.90-17.82) and 9.61% (95% CI: 7.19-12.03), respectively. Students who used illegal drugs were twenty-three times more likely to smoke cigarettes compared to their counterparts (OR = 23.57, 95% CI: 10.87-51.1). Living in urban settings (OR = 2.9; 95% CI: 1.15-7.28) and the habit of alcohol consumption (OR = 4.79; 95% CI: 1.57-14.64) were also identified as factors associated with cigarette smoking., Conclusions: We found that more than one in eight students in Ethiopia have engaged in lifetime cigarette smoking. Notably, students who used illegal drugs exhibited a significantly higher likelihood of cigarette smoking. In light of these findings, it is imperative to implement comprehensive public health interventions that target illegal drug use, cigarette smoking, and alcohol consumption, with a particular emphasis on urban residents., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Daba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Internally displaced people (IDPs), uprooted by conflict, violence, or disaster, struggle with the trauma of violence, loss, and displacement, making them significantly more vulnerable to post-traumatic stress disorder (PTSD). Therefore, we conducted a systematic review and meta-analysis to assess the prevalence and associated factors of PTSD among IDPs in Africa., Methods: A comprehensive search of electronic databases was conducted to identify relevant studies published between 2008 and 2023. The search included electronic databases such as PubMed, CABI, EMBASE, SCOPUS, CINHAL, and AJOL, as well as other search sources. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Data were extracted using Microsoft Excel, and analysis was performed using STATA 17 software. The quality of the included studies was assessed using the JBI quality appraisal tool. A random-effects model was used to estimate the pooled prevalence of PTSD and its associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics was used to assess heterogeneity. The protocol for this review has been registered with PROSPERO (ID: CRD42023428027)., Results: A total of 14 studies with a total of 7,590 participants met the inclusion criteria. The pooled prevalence of PTSD among IDPs in Africa was 51% (95% CI: 38.-64). Female gender (OR = 1.99, 95% CI: 1.65-2.32), no longer married (OR = 1.93, 95% CI: 1.43-2.43), unemployment (OR = 1.92, 95% CI: 1.17-2.67), being injured (OR = 1.94, 95% CI: 1.50-1.50), number of traumatic events experienced [4-7(OR = 2.09, 95% CI: 1.16-3.01), 8-11 (OR = 2.09, 95% CI: 2.18-4.12), 12-16 (OR = 5.37, 95% CI: 2.61-8.12)], illness without medical care (OR = 1.92, 95% CI: 1.41-2.29), being depressed (OR = 2.97, 95% CI: 2.07-3.86), and frequency of displacement more than once (OR = 2.13, 95% CI: 1.41-2.85) were significantly associated with an increased risk of PTSD., Conclusions: The findings of this systematic review and meta-analysis highlight the alarming prevalence of PTSD among IDPs in Africa. Female gender, marital status, number of traumatic events, ill health without medical care, depression, and frequency of displacement were identified as significant risk factors for PTSD. Effective interventions and the development of tailored mental health programs are needed to prevent PTSD among IDPs, focusing on the identified risk factors., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Tesfaye et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: The use of swimming pool water for recreation, rehabilitation, and athletics is widespread around the world, especially in large Cities and Towns. However, poorly managed swimming pool water can facilitate the spread of illnesses connected to recreational water. Despite this, there is no evidence on quality of swimming pools water in Kombolcha Town. Therefore, this study was aimed to evaluate the physicochemical and bacteriological quality of swimming pools water in Kombolcha Town., Methods: A laboratory-based cross-sectional study was conducted from February to April, 2021 in Kombolcha Town. A total of 90 water samples were collected from the three outdoor swimming pools. The collected data of both physicochemical and bacteriological parameters were entered into Microsoft Excel 2010 and analyzed using SPSS version 25.0. One-way ANOVA was used to test whether there were statistically significant differences between different swimming pools. The level of significance was declared at a p -value of <0.05., Results: In this study, out of all the pool water samples that were examined, 37.8% had pH values between 7.2 and 7.8, 36.7% had temperatures between 21°C and 32°C, and 26.7% had turbidity values that were within the WHO standard. Furthermore, only 16.7% of the pool water samples showed residual chlorine levels of 2-3 mg/L. In addition, only 27.8, 35.6, and 32.2% of the samples, respectively, met the WHO criterion for total coliform, fecal coliform, and heterotrophic plate count., Conclusion: The result indicates that most pool water samples did not fulfill both the physicochemical and bacteriological quality of the WHO standard limit for swimming pools. Thus, it is crucial to clean and regularly check the pool water, apply pool safety requirements, and raise pool user's awareness about the danger of pool water pollution through training., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Natnael, Hassen, Desye and Woretaw.)

Objective: This study aimed to investigate the prevalence and associated factors of poor sleep quality among Bole Lemi Industrial Park workers in Addis Ababa, the capital of Ethiopia., Design: An institution-based cross-sectional study was conducted from July to August 2022. The data were collected using a validated and standardised Pittsburgh Sleep Quality Index Questionnaire. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14. A multivariable binary logistic regression analysis was conducted to identify factors associated with poor sleep quality. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05., Setting: The study was conducted in Bole Lemi Industrial Park in Addis Ababa., Participants: A total of 370 workers participated in this study., Outcome Measures: The primary outcome of the study was the prevalence of poor sleep quality., Results: The total response rate was 87.7%. The majority (260, 70.3%) of the participants were female. The mean (±SD) age of the participants was 30.5 (±10.6) years. The prevalence of poor sleep quality during the last months was found to be 75.4% (n=279) (95% CI: 70.7% to 79.7%). Undiversified dietary intake (AOR: 1.63; 95% CI (1.09 to 2.78)), caffeine consumption more than 250 mg per day (AOR: 2.57; 95% CI (1.12 to 6.05)) and night shift work (AOR: 2.36; 95% CI (1.27 to 4.41)) were risk factors for poor sleep quality among sampled workers., Conclusion: This study detected that poor sleep quality is highly prevalent among garment and textile industry workers, indicating that it is a significant public health issue that requires immediate attention. Therefore, modifications of the work environment involving night shift work and the improvement of workers' personal lifestyles involving dietary diversification and caffeine consumption are needed to minimise the burden of poor sleep quality among workers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Various review papers have been published regarding the occurrence and fate of micropollutants (MPs). MPs in the aquatic environment are still not well reviewed to generate comprehensive summaries with a special focus on their removal from wastewater using conventional and advanced treatment processes. Therefore, this review aimed to provide a synopsis of the efficiency of the advanced wastewater treatment plants in the removal of MPs., Materials and Methods: A systematic search of published literature was conducted on the National Library of Medicine (NLM) database, Web of Science, Joanna Briggs Institute (JBI) database, Scopus, and Google Scholar, based on studies with evidence of removal of MPs in the wastewater treatment process. Screening of the published articles was made using pre-specified inclusion and exclusion criteria., Results: Amongst the 1545 studies searched, 21 full-length articles were analyzed that showed 7 treatment options related to the removal of MPs from wastewater. MPs from wastewater effluents were successfully and effectively removed by advanced treatment techniques. Advanced Oxidation Processes (AOPs), membrane processes, and adsorption processes have all been shown to be potential solutions for the removal of MPs in advanced treatment plants (WWTPs). But, there are 2 critical issues associated with the application of the advanced treatment options which are high operational cost and the formation of dangerous by-products and concentrated residues., Conclusion: This study identified that the removal of MPs using WWTPs was commonly incomplete with varying removal efficiency. Therefore, the adaptation and scale-up of the cost-effective and efficient combined wastewater treatment technology are vital to creating an absolute barrier to MPs emissions., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Objective: This study aimed to investigate the prevalence and factors associated with work-related musculoskeletal disorders among cashiers in small-scale businesses in Northwestern Ethiopia., Design: A multicentre cross-sectional study was conducted from July to September 2022. The data were collected using a validated and standardised Nordic Musculoskeletal Questionnaire. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14. A multivariable logistic regression analysis was used to ascertain the significance of associations at p<0.05 and the adjusted OR (AOR) with a 95% CI., Setting: The study was conducted in small-scale businesses in the North Gondar Zone., Participants: A total of 618 cashiers participated in this study., Outcome Measures: The primary outcome of the study is the prevalence of work-related musculoskeletal disorders, which was measured using the Nordic Musculoskeletal Questionnaire., Results: The response rate was 97.5% (N=618). The majority (373; 60.4%) of the study participants were female. The mean (±SD) age of the participants was 30 (±8.3) years. The prevalence of work-related musculoskeletal disorders during the last 12 months was found to be 75.4% (n=466) (95% CI 71.8%, 78.8%). Marital status (married) (AOR=2.12; 95% CI 1.26, 3.56), lack of physical exercise (AOR=2.07; 95% CI 1.32, 3.23), alcohol consumption (AOR=3.55; 95% CI 2.18, 5.78) and awkward work posture (AOR=2.40; 95% CI 1.43, 4.0) were significant factors associated with work-related musculoskeletal disorders among sampled cashiers., Conclusion: This study concluded that the overall prevalence of work-related musculoskeletal disorders was high among cashiers in small-scale businesses. Being married, a lack of physical exercise, alcohol consumption and awkward work posture were significant factors of work-related musculoskeletal disorders. To reduce work-related musculoskeletal disorders, it is recommended taking part in physical activity, avoiding alcohol consumption and avoiding awkward work posture., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Occupational respiratory diseases are major global public health problems, particularly for industry workers. Several studies have investigated occupational respiratory symptoms in various parts of Ethiopia. The findings have been inconsistent and inconclusive, and there is no nationally representative data on the subject. Therefore, this study aimed to estimate the pooled prevalence and factors associated with occupational respiratory symptoms among industry workers in Ethiopia (2010-2022)., Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework Guidelines, search was conducted on several international databases including PubMed, CINAHL, African Journals Online, Hinari, Global Health, and Google scholar. The extracted data was analyzed using STATA 14. Random effect model was used to estimate the effect size. Egger regression test and I2 statistics were used to determine potential publication bias and heterogeneity, respectively among the reviewed articles., Results: The meta-analysis included a total of 15 studies with 5,135 participants, revealing a pooled prevalence of 51.6% (95% CI: 43.6-59.6) for occupational respiratory symptoms among industry workers in Ethiopia. The absence of personal protective equipment (OR = 1.97, 95% CI: [1.17-3.32]), lack of occupational health and safety training (OR = 3.04, 95% CI: [2.36-3.93]), previous dust exposure (OR = 3.17, 95% CI: [2.3-4.37]), poor working environment (OR = 2.4, 95% CI: [1.7-3.2]), work experience greater than five years (OR = 4.04, 95% CI: [1.61-10.16]), smoking (OR = 6.91, 95% CI: [2.94-16.2]), and previous respiratory illness (OR = 4.25, 95% CI: [2.44-7.42]) were found to associate with the symptoms., Conclusions: The high prevalence of occupational respiratory symptoms among industry workers in Ethiopia underscores the urgent need for effective interventions. The provision of personal protective equipment and improvement of working environments by the government, industry owners, and other stakeholders are crucial in reducing occupational respiratory symptoms. Additionally, prioritizing occupational health and safety training for industry workers can help prevent and mitigate the impact of occupational respiratory diseases., Registration: This systematic review has been registered in the International Prospective Registry of Systematic Review (PROSPERO) with a specific registration number CRD42022383745., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Daba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Access to safe food is considered a basic human right, but food-borne disease presents a significant public health concern globally. The problem is exacerbated in low- and middle-income countries. Due to the rise in urbanization and the popularity of street food in low- and middle-income countries, understanding the Knowledge, Attitude, and Practice (KAP) of street food vendors is crucial to ensuring food safety. Therefore, this review was aimed to estimate the pooled proportion of KAP of street food vendors toward food safety and its associated factors in low- and middle-income countries. A comprehensive search of published studies before January 30, 2023, was identified using databases like PubMed/MEDLINE, Cochrane Library, HINARI, Science Direct, and African Journals Online, as well as other sources. The preferred reporting items for systematic reviews and meta-analysis guidelines were followed. Data were extracted using Microsoft Excel, and analysis was performed using STATA 14/SE software. The quality of the included studies was assessed using the Joanna Briggs Institute's quality appraisal tool. A random-effects model was used to estimate the pooled proportion of KAP of street food vendors toward food safety and associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics were used to assess heterogeneity. Furthermore, sensitivity analysis and subgroup analysis was also conducted. In this study, fourteen eligible studies with a total of 2,989 study populations were included. The pooled proportions of good knowledge 62% (95% CI: 51-73), positive attitude 66% (95% CI: 47-86), and good practice 51% (95% CI: 36-65) toward food safety were found among street food vendors. Being of secondary school education (OR = 5.95, 95% CI: 4.05-7.85), having training in food safety (OR = 4.64, 95% CI: 2.62-6.67), having a higher monthly income (OR = 2.98, 95% CI: 1.06-4.9), and having good knowledge of food handling (OR = 2.26, 95% CI: 1.17-3.16) were found to be associated factors in the food safety practice of street food vendors. Based on the findings of this study, there was a significant gap in the KAP of street food vendors toward food safety. Therefore, the provision of training and strengthening health education about food safety are invaluable strategies for improving food safety., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Desye et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: This study was designed to determine the prevalence and factors associated with occupational respiratory morbidity among hairdressers in Northwestern Ethiopia., Design: A cross-sectional study was conducted from 6 July 2022 to 17 August 2022. The data were collected using a standardised American Thoracic Society questionnaire. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14. A multivariable logistic regression analysis was conducted to identify factors associated with occupational respiratory morbidity. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05., Setting: The study was conducted in Gondar city, Northwestern Ethiopia., Participants: A total of 403 hairdressers participated in this study., Outcome Measures: The primary outcome is the prevalence of occupational respiratory morbidity., Results: The total response rate was 95.5%. The majority, 250 (62%) of the respondents were women. The mean age (±SD) of the respondents was 27 (±6.0) years. The overall prevalence of occupational respiratory morbidity during the past 12 months was found to be 134 (33.3%) (95% CI (28.7% to 38.1%)). Female hairdressers (18.6%) showed greater respiratory morbidity than male hairdressers (14.7%). Working experience 3-5 years (AOR: 3.05; 95% CI (1.76 to 5.30)) and working experience >5 years (AOR: 6.22; 95% CI (2.73 to 14.16)), overweight (body mass index (BMI)) (AOR: 3.01; 95% CI (1.19 to 7.58)) and working near roadsides (AOR: 2.15; 95% CI (1.33 to 3.37)) were risk factors of occupational respiratory morbidity among hairdressers., Conclusions: This study concluded that one-third of hairdressers experienced occupational respiratory morbidity. Longer work experience, higher BMI and working near roadsides were identified as significant risk factors for respiratory morbidity in hairdressers. Dietary calorie restrictions for overweight individuals and the development and implementation of air pollution mitigation measures targeted at roadside workers are advised to curb the problem., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: More than half of the 700 million people worldwide who lack access to a safe water supply live in sub-Saharan Africa, including Ethiopia. Globally, approximately 2 billion people use drinking water sources that are contaminated with fecal matter. However, little is known about the relationship between fecal coliforms and determinants in drinking water. Therefore, the objective of this study was to investigate the potential for contamination of drinking water and its associated factors in households with children under 5 years of age in Dessie Zuria district in northeastern Ethiopia., Methods: The water laboratory was conducted based on the American Public Health Association guidelines for water and wastewater assessment using a membrane filtration technique. A structured and pre-tested questionnaire was used to identify factors associated with the potential for contamination of drinking water in 412 selected households. A binary logistic regression analysis was performed to determine the factors associated with the presence or absence of fecal coliforms in drinking water, with a 95% confidence interval (CI) and a value of p  ≤ 0.05. The overall goodness of the model was tested using the Hosmer-Lemeshow test, and the model was fit., Results: A total of 241 (58.5%) households relied on unimproved water supply sources. In addition, approximately two-thirds 272 (66.0%) of the household water samples were positive for fecal coliform bacteria. Water storage duration ≥3 days (AOR = 4.632; 95% CI: 1.529-14.034), dipping method of water withdrawal from a water storage tank (AOR = 4.377; 95% CI: 1.382-7.171), uncovered water storage tank at control (AOR = 5.700; 95% CI: 2.017-31.189), lack of home-based water treatment (AOR = 4.822; 95% CI: 1.730-13.442), and unsafe household liquid waste disposal methods (AOR = 3.066; 95% CI: 1.706-8.735) were factors significantly associated with the presence of fecal contamination in drinking water., Conclusion: Fecal contamination of water was high. The duration of water storage, the method of water withdrawal from the storage container, covering of the water storage container, the presence of home-based water treatment, and the method of liquid waste disposal were factors for fecal contamination in drinking water. Therefore, health professionals should continuously educate the public on proper water use and water quality assessment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Berihun, Abebe, Hassen, Gizeyatu, Berhanu, Teshome, Walle, Desye, Sewunet and Keleb.)

The provision of potable water is crucial to ensuring the health and dignity of individuals. In many developing countries, including Ethiopia, waterborne disease has become a major public health problem. There is a significant gap in accessing comprehensive national-wide evidence on Household Water Treatment (HWT) practices and associated factors in Ethiopia. Therefore, this study aims to assess the pooled HWT practice and associated factors in Ethiopia. A comprehensive search of published studies before October 15, 2022, was identified using databases and other sources. Data were extracted using Microsoft Excel, and analysis was performed using STATA 14/SE software. A random-effects model was used to estimate the pooled proportion of HWT practices and the odds ratio of associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics was used to assess heterogeneity. Duval and Tweedie's "trim and fill" method was performed to adjust the pooled estimate. A subgroup analysis was also conducted to identify the sources of heterogeneity. In this study, a total of 708 articles were retrieved, and 16 eligible studies were included. The pooled proportion of HWT practice in Ethiopia was found to be 21% (95% CI: 17-24). Having a formal education (OR: 2.42, 95% CI (2.11-2.74)), being male (OR: 1.32, 95% CI (1.13-1.51)), owning radio (OR: 1.33, 95% CI (1.18-1.47)), having a higher income (OR: 1.73, 95% CI (1.41-2.04)), unimproved water source (OR: 1.71, 95% CI (1.41-2.01)), fetching water at more frequently (OR: 3.31, 95% CI (1.99-4.64)), dipping methods of water drawing (OR: 2.08, 95% CI (1.66-2.51)), and taken training of water treatment (OR: 2.15, 95% CI (1.55-2.75)) were all found to be associated with HWT practice. Based on the findings of this study, the pooled proportion of HWT practice in Ethiopia was found to be one-fifth, which indicated that it was significantly low. Therefore, the authors recommend that households could better receive adequate information about HWT practices through strengthened health education and intensive training on HWT., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Desye et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Electronic waste (e-waste) is an emerging human and environmental problem. Lead (Pb) is one of the most dangerous chemicals for human health, and it is the most prevalent heavy metal pollutant in e-waste. Despite the rapid growth of e-waste globally and the health effects of Pb, there is little information regarding the effects of Pb exposure from e-waste on children. Therefore, the aim of this review was to provide concise information on the health effects of Pb exposure from e-waste on children., Methods: A comprehensive search of databases was undertaken using PubMed/MEDLINE, Cochrane Library, Science Direct, HINARI, African Journal Online (AJOL), and additional sources were searched up to November 25, 2022. Eligibility criteria were determined using Population, Exposure, Comparator, and Outcome (PECO). The guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were used during the article selection process. The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (Registration ID: CRD42022377028). The Joanna Briggs Institute (JBI) quality appraisal checklist was used to assess the quality of the included studies., Results: From a total of 1,150 identified studies, 20 full-text studies were included in the systematic review. All most included studies were conducted in China recycling area for e-waste. The included studies were conducted with an exposed group versus a reference group. The majority of the included studies found that blood Pb levels were ≥5 μg/dl and that Pb exposures from e-waste were affecting children's health, such as a decrease in serum cortisol levels, inhibition of hemoglobin synthesis, impact on neurobehavioral development, affect physical development, etc., Conclusion: Lead exposure had a significant impact on children's health as a result of informal e-waste recycling. Therefore, formalizing the informal sector and raising public health awareness are important steps toward reducing Pb exposure from e-waste. Moreover, the concerned stakeholders, like national and international organizations, should work together to effectively manage e-waste., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Desye, Tesfaye, Berihun, Ademas and Sewunet.)

Milk is a complete and highly nutritious source of food for human beings. However, in many developing countries, including Ethiopia, the quality of milk products has become a major health concern for consumers, particularly for infants and children. Therefore, the aim of the present study was to assess the quality of raw and pasteurized milk marketed in Gondar city, Northwest Ethiopia. A laboratory-based cross-sectional study was conducted on 90 milk samples. The samples were chosen using a simple random sampling technique. For statistical analysis, ANOVA and the Pearson correlation coefficient were used. The specific gravity of pasteurized milk, farm milk, and milk vendors were found to be 1.021, 1.027, and 1.026, respectively. Farm milk, milk vendors, and pasteurized milk had fat contents of 3.38%, 3.22%, and 3.09%, respectively. The total bacterial count in pasteurized milk, farm milk, and milk vendors was found to be 7.08, 6.73, and 6.94 log 10  CFU/mL, respectively. In raw milk, hydrogen peroxide (7.7%), formalin (7.7%), and water (3.8%) were found, whereas in pasteurized milk, hydrogen peroxide (50%), formalin (50%), and water (19.8%) were found. Based on the findings of this study, the quality of both raw and pasteurized milk was found to be poor as per the milk quality standards. This may cause significant public health-related problems. Therefore, an appropriate intervention should be conducted to improve the quality of milk., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors.)

COVID-19 is a major public health problem that has been seriously affecting the global community. Healthcare workers (HCWs) are at high risk of infection due to being directly involved in diagnosing and taking care of patients. Due to this, they were prioritized to receive the initial supply of vaccines. However, vaccine hesitancy has been identified as a major global public health threat. Therefore, this review aimed to synthesize pieces of evidence on the prevalence of COVID-19 vaccine acceptance and determinate factors among HCWs. A systematic search of published articles was identified using PubMed, Science Direct, Web of Science, and Google Scholar for relevant studies of vaccine acceptance and determinant factors among HCWs. Published articles were identified using abstracts and titles of the articles, and articles were assessed for eligibility criteria. The review process was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). An electronic database search identified 365 articles, from which 33 full-text articles were included in the systematic review. In this review, the highest rate of vaccine acceptance was reported at 95% and the lowest rate of vaccine acceptance was found at 21%. Factors such as sex (male), age, profession (medical doctors), and previous influenza vaccination were the main positive predictors for COVID-19 vaccine acceptance among HCWs. Concerns about vaccine safety, efficacy, and effectiveness were the main barriers and drivers for vaccine hesitancy. Therefore, to improve the COVID-19 vaccine acceptance among HCWs, governments, public health authorities, and private healthcare systems should work together to provide continuous professional development and training on the safety and effectiveness of the COVID-19 vaccine., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Desye.)

Waste stabilization pond (WSP) technology is one of the most promising wastewater treatment methods. In developing countries, including Ethiopia, only a small proportion of the wastewater is being treated. Discharge of untreated wastewater into receiving water bodies may lead to disruption of ecological integrity, economic, and public health risks. However, there is limited evidence on WSP efficiency and effluent water quality in Ethiopia. A laboratory-based cross-sectional study was conducted on 60 wastewater samples. A standard method of procedure was used to collect and analyze samples. SPSS version-24 was used for statistical analysis and a paired t -test was used to test for statistical significant differences. A statistically significant difference ( p < 0.001) in the removal efficiency of BOD 5 up to 75.3% (117 mg/L effluent) and COD up to 56.5% (457.5 mg/L effluent) was recorded. A statistically significant difference ( p < 0.001) in the removal efficiency of TN up to 79% (17.4 mg/L effluent), TP up to 69.2% (4.8 mg/L effluent), and PO 4 -3 up to 71% (3.36 mg/L effluent) was recorded. Whereas, a statistically significant difference ( p < 0.001) in the removal efficiency of total coliforms up to 99.99% (3.4 × 10 3 MPN/100 mL effluent) and fecal coliforms up to 94.3% (8.54 × 10 2 MPN/100 mL effluent) was recorded. The overall efficiency of the treatment plant was 73.5% and its water quality index of the effluent water quality of WSP was 30. The finding showed that the efficiency of the WSP was judged as satisfactory and the effluent water quality of WSP is unsuitable for the discharge into the environment. Therefore, to improve the efficiency of the WSP and to produce adequately treated water, it required adequate preliminary treatment, modification of the design, desludging of the pond, additional treatment, and frequent monitoring and maintenance of the pond., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Belay Desye et al.)

Background: In order to protect public health during the outbreaks of infectious diseases including the pandemic COVID-19, provision of Water, Sanitation, and Hygiene (WASH) services is important. The challenges of inaccessible WASH services along with the pandemic COVID-19 in low-income countries can lead to a devastating problem., Method: A systematic search of published articles was identified using PubMed, Web of Science, and Google Scholar, on relevant studies of COVID-19 and WASH services. Published articles were identified using abstracts and titles of the articles, followed by assessed for eligibility, and screening of the full text reports of relevant studies., Results: Electronic database search identified 798 articles from which 28 full text articles were included in the systematic review. A lack of access to WASH services in households, schools, health care facilities, and other public spaces were the main identified COVID-19 related public health risks. A lack of adequate data and financial shortages were the challenges for mitigating the problems of COVI-19 and WASH services., Conclusion: This systematical review identified the impacts and challenges of COVID-19 in the provision of WASH services. The results implied that COVID-19 has significant impacts on WASH services that can affect the health of the public. Therefore, strengthening and ensuring access to WASH services are important for preventing COVID-19 and realizing human rights. Community engagement also can be used to support for prevention and control of COVID-19. Countries need to be expand their investment in WASH services as an important mechanism for mitigating COVID-19., Competing Interests: Declaration of Conflicting Interests: The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

Introduction: Access to safe drinking water is essential to health, and it is a basic human right. However, drinking water treatment plant efficiency and its water quality are not well investigated in low-income countries including Ethiopia., Methods: A laboratory-based cross-sectional study was conducted among 75 water samples. Data analysis was carried out using SPSS version 22 to generate descriptive statistics, and one-way ANOVA was used to test statistically significant difference., Results: Physicochemical qualities of the water samples from tap water sources were found to be pH (6.88 ± 0.05), turbidity (5.15 ± 0.006 NTU), electrical conductivity (170.6 ± 0.1 μ S/cm), residual chlorine (0.19 ± 0.003 mg/L), and fluoride (1.17 ± 0.009 mg/L). The removal efficiency of turbidity, total hardness, and nitrate was found to be 94.4%, 52.3%, and 88.7%, respectively. Removal efficiency of the treatment plant for total coliforms up to 91.6% (15 ± 0.26 CFU/100 mL in tap water) and faecal coliforms up to 99% (1.51 ± 0.03 CFU/100 mL in tap water) was recorded. Parameters of pH, temperature, and faecal coliform were statistically significant different at p < 0.05 in tap water source. The overall efficiency of the treatment plant (68.5%) and the water quality index (76) were recorded., Conclusion: Based on the results, some of the investigated parameters of water quality (turbidity, residual chlorine, total coliform, and faecal coliform) were found to be not within the permissible limits of WHO guideline values for drinking water quality. The water quality index of the water samples was categorized under good water quality. To adequately treat drinking water and improve the treatment plant, adequate preliminary treatments like screening to reduce the incoming organic loading, proper chlorination of the drinking water system, and frequent monitoring and maintenance of the treatment plant system are required., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2021 Belay Desye et al.)