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1. Level of JMP ladders for water, sanitation, and hygiene (WASH) services among healthcare facilities of Bishoftu Town, Ethiopia: An implication of healthcare-associated infection prevention status

Author

Aderajew Mekonnen Girmay, Moa Abate Kenea, Sisay Derso Mengesha, Bedasa Wagari, Abel Weldetinsae, Zinabu Assefa Alemu, Daniel Abera Dinssa, Mesaye Getachew Weldegebriel, Melaku Gizaw Serte, Tsigereda Assefa Alemayehu, Kirubel Tesfaye Teklu, Ermias Alemayehu Adugna, Waktole Gobena, Getinet Fikresilassie, Masresha Tessema, and Getachew Tollera

Subjects
healthcare, healthcare-associated infection, jmp ladders, wash, Environmental technology. Sanitary engineering, TD1-1066
Abstract

This study aimed to assess the level of JMP ladders for WASH services. A cross-sectional study was conducted. Forty-four healthcare facilities were enrolled. From each healthcare facility, water samples were collected directly from water storage facilities. In addition to the interview, an observational checklist was used. Descriptive statistics and a chi-square test were conducted to analyze the data. The coverage of advanced and basic drinking water services in healthcare facilities was 4.6 and 70.4%, respectively. However, the healthcare facilities’ access to advanced and basic sanitation services was nil. Similarly, 61.4 and 88.6% of the healthcare facilities had no hygiene and waste disposal services, respectively. While 2.6, 4.5, and 75% of healthcare facilities had advanced, basic, and limited environmental cleaning services, 18.2% lacked environmental cleaning services. Water samples of 15.9, 11.4, and 6.8% of the healthcare facilities were found positive for total coliforms, fecal coliforms, and E. coli, respectively. The WASH services of the healthcare facilities were very low and not on track to achieve the Sustainable Development Goal target. Healthcare facilities could be sources of healthcare-associated infections. Hence, the government and other concerned bodies should take urgent action to improve WASH services. HIGHLIGHTS 4.6 and 70.4% of the healthcare facilities used advanced and basic water services, respectively.; The healthcare facilities’ access to advanced and basic sanitation services was nil.; The majority of the healthcare facilities had no hygiene and waste disposal services.; 18.2% of the healthcare facilities lacked environmental cleaning services.; Bacteria and chemical contaminants contaminated many water samples.;

Published
2023
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2. Access to water, sanitation and hygiene (WASH) services and drinking water contamination risk levels in households of Bishoftu Town, Ethiopia: A cross‐sectional study

Author

Aderajew Mekonnen Girmay, Sisay Derso Mengesha, Daniel A. Dinssa, Zinabu Assefa Alemu, Bedasa Wagari, Mesaye G. Weldegebriel, Melaku G. Serte, Tsigereda A. Alemayehu, Moa Abate Kenea, Abel Weldetinsae, Kirubel T. Teklu, Ermias Alemayehu Adugna, Kaleab S. Awoke, Tesfaye L. Bedada, Waktole Gobena, Getnet Fikreslassie, Wendayehu Wube, Vivian Hoffmann, Masresha Tessema, and Getachew Tollera

Subjects
access, contamination risk level, hygiene, sanitation, WASH, water, Medicine
Abstract

Abstract Background and Aims Access to safe drinking water, sanitation, and hygiene is a fundamental human right and essential to control infectious diseases. However, many countries, including Ethiopia, do not have adequate data to report on basic water, sanitation, and hygiene (WASH) services. Although contaminated drinking water spreads diseases like cholera, diarrhea, typhoid, and dysentery, studies on drinking water contamination risk levels in households are limited in Ethiopia. Therefore, closing this gap needs investigation. Methods A community‐based cross‐sectional study was conducted. A total of 5350 households were included. A systematic, simple random sampling technique was used to select the participants. The information was gathered through in‐person interviews using a standardized questionnaire. Furthermore, 1070 drinking water samples were collected from household water storage. Results This investigation revealed that 9.8%, 83.9%, and 4.9% of households used limited, basic, and safely managed drinking water services, respectively. Besides, 10.2%, 15.7% and 59.3% of households used safely managed, basic and limited sanitation services, respectively. Yet, 10.6% and 4.2% of households used unimproved sanitation facilities and open defecation practices. Also, 40.5% and 19.4% of households used limited and basic hygiene services. On the other hand, 40.1% of households lacked functional handwashing facilities. In this study, 12.1%, 26.3%, and 42% of households’ drinking water samples were positive for Escherichia coli, fecal coliforms, and total coliforms, respectively. Also, 5.1% and 4.5% of households’ drinking water samples had very high and high contamination risk levels for E. coli, respectively. We found that 2.5% and 11.5% of households and water distributors had unacceptable fluoride concentrations, respectively. Conclusion The majority of households in Bishoftu town lack access to safely managed sanitation, drinking water, and basic hygiene services. Many households’ water samples had very high and high health risk levels. Hence, the government and partner organizations should implement water and sanitation safety plans.

Published
2023
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3. Factors influencing access to basic water, sanitation, and hygiene (WASH) services in schools of Bishoftu Town, Ethiopia: a cross-sectional study

Author

Aderajew Mekonnen Girmay, Mesaye Getachew Weldegebriel, Sisay Derso Mengesha, Melaku Gizaw Serte, Abel Weldetinsae, Zinabu Assefa Alemu, Daniel Abera Dinssa, Bedasa Wagari, Tsigereda Assefa Alemayehu, Moa Abate Kenea, Kirubel Tesfaye Teklu, Waktole Gobena, Getinet Fikresilassie, Ermias Alemayehu Adugna, Masresha Tessema, and Getachew Tollera

Subjects
Water, Sanitation, Hygiene, Access, Influencing-factor, School, Environmental sciences, GE1-350
Abstract

Abstract Access to basic water, sanitation and hygiene services is the most effective mechanism to reduce many infectious diseases. WASH in schools related to better educational outcomes although adequate water, sanitation, and hygiene services were unavailable to millions of school-age children in Ethiopia. Therefore, it is crucial to assess the level of WASH coverage and identify factors affecting access to basic water, sanitation, and hygiene services. A cross-sectional study was carried out among 82 school facilities. A structured questionnaire and an observational checklist were used to gather the data. Water samples were taken from the schools' water storage. Descriptive and multivariable logistic regression analyses were used to analyze the data. In this study, 74.7%, 61. 3% and 37.3% of the schools had access to basic drinking water, sanitation, and hygiene services, respectively. Additionally, 21.3%, 29.4%, and 30.7% of the schools had access to limited drinking water, sanitation, and hygiene services, respectively. However, 4%, 9.3%, and 32% of the schools lacked water, sanitation, and hygiene services, respectively. We discovered that schools with male heads were 7% less likely to have access to basic hygiene services (AOR = 0.07 with 95% CI 0.01–0.5) than those with female directors. In addition, schools with hygiene and environmental health clubs had an 11.8-fold higher access rate to basic hygiene services (AOR = 11.8 with 95% CI 1.35–104) than schools without such clubs. Besides, schools that conduct WASH lessons at least once a week were 8.63 times more likely to use basic hygiene services (AOR = 8.63; 95% CI 1.18–63.22) than schools that did not. This study offers scientific evidence that could be used for sound decisions to fill the school WASH gaps. This is a unique study in determining the level of WASH coverage and identifying factors affecting access to basic hygiene services. The investigation provides some insights into how access to WASH services can be improved at the grassroots level. Federal and regional governments should implement effective interventions that assist schools to attain Sustainable Development Goal 6 by 2030. School administrators and other partner organizations should take proactive measures to enhance and maintain the WASH services.

Published
2023
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4. Associations of WHO/UNICEF Joint Monitoring Program (JMP) Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia: a cross-sectional study

Author

Vivian Hoffmann, Masresha Tessema, Sisay Derso Mengesha, Danial Abera Dinssa, Getachew Tollera, Aderajew Mekonnen Girmay, Abel Weldetinsae, Ermias Alemayehu Adugna, Zinabu Assefa Alemu, Bedasa Wagari, Melaku Gizaw Serte, Kaleab Sebsibe Awoke, Tesfaye Legesse Bedada, Mesaye Getachew Weldegebriel, Tsigereda Assefa Alemayehu, Moa Abate Kenea, Kirubel Tesfaye Tekulu, Waktole Gobena, Getinet Fikresilassie, Wendayehu Wube, Abayew Wassie Melese, and Ekram Redwan

Subjects
Medicine
Abstract

Objective To determine the associations of WHO/UNICEF Joint Monitoring Program Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia.Design A community-based cross-sectional study.Setting Bishoftu town, Ethiopia, January–February 2022.Participants A total of 1807 mothers with at least one child under 5 years were included. Sociodemographic and WASH variables were collected using a structured questionnaire. 378 drinking water samples were collected.Outcome The response variable was diarrhoeal disease among children under 5 years.Results The 2-week prevalence of diarrhoeal disease among children under 5 years was 14.8%. Illiteracy (adjusted OR 3.15; 95% CI 1.54 to 6.47), occupation (0.35; 0.20 to 0.62), mother’s age (1.63; 1.15 to 2.31), family size (2.38; 1.68 to 3.39), wealth index (5.91; 3.01 to 11.59), residence type (1.98; 1.35 to 2.90), sex of the child (1.62; 1.17 to 2.24), child’s age (3.52; 2.51 to 4.93), breastfeeding status (2.83; 1.74 to 4.59), food storage practice (3.49; 1.74 to 8.26), unimproved drinking water source (8.16; 1.69 to 39.46), limited drinking water service (4.68; 1.47 to 14.95), open defecation practice (5.17; 1.95 to 13.70), unimproved sanitation service (2.74; 1.60 to 4.67), limited sanitation service (1.71; 1.10 to 2.65), no hygiene service (3.43; 1.91 to 6.16) and limited hygiene service (2.13; 1.17 to 3.86) were significantly associated with diarrhoeal disease.Conclusion In this study, diarrhoea among children is a significant health issue. Child’s age, drinking water service, residence type and hygiene service were the largest contributors with respect to the prevalence of diarrhoeal disease. This investigation provides information that could help to inform interventions to reduce childhood diarrhoea. The findings suggest that state authorities should initiate robust WASH strategies to achieve the Sustainable Development Goal 3 agenda.

Published
2023
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5. Effect of demographic disparities on the use of the JMP ladders for water, sanitation, and hygiene services in Bishoftu Town, Ethiopia

Author

Aderajew Mekonnen Girmay, Zinabu Assefa Alemu, Sisay Derso Mengesha, Daniel Abera Dinssa, Bedasa Wagari, Mesaye Getachew Weldegebriel, Melaku Gizaw Serte, Tsigereda Assefa Alemayehu, Moa Abate Kenea, Abel Weldetinsae, Kirubel Tesfaye Teklu, Ermias Alemayehu Adugna, Waktole Gobena, Getinet Fikresilassie, Belaynesh Demissie, Abayew Wassie Melese, Wendayehu Wube, Ekram Redwan, Masresha Tessema, and Getachew Tollera

Subjects
Water, Sanitation, Hygiene, JMP ladders, Demographic-disparities, Public health, Water supply for domestic and industrial purposes, TD201-500, Environmental sciences, GE1-350
Abstract

Abstract Reducing inequalities in all its forms is one of the key principles of the Sustainable Development Goal (SDG). However, the 2030 SDG Agenda has been a real challenge in addressing inequalities in Water, Sanitation, and Hygiene (WASH) services. There is a disparity in the use of WASH services in Ethiopia. Therefore, this study aimed to identify demographic factors affecting the use of Joint Monitoring Program (JMP) ladders for WASH services. In this study, a total of 5350 households were included. Households having heads with vocational education levels were 2.9 times higher in use of basic drinking-water services ((Adjusted Odds Ratio (AOR) = 2.9 with 95% CI 1.6–5.1) than household having heads who could not read and write. Besides, households living in urban areas were 21.7 times more likely to use basic drinking-water services (AOR = 21.7 with 95% CI 16–30) than in rural parts. Further, households with merchants’ heads were 2.1 times higher to use basic sanitation services (AOR = 2.1 with 95% CI 1.5, 3.1) than households with farmers’ heads. Moreover, households having higher monthly income per head were 2.9 times higher in utilizing basic sanitation services (AOR = 2.9 with 95% CI 2.32–3.58) than the poorest households. Similarly, households with female heads were 1.5 times higher in using the JMP ladder for basic hygiene services (AOR = 1.5 with 95% CI 1.24–1.71) than households with male heads. Additionally, respondents who live in urban areas had 2.8 times higher use of basic hygiene services (AOR = 2.8 with 95% CI 2.26–3.54) than those in rural areas. Many demographic factors that influence the use of the JMP ladders for water, sanitation, and hygiene services were identified. The use of surface water, open defecation practice, unimproved sanitation, and no hygiene services were positively associated with illiteracy. The findings suggest that state authorities should initiate firm WASH policies and strategies to achieve the SDG 6 and 10. Additionally, the government should apply effective WASH interventions that consider demographic disparities.

Published
2022
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6. Microbial risk assessment and health concern of vegetables irrigated with Akaki River in Addis Ababa, Ethiopia

Author

Sisay Derso Mengesha, Yosef Beyene Asfaw, Abel Weldetinsae Kidane, Kirubel Tesfaye Teklu, Melaku Gizaw Serte, Moa Abate Kenea, Daniel Abera Dinssa, Mesay Getachew Woldegabriel, Tsigereda Assefa Alemayehu, and Aderajew Mekonnen Girmay

Subjects
Akaki River, Microbial contamination, Vegetable, Farmland, Irrigation, Wastewater, Science
Abstract

Background: The consumption of vegetables is increasing in Ethiopia because of their high health benefits. Smallholder farmers who use water from the Akaki River for irrigation meet more than 60% of the vegetable needs of Addis Ababa. However, the Akaki River is severely polluted by anthropogenic impacts. Hence, the intake of vegetables grown in fecally contaminated water can lead to many health problems. Therefore, this study aimed to evaluate microbial contamination of irrigation water and vegetables in Addis Ababa. Methods: This study assessed the quality of water and vegetables collected from the Akaki River. Fresh vegetables, such as Ethiopian kale, lettuce, cabbage, and spinach, were collected from 14 farmlands during the dry and wet seasons. The analysis of E. coli non-E. coli, total coliform (TC), fecal coliform (FC), and total aerobic plate count (TAC) were determined using standard methods. Results: The findings of this study indicated that all fresh vegetables were contaminated with total coliforms, fecal coliforms, and total aerobic plate counts in both dry and wet seasons. The overall mean counts of E. coli and non-E. coli in the water samples were 2.09 and >3.48 log10 CFU 10 mL−1, respectively. The mean counts of TC, FC, and TAC on the sampled vegetables were 3.22, 1.37, and 4.72 in the dry season, and 3.87, 2.57, and 5.09 log10 CFU per gram in the wet season, respectively. Conclusion: The Akaki River has been contaminated with non-E. Coli & E. coli coliforms, and did not meet the WHO guideline criteria for safe irrigation. The microbial contamination of vegetables was found to be high and exceeded the hazard analysis and critical control points for total quality management (HACCPTQM) and International Commission on Microbiological Specifications for Food (ICMSF) limits for safe consumption. Therefore, the local government is responsible for ensuring that farmers can use pollution-reducing irrigation systems and that consumers are aware of the health risks of contaminated vegetables and take appropriate precautions.

Published
2023
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7. Assessing the effect of sunlight exposure on physicochemical properties of bottled water in Addis Ababa, Ethiopia: An experimental observational study

Author

Yibeyin Mulualem, Abera Kumie, Yifokir Tefera, Belaynesh Demsie, and Sisay Derso Mengesha

Subjects
Sunlight exposure, Bottled water, Water quality, Parameters, Science
Abstract

Bottled water is potable water that is manufactured, distributed, or offered for sale and intended for human consumption. However, bottled water retailers usually expose bottled water to direct sunlight at the point of sale, and store it for extended periods. Therefore, this study aimed to investigate the effects of sunlight exposure and storage time on the physicochemical properties of bottled water. An experimental observational study design was employed to assess the effect of direct sunlight exposure on selected physicochemical parameters in four water brands (40 samples for both control and exposed) for 28 days in Addis Ababa, Ethiopia. The study's average sunlight intensity and sunshine hours from 3 October to 30/2020 were 197.7 ± 31.8 W/M2 and 7. 3 ± 2. 7 h, respectively. The mean values of the physicochemical parameters of bottled water before and after exposure to sunlight were compared using a paired sample t-test and Wilcoxon signed-rank test with a significance level of 0.05. Approximately 80% of the analysed parameters did not match the labelled value of bottled water. This study showed that the values of pH, F-, and NO3− were decreased from 7.31 to 7.02; 0.20 to 0.15 mg/L, and 3.95 to 3.52 mg/L, respectively. Whereas the level of NO2−, TDS, and turbidity was increased with increasing sunlight exposure from 0.00 to 0.02 mg/L, 82.82 to 85.24 mg/L, and 0.00 to 0.57 NTU, respectively. Statistically significant differences in pH, F−, NO2−, and turbidity levels were found between the exposed and non-exposed groups of bottled water. Apart from the increase or decrease in chemical concentration after sunlight exposure, the physicochemical parameters of the exposed bottled waters were within the recommended standards, except for fluoride and turbidity. However, the fluoride concentration was below the recommended level in both exposed and unexposed samples, with a further reduction in sunlight-exposed bottled water samples. Therefore, regulators should ensure that bottled water is protected against long-term direct exposure to sunlight to provide safe water to consumers.

Published
2023
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8. Tobacco use prevalence and its determinate factor in Ethiopia- finding of the 2016 Ethiopian GATS

Author

Sisay Derso Mengesha, Kirubel Tesfaye Teklu, Abel Weldetinsae, Melaku Gizaw Serte, Moa Abate Kenea, Daniel Abera Dinssa, Mesay Getachew Woldegabriel, Tsigereda Assefa Alemayehu, and Wassihun Melaku Belay

Subjects
Tobacco use, Predicting factor, GATS, NCD, Ethiopia, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Tobacco, one of the risk factors for non-communicable diseases, kills 8 million people each year. Like other sub-Saharan countries, Ethiopia faces the potential challenge of a tobacco epidemic. However, there is no organized data on the prevalence of tobacco use in the country. Therefore, this study aims to determine adult tobacco use in Ethiopia. Methods The study was conducted using the WHO and CDC GATS survey methods. Complex survey analysis was used to obtain prevalence and population estimates with 95% confidence intervals. Bivariate regression analyses were employed to examine factors related to tobacco use. Results The overall tobacco use percentage was 5.0% [95% CI (3.5, 6.9)], of which 65.8% [95% CI (53.4, 76.3)] only smoked tobacco products; 22.5% [95% CI (15.7, 31.2)] used smokeless tobacco only; and 11.8% [95% CI (6.5, 20.4)] used both smoked and smokeless tobacco products. In 2016, more men adults (8.1%) used tobacco than women did (1.8%). Eight out of eleven states have a higher smoking rate than the national average (3.7%). Gender, employment, age, religion, and marital status are closely linked to current tobacco use (p-value

Published
2022
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9. Organoleptic and palatability properties of drinking water sources and its health implications in Ethiopia: a retrospective study during 2010-2016

Author

Sisay Derso Mengesha, Abel Weldetinsae, Kirubel Tesfaye , Girum Taye, and Girum Taye

Subjects
Drinking water, Water quality, Water sources, Taste, Physicochemical properties, Retrospective study, Ethiopia, Logistic models., Environmental sciences, GE1-350
Abstract

Background: This retrospective study aimed to investigate the physicochemical properties of drinking water sources in Ethiopia and compare the water quality with the health-based target. For this purpose, the water quality database of Ethiopian Public Health Institute (EPHI) from 2010 to 2016 was used. Methods: The concentration and other properties of the water samples were analyzed according to the Standard Methods of Water and Wastewater analysis. Quality control and quality assurance were applied in all stages following our laboratory standard operation procedures (SOPs). Results: The concentration of the selected parameters varied based on the type of water sources. The mean concentration of turbidity was higher in spring water (21.3 NTU) compared to tap (12.6 NTU) and well (3.9 NTU) water sources. The mean concentration of total dissolved solids (TDS), electrical conductivity (EC), sodium (Na+), and sulfate (SO4-2) was found to be higher in spring water sources than tap and well water sources. Comparably, the concentration of hardness, calcium, and magnesium was found to be higher in well water sources than spring and tap water sources. The bivariate analysis indicated that out of 845 analyzed water samples, more than 50% of the samples from Oromia region had turbidity, pH, TDS, hardness, Ca++, K+, and Na+ within an acceptable limit. In addition, the logistic regression analysis showed that water quality parameters were strongly associated with the type of water sources and regional administration at P < 0.05. Conclusion: More than 80% of the samples analyzed from drinking water sources were in agreement with WHO guidelines and national standards. However, the remaining 20% specifically, pH (25%), calcium (20%), hardness (18.1%), TDS (15.5%), and turbidity (13.3%) analyzed from improved water sources did not comply with these recommendations. Due to objectionable or unpleasant taste, people may force to look for alternative unprotected water sources that lead to health concerns.

Published
2018
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10. Factors associated with food safety practice and drinking-water quality of food establishments in Bishoftu Town, Ethiopia

Author

Aderajew Mekonnen Girmay, Sisay Derso Mengesha, Abel Weldetinsae, Zinabu Assefa Alemu, Daniel Abera Dinssa, Bedasa Wagari, Mesaye Getachew Weldegebriel, Melaku Gizaw Serte, Tsigereda Assefa Alemayehu, Moa Abate Kenea, Kirubel Tesfaye Teklu, Ermias Alemayehu Adugna, Waktole Gobena, Getinet Fikresilassie, Wendayehu Wube, Abayew Wassie Melese, Ekram Redwan, Masresha Tessema, and Getachew Tollera

Abstract

Introduction Globally, food and waterborne diseases remain a critical public health problem, although the issue is severe in low and middle-income countries, including Ethiopia. This study aimed to identify factors associated with food safety practices and the drinking water quality of food establishments. Method A cross-sectional study was conducted. A total of 160 food outlets were enrolled using a systematic random sampling method. A structured questionnaire and observational checklist were used to collect data. Descriptive, binary, and multivariable logistic regression analyses were conducted. Drinking water samples were taken from the food establishments' drinking-water storage and were bacteriologically and chemically tested. Heat-sterilized bottles of 250 ml capacity for bacteriological and 1000 ml plastic bottles for chemical parameters were used to collect drinking-water samples. Results In this study, food establishments with female managers were 3.7 times higher in good food safety practices than those with male managers (AOR = 3.7, with 95% CI 1.33–10.21). Moreover, food establishments that owned trained food handlers in sanitation and hygiene were 4.8 times more likely to be in good food safety practices than those that did not have trained food handlers (AOR = 4.8, with 95% CI 1.37–17.00). Besides, food outlets with large service were 9.6 times higher in good food safety practices than those with small service (AOR = 9.6, with 95% CI 2.2–42.1). On the other hand, food outlets which had married managers were 0.3 times less likely to be in good food safety practices than those food establishments which had single managers (AOR = 0.3, with 95% CI 0.11–0.93). In this study, only 51% of the food establishments had good food safety practices. Besides, 29.5%, 16.8%, and 7.4% of the food outlets’ drinking-water samples were positive for total coliforms, fecal coliforms, and E. coli, respectively. Conclusion Many vital factors influencing the food safety practice of food establishments were identified. Almost half of the food outlets had poor food safety practices. A significant number of drinking water samples from the food outlets' were contaminated. Therefore, food establishments should implement continuous monitoring and inspection systems to improve food safety practices. In addition, the government should implement an effective regulatory system to improve the food safety practices, water quality, sanitation, and hygiene services of the food outlets.

Published
2022

11. Response of legal and illegal cigarette prices to a tax increase in Ethiopia

Author

Sisay Derso Mengesha and Hana Ross

Subjects
Health (social science), Public Health, Environmental and Occupational Health
Abstract

BackgroundIn 2020, Ethiopia passed a landmark tax proclamation implementing an evidence-based mixed excise system aimed at curbing tobacco use. This study evaluates the impact of the tax increase of more than 600% on both legal and illegal cigarette prices in order to gauge the impact of the tax reform in the presence of a sizeable illicit cigarette market.MethodsData on 1774 cigarette prices were obtained from retailers during Empty Cigarette Pack Surveys in the capital and major regional cities conducted in 2018 and 2022. Packs were categorised as ‘legal’ or ‘illicit’ using criteria from the tobacco control directives. Descriptive and regression analyses were used to study the cigarette price changes during the period of 2018–2022, capturing the impact of the 2020 tax increase.ResultPrices of both legal and illegal cigarettes increased in response to the tax increase. In 2018, the stick prices ranged from ETB0.88 (Ethiopian birr) to ETB5.00 for legal cigarettes while they ranged from ETB0.75 to ETB3.25 for illegal ones. In 2022, a legal stick sold for ETB01.50–ETB2.73 and an illegal stick for ETB1.92–ETB8.00. The average real price of legal and illegal brands increased by 18% and 37%, respectively. The multivariate analysis confirms that prices of illicit cigarettes grew faster compared with the legal ones. By 2022, illicit brands were on average more expensive compared with their legal counterparts. This result is statistically significant at pConclusionThe prices of both legal and illegal cigarettes increased following the 2020 tax increase, with the average real cigarette price increasing by 24%. As a result, the tax increase likely had a positive impact on public health despite a sizeable illicit cigarette market.

Published
2023

12. Smoke-free law compliance and predictive factors in Ethiopia: observational assessment of public places and workplaces

Author

Sisay Derso Mengesha, Bitsat Shimeles, Baharu Zewdie, Asnakech Alermu, Heran Gerba, and Coral E Gartner

Subjects
Health (social science), Public Health, Environmental and Occupational Health
Abstract

ObjectivesThe primary objective of this observational study was to assess the status of public place and workplace compliance with smoke-free provisions in Ethiopia.MethodsThis study was conducted in four regions of Ethiopia (Oromia; Sidama; Harari; and Southern Nations, Nationalities, and Peoples’ Region) from September to October 2021. Data were collected using a standardised smoke-free checklist. Χ2tests were used to assess the association between categorical variables and the smoke-free status. Multivariable binary logistic regression analysis was used to identify factors associated with the presence of at least one person actively smoking.ResultsApproximately 97% (95% CI 93.1%, 98.8%) of government buildings, 92.5% (95% CI 85.7%, 96.2%) of educational institutions, 89.8% (95% CI 86.3%, 92.5%) of bars, restaurants and cafés, 88.4% (95% CI 82.9%, 92.3%) of food establishments and 84.0% of hotels (95% CI 79.5%, 87.6%) were non-compliant with the tobacco control law. Overall, only 12.3% of sites met the requirements of the current smoke-free law. The multivariable logistic regression models showed that transit facilities (adjusted OR (AOR)=26.66 (95% CI 7.53, 94.41)) and being located in the Harari region (AOR=4.14 (95% CI 2.30, 7.45)) were strongly associated with the presence of active smoking observed during the site visit.ConclusionThis study indicated that public place and workplace non-compliance level was very high in all sites. This calls for more effective implementation of complete smoke-free provisions across all government buildings and institutions in all regions, such as public educational campaigns about the laws and enforcement action for non-compliance. Furthermore, all regional states should adopt Federal Proclamation 1112/2019.

Published
2023

13. The global burden of cancer attributable to risk factors, 2010–19 : A systematic analysis for the Global Burden of Disease Study 2019

Author

Khanh Bao Tran, Justin J Lang, Kelly Compton, Rixing Xu, Alistair R Acheson, Hannah Jacqueline Henrikson, Jonathan M Kocarnik, Louise Penberthy, Amirali Aali, Qamar Abbas, Behzad Abbasi, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, Michael Abdelmasseh, Sherief Abd-Elsalam, Ahmed Abdelwahab Abdelwahab, Gholamreza Abdoli, Hanan Abdulkadir Abdulkadir, Aidin Abedi, Kedir Hussein Abegaz, Hassan Abidi, Richard Gyan Aboagye, Hassan Abolhassani, Abdorrahim Absalan, Yonas Derso Abtew, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Basavaprabhu Achappa, Juan Manuel Acuna, Daniel Addison, Isaac Yeboah Addo, Oyelola A Adegboye, Miracle Ayomikun Adesina, Mohammad Adnan, Qorinah Estiningtyas Sakilah Adnani, Shailesh M Advani, Sumia Afrin, Muhammad Sohail Afzal, Manik Aggarwal, Bright Opoku Ahinkorah, Araz Ramazan Ahmad, Rizwan Ahmad, Sajjad Ahmad, Sohail Ahmad, Sepideh Ahmadi, Haroon Ahmed, Luai A Ahmed, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Wajeeha Aiman, Marjan Ajami, Gizachew Taddesse Akalu, Mostafa Akbarzadeh-Khiavi, Addis Aklilu, Maxwell Akonde, Chisom Joyqueenet Akunna, Hanadi Al Hamad, Fares Alahdab, Fahad Mashhour Alanezi, Turki M Alanzi, Saleh Ali Alessy, Abdelazeem M Algammal, Mohammed Khaled Al-Hanawi, Robert Kaba Alhassan, Beriwan Abdulqadir Ali, Liaqat Ali, Syed Shujait Ali, Yousef Alimohamadi, Vahid Alipour, Syed Mohamed Aljunid, Motasem Alkhayyat, Sadeq Ali Ali Al-Maweri, Sami Almustanyir, Nivaldo Alonso, Shehabaldin Alqalyoobi, Rajaa M Al-Raddadi, Rami H Hani Al-Rifai, Salman Khalifah Al-Sabah, Ala'a B Al-Tammemi, Haya Altawalah, Nelson Alvis-Guzman, Firehiwot Amare, Edward Kwabena Ameyaw, Javad Javad Aminian Dehkordi, Mohammad Hosein Amirzade-Iranaq, Hubert Amu, Ganiyu Adeniyi Amusa, Robert Ancuceanu, Jason A Anderson, Yaregal Animut Animut, Amir Anoushiravani, Ali Arash Anoushirvani, Alireza Ansari-Moghaddam, Mustafa Geleto Ansha, Benny Antony, Maxwell Hubert Antwi, Sumadi Lukman Anwar, Razique Anwer, Anayochukwu Edward Anyasodor, Jalal Arabloo, Morteza Arab-Zozani, Olatunde Aremu, Ayele Mamo Argaw, Hany Ariffin, Timur Aripov, Muhammad Arshad, Al Artaman, Judie Arulappan, Raphael Taiwo Aruleba, Armin Aryannejad, Malke Asaad, Mulusew A Asemahagn, Zatollah Asemi, Mohammad Asghari-Jafarabadi, Tahira Ashraf, Reza Assadi, Mohammad Athar, Seyyed Shamsadin Athari, Maha Moh'd Wahbi Atout, Sameh Attia, Avinash Aujayeb, Marcel Ausloos, Leticia Avila-Burgos, Atalel Fentahun Awedew, Mamaru Ayenew Awoke, Tewachew Awoke, Beatriz Paulina Ayala Quintanilla, Tegegn Mulatu Ayana, Solomon Shitu Ayen, Davood Azadi, Sina Azadnajafabad, Saber Azami-Aghdash, Melkalem Mamuye Azanaw, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Hosein Azizi, Ahmed Y Y Azzam, Amirhesam Babajani, Muhammad Badar, Ashish D Badiye, Nayereh Baghcheghi, Nader Bagheri, Sara Bagherieh, Saeed Bahadory, Atif Amin Baig, Jennifer L Baker, Ahad Bakhtiari, Ravleen Kaur Bakshi, Maciej Banach, Indrajit Banerjee, Mainak Bardhan, Francesco Barone-Adesi, Fabio Barra, Amadou Barrow, Nasir Z Bashir, Azadeh Bashiri, Saurav Basu, Abdul-Monim Mohammad Batiha, Aeysha Begum, Alehegn Bekele Bekele, Alemayehu Sayih Belay, Melaku Ashagrie Belete, Uzma Iqbal Belgaumi, Arielle Wilder Bell, Luis Belo, Habib Benzian, Alemshet Yirga Berhie, Amiel Nazer C Bermudez, Eduardo Bernabe, Akshaya Srikanth Bhagavathula, Neeraj Bhala, Bharti Bhandari Bhandari, Nikha Bhardwaj, Pankaj Bhardwaj, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Soumitra S Bhuyan, Sadia Bibi, Awraris Hailu Bilchut, Bagas Suryo Bintoro, Antonio Biondi, Mesfin Geremaw Birega Birega, Habitu Eshetu Birhan, Tone Bjørge, Oleg Blyuss, Belay Boda Abule Bodicha, Srinivasa Rao Bolla, Archith Boloor, Cristina Bosetti, Dejana Braithwaite, Michael Brauer, Hermann Brenner, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Christina Maree Buchanan, Norma B Bulamu, Maria Teresa Bustamante-Teixeira, Muhammad Hammad Butt, Nadeem Shafique Butt, Zahid A Butt, Florentino Luciano Caetano dos Santos, Luis Alberto Cámera, Chao Cao, Yin Cao, Giulia Carreras, Márcia Carvalho, Francieli Cembranel, Ester Cerin, Promit Ananyo Chakraborty, Periklis Charalampous, Vijay Kumar Chattu, Odgerel Chimed-Ochir, Jesus Lorenzo Chirinos-Caceres, Daniel Youngwhan Cho, William C S Cho, Devasahayam J Christopher, Dinh-Toi Chu, Isaac Sunday Chukwu, Aaron J Cohen, Joao Conde, Sandra Cortés, Vera Marisa Costa, Natália Cruz-Martins, Garland T Culbreth, Omid Dadras, Fentaw Teshome Dagnaw, Saad M A Dahlawi, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Parnaz Daneshpajouhnejad, Anna Danielewicz, An Thi Minh Dao, Reza Darvishi Cheshmeh Soltani, Aso Mohammad Darwesh, Saswati Das, Dragos Virgil Davitoiu, Elham Davtalab Esmaeili, Fernando Pio De la Hoz, Sisay Abebe Debela, Azizallah Dehghan, Biniyam Demisse, Fitsum Wolde Demisse, Edgar Denova-Gutiérrez, Afshin Derakhshani, Meseret Derbew Molla, Diriba Dereje, Kalkidan Solomon Deribe, Rupak Desai, Markos Desalegn Desalegn, Fikadu Nugusu Dessalegn, Samuel Abebe A Dessalegni, Gashaw Dessie, Abebaw Alemayehu Desta, Syed Masudur Rahman Dewan, Samath Dhamminda Dharmaratne, Meghnath Dhimal, Mostafa Dianatinasab, Nancy Diao, Daniel Diaz, Lankamo Ena Digesa, Shilpi Gupta Dixit, Saeid Doaei, Linh Phuong Doan, Paul Narh Doku, Deepa Dongarwar, Wendel Mombaque dos Santos, Tim Robert Driscoll, Haneil Larson Dsouza, Oyewole Christopher Durojaiye, Sareh Edalati, Fatemeh Eghbalian, Elham Ehsani-Chimeh, Ebrahim Eini, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Donatus U Ekwueme, Maha El Tantawi, Mostafa Ahmed Elbahnasawy, Iffat Elbarazi, Hesham Elghazaly, Muhammed Elhadi, Waseem El-Huneidi, Mohammad Hassan Emamian, Luchuo Engelbert Bain, Daniel Berhanie Enyew, Ryenchindorj Erkhembayar, Tegegne Eshetu, Babak Eshrati, Sharareh Eskandarieh, Juan Espinosa-Montero, Farshid Etaee, Azin Etemadimanesh, Tahir Eyayu, Ifeanyi Jude Ezeonwumelu, Sayeh Ezzikouri, Adeniyi Francis Fagbamigbe, Saman Fahimi, Ildar Ravisovich Fakhradiyev, Emerito Jose A Faraon, Jawad Fares, Abbas Farmany, Umar Farooque, Hossein Farrokhpour, Abidemi Omolara Fasanmi, Ali Fatehizadeh, Wafa Fatima, Hamed Fattahi, Ginenus Fekadu, Berhanu Elfu Feleke, Allegra Allegra Ferrari, Simone Ferrero, Lorenzo Ferro Desideri, Irina Filip, Florian Fischer, Roham Foroumadi, Masoud Foroutan, Takeshi Fukumoto, Peter Andras Gaal, Mohamed M Gad, Muktar A Gadanya, Abduzhappar Gaipov, Nasrin Galehdar, Silvano Gallus, Tushar Garg, Mariana Gaspar Fonseca, Yosef Haile Gebremariam, Teferi Gebru Gebremeskel, Mathewos Alemu Gebremichael, Yohannes Fikadu Geda, Yibeltal Yismaw Gela, Belete Negese Belete Gemeda, Melaku Getachew, Motuma Erena Getachew, Kazem Ghaffari, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Mohammad Ghasemi Nour, Fariba Ghassemi, Ajnish Ghimire, Nermin Ghith, Maryam Gholamalizadeh, Jamshid Gholizadeh Navashenaq, Sherief Ghozy, Syed Amir Gilani, Paramjit Singh Gill, Themba G Ginindza, Abraham Tamirat T Gizaw, James C Glasbey, Justyna Godos, Amit Goel, Mahaveer Golechha, Pouya Goleij, Davide Golinelli, Mohamad Golitaleb, Giuseppe Gorini, Bárbara Niegia Garcia Goulart, Giuseppe Grosso, Habtamu Alganeh Guadie, Mohammed Ibrahim Mohialdeen Gubari, Temesgen Worku Gudayu, Maximiliano Ribeiro Guerra, Damitha Asanga Gunawardane, Bhawna Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Mekdes Kondale Gurara, Alemu Guta, Parham Habibzadeh, Atlas Haddadi Avval, Nima Hafezi-Nejad, Adel Hajj Ali, Arvin Haj-Mirzaian, Esam S Halboub, Aram Halimi, Rabih Halwani, Randah R Hamadeh, Sajid Hameed, Samer Hamidi, Asif Hanif, Sanam Hariri, Netanja I Harlianto, Josep Maria Haro, Risky Kusuma Hartono, Ahmed I Hasaballah, S M Mahmudul Hasan, Hamidreza Hasani, Seyedeh Melika Hashemi, Abbas M Hassan, Soheil Hassanipour, Khezar Hayat, Golnaz Heidari, Mohammad Heidari, Zahra Heidarymeybodi, Brenda Yuliana Herrera-Serna, Claudiu Herteliu, Kamal Hezam, Yuta Hiraike, Mbuzeleni Mbuzeleni Hlongwa, Ramesh Holla, Marianne Holm, Nobuyuki Horita, Mohammad Hoseini, Md Mahbub Hossain, Mohammad Bellal Hossain Hossain, Mohammad-Salar Hosseini, Ali Hosseinzadeh, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Mowafa Househ, Junjie Huang, Fernando N Hugo, Ayesha Humayun, Salman Hussain, Nawfal R Hussein, Bing-Fang Hwang, Segun Emmanuel Ibitoye, Pulwasha Maria Iftikhar, Kevin S Ikuta, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Mustapha Immurana, Kaire Innos, Pooya Iranpour, Lalu Muhammad Irham, Md Shariful Islam, Rakibul M Islam, Farhad Islami, Nahlah Elkudssiah Ismail, Gaetano Isola, Masao Iwagami, Linda Merin J, Abhishek Jaiswal, Mihajlo Jakovljevic, Mahsa Jalili, Shahram Jalilian, Elham Jamshidi, Sung-In Jang, Chinmay T Jani, Tahereh Javaheri, Umesh Umesh Jayarajah, Shubha Jayaram, Seyed Behzad Jazayeri, Rime Jebai, Bedru Jemal, Wonjeong Jeong, Ravi Prakash Jha, Har Ashish Jindal, Yetunde O John-Akinola, Jost B Jonas, Tamas Joo, Nitin Joseph, Farahnaz Joukar, Jacek Jerzy Jozwiak, Mikk Jürisson, Ali Kabir, Salah Eddine Oussama Kacimi, Vidya Kadashetti, Farima Kahe, Pradnya Vishal Kakodkar, Laleh R Kalankesh, Leila R Kalankesh, Rohollah Kalhor, Vineet Kumar Kamal, Farin Kamangar, Ashwin Kamath, Tanuj Kanchan, Eswar Kandaswamy, Himal Kandel, HyeJung Kang, Girum Gebremeskel Kanno, Neeti Kapoor, Sitanshu Sekhar Kar, Shama D Karanth, Ibraheem M Karaye, André Karch, Amirali Karimi, Bekalu Getnet Kassa, Patrick DMC Katoto, Joonas H Kauppila, Harkiran Kaur, Abinet Gebremickael Kebede, Leila Keikavoosi-Arani, Gemechu Gemechu Kejela, Phillip M Kemp Bohan, Maryam Keramati, Mohammad Keykhaei, Himanshu Khajuria, Abbas Khan, Abdul Aziz Khan Khan, Ejaz Ahmad Khan, Gulfaraz Khan, Md Nuruzzaman Khan, Moien AB Khan, Javad Khanali, Khaled Khatab, Moawiah Mohammad Khatatbeh, Mahalaqua Nazli Khatib, Maryam Khayamzadeh, Hamid Reza Khayat Kashani, Mohammad Amin Khazeei Tabari, Mehdi Khezeli, Mahmoud Khodadost, Min Seo Kim, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Miloslav Klugar, Jitka Klugarová, Ali-Asghar Kolahi, Pavel Kolkhir, Farzad Kompani, Parvaiz A Koul, Sindhura Lakshmi Koulmane Laxminarayana, Ai Koyanagi, Kewal Krishan, Yuvaraj Krishnamoorthy, Burcu Kucuk Bicer, Nuworza Kugbey, Mukhtar Kulimbet, Akshay Kumar, G Anil Kumar, Narinder Kumar, Om P Kurmi, Ambily Kuttikkattu, Carlo La Vecchia, Arista Lahiri, Dharmesh Kumar Lal, Judit Lám, Qing Lan, Iván Landires, Bagher Larijani, Savita Lasrado, Jerrald Lau, Paolo Lauriola, Caterina Ledda, Sang-woong Lee, Shaun Wen Huey Lee, Wei-Chen Lee, Yeong Yeh Lee, Yo Han Lee, Samson Mideksa Legesse, James Leigh, Elvynna Leong, Ming-Chieh Li, Stephen S Lim, Gang Liu, Jue Liu, Chun-Han Lo, Ayush Lohiya, Platon D Lopukhov, László Lorenzovici, Mojgan Lotfi, Joana A Loureiro, Raimundas Lunevicius, Farzan Madadizadeh, Ahmad R Mafi, Sameh Magdeldin, Soleiman Mahjoub, Ata Mahmoodpoor, Morteza Mahmoudi, Marzieh Mahmoudimanesh, Rashidul Alam Mahumud, Azeem Majeed, Jamal Majidpoor, Alaa Makki, Konstantinos Christos Makris, Elaheh Malakan Rad, Mohammad-Reza Malekpour, Reza Malekzadeh, Ahmad Azam Malik, Tauqeer Hussain Mallhi, Sneha Deepak Mallya, Mohammed A Mamun, Ana Laura Manda, Fariborz Mansour-Ghanaei, Borhan Mansouri, Mohammad Ali Mansournia, Lorenzo Giovanni Mantovani, Santi Martini, Miquel Martorell, Sahar Masoudi, Seyedeh Zahra Masoumi, Clara N Matei, Elezebeth Mathews, Manu Raj Mathur, Vasundhara Mathur, Martin McKee, Jitendra Kumar Meena, Khalid Mehmood, Entezar Mehrabi Nasab, Ravi Mehrotra, Addisu Melese, Walter Mendoza, Ritesh G Menezes, SIsay Derso Mengesha, Laverne G Mensah, Alexios-Fotios A Mentis, Andry Yasmid Mera Mera-Mamián, Tuomo J Meretoja, Mehari Woldemariam Merid, Amanual Getnet Mersha, Belsity Temesgen Meselu, Mahboobeh Meshkat, Tomislav Mestrovic, Junmei Miao Jonasson, Tomasz Miazgowski, Irmina Maria Michalek, Gelana Fekadu Worku Mijena, Ted R Miller, Shabir Ahmad Mir, Seyed Kazem Mirinezhad, Seyyedmohammadsadeq Mirmoeeni, Mohammad Mirza-Aghazadeh-Attari, Hamed Mirzaei, Hamid Reza Mirzaei, Abay Sisay Misganaw, Sanjeev Misra, Karzan Abdulmuhsin Mohammad, Esmaeil Mohammadi, Mokhtar Mohammadi, Abdollah Mohammadian-Hafshejani, Reza Mohammadpourhodki, Arif Mohammed, Shafiu Mohammed, Syam Mohan, Mohammad Mohseni, Nagabhishek Moka, Ali H Mokdad, Alex Molassiotis, Mariam Molokhia, Kaveh Momenzadeh, Sara Momtazmanesh, Lorenzo Monasta, Ute Mons, Ahmed Al Montasir, Fateme Montazeri, Arnulfo Montero, Mohammad Amin Moosavi, Abdolvahab Moradi, Yousef Moradi, Mostafa Moradi Sarabi, Paula Moraga, Lidia Morawska, Shane Douglas Morrison, Jakub Morze, Abbas Mosapour, Ebrahim Mostafavi, Seyyed Meysam Mousavi, Haleh Mousavi Isfahani, Amin Mousavi Khaneghah, Christine Mpundu-Kaambwa, Sumaira Mubarik, Francesk Mulita, Daniel Munblit, Sandra B Munro, Efrén Murillo-Zamora, Jonah Musa, Ashraf F Nabhan, Ahamarshan Jayaraman Nagarajan, Shankar Prasad Nagaraju, Gabriele Nagel, Mohammadreza Naghipour, Mukhammad David Naimzada, Tapas Sadasivan Nair, Atta Abbas Naqvi, Sreenivas Narasimha Swamy, Aparna Ichalangod Narayana, Hasan Nassereldine, Zuhair S Natto, Biswa Prakash Nayak, Rawlance Ndejjo, Sabina Onyinye Nduaguba, Wogene Wogene Negash, Seyed Aria Nejadghaderi, Kazem Nejati, Sandhya Neupane Kandel, Huy Van Nguyen Nguyen, Robina Khan Niazi, Nurulamin M Noor, Maryam Noori, Nafise Noroozi, Hasti Nouraei, Ali Nowroozi, Virginia Nuñez-Samudio, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, Oluwakemi Ololade Odukoya, Onome Bright Oghenetega, Ropo Ebenezer Ogunsakin, Ayodipupo Sikiru Oguntade, In-Hwan Oh, Hassan Okati-Aliabad, Akinkunmi Paul Okekunle, Andrew T Olagunju, Tinuke O Olagunju, Babayemi Oluwaseun Olakunde, Isaac Iyinoluwa Olufadewa, Emad Omer, Abidemi E Emmanuel Omonisi, Sokking Ong, Obinna E Onwujekwe, Hans Orru, Stanislav S Otstavnov, Abderrahim Oulhaj, Bilcha Oumer, Oluwatomi Funbi Owopetu, Babatunji Emmanuel Oyinloye, Mahesh P A, Alicia Padron-Monedero, Jagadish Rao Padubidri, Babak Pakbin, Keyvan Pakshir, Reza Pakzad, Tamás Palicz, Adrian Pana, Anamika Pandey, Ashok Pandey, Suman Pant, Shahina Pardhan, Eun-Cheol Park, Eun-Kee Park, Seoyeon Park, Jay Patel, Siddhartha Pati, Rajan Paudel, Uttam Paudel, Mihaela Paun, Hamidreza Pazoki Toroudi, Minjin Peng, Jeevan Pereira, Renato B Pereira, Simone Perna, Navaraj Perumalsamy, Richard G Pestell, Raffaele Pezzani, Cristiano Piccinelli, Julian David Pillay, Zahra Zahid Piracha, Tobias Pischon, Maarten J Postma, Ashkan Pourabhari Langroudi, Akram Pourshams, Naeimeh Pourtaheri, Akila Prashant, Mirza Muhammad Fahd Qadir, Zahiruddin Quazi Syed, Mohammad Rabiee, Navid Rabiee, Amir Radfar, Raghu Anekal Radhakrishnan, Venkatraman Radhakrishnan, Mojtaba Raeisi, Ata Rafiee, Alireza Rafiei, Nasiru Raheem, Fakher Rahim, Md Obaidur Rahman, Mosiur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Shayan Rahmani, Vahid Rahmanian, Nazanin Rajai, Aashish Rajesh, Pradhum Ram, Kiana Ramezanzadeh, Juwel Rana, Kamal Ranabhat, Priyanga Ranasinghe, Chythra R Rao, Sowmya J Rao, Sina Rashedi, Amirfarzan Rashidi, Mahsa Rashidi, Mohammad-Mahdi Rashidi, Zubair Ahmed Ratan, David Laith Rawaf, Salman Rawaf, Lal Rawal, Reza Rawassizadeh, Mohammad Sadegh Razeghinia, Ashfaq Ur Rehman, Inayat ur Rehman, Marissa B Reitsma, Andre M N Renzaho, Maryam Rezaei, Nazila Rezaei, Negar Rezaei, Nima Rezaei, Saeid Rezaei, Mohsen Rezaeian, Aziz Rezapour, Abanoub Riad, Reza Rikhtegar, Maria Rios-Blancas, Thomas J Roberts, Peter Rohloff, Esperanza Romero-Rodríguez, Gholamreza Roshandel, Godfrey M Rwegerera, Manjula S, Maha Mohamed Saber-Ayad, Bahar Saberzadeh-Ardestani, Siamak Sabour, Basema Saddik, Erfan Sadeghi, Mohammad Reza Saeb, Umar Saeed, Mohsen Safaei, Azam Safary, Maryam Sahebazzamani, Amirhossein Sahebkar, Harihar Sahoo, Mirza Rizwan Sajid, Hedayat Salari, Sana Salehi, Marwa Rashad Salem, Hamideh Salimzadeh, Yoseph Leonardo Samodra, Abdallah M Samy, Juan Sanabria, Senthilkumar Sankararaman, Francesco Sanmarchi, Milena M Santric-Milicevic, Muhammad Arif Nadeem Saqib, Arash Sarveazad, Fatemeh Sarvi, Brijesh Sathian, Maheswar Satpathy, Nicolas Sayegh, Ione Jayce Ceola Schneider, Michaël Schwarzinger, Mario Šekerija, Subramanian Senthilkumaran, Sadaf G Sepanlou, Allen Seylani, Kenbon Seyoum, Feng Sha, Omid Shafaat, Pritik A Shah, Saeed Shahabi, Izza Shahid, Mohammad Amin Shahrbaf, Hamid R Shahsavari, Masood Ali Shaikh, Mohammed Feyisso Shaka, Elaheh Shaker, Mohammed Shannawaz, Mequannent Melaku Sharew Sharew, Azam Sharifi, Javad Sharifi-Rad, Purva Sharma, Bereket Beyene Shashamo, Aziz Sheikh, Mahdi Sheikh, Sara Sheikhbahaei, Rahim Ali Sheikhi, Ali Sheikhy, Peter Robin Shepherd, Adithi Shetty, Jeevan K Shetty, Ranjitha S Shetty, Kenji Shibuya, Reza Shirkoohi, Hesamaddin Shirzad-Aski, K M Shivakumar, Siddharudha Shivalli, Velizar Shivarov, Parnian Shobeiri, Zahra Shokri Varniab, Seyed Afshin Shorofi, Sunil Shrestha, Migbar Mekonnen Sibhat, Sudeep K Siddappa Malleshappa, Negussie Boti Sidemo, Diego Augusto Santos Silva, Luís Manuel Lopes Rodrigues Silva, Guilherme Silva Julian, Nicola Silvestris, Wudneh Simegn, Achintya Dinesh Singh, Ambrish Singh, Garima Singh, Harpreet Singh, Jasvinder A Singh, Jitendra Kumar Singh, Paramdeep Singh, Surjit Singh, Dhirendra Narain Sinha, Abiy H Sinke, Md Shahjahan Siraj, Freddy Sitas, Samarjeet Singh Siwal, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Bogdan Socea, Matthew J Soeberg, Ahmad Sofi-Mahmudi, Yonatan Solomon, Mohammad Sadegh Soltani-Zangbar, Suhang Song, Yimeng Song, Reed J D Sorensen, Sergey Soshnikov, Houman Sotoudeh, Alieu Sowe, Mu'awiyyah Babale Sufiyan, Ryan Suk, Muhammad Suleman, Rizwan Suliankatchi Abdulkader, Saima Sultana, Daniel Sur, Miklós Szócska, Seidamir Pasha Tabaeian, Rafael Tabarés-Seisdedos, Seyyed Mohammad Tabatabaei, Takahiro Tabuchi, Hooman Tadbiri, Ensiyeh Taheri, Majid Taheri, Moslem Taheri Soodejani, Ken Takahashi, Iman M Talaat, Mircea Tampa, Ker-Kan Tan, Nathan Y Tat, Vivian Y Tat, Ahmad Tavakoli, Arash Tavakoli, Arash Tehrani-Banihashemi, Yohannes Tekalegn, Fisaha Haile Tesfay, Rekha Thapar, Aravind Thavamani, Viveksandeep Thoguluva Chandrasekar, Nihal Thomas, Nikhil Kenny Thomas, Jansje Henny Vera Ticoalu, Amir Tiyuri, Daniel Nigusse Tollosa, Roman Topor-Madry, Mathilde Touvier, Marcos Roberto Tovani-Palone, Eugenio Traini, Mai Thi Ngoc Tran, Jaya Prasad Tripathy, Gebresilasea Gendisha Ukke, Irfan Ullah, Saif Ullah, Sana Ullah, Bhaskaran Unnikrishnan, Marco Vacante, Maryam Vaezi, Sahel Valadan Tahbaz, Pascual R Valdez, Constantine Vardavas, Shoban Babu Varthya, Siavash Vaziri, Diana Zuleika Velazquez, Massimiliano Veroux, Paul J Villeneuve, Francesco S Violante, Sergey Konstantinovitch Vladimirov, Vasily Vlassov, Bay Vo, Linh Gia Vu, Abdul Wadood Wadood, Yasir Waheed, Mandaras Tariku Walde, Richard G Wamai, Cong Wang, Fang Wang, Ning Wang, Yu Wang, Paul Ward, Abdul Waris, Ronny Westerman, Nuwan Darshana Wickramasinghe, Melat Woldemariam, Berhanu Woldu, Hong Xiao, Suowen Xu, Xiaoyue Xu, Lalit Yadav, Seyed Hossein Yahyazadeh Jabbari, Lin Yang, Fereshteh Yazdanpanah, Yigizie Yeshaw, Yazachew Yismaw, Naohiro Yonemoto, Mustafa Z Younis, Zabihollah Yousefi, Fatemeh Yousefian, Chuanhua Yu, Yong Yu, Ismaeel Yunusa, Mazyar Zahir, Nazar Zaki, Burhan Abdullah Zaman, Moein Zangiabadian, Fariba Zare, Iman Zare, Zahra Zareshahrabadi, Armin Zarrintan, Mikhail Sergeevich Zastrozhin, Mohammad A Zeineddine, Dongyu Zhang, Jianrong Zhang, Yunquan Zhang, Zhi-Jiang Zhang, Linghui Zhou, Sanjay Zodpey, Mohammad Zoladl, Theo Vos, Simon I Hay, Lisa M Force, Christopher J L Murray, Helsinki University Hospital Area, HUS Comprehensive Cancer Center, Tran, K, Lang, J, Compton, K, Xu, R, Acheson, A, Henrikson, H, Kocarnik, J, Penberthy, L, Aali, A, Abbas, Q, Abbasi, B, Abbasi-Kangevari, M, Abbasi-Kangevari, Z, Abbastabar, H, Abdelmasseh, M, Abd-Elsalam, S, Abdelwahab, A, Abdoli, G, Abdulkadir, H, Abedi, A, Abegaz, K, Abidi, H, Aboagye, R, Abolhassani, H, Absalan, A, Abtew, Y, Abubaker Ali, H, Abu-Gharbieh, E, Achappa, B, Acuna, J, Addison, D, Addo, I, Adegboye, O, Adesina, M, Adnan, M, Adnani, Q, Advani, S, Afrin, S, Afzal, M, Aggarwal, M, Ahinkorah, B, 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Melinda Gates Foundation, Kuwait University (Kuwait), Ministry of Higher Education (Malasia), Lega Italiana per la Lotta ai Tumori, Health Effects Institute (Estados Unidos), Unión Europea. Comisión Europea. European Research Council (ERC), Unión Europea. Comisión Europea. H2020, Fundação para a Ciência e Tecnologia (Portugal), African-German Network of Excellence in Science (AGNES), Federal Ministry of Education & Research (Alemania), Alexander von Humboldt Foundation, Novo Nordisk Foundation, National Institute for Health Research (Reino Unido), National Health and Medical Research Council (Australia), Romanian National Authority for Scientific Research and Innovation, Romanian Ministry of Research Innovation and Digitalization, Ministry of Education, Science and Technological Development (Serbia), Sigrid Jusélius Foundation, Finnish Cancer Foundation, Datta Meghe Institute of Medical Sciences (India), Xiamen University (Malasia), Manipal Academy of Higher Education (India), Panjab University (India), Sistema Nacional de Investigación (Panamá), Secretaría Nacional de Ciencia, Tecnología e Innovación (Panamá), Ministry of Science and Technology (Taiwan), Lung Foundation Australia, National Natural Science Foundation of China, Wellcome Trust, UNSW Sydney (Australia), ICMR - National Institute of Epidemiology (India), University of Tasmania (Australia), National Council for Scientific and Technological Development (Brasil), Coordenação de Aperfeicoamento de Pessoal de Nível Superior (Brasil), Institute for Advanced Studies in Basic Sciences (Irán), Ain Shams University (Egipto), International Center of Medical Sciences Research (Islamabad), National Institutes of Health (Estados Unidos), University of Oxford (Reino Unido), National Institute of Genetic Engineering and Biotechnology (Irán), Marga und Walter Boll - Stiftung, Ministero della Salute (Italia), IRCCS Materno Infantile Burlo Garofolo (Italia), King College London, Wellcome Trust/DBT India Alliance (India), Public Health, University of St Andrews. School of Medicine, and University of St Andrews. Population and Behavioural Science Division

Subjects
Male, DEATHS, DALY, cancer, risk factors, Medizin, systematic analysis, Global Health, Risk Assessment, Cancer prevention, Global Burden of Disease, RC0254, Risk-attributable cancer deaths, SDG 3 - Good Health and Well-being, RA0421, Risk Factors, RA0421 Public health. Hygiene. Preventive Medicine, Quality-Adjusted Life Year, Neoplasms, cancer, Humans, Global Burden of Disease Study, UK, Medicine(all), MCC, RC0254 Neoplasms. Tumors. Oncology (including Cancer), Risk Factor, Smoking, COVID-19, 3rd-DAS, General Medicine, Disability-adjusted life-years, SOCIAL DETERMINANTS, Risk assessments, risk factor, Cardiovascular and Metabolic Diseases, 3121 General medicine, internal medicine and other clinical medicine, OBESITY, Cancer burden, Neoplasm, Female, LIFE-STYLE, Quality-Adjusted Life Years, HEALTH, RA, Human, RC
Abstract

Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01-4·94) deaths and 105 million (95·0-116) DALYs for both sexes combined, representing 44·4% (41·3-48·4) of all cancer deaths and 42·0% (39·1-45·6) of all DALYs. There were 2·88 million (2·60-3·18) risk-attributable cancer deaths in males (50·6% [47·8-54·1] of all male cancer deaths) and 1·58 million (1·36-1·84) risk-attributable cancer deaths in females (36·3% [32·5-41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6-28·4) and DALYs by 16·8% (8·8-25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9-42·8] and 33·3% [25·8-42·0]). Interpretation: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. We are grateful to the surveillance systems, including cancer registries, that generated and shared observed cancer burden data. S M Aljunid acknowledges the Department of Health Policy and Management, College of Public Health, Kuwait University for the approval and support to participate in this research project. H Ariffin acknowledges support from the Ministry of Higher Education, Malaysia (grant FRGS/1/2021/SKK0/UM/01/1). F Barra acknowledges support from Lega Italiana per la Lotta contro i Tumori - LILT - Bando 5 x 1000 anno 2019. L Belo and M Carvalho acknowledge the support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. A J Cohen was supported by the Health Effects Institute, Boston, MA, USA. J Conde acknowledges financial support from the European Research Council - ERC Starting Grant 848325. V M Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. T C Ekundayo was supported by the African-German Network of Excellence in Science (AGNES), the Federal Ministry of Education and Research (BMBF) and the Alexander von Humboldt Foundation (AvH). N Ghith acknowledges support from a grant from Novo Nordisk Foundation (NNF16OC0021856). J C Glasbey is support by a Doctoral Research Fellowship from the National Institute of Health Research (NIHR300175). V K Gupta and V B Gupta acknowledge funding support from National Health and Medical Research Council (NHMRC), Australia. C Herteliu, A Pana, and M Ausloos acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. C Herteliu is also partially supported by a grant of the Romanian Ministry of Research Innovation and Digitalization, MCID, project number ID-585-CTR-42-PFE-2021. S Hussain was supported from Operational Programme Research, Development and Education–Project, Postdoc2MUNI (number CZ.02.2. 69/0.0/0.0/18_053/0016952). M Jakovljevic acknowledges partial support through the grant OI 175 014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. J H Kauppila acknowledges research grants from Sigrid Jusélius Foundation and the Finnish Cancer Foundation. M N Khatib acknowledges support from Datta Meghe Institute of Medical Sciences (deemed-to-be-university). Y J Kim was supported by the Research Management Centre, Xiamen University Malaysia [XMUMRF/2020-C6/ITCM/0004]. S L Koulmane Laxminarayana acknowledges institutional assistance by Manipal Academy of Higher Education, Manipal. K Krishan is supported by the UGC Centre of Advanced Study (Phase II), awarded to the Department of Anthropology, Panjab University, Chandigarh, India. I Landires is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). M-C Li was supported by the Ministry of Science and Technology, Taiwan (MOST 110-2314-B-003-001). G Liu acknowledges support from the CREATE Hope scientific fellowship from Lung Foundation Australia. J Liu acknowledges support from the National Natural Science Foundation (72122001). J A Loureiro was supported by Scientific Employment Stimulus (FCT; CEECINST/00049/2018). E Mathews is supported by a Clinical and Public Health Early Career Fellowship (grant number IA/CPHE/17/1/503345) from the DBT India Alliance/Wellcome Trust Department of Biotechnology, India Alliance (2018–2023). T J Meretoja was supported by an unrestricted grant from Cancer Foundation Finland sr. S Mohammed acknowledges a fellowship grant from Alexander von Humboldt Foundation, outside the submitted work. M Molokhia is supported by the National Institute for Health Research Biomedical Research Center at Guy’s and St Thomas’ National Health Service Foundation Trust and King’s College London. L Monasta received support from the Italian Ministry of Health at the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste - Italy (RC 34/2017). U Mons is supported by the Marga and Walter Boll Foundation, Kerpen, Germany. M A Moosavi acknowledges the financial support of National Institute of Genetics Engineering and Biotechnology (NIGEB). J Musa acknowledges support from the NIH/FICK43TW011416 for research-protected time for cervical cancer research and career development at University of Jos. V Nuñez-Samudio is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). O O Odukoya acknowledges support by the Fogarty International Center of the National Institutes of Health under the award number K43TW010704 for research-protected time. The content is solely the responsibility of all the authors and does not necessarily represent the official views of the National Institutes of Health. A S Oguntade acknowledges funding by a doctoral scholarship from the Nuffield Department of Population Health, University of Oxford (Oxford Population Health). J R Padubidri acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal for their constant support in research collaborations. R G Pestell acknowledges support from NIH grant W81XWH1810605 Breast Cancer Research, Breakthrough Grant R21 CA235139-01. Z Z Piracha acknowledges the International Center of Medical Sciences Research (ICMSR), Islamabad (44000), Pakistan. R A Radhakrishnan acknowledges support from Wellcome Trust/DBT India Alliance - IA/CPHI/18/1/503927. U Saeed acknowledges the International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan. A M Samy acknowledges the support from Ain Shams University and the Egyptian Fulbright Mission Program. F Sha was supported by the Shenzhen Science and Technology Program (grant number KQTD20190929172835662). H R Shahsavari acknowledges the Institute for Advanced Studies in Basic Sciences (IASBS) Research Council. A Shetty acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal for all the academic support. D A S Silva acknowledges financing in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES)—Finance Code 001 and D A S Silva is supported in part by CNPq-Brazil (309589/2021-5). L M L R Silva was supported by project CENTRO-04-3559-FSE-000162, Fundo Social Europeu (FSE). Am Singh is supported by the International Graduate Research Scholarship, University of Tasmania. R Suliankatchi Abdulkader acknowledges support from ICMR—National Institute of Epidemiology. B Unnikrishnan acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. H Xiao acknowledges support from the Public Health Sciences Division of the Fred Hutchinson Cancer Research Center. X Xu is supported by the University of New South Wales (Australia) Scientia Program. C Yu was supported by the National Natural Science Foundation of China (grant number 82173626) and Wuhan Medical Research Program of Joint Fund of Hubei Health Committee (grant number WJ2019H304). Sí

Published
2022

14. Tobacco use prevalence and its determinate factor in Ethiopia- finding of the 2016 Ethiopian GATS

Author

Sisay Derso Mengesha, Kirubel Tesfaye Teklu, Abel Weldetinsae, Melaku Gizaw Serte, Moa Abate Kenea, Daniel Abera Dinssa, Mesay Getachew Woldegabriel, Tsigereda Assefa Alemayehu, and Wassihun Melaku Belay

Subjects
Adult, Male, Tobacco Use, Tobacco, Smokeless, Smoking, Tobacco, Public Health, Environmental and Occupational Health, Prevalence, Humans, Female, Ethiopia
Abstract

Background Tobacco, one of the risk factors for non-communicable diseases, kills 8 million people each year. Like other sub-Saharan countries, Ethiopia faces the potential challenge of a tobacco epidemic. However, there is no organized data on the prevalence of tobacco use in the country. Therefore, this study aims to determine adult tobacco use in Ethiopia. Methods The study was conducted using the WHO and CDC GATS survey methods. Complex survey analysis was used to obtain prevalence and population estimates with 95% confidence intervals. Bivariate regression analyses were employed to examine factors related to tobacco use. Results The overall tobacco use percentage was 5.0% [95% CI (3.5, 6.9)], of which 65.8% [95% CI (53.4, 76.3)] only smoked tobacco products; 22.5% [95% CI (15.7, 31.2)] used smokeless tobacco only; and 11.8% [95% CI (6.5, 20.4)] used both smoked and smokeless tobacco products. In 2016, more men adults (8.1%) used tobacco than women did (1.8%). Eight out of eleven states have a higher smoking rate than the national average (3.7%). Gender, employment, age, religion, and marital status are closely linked to current tobacco use (p-value Conclusion The prevalence of tobacco use is still low in Ethiopia. However, the percentage of female smokers is increasing, and regional governments such as Afar and Gambella have a relatively high prevalence. This calls for the full implementation of tobacco control laws following the WHO MPOWER packages. A tailored tobacco control intervention targeting women, younger age groups, and regions with a high proportion of tobacco use are recommended.

Published
2021

15. Microbial Risk Assessment of Vegetables Irrigated with Akaki River Water in Addis Ababa

Author

Abel Weldetinsae Kidane, Kirubel Tesfaye Teklu, Sisay Derso Mengesha, Daniel Abera Dinssa, Aderajew Mekonnen Girmay, Yosef Beyene Asfaw, Moa Abate Kenea, Mesay Getachew Woldegabriel, Tsigereda Assefa Alemayehu, and Melaku Gizaw Serte

Subjects
Microbial risk, Environmental science, Water resource management, River water
Abstract

Background: Consumption of vegetable plays important role in human health. Above 60% of Addis Ababa, vegetable demand is covered by smallholder farmers who grow various vegetables by using the Akaki River as their main water source for irrigation. However, applying faecally contaminated water for irrigation could expose fresh vegetable consumers to many health problems. Therefore, this study aimed to evaluate the microbial contamination of irrigation water and freshly produced vegetables. The study assessed the quality of Akaki river water and vegetables. Fresh vegetables including Ethiopian Kale, Lettuce, Cabbage, and Spinach were collected from 14 farmlands, irrigated with Akaki River water, in the dry and wet seasons. Using standard methods, analysis of E.coli, Non-E.coli, Total coliform, fecal coliform, and Total Aerobic Plate Count were done among the Akaki River water and vegetables. Result: The finding of the study indicated that all fresh vegetables were contaminated with total coliforms, fecal coliforms, and Total aerobic in the dry and wet seasons. The overall mean count of E. coli and Non-E. Coli from water samples were 2.09 and >3.48 log10 CFU 10 mL−1. The mean count of TC, FC, and TAC on sampled vegetables were 3.22, 1.37, and 4.72 in the dry season, and 3.87, 2.57, and 5.09 log10 CFU per gram in the wet season, respectively.Conclusion: The Akaki River has been contaminated with non-E. Coli & E. coli coliforms and did not meet the WHO guideline criteria for safe irrigation. The microbial contamination of vegetables was found high and exceeded the HACCPTQM and ICMSF limit values for safe consumption. This calls for farmers and the consumer has to insist on properly processed/stored/sliced fresh vegetables needs to be aware.

Published
2021

16. Progress in health among regions of Ethiopia, 1990-2019: a subnational country analysis for the Global Burden of Disease Study 2019

Author

Awoke Misganaw, Mohsen Naghavi, Ally Walker, Alemnesh H Mirkuzie, Ababi Zergaw Giref, Tezera Moshago Berheto, Ebba Abate Waktola, John H Kempen, Getachew Tollera Eticha, Tsigereda Kifle Wolde, Dereje Deguma, Kalkidan Hassen Abate, Kedir Hussein Abegaz, Muktar Beshir Ahmed, Yonas Akalu, Addis Aklilu, Biresaw Wassihun Alemu, Mulusew A Asemahagn, Atalel Fentahun Awedew, Senthilkumar Balakrishnan, Tariku Tesfaye Bekuma, Addisu Shunu Beyene, Misrak Getnet Beyene, Yihienew Mequanint Bezabih, Biruk Tesfaye Birhanu, Tesfaye Yitna Chichiabellu, Berihun Assefa Dachew, Amare Belachew Dagnew, Feleke Mekonnen Demeke, Getu Debalkie Demissie, Meseret Derbew Molla, Nebiyu Dereje, Kebede Deribe, Abebaw Alemayehu Desta, Munir Kassa Eshetu, Tomas Y Ferede, Eyob Alemayehu Gebreyohannes, Abraham Geremew, Hailay Abrha Gesesew, Lemma Getacher, Scott D Glenn, Aregash Samuel Hafebo, Abdiwahab Hashi, Hamid Yimam Hassen, Simon I Hay, Diriba Fufa Hordofa, Dawit Hoyiso Huluko, Ayele Semachew Kasa, Getinet Kassahun Azene, Ermiyas Mulu Kebede, Hafte Kahsay Kebede, Bayew Kelkay, Samuel Z Kidane, Samson Mideksa Legesse, Wondimu Ayele Manamo, Yohannes Adama A Melaku, Endalkachew Worku Mengesha, Sisay Derso Mengesha, Hayimro Edemealem Merie, Abera M Mersha, Amanual Getnet Mersha, Mizan Kiros Mirutse, Ammas Siraj Mohammed, Hussen Mohammed, Salahuddin Mohammed, Henok Biresaw Netsere, Dabere Nigatu, Mohammed Suleiman Obsa, Daniel Bogale Odo, Muktar Omer, Lemma Demissie Regassa, Biniyam Sahiledengle, Mohammed Feyisso Shaka, Wondimeneh Shibabaw Shiferaw, Negussie Boti Sidemo, Abiy H Sinke, Yitagesu Sintayehu, Muluken Bekele Sorrie, Birkneh Tilahun Tadesse, Eyayou Girma Tadesse, Zemenu Tamir, Animut Tagele Tamiru, Amare Abera Tareke, Yonas Getaye Tefera, Yohannes Tekalegn, Ayenew Kassie Tesema, Tefera Tadele Tesema, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Tadesse Tilahun, Gebiyaw Wudie Tsegaye, Biruk Shalmeno Tusa, Geremew Tassew Weledesemayat, Taklo Simeneh Yazie, Yordanos Gizachew Yeshitila, Birhanu Wubale Yirdaw, Desalegn Tegabu Zegeye, Christopher J L Murray, Lia Tadesse Gebremedhin, and GBD 2019 Ethiopia Subnational-Level Disease Burden Initiative Collaborators

Subjects
Adult, Infant, Newborn, Bayes Theorem, General Medicine, Global Health, Global Burden of Disease, Life Expectancy, Risk Factors, Cause of Death, Humans, Human medicine, Ethiopia, Quality-Adjusted Life Years, Child, Aged
Abstract

Background\ud Previous Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) studies have reported national health estimates for Ethiopia. Substantial regional variations in socioeconomic status, population, demography, and access to health care within Ethiopia require comparable estimates at the subnational level. The GBD 2019 Ethiopia subnational analysis aimed to measure the progress and disparities in health across nine regions and two chartered cities.\ud \ud Methods\ud We gathered 1057 distinct data sources for Ethiopia and all regions and cities that included census, demographic surveillance, household surveys, disease registry, health service use, disease notifications, and other data for this analysis. Using all available data sources, we estimated the Socio-demographic Index (SDI), total fertility rate (TFR), life expectancy, years of life lost, years lived with disability, disability-adjusted life-years, and risk-factor-attributable health loss with 95% uncertainty intervals (UIs) for Ethiopia's nine regions and two chartered cities from 1990 to 2019. Spatiotemporal Gaussian process regression, cause of death ensemble model, Bayesian meta-regression tool, DisMod-MR 2.1, and other models were used to generate fertility, mortality, cause of death, and disability rates. The risk factor attribution estimations followed the general framework established for comparative risk assessment.\ud \ud Findings\ud The SDI steadily improved in all regions and cities from 1990 to 2019, yet the disparity between the highest and lowest SDI increased by 54% during that period. The TFR declined from 6·91 (95% UI 6·59–7·20) in 1990 to 4·43 (4·01–4·92) in 2019, but the magnitude of decline also varied substantially among regions and cities. In 2019, TFR ranged from 6·41 (5·96–6·86) in Somali to 1·50 (1·26–1·80) in Addis Ababa. Life expectancy improved in Ethiopia by 21·93 years (21·79–22·07), from 46·91 years (45·71–48·11) in 1990 to 68·84 years (67·51–70·18) in 2019. Addis Ababa had the highest life expectancy at 70·86 years (68·91–72·65) in 2019; Afar and Benishangul-Gumuz had the lowest at 63·74 years (61·53–66·01) for Afar and 64.28 (61.99-66.63) for Benishangul-Gumuz. The overall increases in life expectancy were driven by declines in under-5 mortality and mortality from common infectious diseases, nutritional deficiency, and war and conflict. In 2019, the age-standardised all-cause death rate was the highest in Afar at 1353·38 per 100 000 population (1195·69–1526·19). The leading causes of premature mortality for all sexes in Ethiopia in 2019 were neonatal disorders, diarrhoeal diseases, lower respiratory infections, tuberculosis, stroke, HIV/AIDS, ischaemic heart disease, cirrhosis, congenital defects, and diabetes. With high SDIs and life expectancy for all sexes, Addis Ababa, Dire Dawa, and Harari had low rates of premature mortality from the five leading causes, whereas regions with low SDIs and life expectancy for all sexes (Afar and Somali) had high rates of premature mortality from the leading causes. In 2019, child and maternal malnutrition; unsafe water, sanitation, and handwashing; air pollution; high systolic blood pressure; alcohol use; and high fasting plasma glucose were the leading risk factors for health loss across regions and cities.\ud \ud Interpretation\ud There were substantial improvements in health over the past three decades across regions and chartered cities in Ethiopia. However, the progress, measured in SDI, life expectancy, TFR, premature mortality, disability, and risk factors, was not uniform. Federal and regional health policy makers should match strategies, resources, and interventions to disease burden and risk factors across regions and cities to achieve national and regional plans, Sustainable Development Goals, and universal health coverage targets.\ud \ud Funding\ud Bill & Melinda Gates Foundation.

Published
2021

17. Sanitary condition and its microbiological quality of improved water sources in the Southern Region of Ethiopia

Author

Ana Maria de Roda Husman, Sisay Derso Mengesha, Melaku Gizaw Serte, Harold H. J. L. van den Berg, Daniel Abera Dinssa, Tesfaye Legese Bedada, Kirubel Tesfaye Teklu, Abel Weldetinsae, Tsigereda Assefa Alemayehu, Yosef Beyene Asefa, Mesay Getachew Woldegabriel, Moa Abate Kenea, Firehiwot Abera Derra, and Zinabu Assefa Alemu

Subjects
Enterococci, Water source, Risk priority matrix, 010501 environmental sciences, Management, Monitoring, Policy and Law, 01 natural sciences, Article, 03 medical and health sciences, 0302 clinical medicine, Water Supply, Environmental protection, Water Quality, Grazing, Animals, Humans, 030212 general & internal medicine, Drainage, Productivity, 0105 earth and related environmental sciences, General Environmental Science, Drinking Water, E. coli, General Medicine, Climate resilience, Pollution, Environmental science, Cattle, Female, Water treatment, Ethiopia, Water quality, Water Microbiology, Cow dung, Environmental Monitoring
Abstract

In the Southern Nations, Nationalities, and Peoples’ Region of Ethiopia, improved water is the main source of water for household purposes. Access to improved water closer to their homes benefits the community in many ways. It improves their health status, saves their time and energy, and improves their productivity in jobs and education they are engaged in. However, due to natural and human activities, improved water sources do not always deliver good quality of water. It can be contaminated by different pathogenic microorganisms and chemicals. The result indicated that 44.7% and 50.9% of the samples were contaminated with Escherichia coli and enterococci respectively, and from the sanitary condition survey, 57.6% of the water sources exhibited from intermediate- to very high-risk level. And the risk priority matrix identifies 95 (27.9%) samples with high risk and 54 (15.9%) of the samples with very high risk. The main risks identified at those unsafe water sources were that the drainage canals were blocked with mud, grass, leaves, and stones; animals drinking the overflow water and grazing in the proximity of water sources and feces such as cow dung were observed; inadequate protection of water sources such as absence of fences and diversion ditches; and stagnant water near the source. The study conducted in the Southern Nations, Nationalities, and Peoples’ Region has clearly indicated that people may be at risk of being exposed to pathogens in half of the improved water sources when used for drinking based on the microbial indicator data or the sanitary inspection risk score. Though no correlation resulted from water quality and sanitary condition of sources, the risk priority matrix did enable prioritization of 54 very high-risk-level water sources for urgent targeted interventions from a total of 340 improved drinking water sources. From this, targeted interventions, improving water management practices, identifying and implementing effective water treatment options, providing sustainable energy sources for the supply of continuous water, and implementing climate resilience water safety planning, are recommended.

Published
2020

18. A collaboratively derived international research agenda on legislative science advice

Author

Irene Ramos-Vielba, Michael Nentwich, Donatus Dube, Snezana B. Krstic, Jon M. Peha, John A. Hird, Alma Cristal Hernández-Mondragón, Marc Saner, Kerry Holden, Jean Marie Mbonyintwali, Wim Winderickx, Elizabeth M. Prescott, Sisay Derso Mengesha, Selena M. Nelson, Jauad El Kharraz, Jude Tochukwu Omenma, Orlando Santillán, Hiroshi Nagano, Louis François Pau, Chris Tyler, Laura dos Santos Boeira, Raimundo Roberts, Karen Akerlof, Liam A. Berigan, Paul A. Sandifer, Paul Cairney, Harris Francis Andoh, Liliana Estrada Galindo, Erin Heath, Abiodun Egbetokun, Deborah D. Stine, Sarah Elizabeth Foxen, Gavin Costigan, Ferguson Mark William James, Cameryn J. Gonnella, Alessandro Allegra, Meghnath Dhimal, Martín Hernán Di Marco, Ayodele Samuel Jegede, Maruf Sanni, Edmond Sanganyado, Emily Cloyd, Zach Graves, Tomas Michalek, Marga Gual Soler, Olusegun M. Ogundele, Pieter van Boheemen, Miron L. Straf, Peter Tangney, Christina T. Nguyen, Carlos R. Abeledo, Ali Nouri, Peter Dithan Ntale, Masaru Yarime, Tamara Adel Al-Yakoub, Emily Hayter, Carla-Leanne Washbourne, Robert Cook-Deegan, José Franco, Abbi D. Hobbs, Carel IJsselmuiden, and National Science Foundation (US)

Subjects
010504 meteorology & atmospheric sciences, media_common.quotation_subject, Science Technology and society, RESEARCH, Developing country, purl.org/becyt/ford/5.4 [https], 050905 science studies, 01 natural sciences, Scientific evidence, lcsh:Social Sciences, State (polity), Development studies, Political science, ADVISE, AGENDA, General Psychology, 0105 earth and related environmental sciences, media_common, LEGISLATIVE, purl.org/becyt/ford/5 [https], business.industry, General Arts and Humanities, 05 social sciences, Rank (computer programming), General Social Sciences, Legislature, Public relations, Politics and international relations, Field (geography), lcsh:H, 0509 other social sciences, business, General Economics, Econometrics and Finance, Advice (complexity)
Abstract

© The Author(s) 2019., The quantity and complexity of scientific and technological information provided to policymakers have been on the rise for decades. Yet little is known about how to provide science advice to legislatures, even though scientific information is widely acknowledged as valuable for decision-making in many policy domains. We asked academics, science advisers, and policymakers from both developed and developing nations to identify, review and refine, and then rank the most pressing research questions on legislative science advice (LSA). Experts generally agree that the state of evidence is poor, especially regarding developing and lower-middle income countries. Many fundamental questions about science advice processes remain unanswered and are of great interest: whether legislative use of scientific evidence improves the implementation and outcome of social programs and policies; under what conditions legislators and staff seek out scientific information or use what is presented to them; and how different communication channels affect informational trust and use. Environment and health are the highest priority policy domains for the field. The context-specific nature of many of the submitted questions—whether to policy issues, institutions, or locations—suggests one of the significant challenges is aggregating generalizable evidence on LSA practices. Understanding these research needs represents a first step in advancing a global agenda for LSA research., This material is based upon work supported by the National Science Foundation under Grant No. 1842117.

Published
2019

19. Physicochemical quality of drinking water sources in Ethiopia and its health impact: a retrospective study

Author

Tsigereda Assefa Alemayehu, Kirubel Tesfaye Teklu, Zinabu Assefa Alemu, Kifle Habte Balcha, and Sisay Derso Mengesha

Subjects
geography, medicine.medical_specialty, geography.geographical_feature_category, business.industry, media_common.quotation_subject, Public health, Water source, Distribution (economics), Tap water, Spring (hydrology), medicine, Environmental science, Quality (business), Water quality, business, Water resource management, Risk assessment, media_common
Abstract

This retrospective study was aimed to examine the distribution of some physicochemical parameters and its health impact in selected drinking water sources of Ethiopia. The study used 983 water samples collected from different regions of the country, and have been tasted in the Environmental Health Laboratory, Ethiopian Public Health Institute, from 2003 to 2011. The samples were collected from eight regions plus two administrative cities of the country and classified based on the source type as spring, well, and tap water. The physicochemical parameter analysis was executed based on standard method. Microsoft Excel and IBM SPSS Statistical software were used for the statistical analysis of median and graph. The median result indicates that some values are within the acceptable range (PH, magnesium, chloride and sodium from spring and tap water), but, there are some measured values in some regions which are out of the recommended limit, (total hardness and calcium in spring, tap and well water). On the other hand, very high Sodium and chloride concentration were recorded in spring, tap, and well water sources of the region such as Somali, Afar, and Oromia. Those water sources that do not conform to National Standard will result in public health problem in long time exposure. Therefore, the local water authority shall strengthen local water quality monitoring and control system as well as risk assessment and management mechanisms.

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