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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< 0.05). Men adults who are employed, married, and mostly from Muslim society are more likely to use tobacco. 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.

Background: Household air pollution associated with biomass (wood, dung, charcoal, and crop residue) burning for cooking is estimated to contribute to approximately 4 million deaths each year worldwide, with the greatest burden seen in low and middle-income countries. We investigated the relationship between solid fuel type and respiratory symptoms in Uganda, where 96% of households use biomass as the primary domestic fuel. Materials and Methods: Cross-sectional study of 15,405 pre-school aged children living in charcoal or wood-burning households in Uganda, using data from the 2016 Demographic and Health Survey. Multivariable logistic regression analysis was used to identify the associations between occurrence of a cough, shortness of breath, fever, acute respiratory infection (ARI) and severe ARI with cooking fuel type (wood, charcoal); with additional sub-analyses by contextual status (urban, rural). Results: After adjustment for household and individual level confounding factors, wood fuel use was associated with increased risk of shortness of breath (AOR: 1.33 [1.10–1.60]), fever (AOR: 1.26 [1.08–1.48]), cough (AOR: 1.15 [1.00–1.33]), ARI (AOR: 1.36 [1.11–1.66] and severe ARI (AOR: 1.41 [1.09–1.85]), compared to charcoal fuel. In urban areas, Shortness of breath (AOR: 1.84 [1.20–2.83]), ARI (AOR: 1.77 [1.10–2.79]) and in rural areas ARI (AOR: 1.23 [1.03–1.47]) and risk of fever (AOR: 1.23 [1.03–1.47]) were associated with wood fuel usage. Conclusions: Risk of respiratory symptoms was higher among children living in wood compared to charcoal fuel-burning households, with policy implications for mitigation of associated harmful health impacts.

Background Ensuring the availability of safe drinking water remains a critical challenge in developing countries, including Ethiopia. Therefore, this paper aimed to investigate the prevalence of fecal coliform and E. coli bacteria and, geographical, children availability, and seasonal exposure assessment through a meta-analysis. Methods Two independent review groups extensively searched internet databases for English-language research articles published between 2013 and 2023. This systematic review and meta-analysis followed PRISMA guidelines. The methodological quality of each included study was evaluated using the STROBE guidelines. Publication bias was assessed by visual inspection of a funnel plot and then tested by the Egger regression test, and meta-analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. Subgroup analyses were also conducted to explore heterogeneity. Results Out of 48 potentially relevant studies, only 21 fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of fecal coliform and E. coli was 64% (95% CI: 56.0–71.0%, I 2  = 95.8%) and 54% (95% CI: 45.7–62.3%, I 2  = 94.2%), respectively. Subgroup analysis revealed that the prevalence of fecal coliform bacteria increased during the wet season (70%) compared to the dry season (60%), particularly in households with under-five children (74%) compared to all households (61%), in rural (68%) versus urban (66%) areas, and in regions with high prevalence such as Amhara (71%), Gambela (71%), and Oromia (70%). Similarly, the prevalence of E. coli was higher in households with under-five children (66%) than in all households (46%). Conclusions The analysis highlights the higher prevalence of fecal coliform and E. coli within households drinking water, indicating that these bacteria are a significant public health concern. Moreover, these findings emphasize the critical need for targeted interventions aimed at improving drinking water quality to reduce the risk of fecal contamination and enhance public health outcomes for susceptible groups, including households with under-five children, in particular geographical areas such as the Amhara, Gambela, and Oromia regions, as well as rural areas, at point-of-use, and during the rainy season. Registration This review was registered on PROSPERO (registration ID - CRD42023448812).

ObjectiveTo 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.DesignA community-based cross-sectional study.SettingBishoftu town, Ethiopia, January–February 2022.ParticipantsA 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.OutcomeThe response variable was diarrhoeal disease among children under 5 years.ResultsThe 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.ConclusionIn 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.

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.

Introduction The use of unimproved energy sources is associated with a range of health problems. However, in Ethiopia, studies focused on the utilization of unimproved energy sources and associated factors are limited. Therefore, this study aimed to close this gap. Methods In this community-based cross-sectional study, 5,350 participants were enrolled. Multivariable logistic regression analyses were employed to examine the associations between the utilization of unimproved energy sources and the predictor variables. Additionally, the chi-square test was used to examine the association between households' unimproved energy source utilization and the occurrence of health problems. Results In this study, 45% of households used unimproved energy sources. In the multivariable analysis, households headed by men (adjusted odds ratio [AOR] = 0.76; with 95% confidence interval [CI] 0.66, 0.87), households headed by illiterate heads (AOR = 1.77 with 95% CI 1.47, 2.14), household family size (AOR = 0.79 with 95% CI 0.79, 0.93), households headed with farmers (AOR = 3.33 with 95% CI 2.31, 4.81), households with low income (AOR = 3.41 with 95% CI 2.57, 4.51), rural households (AOR = 7.94 with 95% CI 6.76, 9.32), and households with regular coffee ceremony practices (AOR = 1.17 with 95% CI 1.00, 1.36) were significantly associated with the utilization of unimproved energy sources. Additionally, the results of the chi-square test revealed that households that relied on unimproved energy sources had a 1.5-fold greater risk of developing respiratory illnesses, an 8.5-fold greater risk of developing cataract disease, and a 5.2-fold greater risk of developing trachoma than households that used improved energy sources. Conclusion A significant proportion of households in Bishoftu town still rely on unimproved energy sources for cooking and other household needs. This indicates a substantial challenge in achieving universal access to clean and sustainable energy in the area. Several socioeconomic and demographic factors are associated with the use of unimproved energy sources, including male-headed households, illiteracy of household head, smaller family size, farming occupation, low income, rural residence, and regular coffee ceremony practices. Most importantly, the use of unimproved energy sources is associated with higher risks of respiratory illnesses, cataracts, and trachoma among household members. Therefore, the government should implement targeted interventions to promote the adoption of clean and improved energy sources among vulnerable households such as households headed by farmers, those with illiterate heads, households with low socioeconomic status, households with regular coffee ceremony practices, and those in rural areas. In addition, the local government should develop and implement educational campaigns to raise awareness about the health and environmental risks associated with the use of unimproved energy sources, particularly among households with high-risk factors identified in the study. Highlights ➣ Nearly half of households in Bishoftu use harmful energy sources for cooking. ➣ Utilization of unimproved energy use links to serious health issues like respiratory diseases, Trachoma and cataracts. ➣ Many determinant factors influencing households' utilization of unimproved energy sources were identified. ➣ Targeted education and support are needed to promote clean energy adoption in vulnerable communities.

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.

Background: Open defecation is a significant global challenge, impacting public health, environmental sanitation, and social well-being, especially in low- and middle-income countries like Ethiopia. It is the second-largest cause of disease burden worldwide by facilitating the spread of germs that cause diarrhea diseases. Studies examining open defecation practices are insufficient, especially in areas implementing Ethiopia’s Geshiyaro project. Therefore, this study aimed to assess the status of open defecation practice and associated factors in the study area. Method: A community-based cross-sectional study was conducted from June to July 2023. The total number of households included in this study was 7995. A structured questionnaire and observational checklist were used to collect data. Descriptive and multivariate logistic regression analyses were performed using STATA version 16. Results: The study found that 16.5% of households practiced open defecation. The following factors were significantly associated with the occurrence of open defecation: residence (AOR = 1.56, 95% CI: 1.26-1.92), education (AOR = 0.59, 95% CI: 0.49-0.72), age (AOR = 0.53, 95% CI: 0.41-0.69), knowledge on diarrhea prevention (AOR = 1.32, 95% CI: 1.17-1.50), marital status (AOR = 1.61, 95% CI: 1.32-1.97), and awareness creation about WASH services (AOR = 1.96, 95% CI: 1.71-2.25). On the other hand, no significant association was observed between the occurrence of open defecation and the household’s income (AOR = 1.07, 95% CI: 0.93-1.23) or the head of household sex (AOR = 0.94, 95% CI: 0.78-1.12). Conclusion: Open defecation remains a critical public health concern in Ethiopia’s Geshiyaro project sites. Various factors influencing this practice have been identified. Targeted interventions are needed to enhance access to safe sanitation facilities and promote awareness of WASH services, aligning with SDG 3 target 3, and SDG 6 target 2.

Background Access to basic sanitation services is essential to enhance public health and well-being. However, ensuring adequate sanitation coverage is difficult in many parts of Ethiopia, including the Geshiyaro Project implementation sites. The Geshiyaro project is part of monitoring and evaluation activities aimed at assessing access to water and basic sanitation services. Hence, research on access to basic sanitation services and the associated risk factors in the Geshiyaro project sites is lacking. Thus, the purpose of this study was to fill this gap. Methods A community-based cross-sectional study was conducted from June to July 2023. A total of 7995 households were included in this study. A structured questionnaire was used to collect the data. STATA version 16 was used to conduct both descriptive and multivariable analysis. Results The study reported that 8.4% of households had basic sanitation services. The following factors were significantly associated with the availability of basic sanitation services: residence (AOR = 0.31, 95% CI 0.25–0.37), education (AOR = 1.36, 95% CI 1.12–1.66), occupation (AOR = 0.44, 95% CI 0.33–0.57), annual income (AOR = 0.66, 95% CI 0.55–0.80), age (AOR = 1.77, 95% CI 1.10–2.84), awareness creation about WASH services (AOR = 0.58, 95% CI 0.49–0.70), family size (AOR = 1.22, 95% CI 1.01–1.46), and water source type (AOR = 0.27, 95% CI 0.13–0.57). Conclusion Households’ access to basic sanitation services in Ethiopia’s Geshiyaro project site is a significant public health concern. Many factors that affect access to basic sanitation services have been identified. The study highlights the importance of targeted interventions to address sociodemographic disparities and improve sanitation facilities. Similarly, the findings of this research will contribute to the achievement of Sustainable Development Goals (SDG) target 3.3 to eradicate the epidemics of AIDS, neglected tropical diseases, tuberculosis, and malaria, as well as combat hepatitis and water-borne illnesses and Sustainable Development Goals (SDG) target 6.2, which deal with the elimination of open defecation, access to sufficient and equitable sanitation and hygiene for everyone, and reducing infectious diseases.

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.