Examining carcinogenic and noncarcinogenic health risks related to arsenic exposure in Ethiopia: A longitudinal study

Background

The carcinogenic properties of arsenic make it one of the most hazardous chemicals globally. Nevertheless, the exact level of human exposure to arsenic and the associated risks of cancer and non-cancer effects through different pathways in Ethiopia are still uncertain.

Objective

The primary aim of this study was to evaluate the risk of both cancer and non-cancer outcomes among children and adults who have been exposed to arsenic through drinking water in the Adami Tulu Jido Kombolcha district of Ethiopia.

Methods

For this study, a longitudinal study design was employed. A total of 45 groundwater sources were sampled using the census sampling method. The concentrations of total arsenic were measured using Agilent 7900 series inductively coupled plasma mass spectrometry. Carcinogenic and noncarcinogenic risk assessments were conducted by calculating lifetime cancer risk and hazard quotients. Microsoft Office Excel was utilized to calculate human health risk indices, and descriptive statistical analysis were performed using SPSS software.

Results

Our findings revealed that during the dry season, the mean arsenic concentration in the groundwater samples was 11.15 ± 9.38 µg/L, while during the rainy season, it was 10.67 ± 8.16 µg/L. The total cancer risk for children, resulting from oral ingestion and skin contact, was 1.15 × 10-2 and 1.07 × 10-2 during the dry and rainy seasons, respectively. For adults, the total cancer risk from oral ingestion and skin contact during the dry and rainy seasons was 4.95 × 10-3 and 4.59 × 10-3, respectively. Furthermore, the total hazard quotients for children via oral ingestion and skin absorption were 25.9 and 24.0 during the dry and rainy seasons, respectively. For adults, the total hazard quotients from ingestion and dermal contact during the dry and rainy seasons were 11 and 10, respectively.

Conclusions

The findings indicate that the risks of cancer and non-cancer effects resulting from arsenic exposure through ingestion and dermal exposure were found to exceed the acceptable thresholds in both seasons. These results emphasize the urgent need for focused attention on the study population in the study area due to the high likelihood of experiencing adverse health outcomes.

Prevalence of arsenic-induced skin lesions and associated factors in Ethiopia: Community-based study

The study aimed to assess the prevalence of arsenic-induced skin lesions and associated factors among the population in the Adami Tulu Jido Kombolcha district, Ethiopia. A community-based cross-sectional study design was employed among 403 participants from June 02-20, 2022. A two-stage cluster sampling method was conducted to select study subjects. A pretested structured and semi-structured interview questionnaire and observation using a WHO flow chart were used for data collection. Data analysis was performed using SPSS version 24 statistical software for Windows. A multivariable binary logistic regression model was applied to examine the relationship between predictor variables and an outcome variable. The degrees of association between outcomes and predictor variables were assessed using ORs and 95% CIs, and P-values < 0.05 were considered significant. The prevalence of arsenic-induced skin lesions (arsenicosis) in the study area was 2.2% [95% CI: 1.0-3.7]. The most common arsenic-induced manifestation was keratosis (55.6%), followed by hyperpigmentation (33.3%) and hyperkeratosis (11.1%). Consumption of well water, smoking cigarettes, and chewing khat were significantly associated with arsenic-induced skin lesions. Therefore, the findings of this study should trigger further research on arsenic exposure and health risks.

Effect of conventional and household water treatment technologies on the removal of pesticide residues in drinking water, Jimma town, Southwestern, Ethiopia

Water resources have been contaminated by pesticides due to the different activities of human beings. Different studies documented that advanced water treatment systems can eliminate pesticides while conventional and household treatment technologies are not well studied. The main aim of the present study is to determine the effect of conventional and household water treatment technologies on the removal of pesticide residue in drinking water. Water samples were collected from the Gibe River (intake point), from each treatment process, and from the distribution system. To determine the effect of the household water treatment process (solar disinfection and boiling), pesticides were spiked into distilled water and then passed through solar disinfection (SODIS) and boiling. The extraction of samples was conducted by following a low-density-based dispersive liquid-liquid microextraction procedure. The result of the study revealed that almost all studied pesticides except o´p-DDT were detected in water samples. Most pesticides that were detected in water samples from our study areas exceeded the maximum residue limits (MRLs), except for p,p'-DDE. The percent reduction of pesticide residue after post-chlorination by conventional water treatment ranges from 11.7% (from 70.83 μg/L to 62.54 μg/L) for p´p-DDD to 97.29% (5510.1μg/L to 149.5μg/L) for Dimethachlor, and the percent reduction of pesticide residue by SODIS and boiling ranges from 2.31% (o´p-DDT) to 54.45% (Cypermethrin) and 27.13% (γ-Chlordane) to 38.9% (p´p-DDE) respectively. This indicates that treatment technologies are important for the reduction of pesticides in water. Since studied pesticides are persistent and the resides were exceed MRL (have a health impact), monitoring of pesticides in treatment plant units is necessary and treatment technology improvement is important to allow further removal of pesticides.

Determination of pesticide residues in the serum of flower farm workers: A growing occupational hazards in low income countries

Ethiopia is one the major exporter of cut flowers in East Africa. However, the sector is blamed for the intensive use of pesticides which leads to exposure of workers. This study aims to investigate the level of pesticides in blood serum of flower farm workers as a predictor to occupational exposure. A cross-sectional laboratory based study was conducted in central Ethiopia among 194 flower farm workers. Blood sample were collected from 100 study participants (50 from farm workers and 50 civil servants as control). Blood-serum separation, extraction, and clean-up was performed following standard analytical methods. Ten organochlorine pesticides (OCPs) (o,p'-DDT, p,p'-DDD, p,p'-DDE, p,p'-DDT, heptachlor, heptachlor epoxide, endosulfan, dieldrin, methoxychlor, dibutychloridate), and three pyrethroids (cypermethrin, permethrin and deltamethrin) were detected in the serum of the study participants. From the detected pesticides p,p'-DDT and p,p'-DDE were observed at high mean concentration (81.5 ± 83.5, and 12.5 ± 6.7 ng/mL),(38.0 ± 31.8 and 6.84 ± 7.4 ng/mL) in the flower farm and controls, respectively. From the Mann-Whitney U-test, there is a significant difference for total DDT (P < 0.02), p,p'-DDE (P < 0.001), cypermethrin (P < 0.001), heptachlor (P < 0.04), heptachlor-epoxide (P < 0.001) and dibutyl chlorendate (P < 0.01) among the flower farm workers and controls. Multinomial regression revealed, being flower farm worker is a significant predictor of moderate to high residues of p,p'-DDE, total DDT, heptachlor-epoxide and dibutyl chlorendate. The pesticides under study were detected more frequently in the flower farm workers than controls which is an indicative for occupational exposure to pesticides and strict regulation is important for the safety of workers.

Determination of organochlorine and organophosphorus pesticide residues in tomato, potato, and pineapple samples of selected farmlands in southwest Ethiopia

ABSTRACT. In this study, the residual concentrations of some organophosphate and organochlorine pesticides were determined in tomato, potato, and pineapple samples from selected farmlands of Jimma and Kefa Zones, Southwest of Ethiopia. The QuEChERS procedure, AOAC-2007, was used for extraction of the pesticides from the samples prior to their determinations by a gas GC-ECD. Pesticides including dichlorodiphenyltrichloroethane, endrin, and dieldrin were not detected in all studied samples. Dimethoate was detected only in Mana and Saka Buyo Qacama tomato samples. Likewise, malathion was detected only in the Saka Buyo Qacama tomato sample. The residual concentrations of most of the studied pesticides were below their MRLs set in EU guideline. However, the recorded residual concentrations of dibutyl chlorendate and chloroflurenol-methyl pesticides were above the EU general default MRL. The percent recoveries studied by spiking known concentrations of the analytes ranged from 71.22–121.56%. However, the recoveries of chloroflurenol-methyl and chlorpyrifos in the potato sample were 65.65 and 67.90%, respectively. One-way ANOVA results (p ≤ 0.05) indicated the presence of significant variations in the concentrations of the detected pesticides among the sampling sites. Generally, the findings showed that regular monitoring of pesticide residues in agricultural products of the area is needed.   KEY WORDS: Organophosphates and organochlorines pesticides, QuEChERS, Tomato, potato, and pineapple samples, GC-ECD   Bull. Chem. Soc. Ethiop. 2023, 37(1), 23-33.                                                             DOI: https://dx.doi.org/10.4314/bcse.v37i1.3

Prevalence of Pesticide Use and Occupational Exposure Among Small-Scale Farmers in Western Ethiopia

OBJECTIVE

This study aims to assess the prevalence of pesticide use and its occupational exposure among small-scale farmers in the Kellem Wellega Zone of western Ethiopia.

METHODS

A cross-sectional study design using a structured questionnaire was used to collect data from 249 small-scale farmers' households through face-to-face interviews. Statistical analysis such as descriptive statistics, Chi-square test, and binary logistic regression analysis was applied, and a P-value <.05 at 95% CI was considered statistically significant.

RESULTS

The prevalence of pesticide use was 87.15%. About 44.2%, 40.2%, and 43.8% of the study participants were classified as having poor knowledge, poor practice, and negative attitude toward pesticide use, respectively. Thus, small-scale farmers whose age was greater than 40 years were 7.87 times more likely to be exposed to skin irritation than those whose age was less than 20 years (AOR = 7.87; 95% CI: 1.75-35.45) and skin contact (AOR = 0.37; 95% CI: 0.15-0.91). Most farmers who were directly involved in agriculture were 2.22 times more likely to be exposed to the inhalation of pesticide chemicals than those involved in another activity (AOR = 2.22; 95% CI: 1.14-4.33). Based on educational level, small-scale farmers who have a primary school and above were 81% less likely to inhale pesticide chemicals than those who did not have formal education (AOR = 0.19; 95% CI: 0.09-0.41). Furthermore, low-income small-scale farmers were 2.62 times more likely to be exposed to coughing (AOR = 2.62; 95% CI: 1.25-5.51) than high-income participants. Furthermore, farmers with good knowledge were 1.79 times more likely to be exposed to skin irritation than those with poor knowledge (AOR = 1.79; 95% CI: 1.0-3.17). Farmers with poor practice were 1.85 times more likely to show coughing symptoms than those with good practice (AOR = 1.85; 95% CI: 1.08-3.2), and farmers with good practice were 48% less likely to be exposed to headache than those with poor practice (AOR = 0.52; 95% CI: 0.31-0.88).

CONCLUSIONS

This study shows that small-scale farmers were exposed to pesticides through coughing, headache, skin irritation, inhalation, and skin contact. Low level of knowledge, poor practice, job, low income, older age, and educational level.

Exposure of infants to organochlorine pesticides from breast milk consumption in southwestern Ethiopia

Breast milk is often used as an environmental bioindicator since it serves as an important medium to accumulate organochlorine pesticides. The main aim of this study is to determine the level of organochlorine pesticides in human breast milk collected from three districts of southwestern Ethiopia (Asendabo, Deneba, and Serbo) at three times points baselines (1st month), midline ( six months), and end line (12 months) and risk of infants’ exposure. A longitudinal study was conducted to assess pesticide residues in human breast milk samples and evaluate the risk-exposure of infants to these pesticides from consumption of mother’s milk in Ethiopia. Breast milk samples were collected from 168 mothers at three time points and pesticides were extracted using the quick, easy, cheap, effective, rugged, and safe (QuEChERS) method. The level of pesticide residues in human milk samples and exposure of infants to the pesticides was evaluated by calculating the estimated daily intake and compared with the provisional tolerable daily intake of the pesticides under study. The results indicated that, from the eight organochlorine pesticides analyzed in 447 breast milk samples at three sampling times, DDT and its metabolites were detected. p,p′-DDE and p,p′-DDT were detected in all (100%) of the breast milk samples while, p,p-DDD, and o,p-DDT were detected in 53.9%, and 42.7%, respectively. The mean concentration of total DDT at three time points(baseline, midline and endline) were 2.25, 1.68 and 1.32 µg/g milk fat, respectively. The mean concentration of total DDT from the three districts was 1.85 µg/g milk fat which is above the maximum residue limit (MRL = 0.02 µg/g milk fat set by FAO/WHO). The mean ratio of DDT/DDE for the three areas was calculated less than five (< 5) indicates historical DDT use in the study area. The estimated daily intake of infants at the first month of breastfeeding was 11.24 µg/kg-BW/day, above the provisional tolerable daily intake (PTDI) for total DDT set by FAO/WHO, which is 10 µg/kg body weight. An intake of OCPs is a big concern for infants' health in Ethiopia and countries with a similar condition, particularly at the first month of lactation. Strict regulations of the health-threatening pesticide by the regulatory body (Environment, Forest and Climate Change Commission) at the country and regional levels is advocated.

Exposure to organochlorine pesticides as a predictor to breast cancer: A case-control study among Ethiopian women

Breast cancer (BC) is becoming one of the most prevalent non-infectious disease in low and middle income countries. The steady rise of BC incidence may be related to the different risk factors. Among many, rampant presence of environmental pollutants might be one of the risk factors. Therefore, the aim of this study is to investigate exposure to organochlorine pesticides as a risk factor to breast cancer. A case-control study design was employed among breast cancer patients and non-breast cancer individuals (controls). Blood samples were collected from 100 study participants (50 cases and 50 controls) followed by serum separation, extraction and cleanup using standard analytical procdures. The findings revealed that ten organochlorine pesticides were detected in the serum of the study participants. From the detected organochlorine pesticides, heptachlor was observed at higher concentration for breast cancer patients (6.90±4.37 μg/L) and controls (9.15±3.84 μg/L). Mean serum level of p,p’-DDE, p,p’-DDT, heptachlor, gamma-chlordane, endosulfan, and dibutyl-chlorendate were significantly higher in the serum of breast cancer patients than the controls. From the studied pesticides, p,p’-DDT and gamma-chlordane are significant predictors for BC, while, others are equivocal. A unit increment of the concentration of p,p’-DDT (AOR; 2.03, 95% CI: 1.041–3.969) increased the odds of developing breast cancer by two, while for gamma-chlordane (AOR;3.12, 95% CI; 1.186–8.203) by three. Our study results suggesting that, organochlorines are a risk factors for breast cancer in Ethiopia. Decreasing exposure to such organochlorines might have a significant public health relevance in reducing non-communicable chronic illnesses. Besides, continues monitoring of persistent organic pollutants using body biomarkers is important for disease prevention and device mitigation measures.

Evaluating the Level of Pesticides in the Blood of Small-Scale Farmers and Its Associated Risk Factors in Western Ethiopia

BACKGROUND

The presence of agricultural pesticide residue can cause adverse health effects.The main objective of this study was to evaluate the level of pesticides in the blood of small-scale farmers (SSFs) and associated risk factors in western Ethiopia.

METHODS

Across sectional study was conducted in June 2020 using 240 blood samples, 140 from the exposed small-scale farmers (ESSFs) and 100 from non-exposed small-scale farmers (NESSFs). The blood sample analysis was mad for 5 organochlorines (OCs) and 3 synthetic pyrethroids (SPs) pesticides by gas-liquid chromatography with an electron capture detector (GC-ECD) methods. Extraction, and clean up of the samples were made by using standard analytical methods. To define the relationships between the outcomes and explanatory variables, logistic regression models were used.

RESULTS

The results shows that p,p'-DDT, heptachlor and deltamethrin were the most frequently detected pesticides with 96.4%, 95%, and 100% in both ESSFs and NESSFs, respectively. The ESSFs blood samples have shown the highest mean concentrations of permethrin and p,p'-DDT(1.26 ± 0.15) and (0.28 ± 0.4) mgL^-1, respectively. SSFs under the age of 40 were 21% less likely to be exposed to permethrin than those above the age of 40 (Adjusted Odd Ratio, AOR, 0.21; 95% CI: 0.1-0.44). Male SSFs were 17 times more likely to be exposed to heptachlor than females (AOR, 17.36; 95%CI: 7.34-41.09) and farmers with no formal education were 18 times more likely to be exposed to deltamethrin than those with primary schools and beyond (AOR, 18.1; 95 %CI: 4.53-72.06). Furthermore, SSFs that did not use PPE appropriately were 3.6 and 6.21 times more likely to be exposed to cypermethrin (AOR, 3.6; 95%CI: 1.94-6.54) and p,p'-DDE(AOR, 6.21; 95%CI: 3.38-11.41) blood levels than those who did, respectively. SSFs that perform different activities like eating and drinking (11%), chewing (10%), and diverse activities (8%) were more likely to be exposed to p,p'-DDT than those farmers who didn't use pesticides.

CONCLUSIONS

This study identified a high concentration p,p'-DDE, p,p'-DDT, heptachlor, cypermethrin, permethrin, and deltamethrin in the blood of small scale farmers. The older age, less education, and farmers with inappropriate PPE use are more likely exposed to pesticides.

A review of environmental occurrence, analysis, bioaccumulation, and toxicity of organophosphate esters

The ban and restriction of polychlorinated biphenyls (PCBs) and major brominated flame retardants (BFRs), including hexabromocyclododecane (HBCD) and polybrominated diphenyl ethers (PBDEs), due to their confirmed detrimental effects on wildlife and humans have paved the way for the wide application of organophosphate esters (OPEs). OPEs have been extensively used as alternative flame retardants, plasticizer, and antifoaming agents in various industrial and consumer products, which leads to an increase in production, usage, and discharge in the environment. We compile recent information on the production/usage and physicochemical properties of OPEs and discussed and compared the available sample treatment and analysis techniques of OPEs, including extraction, clean-up, and instrumental analysis. The occurrence of OPEs in sediment, aquatic biota, surface, and drinking water is documented. Toxicity, human exposure, and ecological risks of OPEs were summarized; toxicological data of several OPEs shows different adverse health effects on aquatic organisms and humans. Much attention was given to document evidence regarding the bioaccumulation and biomagnification potential of OPEs in aquatic organisms. Finally, identified research gaps and avenues for future studies are forwarded.

Corrigendum to "Organochlorine pesticide residues in tea and their potential risks to consumers in Ethiopia" [Heliyon 7 (7) (July 2021) e07667]

[This corrects the article DOI: 10.1016/j.heliyon.2021.e07667.].

Risk perceptions and attitudinal responses to COVID-19 pandemic: an online survey in Ethiopia

BACKGROUND

Effective risk communication is one of the critical strategies in the response to COVID-19. This study examined risk perceptions and attitudinal responses to COVID-19 among the educated section of the society in Ethiopia.

METHODS

An internet-based survey was conducted from April 22 to May 04, 2020, in Ethiopia. A questionnaire addressing the perception of health threat-combination of perceived vulnerability (PV) and perceived seriousness (PS), and perceived efficacy-combinations of perceived response efficacy (PRE), perceived self-efficacy (PSE), and perceived collective efficacy (PCE). The data were analyzed using SPSS 21.0. Descriptive statistics were computed after the standardization of the scores. The scores for overall efficacy and threat were split by median value and response classifications were generated through threat by efficacy interactions. For statistical significance, 95% CI and p-value < 0.05 were used.

RESULTS

A total of 929 respondents submitted their responses. Eight hundred and twenty-eight (89.1%) of the respondents were male and 753 (81.1%) were Christian. The perceived threat to COVID-19 was generally low (median = 58.3). The median score for overall efficacy, PRE, and PSE were 79.8, 87.5, and 80.0, respectively. However, the median value (66.7) for PCE was relatively low. Perceived threat significantly varied by age, education, occupation, and place of residence (p < 0.05). Perceived efficacy significantly differed by gender, residence, and use of some sources of information (p < 0.05). In terms of response to COVID-19, 290 (31.2%), 239 (25.7%), 175 (18.8%) and 225 (24.2%) of the respondents were in the responsive, pro-active, avoidant, and indifferent attitudinal categories, respectively. The avoidant and indifferent groups constituted a fear control response (mal-adaptive motivation towards COVID-19 protective behavior) whereas responsive and pro-active categories formed a danger control response (self-protective motivation). These responses varied significantly by residence, region, religion, and sources of information (p < 0.05).

CONCLUSIONS

Understanding people's perceived health threat and efficacy is a critical step toward creating risk communication campaigns. Hence, this study provided an insight that has the potential to inform the COVID-19 risk communication campaigns targeting the educated section of the society, by ensuring a balanced combination of threat appeals and efficacy messages for improved self-protective responses.

Relevance of macroinvertebrate communities as a water quality monitoring tool in ecosystems under harsh environmental conditions in the Rift Valley region

Ecological assessment was performed in different thermal springs located in the Ethiopian Rift Valley area: Gergedi, Sodere, Halaba, and Gara. We assessed the habitat conditions, physicochemical characteristics, and macroinvertebrate composition at 12 sampling sites in four thermal spring systems. The physicochemical properties of the water samples varied among the sampling stations. Temperature ranged from 38.5 to 90°C among the 12 sites. Dissolved oxygen, which is essential to aquatic ecosystem normal functioning, was not detected at three sampling sites. An average of 109 macroinvertebrates were identified in three sampling campaigns. Relatively higher macroinvertebrate abundance 94 (86.2%) was registered in Gergedi than any other thermal spring sites. The macroinvertebrate abundance was 9 (8.3%) and 6 (5.5%) for the Gara and Sodere thermal springs. No macroinvertebrate communities were observed in all sites of Halaba thermal spring. From all macroinvertebrate groups, 82 (75.2%) were dipterans, 20 (18.4%) Oligochaeta, 5 (4.6%) Gastropoda, and the rest Hemipterans and Coleopterans, which comprises 2 (1.8%) individuals. Chironomidae was the dominant invertebrate taxa at all sites, and when the water temperature exceeds 42°C, it becomes the only taxon in the thermal springs. Macroinvertebrates were absent in thermal springs where the water temperature is 52°C or higher. Other diversity measures were not sensitive enough to discriminate sampling sites regardless of physicochemical variabilities except the richness and abundance. Water temperature, chloride, pH, and phosphate were identified as major determinants of macroinvertebrate richness in the Ethiopian Rift Valley region.

Psychological impact of COVID-19 outbreak among Jimma University Medical Centere visitors in Southwestern Ethiopia: a cross-sectional study

BACKGROUND

COVID-19 has posed several medical, psychosocial and economic impacts among the majority of the society. The ambiguity of its transmission, the intense desire of self-protection, family, and friends, the unknown impact of catching the disease itself, unstoppable spread, the panic and outright misinformation lead to acute stress reaction syndrome. However, reliable data related to this contagion lack the prevalence of acute stress reaction syndrome and associated factors among Jimma University Medical Centre hospital visitors in Southwestern Ethiopia.

AIMS

The main objective of the study was to assess the prevalence and factors associated with acute stress reaction syndrome during the COVID-19 outbreak among Jimma University Medical Centre Hospital visitors, Ethiopia.

METHODS

An interviewer-administered cross-sectional study was conducted among 247 visitors of the Jimma University Medical Centre in Ethiopia. The study was conducted within 2 weeks of the first COVID-19 cases detected on 13 March 2020 in Ethiopia. Data on demographic and socioeconomic status were collected during the interview using structured questionnaires. The psychological impact was assessed using the Impact of Event Scale-Revised, and symptoms of insomnia were measured using the Insomnia Severity Index. Social support was evaluated using Oslo three-item Social Support Scale. Logistic regression was employed to determine the associations between dependent and independent variables. Besides, psychosocial stress score was generated using principal component analysis. A paired permutation test was also performed to determine the variability of psychosocial stress between groups.

RESULTS

The mean age of participants was 30.47 years, and 76.5% of the participants were male. Acute stress reaction syndrome was detected in 44.1% of hospital visitors. Of the participants, 38.5%, 17.4%, 8.5% and 35.6% had a minimal, mild, moderate and severe psychological impact, respectively. Factors positively associated with acute stress reaction syndrome were individuals who perceived that COVID-19 leads to stigma (adjusted OR (AOR): 3.24, 95% CI 1.11 to 9.45), mild insomnia (AOR: 14.74, 95% CI 6.14 to 35.40), moderate to severe insomnia (AOR: 35.1, 95% CI 10.76 to 114.66), low social support (AOR: 4.08, 95% CI 1.31 to 12.67) and governmental employees (AOR: 8.09, 95% CI 1.38 to 47.18).

CONCLUSION

The study revealed the existence of a high prevalence of acute stress reaction syndrome during the COVID-19 outbreak among different groups of the community. Therefore, our results will contribute to the global awareness of the psychological impact of the COVID-19 outbreak.

Mental health of healthcare professionals during the early stage of the COVID-19 pandemic in Ethiopia

BACKGROUND

The coronavirus (COVID-19) pandemic causes healthcare professionals to suffer mental health problems such as psychological distress, anxiety, depression, denial and fear. However, studies are lacking related to Ethiopia and to Africa in general.

AIMS

To study the mental health of healthcare professionals during the COVID-19 pandemic in Ethiopia.

METHOD

A hospital-based cross-sectional study was conducted at Jimma University Medical Center among 249 healthcare professionals. The data were collected using self-administered questionnaires between 22 and 28 March 2020. The psychological impact was assessed using the Impact of Event Scale - Revised (IES-R) and symptoms of insomnia were measured using the Insomnia Severity Index (ISI). Social support was evaluated using the three-item Oslo Social Support Scale. Data were analysed using logistic regression to examine mutually adjusted associations, expressed as adjusted odds ratios. The psychosocial status of the healthcare professionals was predicted using a classification tree model supported by the genetic search method.

RESULTS

The prevalence of psychological distress among healthcare professionals was 78.3%. The mean IES-R score was 34.2 (s.d. = 19.4). The ISI score indicated that the prevalence of insomnia was 50.2%. Higher psychological distress was associated with younger age, having insomnia, not having a daily update on COVID-19, and feeling stigmatised and rejected in the neighbourhood because of hospital work.

CONCLUSIONS

This study indicates that, in Ethiopia, the prevalence of psychological distress among healthcare professionals is high and associated with specific sociodemographic risks.

Knowledge, perceptions and preventive practices towards COVID-19 early in the outbreak among Jimma university medical center visitors, Southwest Ethiopia

BACKGROUND

Novel-coronavirus disease-2019 (COVID-19) is currently a pandemic and public health emergency of international concern, as avowed by the World Health Organization (WHO). Ethiopia has become one of the affected countries as of March 15, 2020.

OBJECTIVE

This study aimed to assess the knowledge, perceptions, and practices among the Jimma University medical center (JUMC) visitors in Jimma town.

METHODS

A cross-sectional study was conducted on 247 sampled visitors, from 20-24 March 2020. Consecutive sampling was used to recruit the participants. The study tools were adapted from WHO resources. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Descriptive statistics were used to describe the status of knowledge, perception, and practices. Logistic regression was executed to assess the predictors of dominant preventive practices.

RESULTS

Of the 247 respondents, 205 (83.0%) knew the main clinical symptoms of COVID-19. 72.0% knew that older people who have chronic illnesses are at high risk of developing a severe form of COVID-19. About 95.1% knew that the COVID-19 virus spreads via respiratory droplets of infected people, while 77 (31.2%) of the respondents knew about the possibility of asymptomatic transmission. Only 15 (6.1%) knew that children and young adults had to involve preventive measures. Overall, 41.3% of the visitors had high knowledge. The majority, 170(68.8%), felt self-efficacious to controlling COVID-19. 207(83.3%) believed that COVID-19 is a stigmatized disease. Frequent hand washing (77.3%) and avoidance of shaking hands (53.8%) were the dominant practices. Knowledge status and self-efficacy (positively), older age, and unemployment (negatively) predicted hand washing and avoidance of handshaking.

CONCLUSIONS

The status of knowledge and desirable practices were not sufficient enough to combat this rapidly spreading virus. COVID-19 risk communication and public education efforts should focus on building an appropriate level of knowledge while enhancing the adoption of recommended self-care practices with special emphasis on high-risk audience segments.

Reduction of pesticide residues from teff (Eragrostis tef) flour spiked with selected pesticides using household food processing steps

Teff (Eragrostis tef) is an ancient cereal that is indigenous from Ethiopia. Nowadays, teff grain is becoming popular to many parts of the world. Teff is gluten-free in nature, has high iron and fiber content, and many other health benefits make this crop interesting to many consumers. Since no insect pests are attacking the teff grains, farmers do not apply pesticides on it, unlike maize and other grains. Nevertheless, residues of organochlorine pesticides have been detected at an alarming level that could pose a consumer risk. Teff is often consumed as injera which is a fermented flat pancake. The main aim of the present study is, therefore, to investigate the effect of household food processing (doughing and baking) on the reduction of pesticide residues from teff. Pesticide residues previously detected in teff grain such as permethrin, cypermethrin, deltamethrin, chlorpyrifos ethyl, p,p'-DDE, p,p'-DDD, o,p'-DDT, and p,p'-DDT were spiked and extracted followed by the subsequent household processing which are generally doughing (dough making followed by fermentation) and baking. From the findings of this study, doughing decrease the pesticide residues in the range of 59.9-86.4% and baking in the range of 63.2-90.2%. Kruskal-Wallis analysis indicates that the reduction of pesticide residues by baking is significantly different from doughing (p-value < 0.0001). There is also a significant difference between non-fermented and fermented dough (p-value = 0.012). The processing factor for doughing and baking was less than one (PF < 1 = reduction factor) which indicates the reduction of pesticides due to teff processing. The cumulative effect of these processing methods is important to evaluate the risks associated with the ingestion of pesticides, particularly in teff grain.

Exposure to DDT and its metabolites from khat (Catha edulis) chewing: Consumers risk assessment from southwestern Ethiopia

Khat (Catha edulis) is one of the most consumed plant in the horn of African countries. However, it is a stimulant plant that has several side effects on the health of consumers. On top of that, the khat leaves used for human consumption are often contain contaminants such as pesticide residues. The present study aims to investigate the level of DDT residue and its metabolites (p'p-DDE, p'p-DDD, o'p-DDT and p'p-DDT) in khat samples and to undertake exposure assessment to consumers. The khat samples were collected from local markets in southwestern Ethiopia. Consumption survey was undertaken using 24 h recall method for both male and female khat consumers. The finding showed that 80% of the khat samples contained DDT and its metabolites. Some of the residues were above the maximum residue limit (MRL) set by Food and Agricultural Organization (FAO). The concentration of p'p-DDE and p'p-DDT in khat were in the range of 0.033-0.113 and 0.010-0.026 mg/kg, respectively. High concentration of the metabolite (p'p-DDE) compared to the parent compound (p'p-DDT) revealed the historical use of DDT in the study area. Probabilistic exposure analysis indicated that the mean and 97.5 percentile (P97.5), of the estimated daily intake of total DDT were 0.002 and 0.006 mg/kg bw/day, respectively. The study concluded that khat consumers are exposed to the stimulant effect of the plant as well as DDT and its metabolites in Jimma zone.

Pesticide residues in drinking water and associated risk to consumers in Ethiopia

Access to safe and reliable drinking water is vital for a healthy population. However, surface water may be contaminated with pesticides because of the nearby agricultural areas as well as from household application. Water samples were collected from water sources in Jimma zone and Addis Ababa, Ethiopia. The extraction and clean up of the samples were undertaken using liquid-solid and liquid-liquid methods. Human exposure was assessed by calculating the estimated daily intake (EDI) of pesticides in water and compared with the acceptable daily intake (ADI) and the acute reference dose (ARfD). The mean concentrations of 2,4-D, malathion, diazinon and fenpropimorph were 1.59-13.90 μg/l and 0.11-138 µg/l in Jimma and Addis Ababa water sources, respectively. The residue level of some of the pesticides were above the European drinking water guide line values, which is an indication of an illegal use of pesticides in the study areas. Concerning human health risk estimation, there was no acute risk (EDI < ARfD). However, chronic risks to human health were observed from exposure to diazinon and fenpropimorph (EDI > ADI) for Jimma and Addis Ababa populations, respectively. A comprehensive monitoring is required to reduce the level of pesticide residues in the water and to minimize particularly the long term human health risks.

Effect of Household Coffee Processing on Pesticide Residues as a Means of Ensuring Consumers' Safety

Coffee is a highly consumed and popular beverage all over the world; however, coffee beans used for daily consumption may contain pesticide residues that may cause adverse health effects to consumers. In this monitoring study, the effect of household coffee processing on pesticide residues in coffee beans was investigated. Twelve pesticides, including metabolites and isomers (endosulfan α, endosulfan β, cypermethrin, permethrin, deltamethrin, chlorpyrifos ethyl, heptachlor epoxide, hexachlorobenzene, p'p-DDE, p'p-DDD, o'p-DDT, and p'p-DDT) were spiked in coffee beans collected from a local market in southwestern Ethiopia. The subsequent household coffee processing conditions (washing, roasting, and brewing) were established as closely as possible to the traditional household coffee processing in Ethiopia. Washing of coffee beans showed 14.63-57.69 percent reduction, while the roasting process reduced up to 99.8 percent. Chlorpyrifos ethyl, permethrin, cypermethrin, endosulfan α and β in roasting and all of the 12 pesticides in the coffee brewing processes were not detected. Kruskal-Wallis analysis indicated that the reduction of pesticide residues by washing is significantly different from roasting and brewing (P < 0.0001). However, there was no significant difference between coffee roasting and brewing (P > 0.05). The processing factor (PF) was less than one (PF < 1), which indicates reduction of pesticides under study during processing of the coffee beans. The cumulative effect of the three processing methods has a paramount importance in evaluating the risks associated with ingestion of pesticide residues, particularly in coffee beans.

Risk of DDT residue in maize consumed by infants as complementary diet in southwest Ethiopia

Infants in Ethiopia are consuming food items such as maize as a complementary diet. However, this may expose infants to toxic contaminants like DDT. Maize samples were collected from the households visited during a consumption survey and from markets in Jimma zone, southwestern Ethiopia. The residues of total DDT and its metabolites were analyzed using the Quick, Easy, Cheap, Effective, Rugged and Safe (QuEChERS) method combined with dispersive solid phase extraction cleanup (d-SPE). Deterministic and probabilistic methods of analysis were applied to determine the consumer exposure of infants to total DDT. The results from the exposure assessment were compared with the health based guidance value in this case the provisional tolerable daily intake (PTDI). All maize samples (n=127) were contaminated by DDT, with a mean concentration of 1.770 mg/kg, which was far above the maximum residue limit (MRL). The mean and 97.5 percentile (P 97.5) estimated daily intake of total DDT for consumers were respectively 0.011 and 0.309 mg/kg bw/day for deterministic and 0.011 and 0.083 mg/kg bw/day for probabilistic exposure assessment. For total infant population (consumers and non-consumers), the 97.5 percentile estimated daily intake were 0.265 and 0.032 mg/kg bw/day from the deterministic and probabilistic exposure assessments, respectively. Health risk estimation revealed that, the mean and 97.5 percentile for consumers, and 97.5 percentile estimated daily intake of total DDT for total population were above the PTDI. Therefore, in Ethiopia, the use of maize as complementary food for infants may pose a health risk due to DDT residue.

The application of predictive modelling for determining bio-environmental factors affecting the distribution of blackflies (Diptera: Simuliidae) in the Gilgel Gibe watershed in Southwest Ethiopia

Blackflies are important macroinvertebrate groups from a public health as well as ecological point of view. Determining the biological and environmental factors favouring or inhibiting the existence of blackflies could facilitate biomonitoring of rivers as well as control of disease vectors. The combined use of different predictive modelling techniques is known to improve identification of presence/absence and abundance of taxa in a given habitat. This approach enables better identification of the suitable habitat conditions or environmental constraints of a given taxon. Simuliidae larvae are important biological indicators as they are abundant in tropical aquatic ecosystems. Some of the blackfly groups are also important disease vectors in poor tropical countries. Our investigations aim to establish a combination of models able to identify the environmental factors and macroinvertebrate organisms that are favourable or inhibiting blackfly larvae existence in aquatic ecosystems. The models developed using macroinvertebrate predictors showed better performance than those based on environmental predictors. The identified environmental and macroinvertebrate parameters can be used to determine the distribution of blackflies, which in turn can help control river blindness in endemic tropical places. Through a combination of modelling techniques, a reliable method has been developed that explains environmental and biological relationships with the target organism, and, thus, can serve as a decision support tool for ecological management strategies.

Exposure and health risk assessment of lead in communities of Jimma town, southwestern Ethiopia

Human beings could be exposed to lead arising from different environmental sources, such as air, water and soil. Tap water, air and soil samples were collected from four quadrants of Jimma town in southwestern Ethiopia. Eighty samples from each environmental source: water, air and soil samples were collected and analyzed for lead concentration. Prediction of the blood lead level and risk characterization was made using integrated exposure uptake biokinetic model and lead risk was calculated using USEPA guideline. Average concentration of lead in water, air and soils were 24.55 ± 10.01, 1.01 ± 0.41 µg/m(3), and 220.08 ± 135.95 µg/g respectively. Uptake of lead by children is significantly higher than the adults. The total risk value was 1.41 for children and 0.37 for adults. The finding revealed that children are more at risk than adults.

Pesticide residue evaluation in major staple food items of Ethiopia using the QuEChERS method: a case study from the Jimma Zone

Samples of maize, teff, red pepper, and coffee (green bean and coffee bean with pulp) were collected from a local market in the Jimma Zone, Ethiopia. Samples were analyzed for the occurrence of cypermethrin, permethrin, deltamethrin, chlorpyrifos ethyl, DTT and its metabolites, and endosulfan (α, β). In the analytical procedure, the QuEChERS (Quick, Easy, Cheap, Effective, Rugged and Safe) extraction methodology with dispersive solid phase extraction clean up (d-SPE) technique was applied. Validation of the QuEChERS method was satisfactory. Recovery percentages of most pesticides were in the range of 70% to 120%, with good repeatability (%relative standard deviation < 20). The limit of detection and limit of quantification varied between 0.001 µg/g and 0.092 µg/g and between 0.002 µg/g and 0.307 µg/g, respectively. The main pesticides detected were DDT, endosulfan, cypermethrin, and permethrin. All of the pesticides analyzed were detected in red pepper and green coffee bean. Residues of DDT in coffee pulp significantly differed (p < 0.01) from other food items except for red pepper. The concentration of pesticides in the food items varied from 0.011 mg/kg to 1.115 mg/kg. All food items contained 1 or more pesticides. Two-thirds of the samples had residues below corresponding maximum residue limits, and the remaining one-third of samples were above the maximum residue limits. These results indicate the need for a good pesticide monitoring program to evaluate consumer risk for the Ethiopian people.

Solar disinfection: an approach for low-cost household water treatment technology in Southwestern Ethiopia

Disinfection of contaminated water using solar radiation (SODIS) is known to inactivate bacteria. Its inactivation efficiency depends on local conditions where the disinfection is made. This study was aiming to test the efficiency of solar disinfection using different water parameters as low-cost household water treatment technology. Inactivation of microbes was tested using fecal coliform as test organism. The SODIS experiment was carried out at turbidity 2NTU, pH 7, and various water temperature (38.1°C, 41.8°C, 45.6°Cand 51.1°C) and solar intensities, using clear and black plastic bottles filled to different depths. The results show that the rate of microbial inactivation in relation to depth of water, turbidity, container type, intensity of light and color of container was statistically significant (p < 0.05). However, bottle placement, exposure and water pH were unrelated to microbial inactivation. Bacterial re-growth was not observed after solar disinfection. By adjusting the parameters, complete and irreversible fecal coliform inactivation was achieved within an exposure time of less than four hours in the areas where the solar irradiance is about 3.99 kW/m2 and above. Our results indicate that application of SODIS could play a significant role in the provision of safe water in rural communities of developing countries where there is ample sunshine, specifically in sub-Saharan African countries.