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Abstract：
BACKGROUND: Cholera outbreaks have afflicted Ethiopia, with nearly 100 000 cases and 1030 deaths reported from 2015 to 2023, emphasizing the critical need to understand water, sanitation, and hygiene (WaSH) risk factors.
METHODS: We conducted a cross-sectional household (HH) survey among 870 HHs in Shashemene Town and Shashemene Woreda, alongside extracting retrospective cholera case data from the Ethiopian Public Health Institute database. Relationships between WaSH and sociodemographic/economic-levels of HHs were examined. WaSH status and cholera attack rates (ARs) were described at kebele-level using geospatial mapping, and their association was statistically analyzed.
RESULTS: Access to basic drinking water, sanitation, and hygiene facilities was limited, with 67.5% (95% confidence interval, 64.4-70.6), 73.4% (70.3-76.3), and 30.3% (27.3-33.3) of HHs having access, respectively. Better WaSH practices were associated with urban residence (adjusted odds ratio, 1.7, [95% confidence interval, 1.1-2.7]), higher educational levels (2.7 [1.2-5.8]), and wealth (2.5 [1.6-4.0]). The association between cholera ARs and at least basic WaSH status was not statistically significant (multiple R2 = 0.13; P = .36), although localized effects were suggested for sanitation (Moran I = 0.22; P = .024).
CONCLUSIONS: Addressing gaps in WaSH access and hygiene practices is crucial for reducing cholera risk. Further analyses with meaningful covariates and increased sample sizes are necessary to understand the association between cholera AR and specific WaSH components.
METHODS: We conducted a cross-sectional household (HH) survey among 870 HHs in Shashemene Town and Shashemene Woreda, alongside extracting retrospective cholera case data from the Ethiopian Public Health Institute database. Relationships between WaSH and sociodemographic/economic-levels of HHs were examined. WaSH status and cholera attack rates (ARs) were described at kebele-level using geospatial mapping, and their association was statistically analyzed.
RESULTS: Access to basic drinking water, sanitation, and hygiene facilities was limited, with 67.5% (95% confidence interval, 64.4-70.6), 73.4% (70.3-76.3), and 30.3% (27.3-33.3) of HHs having access, respectively. Better WaSH practices were associated with urban residence (adjusted odds ratio, 1.7, [95% confidence interval, 1.1-2.7]), higher educational levels (2.7 [1.2-5.8]), and wealth (2.5 [1.6-4.0]). The association between cholera ARs and at least basic WaSH status was not statistically significant (multiple R2 = 0.13; P = .36), although localized effects were suggested for sanitation (Moran I = 0.22; P = .024).
CONCLUSIONS: Addressing gaps in WaSH access and hygiene practices is crucial for reducing cholera risk. Further analyses with meaningful covariates and increased sample sizes are necessary to understand the association between cholera AR and specific WaSH components.
摘要：
背景：霍乱疫情困扰着埃塞俄比亚，从2015年到2023年，报告了近10万例病例和1030例死亡，强调了了解水的迫切需要，卫生，和卫生（WaSH）危险因素。
方法：我们对ShashemeneTown和ShashemeneWoreda的870名HH进行了横断面家庭（HH）调查，同时从埃塞俄比亚公共卫生研究所数据库中提取回顾性霍乱病例数据。研究了WaSH与HH的社会人口统计学/经济水平之间的关系。使用地理空间映射在kebele级别描述了WaSH状态和霍乱发作率（AR），并对其关联进行统计学分析。
结果：获得基本饮用水，卫生，卫生设施有限，67.5%(95%置信区间，64.4-70.6),73.4%（70.3-76.3），30.3%(27.3-33.3)的HHs可以进入，分别。更好的WASH实践与城市居住相关(调整后的优势比，1.7，[95%置信区间，1.1-2.7]),更高的教育水平（2.7[1.2-5.8]），和财富（2.5[1.6-4.0]）。霍乱ARs与至少基本WaSH状态之间的关联没有统计学意义（倍数R2=0.13；P=0.36），尽管建议对卫生设施有局部影响（MoranI=0.22；P=0.024）。
结论：解决WaSH获取和卫生习惯方面的差距对于降低霍乱风险至关重要。有意义的协变量和增加样本量的进一步分析对于了解霍乱AR和特定WaSH成分之间的关联是必要的。
方法：我们对ShashemeneTown和ShashemeneWoreda的870名HH进行了横断面家庭（HH）调查，同时从埃塞俄比亚公共卫生研究所数据库中提取回顾性霍乱病例数据。研究了WaSH与HH的社会人口统计学/经济水平之间的关系。使用地理空间映射在kebele级别描述了WaSH状态和霍乱发作率（AR），并对其关联进行统计学分析。
结果：获得基本饮用水，卫生，卫生设施有限，67.5%(95%置信区间，64.4-70.6),73.4%（70.3-76.3），30.3%(27.3-33.3)的HHs可以进入，分别。更好的WASH实践与城市居住相关(调整后的优势比，1.7，[95%置信区间，1.1-2.7]),更高的教育水平（2.7[1.2-5.8]），和财富（2.5[1.6-4.0]）。霍乱ARs与至少基本WaSH状态之间的关联没有统计学意义（倍数R2=0.13；P=0.36），尽管建议对卫生设施有局部影响（MoranI=0.22；P=0.024）。
结论：解决WaSH获取和卫生习惯方面的差距对于降低霍乱风险至关重要。有意义的协变量和增加样本量的进一步分析对于了解霍乱AR和特定WaSH成分之间的关联是必要的。
