Determinants of cholera among affected population of Ethiopia: a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: In Ethiopia, cholera is still a serious public health concern, and outbreaks are frequently caused by a lack of safe drinking water, sanitation, and hygiene (WASH) facilities. Very few nationally representative studies from Ethiopia exist, despite the global determinants of cholera being widely known. Therefore, this study aimed to identify the key determinants of cholera outbreaks across various regions in Ethiopia. METHODS: We conducted a systematic review and meta-analysis following the PRISMA and MOOSE guidelines, and the study was registered on PROSPERO (CRD420251035681). We included English observational studies (both cross-sectional and case-control studies) on the determinants of cholera in Ethiopia, regardless of the publication year. Using MeSH terms and Boolean operators, searches were conducted throughout PubMed, Web of Science, EMBASE, SCOPUS, MEDLINE, CINAHL, and gray literature. The Newcastle-Ottawa Assessment Scale was used to evaluate the quality of each featured article. STATA version 17 and Microsoft Excel 2013 were used for data extraction and analysis, respectively. A random-effects model was used for the meta-analysis, and heterogeneity was assessed using the Cochrane Q statistic and I2 statistic. Furthermore, publication bias was identified using Egger’s test (p < 0.05) and/or visually inspecting the asymmetry of the funnel plot. RESULTS: The search strategy retrieved 1701 articles, leaving 805 after duplicates were removed. After screening, 62 were eligible; however, 53 papers were removed due to the outcome of interest not being reported. For the final analysis, nine studies, eight case-control studies, and one cross-sectional study were examined. Key determinants for cholera in Ethiopia included not using sanitary latrines (AOR: 3.52; 95% CI: 1.40–5.65), drinking untreated water (AOR: 3.03; 95% CI: 1.62–4.45), and proper handwashing practices (AOR: 0.16; 95% CI: 0.01–0.30). CONCLUSION: Access to safe drinking water, the use of sanitary latrines, and proper handwashing practices are key determinants of cholera in Ethiopia. Therefore, strengthening WASH interventions and promoting behavior change are essential strategies for cholera prevention and control. CLINICAL TRIAL NUMBER: Not applicable.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.033 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.035 |
| Bibliometrics | 0.011 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".