Prevalence and Determinants of Acute Gastrointestinal Illness among Irrigation Farmworkers in Gelan Farm Sites, Sheger City, Ethiopia Iyasu Gudisa, Bezatu Mengistie, Adey Feleke Desta, Haile Alemayehu, Sirak Robele Gari Environmental Health Insights, 2026 The health risk of exposure to the Akaki River water remains an underrecognized issue among irrigation farmworkers at Gelan Farm Sites. To show the risk, this study assessed the prevalence and determinants of acute gastrointestinal illness (AGI) among these workers. A cross-sectional survey study was conducted between December 13, 2023, and January 8, 2024, within 296 randomly selected farmworkers aged 18 years and above who had been actively engaged in irrigation farming for at least a month. Totally, the prevalence of AGI was about 23% (95% CI: 18.2%-27.8%). In this study, factors such as being married, older age, higher education level, farming experience, and handwashing awareness were protective. The interaction between farming experience and safe water sources, were also protective. On the other hand, residing on the farmland, using untreated river water for cooking, unintentional ingestion of irrigation water, and interaction of river water use with limited access to clean water were AGI-exacerbating factors. For intervention, access to clean water, sanitation facilities, and health education are needed to protect the health and productivity of the workers.
Indicator Bacteria-Based Assessment of Microbial Contamination with Wastewater-Agriculture-Health Nexus: Implication for Irrigation Water Safety in Gelan, Ethiopia Iyasu Gudisa, Bezatu Mengistie, Adey Feleke Desta, Haile Alemayehu, Sirak Robele Gari Environmental Health Insights, 2026 Urban rivers in rapidly urbanizing low-income countries frequently receive untreated wastewater, converting downstream irrigation systems into persistent exposure interfaces within a wastewater-agriculture-health nexus. This study quantified Escherichia coli and total coliform concentrations in irrigation water from 16 sites along the Akaki and Dongora Rivers in Gelan, Ethiopia, over 7 weeks (n = 112) using membrane filtration on CHROMagar™ ECC to assess spatiotemporal fecal contamination loads. Indicator bacteria were detected at all locations, with concentrations routinely surpassing internationally accepted limits for irrigation water by several orders of magnitude. The Escherichia coli concentrations ranged from 1.10 × 10 5 to 2.82 × 10 6 CFU/100 mL and total coliforms from 1.13 × 10 5 to 2.95 × 10 7 CFU/100 mL, with Akaki River loads substantially higher than the Dongora River ( P < .05), suggesting spatial variance from distinct contamination sources. Conceptually, exceedances position the irrigation corridor in a high-risk exposure domain, where regular agricultural activities may enhance occupational and foodborne transmission. While indicator bacteria do not directly quantify pathogen risk, their magnitude indicates elevated public health vulnerability. The site-specific evidence emphasizes the need for risk for health-based monitoring, including continuous microbial surveillance, and farm-level exposure reduction strategies to safeguard livelihood and downstream environmental health.
Prevalence, microbiological profiles, and determinants of hospital-acquired pneumonia in Addis Ababa: A focus on Pseudomonas aeruginosa and its antimicrobial resistance patterns in three hospitals Etsub Brhanesilassie Hailemichael, Adey Feleke Desta, Girma Taye, Sirak Robele Gari, Etsehiwot Adamu, et al. Plos One, 2026 Hospital-acquired pneumonia is typically polymicrobial; nevertheless, Pseudomonas aeruginosa is a principal causative pathogen, attributable to its link with poor clinical prognoses and extensive antimicrobial resistance. Our study aims to assess the prevalence, microbiological profiles and determinants of hospital-acquired pneumonia with a focus on antibiotic-resistant P. aeruginosa across three hospitals in Addis Ababa. A cross-sectional study was conducted in which 1,800 patients were screened, and 298 cases of hospital-acquired pneumonia were identified between September 2022 and April 2024. Patient interviews and microbiological analysis of lower respiratory tract samples were performed. We detected a 17% prevalence of hospital-acquired pneumonia and 19% prevalence of ventilator-associated pneumonia across the study hospitals. Our patient profiles indicated a predominance of males (59%), with the largest proportion aged 30–39 years (28%), most were married (71%) and had attained secondary-level education (33%). Over half of the patients were admitted to the adult ICU (55%), 60% had a history of prior hospitalization and respiratory disease was the leading cause of admission (30%). Acinetobacter baumannii (n = 24) was the most frequently isolated pathogen, followed by Pseudomonas aeruginosa (n = 21) and Staphylococcus aureus (n = 13). Compounding these challenges, the P. aeruginosa isolates (7%) exhibited high resistance to ceftazidime and cefepime (89% resistance), while retaining relatively high susceptibility to amikacin (90%); notably, 67% of the isolates were multidrug resistant. We tested several patient-level vulnerabilities, only aspiration remained independently associated with presence of pneumonia-associated pathogen in patient samples (AOR = 4.43, 95% CI: 1.74–11.24, p = 0.002). This study demonstrates a substantial burden of multidrug resistance hospital-acquired pneumonia by ESKAPE pathogens that indicate deficiencies in hospital defences against hospital-acquired pathogens and risk of adverse patient outcomes. There is an urgent need to shift infection prevention strategies, emphasizing aspiration prevention measures and strengthened diagnostic stewardship.
Water management practices and antibiotic-resistant Pseudomonas aeruginosa contamination in Ethiopian tertiary hospitals: implications for waterborne healthcare-associated infections Etsub Brhanesilassie Hailemichael, Adey Feleke Desta, Girma Taye, Sirak Robele Gari, Amare Alemu, et al. Journal of Water and Health, 2025 The threat of healthcare-associated infections is significantly heightened when caused by drug-resistant pathogens. This study evaluates water management practices and prevalence of antibiotic-resistant Pseudomonas aeruginosa in water systems of two tertiary hospitals of Ethiopia. We employed a mixed-methods approach, combining the qualitative data thematic analysis with quantitative microbiological results from 120 potable water samples. P. aeruginosa isolates were identified and subjected to antimicrobial susceptibility testing. Data collection was conducted between December 2023 and January 2024. The findings indicate that neither hospital had a dedicated water management programme for preventive maintenance. Microbial analysis revealed a 16% prevalence of P. aeruginosa in the water samples, with 26.3% of isolates demonstrating resistant to at least one antibiotic class. Notably, two isolates from the maternity ward of Hospital A exhibited multidrug resistance (MDR) to ciprofloxacin, amikacin, and imipenem. Overall, the structural and operational standard of the water management programmes in both hospitals were found to be non-conformant to international standards. A higher rate of Pseudomonas positivity, including resistant and MDR strains, indicates persistent hospital water contamination and a tangible risk for HAIs. These results underscore the critical need for the formation of multidisciplinary water safety team to optimize water quality management in these hospitals.
Contribution of wastewater irrigated vegetables to the prevalence of soil-transmitted helminth infection among female farmers in Addis Ababa, Ethiopia Bethlhem Kinfu Gurmassa, Sirak Robele Gari, Ephrem Tefera Solomon, Michaela L. Goodson, Claire L. Walsh, et al. Tropical Medicine and Health, 2024 Background Untreated or inadequately treated wastewater carrying human feces can host helminth eggs and larvae, contaminating the soil and plants that are irrigated with it. In Addis Ababa, farmers use untreated wastewater to grow vegetables; however, there are little data currently available published on vegetables' contribution to the prevalence of helminth among female farmers along the Akaki River, in Addis Ababa, Ethiopia. Methods A cross-sectional study was conducted in Addis Ababa City in February 2022. A stratified random sampling method was used to sample farming households. The sample size for each district was determined by a proportional allocation to the total number of households in the area. Two hundred and fifty-two composite vegetable samples and 101 farmers’ stool samples were collected and analyzed for helminth prevalence. Data on socio-demographics were collected by trained data collators using a structured questionnaire. Kato-Katz concentration was used to detect STH from a stool sample. Stata version 14.0 was used to process the data. Poisson regression was used to identify the association between STH prevalence in the vegetable and the farm's stool. Results Helminths were found in 67.5% of vegetables sampled and 20.8% of female farmers' stools. Ascaris lumbricoides eggs (vegetable 48.4% and stool 9.9%) were identified in all analyzed samples. Hookworm eggs (vegetable 13.1% and stool 8.9%) and Trichuris trichiura eggs (vegetable 5.9% and stool 2%) were also isolated. The total number of helminth eggs present in wastewater-irrigated vegetables and female farmers’ stool had a positive association (p < 0.05) with a regression coefficient of 1.92 (95% CI = 1.56–2.28). Conclusions The study found a significant prevalence of helminth infections, particularly Ascaris lumbricoides, in stool and vegetable samples irrigated with wastewater. A clear association was found between vegetable production and a higher prevalence of helminth infections among female farmers. Therefore, it is important to ensure that farmers are educated in the importance of food washing and sanitation/hygiene practices when using wastewater irrigation for vegetable crops. Graphical Abstract
Building an integrated analytical framework: a new methodology to analysing social-ecological systems SR Gari, A Newton, JD Icely Journal of Environmental Planning and Management 69 (5), 1317-1345 , 2026 2026 Citations: 2
Indicator Bacteria-Based Assessment of Microbial Contamination with Wastewater-Agriculture-Health Nexus: Implication for Irrigation Water Safety in Gelan, Ethiopia I Gudisa, B Mengistie, AF Desta, H Alemayehu, SR Gari Environmental Health Insights 20, 11786302261443018 , 2026 2026
Factors influencing access to advanced sanitation service level and drinking-water quality in healthcare facilities in Addis Ababa, Ethiopia: a convergent sequential study MT Retta, SR Gari, BM Alemu, A Ambelu Applied Water Science , 2026 2026
Prevalence and Determinants of Acute Gastrointestinal Illness among Irrigation Farmworkers in Gelan Farm Sites, Sheger City, Ethiopia I Gudisa, B Mengistie, AF Desta, H Alemayehu, SR Gari Environmental Health Insights 20, 11786302261423280 , 2026 2026
Prevalence, microbiological profiles, and determinants of hospital-acquired pneumonia in Addis Ababa: A focus on Pseudomonas aeruginosa and its antimicrobial … EB Hailemichael, AF Desta, G Taye, SR Gari, E Adamu, Z Ayenew, ... PloS one 21 (1), e0340680 , 2026 2026 Citations: 1
Determinants of access to advanced water service level in healthcare facilities located in Addis Ababa, Ethiopia: a cross sectional study MT Retta, SR Gari, BM Alemu, A Ambelu Discover Public Health 22 (1), 1-16 , 2025 2025
Water management practices and antibiotic-resistant Pseudomonas aeruginosa contamination in Ethiopian tertiary hospitals: implications for waterborne … EB Hailemichael, AF Desta, G Taye, SR Gari, A Alemu, W Gobena, ... Journal of Water and Health 23 (10), 1180-1195 , 2025 2025
Physicians’ degree of awareness regarding the risks, clinical practices, and management challenges of nosocomial legionnaires’ disease: A cross-sectional study from two … EB Hailemichael, AF Desta, G Taye, SR Gari, S Biadgilign, W Amogne SAGE Open Medicine 13, 20503121251344144 , 2025 2025
Incidence of diarrhea and risk factors among wastewater-irrigating urban farmers along Akaki Rivers in Addis Ababa AS Ali, SR Gari, ML Goodson, CL Walsh, BK Dessie, A Ambelu International Journal of Environmental Health Research 35 (4), 909-921 , 2025 2025 Citations: 1
Corrected Proof AM Girmay, SR Gari, AG Gebremariam, BM Alemu, MR Evans, ... 2025
Prevalence and risk factors of soil transmitted helminths among vegetable farmers of Akaki river bank, Addis Ababa, Ethiopia BK Gurmassa, SR Gari, ET Solomon, ML Goodson, CL Walsh, BK Dessie, ... BMC Infectious Diseases 24 (1), 961 , 2024 2024 Citations: 15
Solid waste management service chain and sanitation safety: a case study of existing practice in Addis Ababa, Ethiopia SF Sisay, SR Gari, A Ambelu Frontiers in Environmental Engineering 3, 1414669 , 2024 2024 Citations: 17
Fecal sludge management and sanitation safety: an assessment in Addis Ababa, Ethiopia SF Sisay, SR Gari, A Ambelu Environmental Health Insights 18, 11786302241267187 , 2024 2024 Citations: 14
The nexus between household water insecurity, mother's handwashing practices, and diarrheal diseases among under-five children AA Aydamo, SR Gari, ST Mereta Journal of Water and Health 22 (8), 1357-1371 , 2024 2024 Citations: 9
Contribution of wastewater irrigated vegetables to the prevalence of soil-transmitted helminth infection among female farmers in Addis Ababa, Ethiopia BK Gurmassa, SR Gari, ET Solomon, ML Goodson, CL Walsh, BK Dessie, ... Tropical Medicine and Health 52 (1), 41 , 2024 2024 Citations: 6
Water safety practices along the water service chain in Addis Ababa: a cross-sectional study in a cosmopolitan city SF Sisay, SR Gari, A Ambelu Environmental Health Insights 18, 11786302241235006 , 2024 2024 Citations: 9
Distribution of helminth eggs in environmental and stool samples of farming households along Akaki River in Addis Ababa, Ethiopia BK Gurmassa, SR Gari, ET Solomon, ML Goodson, CL Walsh, BK Dessie, ... Tropical Medicine and Health 51 (1), 67 , 2023 2023 Citations: 9
Prevalence and risk factors of childhood diarrhea among wastewater irrigating urban farming households in Addis Ababa AS Ali, SR Gari, ML Goodson, CL Walsh, BK Dessie, A Ambelu Plos one 18 (11), e0288425 , 2023 2023 Citations: 8
The impact of wastewater-irrigated urban agriculture on microbial quality of drinking water at household level in Addis Ababa, Ethiopia AS Ali, SR Gari, ML Goodson, CL Walsh, BK Dessie, A Ambelu Urban Water Journal 20 (9), 1207-1218 , 2023 2023 Citations: 5
Access to drinking water, sanitation, and hand hygiene facilities in the peri-urban and informal settlements of Hosanna Town, Southern Ethiopia AA Aydamo, SR Gari, ST Mereta Environmental health insights 17, 11786302231193604 , 2023 2023 Citations: 26
MOST CITED SCHOLAR PUBLICATIONS
A review of the application and evolution of the DPSIR framework with an emphasis on coastal social-ecological systems SR Gari, A Newton, JD Icely Ocean & coastal management 103, 63-77 , 2015 2015 Citations: 625
A DPSIR-analysis of water uses and related water quality issues in the Colombian Alto and Medio Dagua Community Council SR Gari, CEO Guerrero, A Bryann, JD Icely, A Newton Water Science 32 (2), 318-337 , 2018 2018 Citations: 95
An analysis of the global applicability of Ostrom’s design principles to diagnose the functionality of common-pool resource institutions SR Gari, A Newton, JD Icely, MM Delgado-Serrano Sustainability 9 (7), 1287 , 2017 2017 Citations: 80
Association between microbial water quality, sanitation and hygiene practices and childhood diarrhea in Kersa and Omo Nada districts of Jimma Zone, Ethiopia NE Soboksa, SR Gari, AB Hailu, BM Alemu Plos one 15 (2), e0229303 , 2020 2020 Citations: 65
Determination and health risk assessment of trace elements in the tap water of two Sub-Cities of Addis Ababa, Ethiopia BK Dessie, SR Gari, A Mihret, AF Desta, B Mehari Heliyon 7 (5) , 2021 2021 Citations: 59
Handwashing effect on diarrheal incidence in children under 5 years old in rural eastern Ethiopia: a cluster randomized controlled trial ET Solomon, SR Gari, H Kloos, BM Alemu Tropical medicine and health 49 (1), 26 , 2021 2021 Citations: 57
Water supply, sanitation and hygiene interventions and childhood diarrhea in Kersa and Omo Nada districts of Jimma Zone, Ethiopia: a comparative cross-sectional study NE Soboksa, AB Hailu, SR Gari, BM Alemu Journal of Health, Population and Nutrition 38 (1), 45 , 2019 2019 Citations: 50
Childhood malnutrition and the association with diarrhea, water supply, sanitation, and hygiene practices in Kersa and Omo Nada Districts of Jimma Zone, Ethiopia NE Soboksa, SR Gari, AB Hailu, B Mengistie Alemu Environmental Health Insights 15, 1178630221999635 , 2021 2021 Citations: 49
Barriers of persistent long-lasting insecticidal nets utilization in villages around Lake Tana, Northwest Ethiopia: a qualitative study A Malede, M Aemero, SR Gari, H Kloos, K Alemu BMC public health 19 (1), 1303 , 2019 2019 Citations: 44
Determinants of sanitation and hygiene status among food establishments in Addis Ababa, Ethiopia AM Girmay, SR Gari, B Mengistie Alemu, MR Evans, AG Gebremariam Environmental Health Insights 14, 1178630220915689 , 2020 2020 Citations: 41
The importance of water quality in classifying basic water services: the case of Ethiopia, SDG6. 1, and safe drinking water ST Gemeda, E Springer, SR Gari, SM Birhan, HT Bedane PLoS One 16 (8), e0248944 , 2021 2021 Citations: 34
Meta-analysis of public health risks of lead accumulation in wastewater, irrigated soil, and crops nexus AS Ali, AA Bayih, SR Gari Frontiers in public health 10, 977721 , 2022 2022 Citations: 33
Evaluation of toxic elements in nails of tannery workers in Addis Ababa, Ethiopia BK Dessie, S Melaku, SR Gari, BT Ayele, AF Desta, A Mihret Microchemical Journal 159, 105589 , 2020 2020 Citations: 31
Diarrheal disease and associated behavioural factors among food handlers in Addis Ababa, Ethiopia AM Girmay, SR Gari, BM Alemu, MR Evans, AG Gebremariam AIMS Public Health 7 (1), 100 , 2020 2020 Citations: 31
Urban health extension service utilization and associated factors in the community of Gullele sub-city administration, Addis Ababa, Ethiopia AM Girmay, MR Evans, SR Gari, AG Gebremariam, MT Reta Int J Community Med Public Health 6 (3), 976-985 , 2019 2019 Citations: 31
Diarrheal morbidity and predisposing factors among children under 5 years of age in rural East Ethiopia ET Solomon, SR Gari, H Kloos, B Mengistie Tropical medicine and health 48 (1), 66 , 2020 2020 Citations: 30
Determinants of drinking water quality and sanitary risk levels of water storage in food establishments of Addis Ababa, Ethiopia AM Girmay, SR Gari, GT Gessew, MT Reta Journal of Water, Sanitation and Hygiene for Development 11 (5), 831-840 , 2021 2021 Citations: 29
Access to drinking water, sanitation, and hand hygiene facilities in the peri-urban and informal settlements of Hosanna Town, Southern Ethiopia AA Aydamo, SR Gari, ST Mereta Environmental health insights 17, 11786302231193604 , 2023 2023 Citations: 26
Exposure and carcinogenic risk assessment of trihalomethanes (THMs) for water supply consumers in Addis Ababa, Ethiopia N Tafesse, M Porcelli, BB Hirpessa, J Gasana, RK Padhi, SR Garie, ... Toxicology Reports 10, 261-268 , 2023 2023 Citations: 26
Fecal contamination in the wastewater irrigation system and its health threat to wastewater-based farming households in Addis Ababa, Ethiopia AS Ali, SR Gari, ML Goodson, CL Walsh, BK Dessie, A Ambelu Environmental health insights 17, 11786302231181307 , 2023 2023 Citations: 25