JIMMA UNIVERSITY

COLLEGE OF NATURAL SCIENCE

DEPARTMENT OF BIOLOGY

PREVALENCE OF WATER BORNE DISEASE AND RELATED FACTORS AMONG

PATIENT VISITED IN HARO HEALTH CENTER, MANNA DISTRICT, JIMMA
ZONE, SOUTH WEST ETHIOPIA

BY: MESKEREM BESHA

ADVISOR: Ms. TAMENE BELUDE

A SENIOR PROJECT SUBMITTED TO DEPARTMENT OF BIOLOGY IN PARTIAL

FULFILLMENT THE BACHELOR DEGREE IN BIOLOGY.

JUNE, 2016

JIMMA, ETHIOPIA

1
COLLEGE OF NATURAL SCINCE

DEPARTEMENT OF BIOLOGY

A REASERCH OF THE SENIOR IN PARTIAL FULFILMENT TO THE

REQURUIREMENT FOR THE BACHELOR DEGREE IN BIOLGY

PREVALENCE OF WATER BORNE DISEASE AND RELATED FACTORS AMONG

PATIENT VISITED IN HARO HEALTH CENTER, MANNA DISTRICT, JIMMA
ZONE, SOUTH WEST ETHIOPIA.

BY; MESKEREM BESHA.

ADVISOR; MR; TAMENE BELUDE.

2
Content Phage

Table content I

Abstract II

List of table .III

Abbreviation

IVIntroduction .1.2

Statementofproblem ..1.3 hypothesis

.3

3
1.4 Objective of the study .....3

1.4.1 General objective ..3

1.4.1 Specific objective ...3

1.5 Significant of the study ....3

2 Literature review 4

2.1 Prevalence of water borne disease .4

2.2 Water borne disease 5

2.3 The most common types of water borne disease 12

2.4 Common symptoms of water borne disease ...12

2.5 Source of contamination and made of transmission and made of transmission 13

2.6 Prevention of water borne disease .....13

2.6.1 Safe drinking water ...14

2.6.1 health education ..14

2.6,3 Sanitation .....14

2.7 Treatment of water borne disease 14

3 Methodology 15

3.1 Description of study area 15

3.2 Study design 15

3.3 Study population 15

3.4 Data collection .15

3.5 Sampling technique ..16

3.6 Data analysis and interpretation .16

3.7 Ethical consideration ... ..16

4.Result and discussion ..

4
4.1 Discussion

5.Conclusion and recommendation ...

5.1 . Recommendation

List of table

Table1;Microbial agent, Source of agent in water and general symptoms of protozoan infection
8

Table2; Microbial agent, source of agent in water and general symptoms of bacterial infection
..9

Table3; Microbial agent, source of agent in water and general symptoms of parasitic infection
.10

Table4; Microbial agent; source agent in water and general symptoms of viral infection
.. ...

Table5;The prevalence of water borne disease in Haro Health center in 2006E.C

......

Table6;Prevalence of water borne disease in Haro Health center in 2007E.C

.

Table7; Trends of water borne disease and causative agent in Haro Health center between 2006-
2007E.C .

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Abbreviation

WHO- World health organization.

UNWWDR- Nation Worldwide Development report.

DALYS- Disability Adjusted Life Years.

EDEP- Ethiopia Dracunculisis Erudition program.

Acknowledgement

I would like to thanks to my lord without his help all this would have been
impossible.
All my heart goes to thank my advisor Mr. Tamene Belude for his continuous
assistance with relevant description to complete this research and my friends who
help me by many things.
I would like to thank my families for their economical support, moral and by
fulfilling the basic necessities that are essential for doing this research throughout
the year.
I would thanks to Haro Kebele health center workers who gave me secondary data
and some information about water borne diseases.
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 I also want to thank Jimma University for providing us an opportunity to use
internet access.

Abstract

Water borne diseases are disease that can spread through contaminated water.
The contamination involves bacteria, viral and parasite. Water-borne disease
cause many health problems to human around the world. The problems are
common in developing country like Africa. Water borne disease was the one that
causes for morbidity and infant mortality in Ethiopia. About 300,00 children under
the age of 5 die every year in Ethiopia. Persons may be affected by drinking
contaminated water directly or through food and use for the purpose of personal
hygiene and recreation. The objective of the study was to assess the prevalence of
water borne disease and related factors. In this study, secondary data was used to
collect necessary information from Haro health center .Sample technique used in
this study was convenience technique and data was analyzed by using table and
percentage. The result show that prevalence of water borne disease in Haro
health center in past two year(2006-2007) was 94.6%. This indicate that in past
two year prevalence of water borne disease was higher than other disease. The
major causative agent was bacteria 1388 (69.33%) followed by parasite 379
(18.93%) and the least causative agent is viral 235 (11.73%). The study indicate
that the prevalence of water borne disease was high in 2006 E.C in age group 1-10

7
male (65.35) and the least affected was female 1-10 age group (34.65%). This
study indicates that prevalence of water borne disease high in 2006 (51.65%) and
low in 2007 (48.35%) this means the prevalence of this disease became decreases.

Key Words; Water borne disease, prevalence, pathogen, water, contaminate

CHAPTER ONE

1. INTRODUCTION

Water borne diseases are disease that can spread through contaminated water.
Contamination can involve bacteria, viruses or protozoa organism. Some example
of water borne disease includes cholera, dysentery (bacteria or amoeba), and
cryptosporidiosis (protozoa) hepatitis A (virus ) and Giardiasis (protozoa).
Infection can result not only from drinking the water but also from slimming
in the water where it can inter the body other ways such as through broken
skin (Shears1995).
Prevalence of water born disease is related to poor hygiene and inadequate
sanitary condition as well as polluted environmental condition. Number of
disease caused by human consumption of impure water is preventable if proper
health and sanitation standards are enforced (Lattimore,1928 and
France,2002). In developing countries four fifth of all the illness are caused by
water borne disease with diarrhea being the leading cause of childhood death
(WHO,20000).The global picture of water and health has a strong local dimension
with some 1.1 billion people still leaking access to improved drinking water
sources and some 2 billion to adequate sanitation. Today we have strong evidence
that water sanitation and hygiene related disease account for some 221300 deaths

8
annually and annual loss of 28196000 disability adjusted life years (DALYS)
(Bas,2014).
Micro-organism causing diseases that characteristically are water borne
predominantly include protozoa and bacteria, many of which are intestinal
parasites or invade the tissue or circulator system through walls of the digestive
tract . Various other water borne diseases is caused by viruses (Jalopy et al., 1996).

Another class of water-borne metazoan pathogens certain members of the

schistomatidae, a family of food flukes. They usually infect victims that make skin
contact with water. Blood flukes are pathogens that cause schistosomiasis of
various forms, more or less seriously affecting hundreds of millions of peoples
worldwide (Brunette and Gary, 2012).
Long before modern studies had established the germ theory of diseases or any
advanced understanding of the nature of water as a vehicles for transmitting
diseases, traditional beliefs had caution (mistakes) against the consumption of
water rather favoring processed beverages such as beer, wine, and tea.
Many poorer counters have limited uncontaminated water supplies so water
borne disease is a huge health issue worldwide (WHO, 2014).

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1.2. STATEMENT OF THE PROBLEM

Water-borne diseases are viral, Bacteria and parasitic diseases which use water as a
common means of transmission. Water-borne disease cause serious health
problem over the world wide. According to WHO report every year more than 3.4
million people die as a result water borne disease. Most of the majority of who
die of illness caused by organisms that thrive in water source contaminated by raw
sewage (WHO, 2000).
WHO estimates indicate that worldwide over 2 billion people are affected with
schistosomes and soil transmitted helminthes of these suffer serious illnesses as a
result (Bal,2004).Water borne diseases many serious health problem human
around the world. The problem has where significance to the developing and
develop world, particularly in Africa. Asia and south America (WHO, 2000).
The water related diseases have basically prevalent in developing countries.
However it is a major problem with Africa villages, with a death billion from
diarrhea each year, lack of clean is what brings this result , unclean
water is responsible for additional disease such as cholera, guinea, typhoid
and intestinal worm, which kill more than 8 million people throughout the
world each year(WHO,2000). So , this study was assess the prevalence of
water borne disease and answer the following question:

1. What is prevalence of water borne disease?

2. Water are causative agent of water borne disease?

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3. What is the majority source of water contamination and how people prevent this
contamination of water to reduce water borne disease?

1.4. Objective

1.4.1. General objective

►To assess the prevalence of water borne disease among patient visited in

Haro health center in the past two years (2014 & 2015)

1.4.2. Specific objectives

 To identify major source of water contamination in the study area.

 To identify the major causative agent of water borne disease in the
study area.

1.5. Significance of the study

The significance of the study was to reduce the prevalence of water borne disease
and water related disease. These studies added new information on the existing
knowledge on how to reduce water borne diseases.

1.5. Limitation of the study

The limiting factors that can be encountered during conducting the study ,
time constraint was, transportation problems and lack of enough money. In
addition to this limitation there is also lack of facilities such as internet
access to get up date ( recent ) information regarding water borne diseases.

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2. Literature review

The term water borne disease is stand largely for infection that predominantly are
transmitted through contact with consumption of infected water. Trivially many
infections may be transmitted by microbes or parasite that accidently , possibly as
a result of exceptional circumstances have enter they water, but the fact that there
might be an occasional freak infection need not mean that it is useful to categorize
the resulting disease as water borne .Nor it common practice to refer to disease
such as malaria as water borne disease ease just because of treating the war they
inhibit happens to be an effective strategy in control of the mosquitoes that are the
vector (Savory etal,1996).
Public health is the science and art of preventing disease, prolonging life and
promoting health through the organized efforts and informed choices
society,0rganization , public and private, communities and individual (Winslow
and Charles ,2009).
Public health incorporate the interdisciplinary approaches epidemiology, biostatics
and health services. Environmental health, community health, behavioral health,
health economic, public policy, insurance, medicine and occupational health
(Winslow and Charles,1920).
The focus of public health intervention is improve health and faulty of life
through the prevention and treatment of disease and other physical and mental
health condition. Via surveillance of case and health indicator and through
promotion of health behavior (Winslow and Charles,1920).
2.1 Prevalence of water borne disease

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Water borne disease are caused by pathogenic micro-organism, that most common
are transmitted in contaminated fresh water. Infection commonly results during
bathing, drinking, in the preparation of food or the consumption food thus
infected most prominent examples and affects mainly children in developing
counties according WH0, such disease account for an estimate 4.1% of the total
DALYs global burden of disease, and cause about 1.8 million human deaths
annually. The WHO estimates that 88% of that burden is to unsafe water supply,
sanitation and hygiene (WHO,2014).
Many infection diseases are associated with facially contaminated water and are
major cause of morbidity and mortality worldwide. Water borne disease are caused
by enteric pathogen such as bacteria, viruses ,and parasites that transmitted by the
faucal oral routes (Gabo, 1996 and Luceroital., 2002).Water borne spread of
infection by these pathogenic micro- organisms depend on several factors such as:
The survival of these micro-organisms in water environment the infection of the
micro-organisms required to cause a disease in susceptible individual quality of
the water, the presence or absence of water treatment and he season of year(Dteez
etal, 1984 and Lenclos etal,2002).
Water borne disease can have significant impact on the economic, locally as well
as internationally. People who are infected by water borne disease are usually
comforted with related cost seldom with a huge financial burden. This is
especially the case in less developed countries. The financial losses are mostly
caused by e.g. costs for medical treatment and medication, costs for transport,
special food, and by the loss of man power. Many families must even sell their
land to pay for treatment in a proper hospital. On average, a family spends about
10% of the mouthy households income person infected (Schnabel and Bastian,
2004).

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2.2 Water borne disease

Water borne pathogen would encompass and protozoan all bacteria and virus. The
abundance and the prevalence of pathogens depend on the source and the types of
water environment. Water borne faucal pathogens are micro-organisms that can
occur in water as a result f contamination from human or animal faces and cause
gastrointestinal illness. They are often associated with bacteria from the enter
bacteriaceae family. Water borne out breaks of gastrointestinal family illness
include pathogenic E coli, salmonella, shigeua, compile bacteria, and Virginia
Water pathogens which require an obligate intermediate host such as schist soma
species (Percival ital., 2004).
Water borne disease is major causes of morbidity and mortality world. In Ethiopia
sine a large majority of the rural population obtain their water supplies from un
protected sources such as streams, ponds, we us etc. Water borne disease .Are one
the most significant public health problems. A persons health may be affected by
ingestion of contaminated water directly or through food. One ’s health may also be
affected by the use of contaminated water for the purpose of personal hygiene and
recreation. The problem is especially acute where general hygiene and
environmental cogitation are poor and where there is inadequate supply of safe
water(WHO,1996).
Developing countries carry a heavy burden of water borne disease the heaviest
being the diarrhea disease. Diarrheal episode, occur in all countries, but they are
5to6 time more common in developing countries. The total number of diarrheal

14
episodes each year worldwide may be as high as 400 million and each year over3
million death may occur due to diarrheal disease (WHO,1996).

Diarrheal disease are the leading cause of mortality and morbid of children under
5 years of age. Estimated occurrence of diarrhea in developing countries accounts
for 5 episodes per child each year in children under 5 years of age. These young
children are most at risk of water borne disease because their immune system are
not full developed in additional their resistance may be father impaired by mal
nutrition (WHO,1996).

In 1998 a shigella epidemic in central America affected half a million people and
killed 20,000 in India (West Bengali) some years ago shigella caused morbidity
and mortality in 350,00 and 3800 people, respecting. Shigella still causes endless
human suffering in Bangladesh and other Alia, Latin America and Africa countries
(WHO,1996).
Typhoid fever occurs in parts of worldwide where water supply and sanitation a
sub- standard. It affect 17 million people worldwide in more than 600,000 deaths
almost 80% of these cases and deaths are in developing countries. Among 6
months to 12 years old children admitted to children hospital in Addis Ababa
between 1984 and 1996 with typhoid 25% developed intestinal perforation and
37% of those died (WHO, 1997).
Giardiasis occurrence is worldwide affecting to conducted in Ethiopia, it accounts
for a prevalence of between 2 and 11 percentage as recorded in some high land
communities nomadic pastoralist. Urban areas like Addis Ababa are equally
affected with a prevalence 90%recorded in some children (WHO, 1997).
In tropical and sub-tropical areas of the world, there are an estimated 4o300
million infections of amebiasis and 30.000 deaths annually. About 80,000 new
15
cases of amebiosis were reported by the Ethiopia ministry of health in 1988-89,
based on outpatient reports. The highest prevalence of amebiasis in Ethiopia was
found in hospital food handlers in a hospital in Addis Ababa 80% (WHO, 1997).
According to Ethiopia 2002 Dracunculialis eradication program (EDEP) guinea
worm endemic areas are Gambella and south omo. The number of cases
reported were 1252 in 1994,but by 2002 the number of cases fell to only 46(WHO,
198).
Cholera affects age groups. It is more common among the children less than 5
years of age and adults 25-39 years old. World cholera causes 120,000 death a
years. It is particularly deadly in Africa where epidemics have become more wide
spread and more frequent since the 19701. About 79 million people are estimated
to be currently a risk 0f cholera infection in Africa (WHO, 1996).
E coli is a common case of diarrhea worldwide. In addition, the morbidity of E coli
diarrhea is notable for its effects on child hood nutrition and development (WHO,
1996).
In regard to poliomyelitis, a total of 150 countries reported zero cases of
poliomyelitis, 30 countries reported greater than 10 cases, 27 countries from one to
ten cases and 7 countries failed to report. WHO estimated that approximately
80,000 cases of paralytic polio occurred in 1995, in 1996, 20,000 cases and about
7000 deaths were reported. Polio virus is still circulating widely in three specific
areas: 1st large densely populated areas such as Bangladesh, India, Nepal, Pakistan,
South ,Asia. 2nd The Democratic republic Congo, and Niger. 3rdEthiopian, Somalia,
and Sudan (Horn of Africa (WHO, 1998).

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Table 1 That shows disease, microbial agent, source of agent in water and
general symptom of protozoan infection.

Disease Microbial agent Source of agent in General symptom

17
 water

Protozoan Entamoeba Sewage, non-treated Abdominal

Amoebiasis histolytic drinking water flies in discomfort,
water supply Fatigue weight
loss, explosive
diarrhea,
bloating, fever
Protozoan Collects on water Flu-like
cryptospori Cryptosporidium filters and membrane symptoms,
diosis parvum . that can’t be watery diarrhea,
disinfected, Anima l loss of appetite,
manure, seasonal substantial loss
runoff water. of weight,
bloating
increased gas and
nausea.
Giardiasis Protozoan Giardia Unrelated water, poor Diarrhea,
lambia disinfection, pipe Abdominal
breaks, leaks, ground discomfort,
water contamination, bloating and
camp ground water flatulence
human and wild life
use the same source of
water.
Protozoan parasite Sewage, non, treated Cramps, nausea,
Cylosporia vomiting, muscle
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sis (cyclosporine drinking water aches fever and
fatigue

Source: Nwachcuku Nand Gerbacp 2004): Emerging water borne pathogen: can
we kill them all?

Table 2 that shows disease, microbial agent, source of agent in water and general
symptoms of bacterial infection.

Disease Microbial agent Source of agent in General symptom

water
Bacterium vibrio Drinking water Very watery
Cholera cholerae. contaminated with diarrhea, nausea,
bacterium. cramps, nose blood
vomiting, and
hypovolemic
shock
Certain strain of E. Water contaminated Mostly diarrhea
E.coli coli(commonly E. with bacteria. can cause death in
infection coli) immune
compromised
individual
Caused by genera Water contaminated Frequent passage
Dysentery shigella and with bacteria. of faces with blood
salmonella and mucus and
commonly some cases
vomiting of food.

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 Caused by many Drinking water Diarrhea, fever,
Salmonellosis bacteria of gens contaminated with vomiting,
salmonella. bacteria. abdominal cramps.
Salmonella typhoid Ingestion of Fever up to40ᵒc
Typhoid contaminated with profuse sweating:
fever feces of an infected diarrhea may
person. occurs symptoms
progress to
delirium and
spleen and develop
a rash called” rose
spots”
Source: Petrini R and Dziuban, EJ,etal (2006): mycobacterium marium; ubiquitous
agent of water borne granulo matus skin infection.

Table3 That shows disease, microbial agent, source of agent in water and general
symptoms of parasite infection.

Disease Microbial agent Source of agent in General

20
 water symptoms

Schistomiasis Member of the Fresh Blood in urine

genus schistosoma contaminated with (depending on the
certain types of types of
snails that carry infections) rash
schistosoma. or itchy skin
fever, chills,
cough and muscle
aches.
Dracunculiasis Dracunculus Stagnant Allergic reaction,
(Guinea worm medinensis containing larva urticarial, rash,
disease) generally in nausea, vomiting,
parasitized diarrhea,
copepoda Asthmatic attack
Tape worm of the Drinking water Intestinal
Taeniasis genus Tania contamination disturbance,neuro
with eggs. logic,
manifestation,
loss of weight
and cysticercoids.
Ascaris Drinking water Mostly
lumbricoides contaminated with Asymptomatic or
Ascarisis eggs accompanied by
inflammation,
fever diarrhea,

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 nausea.

Source: Dziuban EJ.Ling JI. Cvaum GF, Hiuv, Yu, PA, etal (2006): Surveillances
for water borne disease and out bleaks associated with recreational water-united
state,2003-2004)

Table 4.that shows disease, microbial agent, source of agent in water and general
symptom of viral infection

Disease Microbial Source of agent in General symptoms

agent water
Corona virus Manifest itself in Fever, myalgia,
Severe Acute improperly treated lethargy,
respiratory water gastrointestinal cough
syndrome(SARA) and sore throat

Hepatitis A Hepatitis A Can manifest itself in Symptoms include only

virus(HAU) food water or food acute( no chronic stage
to the virus) and
fatigue, fever.
Abdominal pain,
diarrhea, weight loss,
jaundice and
depression

Polio virus Enter water via the

Poliomyelitis feces infected 90-95% of patients

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(Polio) individuals. show no symptoms 4-
8% minor symptoms
headaches, fever and
occasional seizures and
spa tic paralysis,1%
have symptoms of non-
paralytic aseptic
meningitis. The rest
have serious symptoms
resulting paralysis or
death.

Source; Nwachuku, Gerba CP.Oswald A, tivation of adeno vmashed FB (2005:

Compare five in activation of Aden virus serotypes by light disinfection.

2.3 The most common types of water borne disease

Water borne disease includes typhoid fever and cholera which is cause by bacteria
and hepatitis A, which is caused by viruses.

An especially troublesome water borne disease is diarrhea caused by ingestion of

the protozoan Giardia lambia. The protozoan is problem is only in municipal
water, system, but also in mount aim stream, which are contaminated beavers and

23
other animals.Not all pathogen must be ingested to cause disease. Example, the
helmithes disease schistosomiasis is spread among person who swim or made in
water contaminated by human waste The pathogens are not usually ingested but
are in the form of swimming cercaria bore ( make hole) through skin.
(Nester,2009). Water borne disease is much bigger problem in both developed
and less developing countries. Example, typhoid fever occurs in all parts of the
world water supply and sanitation are substandard. It affects 17 million peoples
worldwide with more then, 600.000 deaths, almost 80% of these cases and deaths
re in developing countries (WHO,2000).

Water borne disease are caused by contaminated water, which is any water source
contains pathogenic micro- organisms. Among the many types of the micro-
organisms that may cause water borne disease are: protozoan, Bacteria. Intestinal
parasites and Viruses are the most common types(hemshaw,2011).

2.4. Common symptoms of water borne disease

The disease that cause by water borne have different symptoms but the most
common symptoms of water borne disease are:

Rash(an area of red spots or patches on the skin), fever (an abnormally high body
temperature and excitements, cough, headaches, abdominal pain, runny nose (semi
liquid and mucus flows through nose),Nausea 9feeling of sickness), Vomiting
pains and vision changes (Hurly,2002).

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Water borne illness scan cause a variety of symptoms. While diarrhea and
vomiting are the most commonly known symptoms of water borne iuness,
Other symptoms can include skin, ear, respiratory or eye problems
(Harcey,2002).

2. 5. Source of contamination and mode of transmission

Water borne disease spread by contamination of drinking water system

with the urine and feces of infected animals or people. This is likely to
occur where public and private drinking water system get their water from
surface water like rain creaks rivers lakes etc. Which can be contaminated by
infected animals or people (Henshaw,1998).

Run off from land, fields, sewer pipes, residential or industrial development can
also sometimes contaminated surface of water. This has been the cause of many
dramatic outbreaks of fecal oral disease such as cholera and typhoid: however,
there are money other ways in which fecal material can reach the mouth, for
example, on the hands the germ in faces causes by even slight contact and transfer.
This contamination may occur due to flows of waters, water run of from landfills
septic fields and sewer pipes (Henshaw, 1998).

The only way break the continue transmission is to improve the people hygiene
behavior and to provide them blithe certain basic need, drinking water, bathing
facilities and washing as well as sanitation (Henshaw,1998).

2.6. Prevention of water borne diseases

Clean water is pre- requisite for reducing the prevalence of water borne disease. It
is well recognized that the prevalence of water borne disease can be greatly

25
reduced by provision of clean drinking water and safe disposal of faces. The water
will be disinfected to kill any pathogen that may present from growing again in the
diminution system(UNWWDR,2011).

Disinfection will be used to prevent the growth of pathogenic organism and to

protect public health and the choice of the disinfected depends on the individual
water quality and supply system without disinfection the risk from water borne
disease will be increased. The two most common methods to kill micro-organism
in water supply are; oxidation with chemical such as chlorine, chlorine dioxide and
irradiation with ultraviolet radiation (UNWWDR, 2011).

2.6.1. Safe –drinking water

Piped water must be properly chlorinated and when an exposed water resource is
used for drinking .It should be protected from contamination by people and
animals. At home families should be encouraged to store drinking water in
covered container or one with narrow mouth to minimize contamination and
boiling water to kill shigella and other bacteria pathogen ( Sofia ’s and
Ayalew,2006).

2.6.2. Health education

Health education for general population should stress the following messages
concerning the utilization of water, hot drinking water spring , stream, river
before boiling and piped water before chlorinated and keep boiled water and clean
utensils separated from uncoiled utensils (Sofonia’s ND Ayelaw,20060.

26
2.6.3. Sanitation

Safe disposal of human excreta, according to the local circumstance and emphasis
should be given to the danger of building toilet above source of water and sanitary
system appropriate for local conditions should be constructed both for human and
other waste disposal (Sofonians and Ayalew)

2.7. Treatment of water borne disease

Water borne disease is resistant to common disinfection using chlorine treatment, it

can be inactivated by lengcoulact with chlorine or ultraviolet which exposure
between 16 mj/cm2 to 40 mj.cm2 commonly used water disinfectant concentration
and contact time cyst are relatively more resistant to disinfectants than bacteria and
high dose and lengthy contact times may be need. Edith ’s may result in high levels
of disinfection by product which are regulated by the EEPA(EEPA,2000).

3. Methodology

3.1 Description of study area

The study was conducted in Jimma zone Manna district Haro Keble. Haro Kebele
health center is one of the Kebeles health center found in Manna district and it is
geographically located around 32 km from Jimma town and 378 km south west of
Addis Ababa. It is bounded in south west by Gomma Werada and south east by
Sombo Manna Kebele, on the east by Dibe Bosona and north west by kella Gudda.
The total population number that lives in Haro Keble was around 7,324 and the

27
total number of male 3,720,and the women is 3604. The climate condition of Haro
Keble was covered with wet estimated mean annual temperature of maximum
28.8c and minimum11.4c respectively.

3.2. Study design and period

The retrospective study was conducted to determine the prevalence of water borne
disease among patient visited in Haro heath center in past two year(2006-2007)
and study from Nov to June(2016).

3.3. Study population

The source of population for this study was the patient visited in Haro kebele
health center in 2006-2007only.

3.4. Data collection

To get necessary data, secondary data was used to assess the prevalence of water
borne disease among patient visited in Haro health center in past two year. The
data was collected from recorded document in past two year(2006-2007)found in
Haro health center and from personal interview .

3.5. Sampling techniques .

The data was conducted by using convenient sampling technique

3.6. Data analysis and interpretation.

To analysis data or the study results appropriate statically tools like descriptive
statics such as percent, tables, and average are used after studying the area.

3.7. Ethical consideration

28
Formal later was written from JU college of natural science department of Biology
to the head of Haro Keble health center and permission from the staff members
was asked to conduct the study to obtain desired co-operational more ours, the
willingness of the respondents will required to give information during data
collection.

4 .Result and discussion

4.1. Results

4.1.1. Prevalence of water borne disease

Among a total of 4096 patient diagnosed in Haro health center for two consecutive
years 3876 of them were infected by water borne diseases. Water borne diseases
cases for each year of the study period were given in table 1 and 2 below.

Table 1. The prevalence of water-borne diseases in Haro Health center in 2006

E.c.

29
Age of Sex Total %
patient Male % Female %
<year 232 39.79 351 60.21 583 100
1-10 83 65.35 44 34.65 127 100
11-20 241 54.89 198 45.1 439 100
21-30 118 47 133 52.99 251 100
31-40 83 44.38 104 55.61 187 100
41-50 102 40.63 149 59.36 251 100
>50 76 46.34 88 53.65 164 100
Total 935 1067 2002

From the above table1the prevalence of water borne disease in 2006 E.C was high
as compared to 2007 E.C. (Table 2 ) below. To compare the number of water borne
disease in case of female and male, females have greater risk than males in 2006
E.C .

Table2. Prevalence of water-borne diseases in Haro Health center in 2007

E.c.

Age of Sex Total %

patient Male % Female %
<year 48 47 54 53 102 100
1-10 105 57 78 43 183 100
11-20 270 51 252 49 522 100
21-30 200 68 90 31 290 100
31-40 164 51 152 48 316 100
30
41-50 102 45 123 54.6 225 100
>50 193 81 43 19 236 100
Total 1082 792 1874

As the above table 2 show prevalence of water borne disease in 2007 was less than
2006 E.C. And individual male were highly affected than female age group 41-
50(54.6%).

Table 3. Trends of water borne disease and causative agent in Haro health
center between 2006-2007 Ec.

Year Causative agent Total

Viral Parasite Bacteria
2006 235 (11.73%) 379 (18.93%) 1388 (69.3 2002
3%)
2007 303 (16%) 394 (21%) 1177 (62.8%) 1874
Total 538 (13.88) 773 (19.94%) 2565 (66%) 3876

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The above table 3 shows that the major causative agent of water borne disease are
bacteria, parasite worm and viral and from those viral was more contributed than
the rest (66%).

4.1 Discussion
The study was conducted in Haro health center to assess or investigated the
prevalence of water borne disease among people visited in Haro health center from
2006-2007 E.C. There were a total of 4090 people who had served with medical
services in Haro health center and from these about 3,876 people were infected by
water borne disease in past two year and the other 222 people were infected with
other diseases. The major causative agents of water borne diseases were
contributed by bacteria 1388(69.33%) followed by parasite 379 (18-93%) and viral
235(11.73%).Water borne disease which highly spread by bacteria were Typhoid
fever, E.coli and Salmonellosis . Based on these evidence, the present study shows

32
that the prevalence of water borne disease greater than other disease and most are
contributed (distributed) by bacterial.
As finding of this study indicated water borne disease are spread through
contaminated water, and poor hygiene and inadequate sanitation conditions as well
as polluted environment. In developing countries 4/5 of the illnesses caused by
water borne disease with diarrhea being the leading cause of child hood deaths
(WHO, 2000).
The result of this study is similar to some of the result from previous research
conducted by Henshaw, 1998 in A.A. Personal health may affected by drinking
contaminated water directly or through the food. The problem is specially acute
where general hygiene and environmental sanitation are poor and where
inadequate supply of water prevail (WHO, 2009).
Similarly, the result of this study indicated that the prevalence of water borne
disease which accounts 51.65% and 48.35%for the last two years i.e. 2006-
2007E.C. In these past two years prevalence of water borne disease decrease and in
2006E.C male 1-10 age group (65.35%)is highly infected and in 2007E.C male
adult age group >50(81%) were highly affected than the rest group .From the
above table1,when we compare the prevalence of water borne disease in case of
male and female, females have great risk than male in 2006E.C, but in 2007 male
is highly affected than female by this water borne disease. The study of prevalence
of water borne disease and related factors among people who live in rural area to
be more affected than urban people, even though there is no the studies were found
which neither contradicted nor agreed.

33
5. Conclusion and recommendation
5.1. Conclusion

This study suggests that 94.6% of the patient visited in Haro health center was
infected by water borne diseases and 5.4% were affected by other diseases. This
indicated that the large number of people (patient visited) infected with water
borne disease than the other disease in past two year. And this study was indicated
that bacteria was the most dominant cause of diseases 1388 (69.33%) and followed

34
by intestinal parasite 379 (18.93%) and the least causative agent is viral235
(11.73%). The study indicate that the prevalence of water borne disease was high
in 2006 E.C.in age group 1-10 male (65.35)and the least affected was female 1-10
age group (34.65). But in this year female was highly affected than male and in
2007 the affected age group were male 21-30(68%) and the least affected were
female 50 age group(19%). This study indicate that prevalence of water borne
disease high in 2006(51.65%) and low in 2007 (48.35%) this means the prevalence
of this disease were become decrease.

5.2. Recommendation

Since water borne is widespread in developing countries the following are

recommended:

► Increase public awareness of potential hazards of water borne disease.

 -Give awareness for society about effect of water contamination.

► Integrating education about the water borne diseases in to primary school,

secondary ,college and university .
35
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Appendix
Questionnaires’ for prevalence of water borne disease and related factors among
Haro Kebele peoples, Manna discrite Jimma.
Direction: Those question are open ended question. Answer the question with brief
explanation
1. Is there water borne disease spread in Haro kebele, Manna district Jimma?
A, Yes B, No
2. If your answer is yes for question number 4 what evidence you there?
As
38
3. Is it water borne disease cause death?
4. If your answer is yes on question number 6 briefly explain
5. How water borne disease transmitted from infected individual to health
individual.
6. Do you think all age group have equally affected by water borne disease
A, Yes B, No
7. If your answer is yes for question number why
8. If your answer is no for number 9, write the most age groups age which are
affected more
9. Do you think both sexes have equally affected by water born disease? A, Yes
B, No
10. If your answer is no for question number 12 explain
11. Do you think all pathogens can cause water borne disease A, Yes B, No
12. If your answer is yes for question number 14 list all types of pathogen
13. If your answer is no on question number 14 why
14. Do you know the relationship between water borne disease and related disease
A yes B, No
15. If you answer is yes for question number 17 can yes explain the relationship
between water borne and water related disease

16. Do you think personal hygiene has towards transmission of water borne
disease?
Yes No
17 Is there recorded data of patient of water borne disease in there?
Yes No
18. If your answer is yes on question number 20 haw many people affect by?
A, Protozoan path open in 2005 -2008 E.C
39
B, Bacteria pathogen in 2005- 2008E.C
C, Viruses path open in 2005- 2008 E.C
19. Diarrhea is one of the major manifestations of water borne disease
A, True B, false
20. All of the following are water borne disease except.
A, typhoid fever B, Dracunculsis 9 Guinea worm infection
C, tuberculosis D, poliomyelitis

40