Sirak Robele Gari

Scopus Publications

Factors influencing access to advanced sanitation service level and drinking-water quality in healthcare facilities in Addis Ababa, Ethiopia: a convergent sequential study
Mulumebet Tadesse Retta, Sirak Robele Gari, Bezatu Mengistie Alemu, Argaw Ambelu
Applied Water Science, 2026
This study investigates factors influencing access to advanced sanitation services and drinking water quality in healthcare facilities (HCFs) in Addis Ababa, Ethiopia. Despite the critical role of sanitation and safe water in preventing healthcare-associated infections, many facilities face significant challenges. A convergent sequential study was conducted in 382 healthcare facilities, which involved observations of sanitation facilities, interviews with facility managers, and water quality tests of 382 samples. Additionally, five water samples from reservoirs and distributors were collected, and eight key informant interviews were conducted purposively. In this investigation, only 14.5% of healthcare facilities had advanced sanitation service, while 23.2% had basic sanitation services. Over half (62.3%) of the facilities provided limited sanitation services. Additionally, 22.7% of water samples tested positive for enterococci, 26% for Escherichia coli, 35% for fecal coliforms, and 38.8% for total coliforms. All samples analyzed for fluoride, conductivity, and total dissolved solids (TDS) were below permissible limits, except for 6.6% of the samples that exceeded the pH level of 8.5. In contrast, all water samples from reservoirs and distributors were free from bacterial contaminations, and their fluoride, conductivity, and TDS levels were within the standard. Factors such as having infection prevention committee (IPC)(AOR = 2.8, 95% CI: 1.07-7.52), trained managers on sanitation safety plan (AOR = 2.96, 95% CI: 1.10-7.94), managers trained in infection prevention (AOR = 3.6, 95% CI: 1.25-10.48), having sanitation standards (AOR = 3.5, 95% CI: 1.06-11.64), availability of sufficient budget for sanitation services (AOR = 3.2, 95% CI: 1.14-9.15), having specific annual sanitation plan (AOR = 3.6, 95% CI: 1.52-8.58), using updated WASH guidelines (AOR = 3.4, 95% CI: 1.05-11.20), absence of a sanitation safety plan (AOR = 0.22, 95% CI: 0.05-0.91), lack of regular monitoring and evaluation (AOR = 0.24, 95% CI: 0.07-0.83), and managers who did not involve in leading renovation of WASH infrastructure (AOR = 0.56, 95% CI: 0.35-0.70) were significantly associated with access to advanced sanitation service level. Access to advanced and basic sanitation services is low in HCFs of Addis Ababa. Several core factors affecting access to advanced sanitation service level has been identified. Many water samples from healthcare facilities were contaminated by bacteria. Enhancing training programs for healthcare managers and securing adequate funding are critical steps toward improving sanitation and water quality.
Building an integrated analytical framework: a new methodology to analysing social-ecological systems
Sirak R. Gari, Alice Newton, John D. Icely
Journal of Environmental Planning and Management, 2026
Appropriate adaptive management frameworks are useful for analyzing social-ecological systems. Natural resource managers and concerned stakeholders can co-design locally adapted, appropriate management systems based on the information obtained using frameworks, which leads to a better understanding of the social-ecological system (SES). However, no single framework addresses all environmental and social issues with equal efficiency. Therefore, the Driver-Activity-Pressure-State-Impact (Welfare)-Response (Measure) framework (DAPSI(W)R(M)), Ostrom's SES Framework (SESF), and the Systems Approach Framework (SAF) were combined to create an integrated analytical framework (IAF). Finally, the integrated analytical framework was tested in the Community Council of Alto and Medio Dagua (AMDA), Colombia, to assess a water quality problem emanating from anthropogenic activities. The approach seems to be valid and useful for the assessment of social-ecological systems.
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, Zeleke Ayenew, Wondwossen Amogne
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.
Determinants of access to advanced water service level in healthcare facilities located in Addis Ababa, Ethiopia: a cross sectional study
Mulumebet Tadesse Retta, Sirak Robele Gari, Bezatu Mengistie Alemu, Argaw Ambelu
Discover Public Health, 2025
Access to advanced water service in healthcare facilities is critical for ensuring patient safety, effective infection prevention and control and over all improves quality of service. However, in Ethiopia, particularly in Addis Ababa, the factors affecting access to advanced water service level in these facilities have not been thoroughly studied. Evidence regarding the determinants of advanced water service level is limited, and the WHO/UNICEF Joint Monitoring Programme (JMP) water service levels remain undocumented, leaving these determinants largely unknown. Therefore, this study aims to investigate factors affecting access to advanced water service level and examines seasonal variations in bacteriological water quality across healthcare facilities in Addis Ababa, Ethiopia. A cross-sectional study was conducted among 382 healthcare facilities. From these facilities, 382 healthcare managers were interviewed, and 382 water samples were collected during both the wet and dry seasons. Multivariable logistic regression analysis was employed to examine the associations between the advanced water service level and its predictor variables. In this study, only 17.5% of healthcare facilities had advanced drinking water service, with significant seasonal variations in contamination levels, notably higher levels of E. coli, Enterococci, and total coliforms during the rainy season. The study’s findings revealed that healthcare facilities (HCFs) headed by male managers (adjusted odds ratio [AOR] = 0.33, 95% CI: 0.15–0.77), healthcare facilities led by managers with a first degree holder (AOR = 0.18, 95% CI: 0.04–0.75), healthcare facilities with water reservoirs located at ground surface (AOR = 0.03, 95% CI: 0.004–0.27), facilities with managers who received training on water safety plans (AOR = 4, 95% CI: 1.5–10.3), healthcare facilities conducting biannual drinking-water chlorination practice (AOR = 3.9, 95% CI:1.10–9.80), healthcare facilities with properly closed water reservoirs (AOR = 3.5, 95% CI: 1.24–9.90), healthcare facilities having water supply guidelines (AOR = 3.5, 95% CI: 1.23–10.12), HCFs having water treatment practice led by healthcare facility managers (AOR = 3.5, 95% CI: 1.20–10.70), and healthcare facilities with specific annual plans for water supply (AOR = 3.2, 95% CI: 1.1.32–7.86) were significantly associated with having advanced water service level. This study highlights a concerning gap in providing advanced drinking water service level in healthcare facilities in Addis Ababa. This investigation identifies seasonal variations indicated higher levels of bacteriological contamination during the rainy season, particularly for E. coli, Enterococci, fecal coliforms, and total coliforms. Furthermore, this study identified key determinants affecting access to advanced water service. Therefore, these results underscore the urgent need for targeted interventions to enhance water infrastructure and management practices, thereby improving health outcomes and supporting the achievement of Sustainable Development Goals in healthcare settings.
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, Waktole Gobena, Wondwossen Amogne
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.
Incidence of diarrhea and risk factors among wastewater-irrigating urban farmers along Akaki Rivers in Addis Ababa
Adnan Sirage Ali, Sirak Robele Gari, Michaela L Goodson, Claire L. Walsh, Bitew K. Dessie, Argaw Ambelu
International Journal of Environmental Health Research, 2025
The importance of diarrhea risk associated with wastewater exposure in agriculture is almost unknown. This study aimed to examine diarrheal infection and risk factors among farmers using wastewater for irrigation in Addis Ababa. A cross-sectional study was employed among 380 farmers (190 exposed and 190 unexposed farmers). Among these, a cohort of 200 adults (100 wastewater-exposed, 100 unexposed farmers) aged 25-69 years were selected and followed up biweekly for two successive vegetables growing seasons to examine the incidence of diarrhea. The incidence rate of reported diarrhea was 12 episodes per 1,000 person-weeks at risk and a maximum of 17 episodes per 1,000 person-weeks at risk. Strongly associated risk factors include washing body and clothes with wastewater [AOR: 4.2, 95%CI (1, 11.2)], using working clothes at home [AOR: 4.7, 95%CI (0.25, 87)], and wearing protective cloth [AOR: 5.6, 95 CI (0.3, 70)]. Moreover, hand washing after work, washing feet and boots, and on-site hand washing were significant determinants of farmers' diarrhea. Exposure to wastewater significantly contributes to the risk of diarrhea among adults. Significant determinants of diarrhea among farmers include washing the body and clothes with irrigation water, contamination with soil and irrigation water, and on-site hand washing. Increased risk factors include hand contamination, washing vegetables with irrigation water, eating raw vegetables, and using work clothes at home.
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, Bitew K. Dessie, Bezatu Mengistie Alemu
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
Prevalence and risk factors of soil transmitted helminths among vegetable farmers of Akaki river bank, Addis Ababa, Ethiopia
Bethelhem Kinfu Gurmassa, Sirak Robele Gari, Ephrem Tefera Solomon, Michaela L. Goodson, Claire L. Walsh, Bitew K. Dessie, Bezatu Mengistie Alemu
BMC Infectious Diseases, 2024
BACKGROUND: In Ethiopia, 79 million people live in soil transmitted helminths endemic areas. The Ethiopia established a National goal to eradicate STH transmission by 2025. To meet that goal, it is imperative that data is acquired on community helminth infection risk. This study examined the prevalence of STH and risk factors for infection in vegetable farmers working on Akaki River Bank, Addis Ababa, Ethiopia. METHODS: A cross-sectional study was conducted between November 7, 2022, and June 2023. A stratified random sampling was used to select farming households. Two hundred and sixteen farmers were enrolled in the study. Data on socio-demographic, WASH, wastewater irrigation related factors were collected by trained data collectors using a structured questionnaire. Kato-Katz concentration was utilized to detect STH. The data were entered using EpiData 3.1 and analyzed with Stata 14.0, using p-values less than 0.05 to identify significant factors. Logistic regression was used to identify independent risk factors for infection. RESULTS: The prevalence of STH was 22.2% (95% CI = 13.6-27.9%), with Ascaris lumbricoides being the most common (11.1%), followed by hookworm (7.4%), and Trichuris trichiura (3.7%). Low income levels (AOR = 1.85, 95% CI = 1.25-5.99), lack of handwashing before eating (AOR = 2.25, 95% CI = 1.58 - 11.3), absence of fingernails cleanliness (AOR = 1.97, 95% CI = 1.74-39.5), not wearing shoes at work (AOR = 3.4, 95% CI = 2.98-82.2), touching the face with dirty hands (AOR = 2.9, 95% CI = 0.68-28.2), washing vegetables with irrigation wastewater (AOR = 2.1, 95% CI = 1.95-45.2), and not wearing protective clothing during farming activities (AOR = 2.99, 95% CI = 1.58 - 22.4) were the significant risk factors for infection with STH. CONCLUSION: Of the farming communities examined in this study, one of the five was found to be infected with soil transmitted helminth. This research has shown clear risk factors for STH infection including: lack of personal hygiene practices, insufficient sanitation access, and limited use of protective equipment. To achieve the national goal, there is a need for farming communities to understand preventative risks of infection, improve WASH (Water access, sanitation and hygine) practices, WASH access, protective equipment, and health education.
The nexus between household water insecurity, mother’s handwashing practices, and diarrheal diseases among under-five children
Abiot Abera Aydamo, Sirak Robele Gari, Seid Tiku Mereta
Journal of Water and Health, 2024
Water Safety Practices Along the Water Service Chain in Addis Ababa: A Cross-Sectional Study in a Cosmopolitan City
Shegaw Fentaye Sisay, Sirak Robele Gari, Argaw Ambelu
Environmental Health Insights, 2024
Fecal Sludge Management and Sanitation Safety: An Assessment in Addis Ababa, Ethiopia
Shegaw Fentaye Sisay, Sirak Robele Gari, Argaw Ambelu
Environmental Health Insights, 2024
Distribution of helminth eggs in environmental and stool samples of farming households along Akaki River in Addis Ababa, Ethiopia
Bethlhem kinfu Gurmassa, Sirak Robele Gari, Ephrem Tefera Solomon, Michaela L. Goodson, Claire L. Walsh, Bitew K. Dessie, Bezatu Mengistie Alemu
Tropical Medicine and Health, 2023
Prevalence and risk factors of childhood diarrhea among wastewater irrigating urban farming households in Addis Ababa
Adane Sirage Ali, Sirak Robele Gari, Michaela L. Goodson, Claire L. Walsh, Bitew K. Dessie, Argaw Ambelu
Plos One, 2023
Trihalomethanes and physicochemical quality of drinking water in Addis Ababa, Ethiopia
Nebiyou Tafesse, Massimiliano Porcelli, Belachew Bacha Hirpessa, Janvier Gasana, R.K. Padhi, Sirak Robele, Argaw Ambelu
Heliyon, 2023
Trace Element Levels in Nails of Residents of Addis Ababa Are Shaped by Social Factors and Geography
Bitew K. Dessie, Bewketu Mehari, Sirak Robele Gari, Adane Mihret, Adey F. Desta, Samuel Melaku, Tena Alamirew, Claire L. Walsh, David Werner, Gete Zeleke
Biological Trace Element Research, 2023
Access to Drinking Water, Sanitation, and Hand Hygiene Facilities in the Peri-Urban and Informal Settlements of Hosanna Town, Southern Ethiopia
Abiot Abera Aydamo, Sirak Robele Gari, Seid Tiku Mereta
Environmental Health Insights, 2023
Fecal Contamination in the Wastewater Irrigation System and its Health Threat to Wastewater-Based Farming Households in Addis Ababa, Ethiopia
Adane Sirage Ali, Sirak Robele Gari, Michaela L Goodson, Claire L Walsh, Bitew K Dessie, Argaw Ambelu
Environmental Health Insights, 2023
The impact of wastewater-irrigated urban agriculture on microbial quality of drinking water at household level in Addis Ababa, Ethiopia
Adnan Sirage Ali, Sirak Robele Gari, Michaela L Goodson, Claire L. Walsh, Bitew K. Dessie, Argaw Ambelu
Urban Water Journal, 2023
Absence of significant association of trace elements in nails with urinary KIM-1 biomarker among residents of Addis Ababa in Upper Awash Basin, Ethiopia: a cross-sectional study
Bitew K. Dessie, Bewketu Mehari, Mahlet Osman, Sirak Robele Gari, Adey F. Desta, Samuel Melaku, Tena Alamirew, Michaela L. Goodson, Claire L. Walsh, Gete Zeleke, Adane Mihret
Biometals, 2022
Meta-analysis of public health risks of lead accumulation in wastewater, irrigated soil, and crops nexus
Adane Sirage Ali, Argaw Ambelu Bayih, Sirak Robele Gari
Frontiers in Public Health, 2022
Diarrheagenic toxins in stool correlate to drinking water from improved water sources in Ethiopia
Shibabaw Tadesse Gemeda, Adey Feleke Desta, Sirak Robele Gari, Jana Jass, Dessalegn Abeje Tefera
Environmental Challenges, 2022
PCR-based detection of pathogens in improved water sources: a scoping review protocol of the evidence in low-income and middle-income countries
Shibabaw Tadesse Gemeda, Negasa Eshete Soboksa, Yonatal Mesfin Tefera, Adey Feleke Desta, Sirak Robele Gari
BMJ Open, 2022
Enterotoxins as a molecular marker of water quality
Shibabaw Tadesse Gemeda, Adey Feleke Desta, Sirak Robele Gari, Jana Jass, Wude Mihret Woldemedhin, Misrak Netsere Haileyesus
Water Practice and Technology, 2022
Prevalence and risk factors of diarrhea among children less than five years of age in the rural suburbs of dire dawa, eastern Ethiopia; robust poisson regression analysis
Ephrem Tefera Solomon, Sirak Robele Gari, Bezatu Mengistie Alemu
African Health Sciences, 2022
Prevalence and Trends of Drinking Water Disinfection Byproducts-Related Cancers in Addis Ababa, Ethiopia
Nebiyou Tafesse, Massimiliano Porcelli, Sirak Robele Gari, Argaw Ambelu
Environmental Health Insights, 2022
Physicians’ degree of awareness regarding the risks, clinical practices, and management challenges of nosocomial legionnaires’ disease: A cross-sectional study from two Ethiopian hospitals
Etsub Brhanesilassie Hailemichael, Adey Feleke Desta, Girma Taye, Sirak Robele Gari, Sibhatu Biadgilign, Wondwossen Amogne
Sage Open Medicine, 2022
Urinary 8-OHdG level is not affected by geography and trace elements in nail of residents of Addis Ababa: It is shaped by interactions between different social factors
Bitew K. Dessie, Bewketu Mehari, Molla Tefera, Mahlet Osman, Yosef Tsegaye, Sirak Robele Gari, Adey F. Desta, Samuel Melaku, Tena Alamirew, Michaela L. Goodson, Claire L. Walsh, Gete Zeleke, Adane Mihret
Toxicology Reports, 2022
Handwashing effect on diarrheal incidence in children under 5 years old in rural eastern Ethiopia: a cluster randomized controlled trial
Ephrem Tefera Solomon, Sirak Robele Gari, Helmut Kloos, Bezatu Mengistie Alemu
Tropical Medicine and Health, 2021
Determinants of drinking water quality and sanitary risk levels of water storage in food establishments of addis ababa, ethiopia
Aderajew Mekonnen Girmay, Sirak Robele Gari, Gebreab Teklebirhan Gessew, Mulumebet Tadesse Reta
Journal of Water Sanitation and Hygiene for Development, 2021
The importance of water quality in classifying basic water services: The case of Ethiopia, SDG6.1, and safe drinking water
Shibabaw Tadesse Gemeda, Emily Springer, Sirak Robele Gari, Solomon Melake Birhan, Hailu Tolasa Bedane
Plos One, 2021
Determination and health risk assessment of trace elements in the tap water of two Sub-Cities of Addis Ababa, Ethiopia
Bitew K. Dessie, Sirak Robele Gari, Adane Mihret, Adey F. Desta, Bewketu Mehari
Heliyon, 2021
Child defecation, feces disposal practices and associated factors in community-led total sanitation adopted districts in Jimma Zone, Ethiopia
Negasa Eshete Soboksa, Sirak Robele Gari, Abebe Beyene Hailu, Bezatu Mengistie Alemu
Environmental Challenges, 2021
Comparing the effect of independent and combined interventions of household chlorination and handwashing on diarrhea of under-fives in rural Dire Dawa, eastern Ethiopia: a cluster randomized controlled trial
Ephrem Tefera Solomon, Sirak Robele Gari, Helmut Kloos, Bezatu Mengistie Alemu
Pan African Medical Journal, 2021
Childhood Malnutrition and the Association with Diarrhea, Water supply, Sanitation, and Hygiene Practices in Kersa and Omo Nada Districts of Jimma Zone, Ethiopia
Negasa Eshete Soboksa, Sirak Robele Gari, Abebe Beyene Hailu, Bezatu Mengistie Alemu
Environmental Health Insights, 2021
Effectiveness of solar disinfection water treatment method for reducing childhood diarrhoea: A systematic review and meta-analysis
Negasa Eshete Soboksa, Sirak Robele Gari, Abebe Beyene Hailu, Dereje Oljira Donacho, Bezatu Mengistie Alemu
BMJ Open, 2020
Longitudinal study of microbial load of drinking water and seasonal variation of water quality at the point of use in food establishments of addis ababa, ethiopia
Aderajew Mekonnen Girmay, Sirak Robele Gari, Azage Gebreyohannes Gebremariam, Bezatu Mengistie Alemu, Martin R. Evans, Gebreab Teklebirhan Gessew
Journal of Water Sanitation and Hygiene for Development, 2020
Diarrheal morbidity and predisposing factors among children under 5 years of age in rural East Ethiopia
Ephrem Tefera Solomon, Sirak Robele Gari, Helmut Kloos, Bezatu Mengistie
Tropical Medicine and Health, 2020
Effect of household water treatment with chlorine on diarrhea among children under the age of five years in rural areas of Dire Dawa, eastern Ethiopia: A cluster randomized controlled trial
Ephrem Tefera Solomon, Sirak Robele, Helmut Kloos, Bezatu Mengistie
Infectious Diseases of Poverty, 2020
The effectiveness of solar disinfection water treatment method for reducing childhood diarrhea: A systematic review and meta-analysis protocol
Negasa Eshete Soboksa, Sirak Robele Gari, Abebe Beyene Hailu, Dereje Oljira Donacho, Bezatu Mengistie Alemu
Systematic Reviews, 2020
Association between microbial water quality, sanitation and hygiene practices and childhood diarrhea in Kersa and Omo Nada districts of Jimma Zone, Ethiopia
Negasa Eshete Soboksa, Sirak Robele Gari, Abebe Beyene Hailu, Bezatu Mengistie Alemu
Plos One, 2020
Diarrheal disease and associated behavioural factors among food handlers in Addis Ababa, Ethiopia
Aderajew Mekonnen Girmay, Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia, Sirak Robele Gari, Bezatu Mengistie Alemu, Martin R. Evans, Azage Gebreyohannes Gebremariam, College of Health, Medical sciences, Haramaya University, Harar, Ethiopia, Microbiology Consultant, Laboratory Director, New York, USA
Aims Public Health, 2020
Trichotomy of awareness, outlook and practice of food handlers towards food and water safety in food establishments in Addis Ababa, Ethiopia
Aderajew Mekonnen Girmay, 1 Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia, Sirak Robele Gari, Azage Gebreyohannes Gebremariam, Bezatu Mengistie Alemu, Martin R. Evans, 2 College of Health, Medical Sciences, Haramaya University, Haramaya, Ethiopia, 3 Microbiology Consultant, Laboratory Director, New York, USA
Aims Public Health, 2020
Determinants of Sanitation and Hygiene Status Among Food Establishments in Addis Ababa, Ethiopia
Aderajew Mekonnen Girmay, Sirak Robele Gari, Bezatu Mengistie Alemu, Martin R Evans, Azage Gebreyohannes Gebremariam
Environmental Health Insights, 2020
Water supply, sanitation and hygiene interventions and childhood diarrhea in Kersa and Omo Nada districts of Jimma Zone, Ethiopia: A comparative cross-sectional study
Negasa Eshete Soboksa, Abebe Beyene Hailu, Sirak Robele Gari, Bezatu Mengistie Alemu
Journal of Health Population and Nutrition, 2019
Barriers of persistent long-lasting insecticidal nets utilization in villages around Lake Tana, Northwest Ethiopia: A qualitative study
Asmamaw Malede, Mulugeta Aemero, Sirak Robele Gari, Helmut Kloos, Kassahun Alemu
BMC Public Health, 2019
Travel to farms in the lowlands and inadequate malaria information significantly predict malaria in villages around Lake Tana, northwest Ethiopia: A matched case-control study
Asmamaw Malede, Kassahun Alemu, Mulugeta Aemero, Sirak Robele, Helmut Kloos
Malaria Journal, 2018
A DPSIR-analysis of water uses and related water quality issues in the Colombian Alto and Medio Dagua Community Council
Sirak Robele Gari, Cesar E. Ortiz Guerrero, Bryann A-Uribe, John D. Icely, Alice Newton
Water Science, 2018
An analysis of the global applicability of Ostrom's design principles to diagnose the functionality of common-pool resource institutions
Sirak Gari, Alice Newton, John Icely, Maria Mar Delgado-Serrano
Sustainability Switzerland, 2017
A review of the application and evolution of the DPSIR framework with an emphasis on coastal social-ecological systems
Sirak Robele Gari, Alice Newton, John D. Icely
Ocean and Coastal Management, 2015
Testing the application of the systems approach framework (SAF) for the management of eutrophication in the Ria Formosa
Sirak R. Gari, Alice Newton, John Icely, Christopher D. Lowe
Marine Policy, 2014

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