MICROBIAL INDOOR AIR QUALITY, ASSOCIATED FACTORS, AND ADVERSE BIRTH OUTCOMES IN HARARGHE HEALTH AND DEMOGRAPHIC SURVEILLANCE SITE (HHDSS), EASTERN ETHIOPIA

Abstract

Background: Microbial contaminants in indoor environments, including bacteria, fungi, viruses, and their by products, pose a significant risk to human health, particularly for vulnerable populations. These microbes originate from various sources, including heating, ventilation, air conditioning systems, building materials, and human activities. Objectives: To investigate microbial indoor air quality, associated factors, and its impact on adverse birth outcomes in Hararghe Health and Demographic Surveillance Site (HHDSS), eastern Ethiopia, from October 25 December 30, 2024. Methods: Community-based cross-sectional study design was conducted among 217 pregnant women. A total of 208 pregnant women were selected from Hararghe Health and Demographic Surveillance Site. Data were collected through interviewer-administered questionnaires, and microbial load samples were collected using passive settle plate method. The data were collected by REDCap software and analyzed by SPSS version 20. Factors associated with household microbial load were determined in multivariable logistic regression model. Adjusted odds ratios and P-values <0.05 were considered statistically significant. Results: A total of 217 pregnant women were initially recruited for the study, of which 208 completed follow up, yielding a response rate of a 208(95.9%). The finding revealed that the microbial load ranged from 71 to 4102 with a mean of 1477 (95% CI: 1252.14-1497.52) and 13 CFU/m³ to 1809 CFU/m³ with mean 596 CFU/m³ (95% CI: 534.61-644.36) for bacteria and fungi respectively. Notably, 119 (57.2%) of household exceeded the acceptable bacteria load, while 202 (49%) surpassed the fungal acceptable limit. Presence Mold damping [AOR = 15.2, 95% CI (6.68-38.4)]. crowding index [AOR = 6, 95% CI (2.4–14.6)], house made from trunk and mud [AOR = 7.04, 95% CI (1.65-29.9)], share main house with domestic animal [AOR = 6.3, 95% CI (1.56-25.36)] were significantly associated with higher bacteria load. Similarly, Presence Mold [AOR = 2.5, 95% CI (1.3–4.5)], Natural floors [AOR = 3.9, 95% CI (1.2–12)], clean homes every twodays daily [AOR = 0.37, 95% CI (0.14–0.98)] were significantly associated with higher fungi load. From study participant about 64 (30.8%) had adverse birth outcomes, of which 81% (r = 0.171, p = 0.016) were associated with high bacterial and 71.4% and (r = 0.159, p = 0.025) to high fungal levels respectively. Conclusion: The study found that the overall mean microbial loads exceeded the acceptable limits. Floor space per inmate, wall type, and Share house with domestic animal, cleaning frequency, and wall and floor type were contributing factors to the occurrence’s higher microbial loads.