{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:50:39Z","timestamp":1777881039803,"version":"3.51.4"},"reference-count":50,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medicine"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Legionella pneumophila<\/jats:italic>\n                      is a waterborne bacterium known to cause Legionnaires\u2019 disease, a severe form of pneumonia particularly affecting older and immune compromised individuals. This study evaluates the level of risk awareness, clinical practices, and barriers to optimal management of nosocomial Legionnaires\u2019 disease in Ethiopia\u2019s two largest hospitals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We employed a cross-sectional survey design, utilizing a self-administered questionnaire to collect data from 374 practicing physicians at two specialized hospitals in Addis Ababa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 324 questionnaires were returned, yielding a response rate of 86.6%. Eighty percent (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009270) reported some level of awareness of Legionnaires\u2019 disease as a clinical condition. However, 43% of the physicians were unaware of the association between hospital water systems and the risk of nosocomial Legionnaires\u2019 disease. Fifty-seven percent of the respondents indicated the absence of technical guidelines to inform the diagnosis and management of nosocomial Legionnaires\u2019 disease. Most physicians relied on clinical assessment (57%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200951) for diagnosing the disease, citing diagnostic barriers (68%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009140) and perceived low reliability of existing laboratory tests as key challenges. Notably, physicians with limited knowledge about Legionnaires\u2019 disease were associated with a 79% reduction in accurate diagnosis of cases. Additionally, poor hospital water quality (43%) and inadequate infection prevention and control measures were identified as significant contributors to the persistence of waterborne hospital-acquired pneumonia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study highlights physicians\u2019 limited awareness of the risks posed by hospital water systems in the transmission of Legionnaires\u2019 disease. Additionally, the diagnosis of Legionnaires\u2019 disease is impeded by the lack of clinical guidelines and specific diagnostic testing capabilities. These findings underscore the urgent need to revise hospital-acquired pneumonia protocols, strengthen infection prevention and control guidelines, and enhance hospital water management practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20503121251344144","type":"journal-article","created":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T23:45:22Z","timestamp":1750376722000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Physicians\u2019 degree of awareness regarding the risks, clinical practices, and management challenges of nosocomial legionnaires\u2019 disease: A cross-sectional study from two Ethiopian hospitals"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6740-4362","authenticated-orcid":false,"given":"Etsub Brhanesilassie","family":"Hailemichael","sequence":"first","affiliation":[{"name":"Department of Water and Public Health, Ethiopian Institute of Water Resources, Addis Ababa University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6431-7363","authenticated-orcid":false,"given":"Adey Feleke","family":"Desta","sequence":"additional","affiliation":[{"name":"Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5488-4636","authenticated-orcid":false,"given":"Girma","family":"Taye","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Addis Ababa University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0495-4488","authenticated-orcid":false,"given":"Sirak Robele","family":"Gari","sequence":"additional","affiliation":[{"name":"Department of Water and Public Health, Ethiopian Institute of Water Resources, Addis Ababa University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7582-5977","authenticated-orcid":false,"given":"Sibhatu","family":"Biadgilign","sequence":"additional","affiliation":[{"name":"Independent Public Health Analyst and Research Consultant, Addis Ababa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4950-3966","authenticated-orcid":false,"given":"Wondwossen","family":"Amogne","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,19]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.1.1.60"},{"key":"e_1_3_3_3_2","volume-title":"Management of Legionella in Water Systems","author":"Committee on Management Legionella in Water Systems","year":"2020","unstructured":"Committee on Management Legionella in Water Systems. 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