Public Awareness and Precautionary Measures for Disease Transmission Prevention: A Microbial Evaluation of Ethiopian Paper Currency in Circulation in Arba Minch Town, SNNPR

Public Awareness and Precautionary Measures for Disease Transmission Prevention: A Microbial Evaluation of Ethiopian Paper Currency in Circulation in Arba Minch Town, SNNPR | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Public Awareness and Precautionary Measures for Disease Transmission Prevention: A Microbial Evaluation of Ethiopian Paper Currency in Circulation in Arba Minch Town, SNNPR Fitsum Dejene Delisho, Saron Dereje Gorfu, Dinka Ejeta Yambo, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4127253/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Money bills are handled by the public every day, which means they can carry microorganisms that can be passed from person to person through direct contact. This study aims to assess the public awareness and evaluate the bacterial contamination on Ethiopian paper currency in circulation in Arba Minch Town, SNNPR, Ethiopia. Methods A cross-sectional study was conducted at the microbiology and parasitology laboratory at Arba Minch University, Ethiopia. A total of 150 Ethiopian paper currency samples were collected aseptically from different sectors in Arba Minch town for microbial analysis. Results The most common microorganisms isolated from the samples were gram-positive bacteria, with yeast being the least common. These microorganisms were identified as klebissela spp, E. coli , Streptococcus spp, Bacillus spp, Aspergillus spp, and Staphylococcus aureus based on their characteristics observed through phenotypic, microscopic, and biochemical analysis. The antimicrobial susceptibility patterns of Staphylococcus aureus and Streptococcus spp. were evaluated, and both showed higher sensitivity to Vancomycin and Tetracycline antibiotics. Similarly, Klebsiella spp showed higher sensitivity to Ciprofloxacin while exhibiting a lower sensitivity rate (6.6667%) to Ampicillin. In contrast, Ampicillin showed higher activity on the E. coli isolates. Regarding the transmission of diseases through paper currency, a significant majority of participants (79.8%) were aware of the associated risk. However, it is worth noting that more than half of the participants (53.9%) reported that they do not take any precautions after handling paper currency. Conclusion Overall, the study confirms that paper bills are a suitable environment for bacterial growth and could potentially contribute to infections. Therefore, it emphasizes the importance of raising awareness about the potential risks associated with mishandling paper currency in all food establishments. Bacteria Fungi Microbial contamination Paper currency Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 1 Introduction The use of paper money originated in China around 1000 AD and has since become a widely circulated medium of economic exchange. However, despite efforts to disinfect currency notes, pathogens such as viruses, bacteria, and spirochetes have been found on paper money. This means that money can serve as a vehicle for potential pathogens, although this aspect is often overlooked [ 1 – 3 ]. Paper money has a large surface area and is frequently passed from one person to another during transactions, increasing the risk of transferring pathogenic organisms [ 4 ]. When handling money, there is a possibility of microorganisms being transferred if the money becomes contaminated with microorganisms from the gastrointestinal or respiratory tract [ 5 ]. It is common for some individuals to neglect washing or disinfecting their hands after coughing, sneezing, using public toilets, and engaging in other unhygienic practices. When these individuals handle money, the risk of contamination becomes very high. This supports previous reports that have found a high prevalence of microorganisms on banknotes and coins, increasing the likelihood of passing pathogens from one person to another [ 1 , 6 ]. Research has demonstrated that paper currency provides an ideal environment for microorganisms to thrive, for several reasons. Firstly, the large surface area of paper bills allows for the accumulation of organisms and organic debris [ 7 ]. Secondly, intentional folds or depressions incorporated into the design of bills as anti-counterfeiting measures serve as breeding grounds for both organisms and debris, enabling microorganisms to survive for extended periods [ 8 ]. Lastly, banknotes circulate within the population for many years before finally settling. Studies indicate a direct correlation between the age and denomination of a bill with the level of contamination observed (e.g., older bills had the highest contamination levels, while newer bills had the lowest) [ 9 ]. The Ethiopian currency known as the "Birr" is the second most widely used currency in Africa, after the Nigerian "Naira," for the exchange of goods and services, including food, in Ethiopia and other countries around the world [ 10 , 11 ]. Paper currency can become contaminated through physical contact with hands, surfaces, and the environment[ 12 , 13 ]. Paper currency is held and transferred by individuals from various socio-economic backgrounds. Any object that can spread communicable diseases among a diverse population should be considered a public health risk. Therefore, paper currency plays a significant role in the transmission of pathogenic microorganisms and poses a moderate risk to public health. Many people, such as market women, motorcyclists, bus drivers and conductors, butchers and meat sellers, and restaurant operators, do not store money in wallets and often squeeze paper currency. For example, women may place money underneath their bras where it can become moist with sweat, while men may hide it in their socks. Market vendors typically squeeze paper money and keep it in dirty pockets, which can introduce microbes to the notes. Furthermore, storing paper currency in polythene, cotton, or leather bags in humid and dark conditions can promote the growth of microorganisms [ 14 ]. According to reports made from several studies, many bacterial groups such as Citrobacter sp., Mycobacterium lepirae , Salmonella sp., Escherichia coli, Staphylococcus aureus, Klebsiella sp, Streptococcus spp. and Pseudomonas aeroginosa were found associated with paper currency notes [ 15 , 16 ]. Paper currencies were also reported contaminated with fungi including Aspergillus niger, A. flavus, A. paraziticus, Candida spp. Penicillium spp. and Rhizopus spp., Alternaria tenuis, Trichoderma spp., Fusarium spp., and Sporotrichum spp [ 15 – 17 ]. Although the significance of hand hygiene in preventing the spread of diseases is widely recognized, there is a lack of research specifically focusing on the use of sanitizers after handling paper currency. Hand hygiene, encompassing hand washing with soap and water or the application of alcohol-based hand sanitizers, plays a crucial role in preventing the transmission of infectious diseases by reducing the spread of pathogens [ 18 – 20 ]. Additionally, little is known about paper currency storage practices and their potential impact on microbial contamination and disease transmission. This study aims were to address these research gaps by investigating sanitizer usage and paper currency storage practices among Arba Minch town. To the best of our knowledge, this study was the first of its kind to evaluate the usage of sanitizers, the practices of storing paper currency, and public awareness regarding the risk of disease transmission after handling paper currency. Specifically, this study focused on Arba Minch town and its contribution to the broader scientific community. Previous studies had investigated the microbial contamination of paper currency in various regions worldwide, but no research had assessed public awareness, sanitizer usage, and storage practices in relation to disease transmission via contaminated paper currency. By exploring these aspects in the context of Arba Minch town, this study aimed to address a crucial knowledge gap and provide valuable insights into potential interventions for reducing the risk of disease transmission through contaminated paper currency. Furthermore, the findings of this study could serve as a foundation for future research and inform public health policies in similar settings. Therefore, the primary aim of this study was to assess public awareness and precautionary measures for disease transmission prevention, as well as examine the microbial load present on Ethiopian paper currency in circulation within Arba Minch city. 2 Methods and Materials 2.1 Study area, period and design Laboratory based cross sectional study was conducted at Arba Minch University in Microbiology and Parasitology Laboratory, from June-August, 2023. This study was conducted in Sikella Sub- city under Arba Minch Town. As shown in Fig. 1 , Arba Minch is located in Southern Nation, Nationalities and Peoples Region (SNNPR) regional zone and the administrative center of the Gamo Zone. It is located 504 km away from capital city Addis Ababa at 30°56′N of the equator and 37°44′E with a surface area of 2184 hectares with an average temperature of 30.6°C and annual rainfall of 575 mm [ 21 ]. 2.2 Eligibility criteria 2.2.1 Inclusion criteria Paper bill were collected where it is likely to circulate frequently or be mishandled, like food handlers or merchant, customers of this merchant. Paper bill were randomly selected from a larger pool of eligible notes. 2.2.2 Exclusion criteria Banknotes exhibiting no signs of microbial contamination may not have been included in the sampling. Fresh and new paper bill were not be selected. 2.3 Population 2.3.1 Source population The study gathered samples from various sources, including merchants working in vegetable shops, customers of these shops, fruit stalls, and mini-market owners in Sikella and secha sub city. For the interview portion of the study, shopkeepers, customers, and merchants were selected from the same location where the paper bills were collected. 2.3.2 Study sample size and sampling method To compare the condition of Ethiopian paper currency in different sectors, this study collected samples from selected merchants in the town using a systematic random sampling method. This approach ensures a representative sample of paper currency in circulation and minimizes the potential for bias in the selection process. The study specifically focused on sectors that are assumed to handle paper bills better, as well as those with conditions that may promote bacterial growth. The sample consisted of 150 notes, with notes collected from each of the following sectors: fruit stalls, vegetable shops, a minimarket, supermarket, cafeteria and from market customers. The samples were collected in a sterile manner by providing verbal questionnaires to food vendors and asking them to drop the paper currency into sterile capped test tubes in an ice box. The ice box was promptly sealed, and individuals were given a replacement note of the same denomination. The samples were immediately transported in an aseptic manner to the microbiology laboratory for microbial analysis. 2.4 Laboratory Procedure 2.4.1 Bacterial Load Analysis The collected samples of paper currency were analyzed to determine their microbial load and safety. To do this, 1 ml of each sample was transferred aseptically into 9 ml of buffered peptone water (BPW) and thoroughly mixed using a vortex. The resulting mixtures were then serially diluted from 10 − 1 to 10 − 6 . A 0.1 ml aliquot of each dilution was spread-plated in duplicate on pre-solidified plates of Plate Count Agar, MacConkey Agar, Violet Red Bile Agar, Mannitol Salt Agar, and Potato Dextrose Agar, which was also supplemented with 0.1 g of chloramphenicol. The plates were then incubated at the optimal temperature and time for counting gram positive bacteria, gram negative bacterial, yeasts, and molds, respectively. Colonies ranging from 30 to 300 were considered for counting. The counted colonies (mean values of duplicate plates) were expressed as colony forming units per square centimeter (CFU/cm2) of the sampled paper currencies and then converted into log colony forming units (log CFU/cm2) for data management [ 22 ]. 2.4.2 Isolation and characterizations of Bacterial isolate According to [ 8 , 23 ], As shown in Fig. 2 , each paper currency was soaked separately in a test tube containing 10 ml of sterile buffered peptone water. The bottle was then vigorously shaken for 2 minutes. The currency was removed and the resulting peptone water solution and incubated for 24hours at of 37 o C. The incubated test sample was then serially diluted and cultured by sterilized swab onto Nutrient Agar, MacConkey, and Mannitol Salt Agar. The plates were incubated aerobically overnight in an incubator at 37 0 C. Pure cultures were obtained by sub-culturing distinct colonies. Control samples underwent the same processes. According to Abdullah, Pure isolated colonies were identified using their morphology, Gram reaction as well as biochemical techniques such as the Indole, Motility, MRVP, Catalase, Triple sugar iron tests (sugar fermentation and gas production [ 24 ]. 2.4.3 Determination of Drug-Susceptibility of Bacterial isolates Bacteria were tested for susceptibility to antibiotics by the Kirby-Bauer disc diffusion technique following guidelines of the National Committee for Clinical and Laboratory Standards Institute. Fourteen different antibiotic discs representing used were; Ciprofloxacin (5µg) Ampicillin (AMP, 10 µg), Cotrimoxazole (SXT, 25 µg), Erythromycin (E, 15 µg), Gentamicin (CN, 10 µg), Tetracycline (TE, 30 µg) and Vancomycine (VA, 30 µg). Susceptibility assay was performed on Mueller–Hinton agar plates. Briefly a suspension of the test organism was prepared to match the 0.5% McFarland standard. Plates were then swabbed with the cell suspension and allowed to dry for 10 minutes. Different antimicrobial discs were placed on the inoculated plates ensuring adequate contact of disc and medium. Plates were incubated at 37°C for 24 hours, examined and the diameter of the zone of inhibition measured using a graduated ruler. The diameters were then compared with recommended standards, which conform to those of the Clinical Laboratory Standard Institute (CSLI)[ 25 ]. 2.4.4 Hygiene behaviors and sociodemographic traits A cross-sectional study was conducted to gather data on the demographic characteristics of the participants, their practices for storing paper bills, their perceptions on disease transmission through paper currency, and their use of sanitizer after handling paper currency. The data was collected by means of a structured questionnaire, which was administered through face-to-face interviews conducted by trained researchers. The participants' responses were recorded on paper forms. 2.5 Data quality control Data quality control was ensured from data collection up to final laboratory identification by following the prepared standard operating procedure (SOP). The performance of the prepared media was checked by inoculating control strains like Staphylococcus aureus ATCC25923 and Escherichia coli ATCC25922 which was obtained from Ethiopian Public Health Institute (EPHI).Culture media was prepared according to manufactures instruction, and the sterility was checked by incubating 5% of prepared media at 35–37°C overnight and observing bacterial growth. Those batches of the media that showed the growth were discarded and re-prepared. Data quality control for Experimental Unit is Positive and Negative Control Unit. 2.6 Data Analysis Data from all experiments was checked, cleaned, coded for completeness and entered into Microsoft Excel 2010 for analysis. Descriptive statistics such as mean and percentage were used to describe microbial load and percentage. The data were analyzed using a one-way ANOVA. Statistical analysis was performed using the post-hoc Tukey test with SPSS 25 statistical software version. A p-value of ≤ 0.05 was considered to indicate statistical significance. 3 Results 3.1 Bacterial Load Assessment All paper currency underwent an examination to determine the presence of bacterial contamination. The microbial load of each culture was quantified using the log (CFU/cm 2 ) expression. As depicted in Fig. 3 , bacteria were detected in the entire sample collected from various sources. Figure 3 showcases the microbial loads of Gram-positive bacteria isolated from different sample codes. Notably, code 012 (fruit stalls note) displayed the highest concentration of gram-negative bacteria, whereas code 008 (supermarket note) exhibited the lowest concentration. Moreover, code 001(vegetable shops) had the highest concentration of gram-positive bacteria. Similarly, code 020 (cafeteria note) had a substantial microbial load of mold, while code 016 (market customers note) had a significant microbial load of yeast. Figure 2 highlights that gram-positive bacteria were the most prevalent microbial isolate, while yeast was the least prevalent. 3.2 Phenotypic and Microscopic identification For this study, Microscopic, biochemical and phenotypic characterization were investigated, as shown in Table 1 , 2 and Table 3 . Based on the results from the table, bacteria, mold and yeast were isolated from code 001, 004, 008, 012, 016, and 020 samples. The phenotypic, microscopic, and biochemical characteristics of bacteria and fungi isolated from all sample code suggest that they are Klebsiella spp, E. coli , Streptococcus spp, Bacillus spp and staphylococcus aureus . Regarding the Fungal species, most of the isolated fungal species are more related with Aspergilus spp and yeast. Regarding the prevalence of bacterial spp, among the 200 isolated bacterial colonies, 70 (35%) were staphylococcus aureus , 60 (30%) was streptococcus spp. 50 (25%) were Bacillus spp, and 9 (4.5%) were klebissela spp and 11 (5.5%) are E. coli . Regarding the prevalence of fungal spp, among the 50 isolated fungal colonies, the prevalence of Aspergillus spp is around 20 (40%), and 30 (60%) for the yeast. Table 1 Phenotypic and Microscopic characterization of isolated bacteria Isolates No of Isolates Form Color Elevation Margin GS GR GA 1 11 Circular Pink Convex Entire Bacilli -- Chain 2 15 Irregular White Flat Undulated Bacilli ++ Chain 3 70 Circular Golden Flat Entire Cocci ++ Cluster 4 60 Circular White Convex Entire Cocci ++ Chain 5 9 Circular Red Convex Entire Bacilli -- short chains 6 35 Irregular White Flat Undulated Bacilli ++ Chain Where; GR = Gram Reaction, GS = Gram Shape, GA = Gram Arrangement Table 2 Biochemical characterizations of isolated bacteria (Isolated from code 001,004,008,012,016,020) Isolates No of Isolates Indole Motility Catalase H 2 S-P Gas-P MR-test CU-Test 1 11 ++ ++ ++ -- ++ ++ -- 2 15 -- ++ ++ -- ++ -- ++ 3 70 -- -- ++ -- -- -- -- 4 60 -- -- -- -- -- -- ++ 5 9 -- -- ++ -- -- ++ ++ 6 35 -- ++ ++ -- ++ -- ++ Where; H2S-P = Hydrogen sulfide production; Gas-P = Gas Production; MR-test = Methyl Red Test; CU-Test = Citrate Utilization Test; Table 3 Phenotypic and Microscopic characterization of isolated Fungal (Isolated from code 008 and 020) Isolates No of Isolates ST CP (Front view) CP (Reverse view) ARV NF HN SA SS 1 13 Woolly (Velvety) Yellowish green Yellow Flat Mold Aseptate Uniserate Spherical 2 7 Woolly Dark brown brown Rugose Mold Aseptate Septate spherical 3 30 smooth White Yellow Flat Yeast None None None Where; ST = Surface Texture, CP = Colony Pigmentation, ARV = Appearance of the Reverse view, NF = Nature of the fungus, HN = Hyphae Nature, SA = Spore Arrangement, SS = Spore shape Preliminary classification of the bacterial isolates, based on their phenotypic, microscopic and biochemical characteristics of Table 1 and Table 2 , suggests that bacteria from isolate 1, 2, 3, 4, 5 and 6 may be identified as Escherichia coli , Bacillus spp., Staphylococcus aureus , Streptococcus spp., Klebsiella spp, respectively. Based on the phenotypic and microscopic characteristics of Table 3 , it is possible to tentatively classify isolates 1 and 2 as Aspergillus flavus , while isolate 3 is likely to be Saccharomyces cerevisiae . 3.3 Antimicrobial susceptibility test profile of Isolates Table 4 illustrates the antimicrobial susceptibility patterns of Staphylococcus aureus and Streptococcus spp., revealing diverse sensitivity and resistance profiles. Notably, both Staphylococcus aureus and Streptococcus spp. exhibited 100% sensitivity to the antibiotic vancomycin. Additionally, these two species displayed complete sensitivity to another antibiotic. In contrast, ampicillin showed relatively poor efficacy against the Staphylococcus aureus isolate, while erythromycin also demonstrated limited effectiveness against Streptococcus spp. compared to other antibiotics tested. Table 4 Antimicrobial susceptibility test profile of Staphylococcus aureus and Streptococcus spp Antibiotics Staphylococcus aureus Streptococcus spp % Resistance (Mean ± SEM) % Sensitivity (Mean ± SEM) % Resistance (Mean ± SEM) % Sensitivity (Mean ± SEM) Tetracycline (TE) 16.6667 ± 1.66667 83.3333 ± 1.66667 0 ± 2.88675 95.000 ± 2.88675 Ampicillin (AMP) 80.1667 ± .16667 19.8333 ± .16667 10 ± 1.66667 81.6667 ± 1.66667 Vancomycine (VA) 0.00 ± .00000 100.0000 ± .00000 0 ± .00000 100 ± .00000 Erythromycin (ERY) 40.3333 ± .33333 59.6667 ± .33333 20 ± 1.45297 77.6667 ± 1.45297 Where; P < 0.005, statistically significant, TE (30µg), AMP (10µg), VA (30 µg), ERY (15 µg) Table 5 presents the results of the antimicrobial susceptibility test conducted on Klebsiella spp and E. coli . The antibiotics employed for this species included Ciprofloxacin, Ampicillin, Cotrimoxazole, and Gentamycin. Accordingly, Klebsiella spp. demonstrated a higher sensitivity towards Ciprofloxacin, while exhibiting a lower sensitivity (6.6667 ± 1.66667%) towards Ampicillin. Similarly, E. coli demonstrated a higher sensitivity towards Ampicillin, while exhibiting a lower sensitivity (29.6667 ± .33333%) towards Gentamycin. Table 5 Antimicrobial susceptibility test profile of gram negative bacteria Antibiotics Klebsiella spp Escherichia coli % Resistance (Mean ± SEM) % Sensitivity (Mean ± SEM) % Resistance (Mean ± SEM) % Sensitivity (Mean ± SEM) Gentamycin (GEN) 4.8 ± 1.66667 51.6667 ± 1.66667 70.3333% ± .33333 29.6667% ± .33333 Ciprofloxacin (CIP) 15.000 ± 2.88675 85.0000 ± 2.88675 59.6667% ± .33333 40.3333% ± .33333 Ampicillin (AMP) 93.333 ± 1.66667 6.6667 ± 1.66667 19% ± 1.00000 81.0000% ± 1.00000 Cotrimozazole (COT) 55 ± 2.88675 45.0000 ± 2.88675 59.3333% ± .66667 40.6667% ± .66667 Where; P < 0.005, statistically significant, GEN (10µg), AMP (10µg), COT (25 µg), CIP (5 µg) Generally, when comparing the inhibition zones produced by antibiotics on the Staphylococcus aureus isolate, there was a statistically significant difference between groups, as demonstrated by a one-way ANOVA (F (3, 8) = 1658.321, p = .000). A Tukey post hoc test indicated that there was a significant difference between the groups. Similarly, when comparing the inhibition zones produced by antibiotics on the Streptococcus isolate, there was a statistically significant difference between groups, as demonstrated by a one-way ANOVA (F (3, 8) = 34.137, p = .000). A Tukey post hoc test indicated that there was a significant difference between the groups. However, there is no statistically significant difference between the antibiotics Tetracycline and Vancomycin, as well as between Ampicillin and Erythromycin. Generally, when comparing the inhibition zones produced by antibiotics on the Klebsiella spp isolate, there was a statistically significant difference between groups, as demonstrated by a one-way ANOVA (F (3, 8) = 185.792, p = .000). A Tukey post hoc test indicated that there was a significant difference between the groups except Cotrimozazole and gentamycin. Similarly, when comparing the inhibition zones produced by antibiotics on the Escherichia coli isolate, there was a statistically significant difference between groups, as demonstrated by a one-way ANOVA (F (3, 8) = 1230.111, p = .000). A Tukey post hoc test indicated that there was a significant difference between the groups. However, there is no statistically significant difference between the antibiotics Cotrimozazole and Ciprofloxacin. 3.4 Hygiene behaviors and sociodemographic traits Table 6 displays the results of a study involving 178 participants who all completed a survey. Among the participants, 77.5% were literate, 11.2% had completed primary education, 5.6% had completed secondary education, and 5.6% were illiterate. The majority of the participants, specifically 71.9%, were male, while 33.7% were female. The study found that 64% of the participants used pockets to store paper bills, while 20.2% used purses, 6.7% used other storage methods, and 9% used wallets. When it comes to the question "How often do you clean or disinfect the place where you store your paper currency?” 40.4% of the participants rarely clean their storage, 36% clean it occasionally, 15.7% clean it often, and 7.9% clean it very often. For the question "Are you aware of the potential growth of microorganisms from storing paper currency?” 36% of the participants were aware of this potential, 28.1% were somewhat aware, 12.4% were unsure, and 2.2% were not aware. Table 6 Sociodemographic traits and public awareness towards paper currency regarding paper storage Variables Categorical variables frequency Percentage (%) Sex Male Female 128 60 71.9 33.7 Level of education Illiterate Primary Secondary Literate 10 20 10 138 5.6 11.2 5.6 77.5 Age 11–20 21–30 31–40 60 80 38 33.7 45 21.3 Q.1.How do you typically store your paper currency? Wallet Purse Pocket Other storage 16 36 114 12 9 20.2 64 6.7 Q.2.How often do you clean or disinfect the place where you store your paper currency? Very often Often Occasionally Rarely 14 28 64 72 7.9 15.7 36 40.4 Q.3. Are you aware of potential microorganism growth from storing paper currency? Yes, I am aware Somewhat aware Unsure No, I am not aware 64 50 22 4 36 28.1 12.4 2.2 Figure 4 , Picture A, displays the results for the question, "Do you store your paper currency separately from other items, such as coins or cards, to prevent cross-contamination?" The data shows that 34.8% (62) of participants do not store their paper currency separately, 28.1% (50) store them separately, and 27% (48) sometimes store paper currency separately. Additionally, 10.1% (18) of respondents indicated that they do not use or store paper currency, making the question not applicable to them. Similarly, Fig. 3 , Picture B, presents the results for the question, "Do you take any precautions to prevent your paper currency from getting wet, crumpled, or damaged?" The data indicates that 38.2% (68) of participants take several precautions, while 27% take some precautions, and 19.1% occasionally take precautions. Additionally, 15.7% of participants do not take any precautions. In response to the question, "Have you ever experienced any issues with your paper currency, such as unpleasant odors or visible mold that could be related to storage conditions?" 41.6% of participants reported experiencing unpleasant odors or visible mold that could be related to storage conditions. Additionally, 24.7% experienced minor issues, 19.1% have not experienced such issues, and 14.6% were unsure about this problem as reported in Fig. 2 , picture C. Figure 4 , Picture D, shows the results for the question, "How important do you think proper storage of paper currency is in preventing the transmission of diseases?" The responses indicate that 50.6% considered proper storage very important, while 2.2% did not believe in its importance, 2.2% considered it less important, and 5.6% remained neutral on the question. The figure above demonstrates public awareness of the potential for disease transmission through paper currency. In Fig. 5 , Picture D, 79.8% of participants were aware of the disease risk associated with handling paper currency, while 20.2% had no knowledge of this risk. In Picture C, Fig. 5 shows the precautions taken after handling paper currency. According to the figure, 53.9% of participants do not take any precautions, 36% wash their hands, and only 10.1% use hand sanitizer. In Figure B, participants' interest in using digital payment as a lower-risk alternative is shown. 44.9% strongly agree with using digital payment, 42.7% agree, 11.2% are neutral, and 1.1% strongly disagree. The final question asked whether providing information on disease transmission through paper currency should be part of public health campaigns. The responses were as follows: 47.2% agree, 37.1% strongly agree, 9% are neutral, 5.6% disagree, and 1.1% strongly disagree. 4 Discussion In this study, we looked into the amount of bacteria that were present in the collected sample. This study discovered that bacteria and fungi were present across the entire sample drawn from a variety of sources, according to our findings. Our findings demonstrate that all samples harbored bacterial contamination, emphasizing the ubiquity of microbes on frequently exchanged items, such as currency notes. This observation corroborates previous studies that have highlighted the potential role of paper currency in the transmission of pathogens [ 6 , 7 , 26 – 29 ]. Gram-positive bacteria were the most prevalent microbial isolate in our samples, possibly indicating their greater ability to survive on paper currency or a higher rate of contamination from common sources. This finding has important public health implications, as some gram-positive bacteria, including Staphylococcus aureus and Streptococcus pyogenes , are known to cause serious infections [ 30 – 33 ]. Although gram-negative bacteria, mold, and yeast were present at lower concentrations, they should not be disregarded, as these microorganisms can also cause infections, particularly in individuals with weakened immune systems [ 34 , 35 ]. Similar kind of finding in South Africa explore the contamination of banknotes and other surfaces with microorganisms [ 36 ]. Similarly, research from Jimma Town in Ethiopia indicates that paper money may act as a vehicle for the spread of pathogenic microbes [ 22 ]. Therefore, our study suggests that poor handling practices and personal hygiene of food vendors could contribute to these microbial counts. In this study, we employed microscopic, biochemical, and phenotypic characterization methods to identify and assess the prevalence of bacterial and fungal species in samples from various sources. Our results, as shown in Tables 2 and 3 , revealed the presence of a diverse range of microorganisms, including klebissesla spp., Streptococcus spp., Bacillus spp., E. coli , spp., Staphylococcus aureus ., Aspergillus spp., and yeast, across the sampled codes (001, 002, 005, 006, and 008). The microbial diversity observed in our samples underscores the potential public health implications of bacterial and fungal contamination. Notably, we identified gram-positive ( Streptococcus spp., Bacillus spp., and Staphylococcus aureus ) and gram-negative ( Klebsiella spp and E. coli ) bacteria, as well as mold ( Aspergillus spp.) and yeast. This diverse array of microorganisms is consistent with previous studies reporting the presence of various bacterial and fungal species in environmental samples [ 37 – 40 ]. The prevalence of specific bacterial and fungal species varied across the samples. Among the 200 isolated bacterial colonies, Staphylococcus aureus predominated (35%), followed by Streptococcus spp (30%), Bacillus spp. (25%), and Enterobacteriaceae spp (10%). As for the 50 isolated fungal colonies, Aspergillus spp. accounted for 40%, while yeast accounted for 60%. The variation in prevalence across samples could be attributed to factors such as differences in environmental conditions, handling practices, or potential cross-contamination during sample collection and processing. Several of the identified microorganisms are known to have clinical and public health significance. For instance, Staphylococcus aureus , Streptococcus spp., and Enterobacteriaceae spp. have been implicated in various human infections [ 41 , 42 ]. Moreover, the presence of Aspergillus spp. and yeast may pose health risks, particularly for individuals with weakened immune systems or underlying respiratory conditions [ 35 ]. In the study regarding the antibiotics susceptibility test, we investigated the antimicrobial susceptibility patterns of Staphylococcus aureus , Streptococcus spp., Klebissela spp and E. coli . isolated from various samples. Our results, presented in Tables 4 and 5 , demonstrate diverse patterns of sensitivity and resistance to the tested antibiotics. For Staphylococcus aureus and streptococcus spp., our findings indicate high sensitivity towards certain antibiotics, such as Vancomycine and Tetracycline, suggesting that these may be effective treatment options for infections caused by these bacterial species. Conversely, Ampicillin exhibited relatively poor performance against these isolates, which may necessitate the consideration of alternative treatment options or further resistance testing when dealing with infections caused by Staphylococcus aureus and Streptococcus spp. A similar investigation was conducted in Nepal and Ghana, where it was found that all Staphylococcus aureus isolate were resistant to Ampicillin. However, it was observed that all strains were sensitive to vancomycin [ 43 , 44 ]. Similarly, study done in japan also demonstrate that Tetracyclines have emerged as a second choice of antibiotics to beta-lactams for the management of mastitis in dairy herds which is caused by Gram-positive bacteria [ 45 , 46 ]. Klebsiella spp. demonstrated higher sensitivity towards Ciprofloxacin, but showed a notably higher resistance rate (55%) to Cotrimoxazole, and Ampicillin. Zakia and his collegue also made a similar finding. They discovered that antimicrobial agents such as Ciprofloxacin and Gentamycin retained their antimicrobial activities against both strains of E. coli (ZK9, ZK40, and ZK60) and K. pneumoniae (ZK32 and ZK89). On the other hand, studies conducted in Gahana have shown that commonly recovered bacterial enterobacteriace isolates, such as E. coli , Salmonella spp, klebissela spp have a high resistance to co-trimoxazole, and Gentamycin [ 44 ].This finding raises concerns about the use of Cotrimoxazole and Gentamycin as an empirical treatment option for infections caused by E. coli, Salmonella spp, klebissela spp and emphasizes the importance of understanding the local antimicrobial resistance patterns when selecting appropriate treatment. Our findings underscore the significance of antibiotic stewardship in the face of growing antimicrobial resistance. The appropriate selection and use of antibiotics are crucial to minimizing the development of resistance and preserving the effectiveness of available treatments. In this study, we evaluated how aware the public is about the transmission of diseases through paper currency and the precautions they take after handling money. Our findings indicate that a significant majority of participants (79.8%) are aware of the potential risks associated with handling paper currency, while 20.2% are not. This suggests that, although many people recognize the possibility of disease transmission through paper currency, there is still a need for targeted education and awareness campaigns to reach those who are uninformed. While there have been no previous studies specifically focusing on the storage of paper currency and disease transmission, research on other objects, such as doorknobs and handrails, has demonstrated that contaminated surfaces can contribute to the spread of diseases [ 47 – 49 ]. Given that paper currency can also serve as a potential vector for disease transmission, it is crucial to raise awareness about safe storage practices. Our study discovered that a notable percentage of participants (53.9%) do not take any precautions after handling paper currency. In contrast, 36% of participants wash their hands and 10.1% utilize hand sanitizer. This discrepancy in adhering to proper hand hygiene practices is worrisome, considering that hand hygiene is widely recognized as a crucial preventive measure against infection transmission [ 50 , 51 ]. Several studies [ 52 – 54 ] have emphasized the importance of hand washing or the use of hand sanitizers in reducing the transmission of diseases in various settings. However, limited research has specifically focused on hand hygiene practices after handling paper currency. Our findings suggest that public health campaigns should highlight the importance of hand hygiene, particularly in the context of handling money, to minimize potential health risks. Our study examined participants' interest in digital payments as a safer alternative to paper currency, as well as their opinions on including information about disease transmission through paper currency in public health campaigns. A significant number of participants (44.9%) strongly agreed with the use of digital payments as a lower-risk alternative, while 42.7% agreed. Only 11.2% were neutral, and a mere 1.1% strongly disagreed. This high level of interest in digital payments can be attributed to the increasing global trend of adopting cashless payment methods, as pointed out by Rahul, Gardner, and their colleagues [ 55 , 56 ], who emphasized the potential benefits of digital payments in terms of convenience, security, and reduced health risks. Our findings suggest that promoting digital payments could be an effective strategy for minimizing the potential disease transmission associated with handling paper currency. A significant majority of participants (47.2% agree and 37.1% strongly agree) in our study emphasized the importance of including information on disease transmission through paper currency in public health campaigns. This finding is consistent with previous research that has highlighted the critical role of health communication in raising public awareness about disease prevention [ 57 , 58 ]. While there may be limited studies specifically addressing the inclusion of information on disease transmission through paper currency in public health campaigns, our findings suggest that such initiatives would be well-received by the public. The strong support expressed by participants indicates a demand for more targeted and comprehensive health communication strategies that address various aspects of disease prevention, including those related to the handling of paper currency. Our study revealed that a significant portion of participants (34.8%) do not store their paper currency separately from other items, while 28.1% do store them separately, and 27% sometimes store them separately. This finding is concerning, as it suggests that many individuals may not be following optimal practices to minimize the potential for cross-contamination between paper currency and other items. Although there may be limited research specifically addressing the storage of paper currency separately from other items, our findings can be contextualized within the broader literature on hygiene practices and disease transmission. Research has consistently shown that maintaining cleanliness and separating potentially contaminated items can reduce the risk of spreading diseases [ 59 ]. Our study showed that a significant percentage of participants (38.2%) take several precautions to prevent their paper currency from getting wet, crumpled, or damaged, while others take some precautions (27%) or occasionally take precautions (19.1%). However, 15.7% do not take any precautions, suggesting that a portion of the population may not be aware of or concerned about the potential risks associated with damaged or deteriorated paper currency. In line with the above sentence, Studies have shown that individuals' awareness of potential risks and their perception of the severity of these risks influence their likelihood of adopting preventive measures [ 60 ]. In this context, the lack of precautions taken by some participants might indicate a need for targeted education and awareness campaigns. Such initiatives should emphasize the potential risks associated with damaged or deteriorated paper currency, such as the increased likelihood of transmitting diseases, and promote the adoption of preventive measures to minimize these risks. Our study revealed that 41.6% of participants have experienced issues with their paper currency, such as unpleasant odors or visible mold, which could be related to improper storage conditions. Additionally, 24.7% have experienced minor issues, while 19.1% have not encountered such problems, and 14.6% were unsure. These findings suggest that a significant proportion of people have encountered problems related to the storage of paper currency, which could indicate a need for better education on proper storage methods. Research has consistently shown that maintaining cleanliness and proper storage of various items can reduce the risk of spreading diseases and prevent spoilage or damage [ 59 , 61 ]. In light of this evidence, the issues encountered by participants in our study might indicate a need for targeted education and awareness campaigns. Such initiatives should emphasize the importance of proper paper currency storage to prevent potential health risks and maintain the integrity of the currency. Our study found that most participants (50.6%) consider proper storage of paper currency very important for preventing disease transmission. However, small percentages (2.2%) do not believe in its importance, and another 2.2% consider it less important, with 5.6% remaining neutral. These findings suggest that while a majority of people recognize the importance of proper paper currency storage in disease prevention, there are still some who do not see it as a priority. Research on health beliefs and attitudes has shown that individuals' perceptions of the importance of various health-related behaviors can significantly influence their adherence to recommended practices [ 62 , 63 ]. In the context of our study, the varying perceptions of the importance of proper paper currency storage could be explained by differences in individuals' health beliefs and attitudes. In addition, resource variables, such as education level, personal health status, and social support, play moderating roles in perceptions of the importance of proper paper currency storage. Our study found that 64% of participants stored paper bills in pockets, 20.2% used purses, 9% used wallets, and 6.7% used other storage methods. The predominant use of pockets for storing paper currency raises concerns about the potential for microbial contamination and disease transmission, as pockets may not provide a clean and protective environment for storing currency. Previous studies have shown that various surfaces and items, including money, can harbor microorganisms, including fungi, viruses and protozoa [ 64 – 66 ]. The transfer of these microorganisms can occur when people touch contaminated surfaces and then touch their face, increasing the risk of infection [ 67 ]. In the context of our study, storing paper currency in pockets might increase the likelihood of contamination, as pockets can be exposed to various environmental factors and may not be regularly cleaned. Therefore, it is essential to consider alternative storage methods that provide better protection and minimize the risk of microbial transmission. Although there might be limited research specifically addressing the hygiene aspects of different paper currency storage methods, our findings suggest that promoting the use of cleaner and more protective storage options, such as wallets or purses, could contribute to better hygiene practices and reduce the potential for disease transmission. Our study revealed that 40.4% of participants rarely cleaned or disinfected the storage place for their paper currency, while 36% did so occasionally, 15.7% often, and 7.9% very often. This suggests that a significant proportion of participants do not frequently clean or disinfect the areas where they store their paper currency, which could potentially create an environment conducive to microbial growth. Existing research emphasizes the importance of regular cleaning and disinfection of surfaces to minimize microbial contamination and reduce the risk of disease transmission [ 68 , 69 ]. Inadequate cleaning of surfaces can allow for the accumulation of microorganisms, some of which may be potentially harmful to human health. Our findings suggest that promoting more frequent cleaning and disinfection of these areas could contribute to better hygiene and lower the risk of microbial growth. Participants who rarely or occasionally clean their paper currency storage areas may benefit from targeted education on the importance of regular cleaning practices to maintain a cleaner and safer environment for storing their money. Our study found that 36% of participants were aware of the potential for microorganism growth from storing paper currency, 28.1% were somewhat aware, 12.4% were unsure, and 2.2% were not aware. These findings suggest that while a significant proportion of participants have some awareness of the potential risks, there is still a need for further education and awareness campaigns to improve understanding and promote better paper currency storage practices. Existing research emphasizes the importance of public awareness and knowledge in promoting positive health behaviors [ 70 , 71 ]. Knowledge about potential health risks, such as microbial growth on paper currency, can encourage individuals to adopt preventive measures to protect their health and the health of others. Our findings suggest that targeted education campaigns could improve awareness and encourage better storage practices. By providing clear information about the potential risks and preventive measures, these campaigns could help individuals make more informed decisions about how they store and handle paper currency. 5 Conclusion This study presents a comprehensive analysis of microbial contamination in various samples of paper notes and the associated public health risks. In terms of microbial load, gram-positive bacteria had the highest average microbial counts, while yeast had the lowest. The bacteria and fungi isolated from the samples were identified as Klebsiella spp, E. coli, Streptococcus spp, Bacillus spp, Aspergillus spp, and Staphylococcus aureus based on their phenotypic, microscopic, and biochemical characteristics. The antimicrobial susceptibility patterns of Staphylococcus aureus and Streptococcus spp were determined, and both showed 100% sensitivity to Vancomycin and good sensitivity to Tetracycline antibiotics. Similarly, Klebsiella spp showed higher sensitivity to Ciprofloxacin while exhibiting a lower sensitivity rate (6.6667%) to Ampicillin. In contrast, Ampicillin showed higher activity on the E. coli isolates. Socio-demographic factors were found to influence awareness and practices related to disease transmission through paper currency, highlighting the importance of targeted public education campaigns. The study revealed that while some participants are aware and take preventive measures, additional education and awareness campaigns are required to encourage improved handling and storage habits of paper currency. In general, the study affirms that paper bills provide an ideal environment for bacterial growth and could potentially contribute to infections, especially among individuals with compromised immune systems. Thus, it emphasizes the necessity of raising awareness about the potential risks associated with improper handling of paper currency in all food establishments. Declarations Funding: No sources of fund for this study Conflict of interest/Competing interests: The authors declare that they have no conflicts of interest. Ethics approval and consent to participate: Ethical approval is applicable and has been obtained for this study from the Institutional Review Board (IRB) of Arba Minch University, ensuring compliance with established ethical standards and guidelines. Moreover, Informed consent was obtained from all individual participants included in the study. Participants were informed about the objectives of the study, the procedures, the potential risks and benefits, and their right to withdraw from the study at any time without negative consequences. The consent forms were signed by all participants before data collection began. Consent for publication: Written informed consent for the publication of study findings was obtained from all participants who contributed to the research through questionnaires. The participants have been informed that their identity will remain anonymous, and no personal identifying information will be disclosed in the publication. Data Availability: The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request. Materials availability: Not applicable Code availability: Not applicable Authors Contributions: F.D. played a central role in all phases of the study, including research design, data collection and monitoring in the laboratory, data analysis, interpretation, and the write-up of the manuscript. D.E., Y.S., and S.D. were involved in designing the study project, supervised the research, and critically revised the manuscript for publication. All authors read and approved the final manuscript. Acknowledgments: The authors would like to sincerely thank Arba Minch University for their invaluable support and resources. References Alemu, A., Microbial contamination of currency notes and coins in circulation: a potential public health hazard. Biomedicine and biotechnology, 2014. 2 (3): p. 46-53. Angelakis, E., et al., Paper money and coins as potential vectors of transmissible disease. Future Microbiol, 2014. 9 (2): p. 249-61. Angelakis, E., et al., Paper money and coins as potential vectors of transmissible disease. Future microbiology , 2014. 9 (2): p. 249-261. Akoachere, J.-F.T.K., et al., Public health implications of contamination of Franc CFA (XAF) circulating in Buea (Cameroon) with drug resistant pathogens. BMC research notes , 2014. 7 : p. 1-13. Gedik, H., T.A. Voss, and A. Voss, Money and transmission of bacteria. Antimicrobial resistance and infection control , 2013. 2 : p. 1-4. Moosavy, M.-H., et al., Bacterial contamination of Iranian paper currency. Iranian journal of public health , 2013. 42 (9): p. 1067. Ayandele, A. and S. Ayandele, Prevalence and antimicrobial resistance pattern of microorganisms isolated from Naira notes in Ogbomoso North, Nigeria. Journal of research in Biology , 2011. 1 (8): p. 587-593. Lamichhane, J., et al., Risk of handling paper currency in circulation chances of potential bacterial transmittance. Nepal Journal of Science and Technology, 2009. 10 : p. 161-166. Pradeep, N., et al., Microbial contamination of Indian currency notes in circulation. Journal of Research in Biology , 2012. 2 (4): p. 377-382. Girma, G., T. Ketema, and K. Bacha, Microbial load and safety of paper currencies from some food vendors in Jimma Town, Southwest Ethiopia. BMC Research Notes , 2014. 7 (1): p. 843. Saripalli, H., et al., Assessment of microbial contamination of ethiopian currency notes. Research Journal of Pharmaceutical, Biological and Chemical Sciences , 2014. 5 : p. 510-515. Ahmed, M.S.U., et al., Evaluation of the microbial contamination of Bangladesh paper currency notes (Taka) in circulation. Advances in biological research , 2010. 4 (5): p. 266-271. Kuria, J., et al., Profile of bacteria and fungi on money coins. East African medical journal, 2009. 86 (4). Girma, G., Health risk associated with handling of contaminated paper currencies in circulation: A review. Am Sci Res J Eng Technol Sci, 2014. 10 (1): p. 40-53. Borah, D., P. Parida, and T. Kumar, Paper currencies, a potential carrier of pathogenic microorganisms. International Journal of Applied Biology and Pharmaceutical Technology, 2012. 3 (1): p. 23-25. Awe, S., et al., Bacteriological quality of some Nigerian currencies in circulation. African journal of Microbiology research , 2010. 4 (21): p. 2231-2234. Alwakeel, S.S. and L.A. Nasser, Bacterial and fungal contamination of Saudi Arabian paper currency and cell phones. 2011. Singh, P., et al., Hand sanitizer an alternative to hand washing—a review of literature. Journal of Advanced Oral Research, 2020. 11 (2): p. 137-142. Abuga, K. and N. Nyamweya, Alcohol-based hand sanitizers in COVID-19 prevention: a multidimensional perspective. Pharmacy , 2021. 9 (1): p. 64. Allegranzi, B. and D. Pittet, Role of hand hygiene in healthcare-associated infection prevention. Journal of hospital infection, 2009. 73 (4): p. 305-315. Dejene, F., B. Regasa Dadi, and D. Tadesse, In vitro antagonistic effect of lactic acid bacteria isolated from fermented beverage and finfish on pathogenic and foodborne pathogenic microorganism in Ethiopia. International journal of microbiology, 2021. 2021 . Girma, G., T. Ketema, and K. Bacha, Microbial load and safety of paper currencies from some food vendors in Jimma Town, Southwest Ethiopia. BMC research notes, 2014. 7 : p. 1-8. Jalgaonkar, S., et al., Currency as fomites? Indian Journal of Community Medicine , 2007. 32 (2): p. 157-158. Abdulla, S.M., Isolation and Identification of causative agents from some Iraqi Banknote currency. Ibn AL-Haitham Journal For Pure and Applied Science, 2017. 26 (1): p. 75-81. Chauwa, A., et al., Assessment of Bacteriological Contamination of the Zambian Paper Currency in Circulation in Selected Areas of Lusaka City, Zambia. International Journal of Research, 2020. 6 (2): p. 14-21. Yazah, A.J., J. Yusuf, and A. Agbo, Bacterial contaminants of Nigerian currency notes and associated risk factors. 2012. Neel, R., Isolation of pathogenic microorganisms from contaminated paper currency notes in circulation from different market places in Korogwe and Mombo towns in Tanzania. 2012. Pal, K., N. Das, and S. Bhattacharya, Bacteriological profile of Indian currency circulating in a tertiary care hospital in rural Bengal. IJRRMS , 2013. 3 (2): p. 23-30. Sadawarte, K., H. Mahobe, and G. Saxena, Microbial contamination of Indian currency notes in Bhopal. Journal of Evolution of Medical and Dental Sciences, 2014. 3 (6): p. 1379-1384. Thapaliya, D., et al., Epidemiology of necrotizing infection caused by Staphylococcus aureus and Streptococcus pyogenes at an Iowa hospital. Journal of infection and public health , 2015. 8 (6): p. 634-641. Del Giudice, P., Skin infections caused by Staphylococcus aureus. Acta dermato-venereologica, 2020. 100 (9). Wong, S.S. and K.-Y. Yuen, Streptococcus pyogenes and re-emergence of scarlet fever as a public health problem. Emerging Microbes & Infections , 2012. 1 (1): p. 1-10. Watanabe, S., et al., Severe invasive streptococcal infection by Streptococcus pyogenes and Streptococcus dysgalactiae subsp. equisimilis. Microbiology and immunology , 2016. 60 (1): p. 1-9. Kraft, S., L. Buchenauer, and T. Polte, Mold, Mycotoxins and a Dysregulated Immune System: A Combination of Concern? Int J Mol Sci, 2021. 22 (22). Luis Enrique Jerez, P., Fungal Infections in Immunosuppressed Patients, in Immunodeficiency, M. Krassimir, Editor. 2012, IntechOpen: Rijeka. p. Ch. 6. Igumbor, E., et al., Microbiological analysis of banknotes circulating in the Venda region of Limpopo province, South Africa: research in action. South African Journal of Science , 2007. 103 (9): p. 365-366. Su, G.L.S., et al., Bacteriological and parasitological assessment of currencies obtained in selected markets of Metro Manila. Asian Pacific Journal of Tropical Disease , 2015. 5 (6): p. 468-470. Aorkwagh, M., et al., Isolation And Identification of Bacteria Prevalent Among Nigerian Currency Notes In Selected Areas In and Around Akperan Orshi College Of Agriculture, Yandev. Journal of Scientific and Industrial Studies, 2015. 13 (3): p. 74-81. Oluduro, A., et al., Antibiotic resistance and public health perspective of bacterial contamination of Nigerian currency. Advances in Life Science and Technology, 2014. 24 : p. 4-9. Al-Tarjuman, J.K., F.N. Mula Abed, and F.K. Al-Dulaimi, Study on fungal contamination of Iraqi paper currency. Biochemical & Cellular Archives, 2020. 20 (1). Dougnon, V., et al., Enterobacteria responsible for urinary infections: a review about pathogenicity, virulence factors and epidemiology. Journal of Applied Biology and Biotechnology, 2020. 8 (1): p. 117-124. Haenni, M., A. Lupo, and J.-Y. Madec, Antimicrobial resistance in Streptococcus spp. Microbiology spectrum, 2018. 6 (2): p. 10.1128/microbiolspec. arba-0008-2017. Pandey, S., M. Raza, and C. Bhatta, Prevalence and antibiotic sensitivity pattern of methicillin-resistant-Staphylococcus aureus in Kathmandu Medical College-Teaching Hospital. Journal of Institute of Medicine Nepal (JIOM Nepal), 2012. 34 (1): p. 13-17. Yar, D.D., Bacterial contaminants and antibiogram of Ghana paper currency notes in circulation and their associated health risks in asante-mampong, Ghana. International Journal of Microbiology, 2020. 2020 : p. 1-8. Kuang, Y., et al., Effect of milk on antibacterial activity of tetracycline against Escherichia coli and Staphylococcus aureus isolated from bovine mastitis. Applied microbiology and biotechnology, 2009. 84 : p. 135-142. Al-Nazawi, M.H., Resistance and residues of antibacterial in dairy farm and dairy production in Al-Hassa Region, Saudi Arabia. 2006. Stephens, B., et al., Microbial exchange via fomites and implications for human health. Current Pollution Reports, 2019. 5 : p. 198-213. Olise, C. and I. Simon-Oke, Fomites: Possible vehicle of nosocomial infections. Journal of Public Health and Nutrition, 2018. 1 (1). Chu, D.-T., et al., Transmission of SARS-CoV-2 infections and exposure in surfaces, points and wastewaters: A global one health perspective. Case Studies in Chemical and Environmental Engineering, 2022. 5 : p. 100184. Toney-Butler, T.J., A. Gasner, and N. Carver, Hand Hygiene, in StatPearls. 2024, StatPearls Publishing Copyright © 2024, StatPearls Publishing LLC.: Treasure Island (FL) ineligible companies. Disclosure: Adi Gasner declares no relevant financial relationships with ineligible companies. Disclosure: Niki Carver declares no relevant financial relationships with ineligible companies. Hoang, D., et al., Video didactic at the point of care impacts hand hygiene compliance in the neonatal intensive care unit (NICU). Journal of Healthcare Risk Management, 2018. 37 (4): p. 9-15. Roy, A., S.P. Parida, and V. Bhatia, Role of disinfection and hand hygiene: a COVID-19 perspective. Int. J. Community Med. Public Health, 2020. 7 : p. 2845. Gupta, M.K. and S.R. Lipner, Hand hygiene in preventing COVID-19 transmission. J Am Acad Dermatol, 2020. 82 : p. 1215-1216. Marumure, J., et al., Effectiveness of hand sanitizers in the prevention of COVID-19 and related public health concerns: A review. Cogent Public Health, 2022. 9 (1): p. 2060904. De’, R., N. Pandey, and A. Pal, Impact of digital surge during Covid-19 pandemic: A viewpoint on research and practice. International Journal of Information Management, 2020. 55 : p. 102171. Gardner, B., Dirty banknotes may be spreading the coronavirus, WHO suggests. Daily Telegraph, 2020. 8 . Badr, E., Public health communication: some lessons for effectiveness. Sudanese Journal of Public Health, 2009. 4 (3): p. 313. J, S., et al., Health communication and its role in the prevention and control of communicable diseases in Europe Current evidence, practice and future developments. 2014. Organization, W.H., Infection prevention and control of epidemic-and pandemic-prone acute respiratory infections in health care. Annex G, use of disinfectants: alcohol and bleach. 2014. 2020. Weinstein, N.D. and W.M. Klein, Resistance of personal risk perceptions to debiasing interventions. Health Psychol, 1995. 14 (2): p. 132-40. Organization, W.H., Cleaning and disinfection of environmental surfaces in the context of COVID-19: interim guidance, 15 May 2020. 2020, World Health Organization. Rosenstock, I.M., The health belief model and preventive health behavior. Health education monographs, 1974. 2 (4): p. 354-386. Ajzen, I., The theory of planned behavior. Organizational Behavior and Hu‐man Decision Processes, 50, 179–211. De Young, 1991. 50 (2): p. 509-526. Kramer, A. and O. Assadian, Survival of Microorganisms on Inanimate Surfaces. Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections. 2014 Jul 12:7-26. doi: 10.1007/978-3-319-08057-4_2. Katzenberger, R.H., A. Rösel, and R.-P. Vonberg, Bacterial survival on inanimate surfaces: a field study. BMC Research Notes, 2021. 14 : p. 1-10. Obinna, C.N., Q.C. Somachi, and D.K.-A. Olushola. Hygiene Assessment of Paper Currency and Fomites Handled by Food Vendors in Covenant University. in IOP Conference Series: Earth and Environmental Science. 2022. IOP Publishing. Castaño, N., et al., Fomite Transmission, Physicochemical Origin of Virus-Surface Interactions, and Disinfection Strategies for Enveloped Viruses with Applications to SARS-CoV-2. ACS Omega, 2021. 6 (10): p. 6509-6527. Gebel, J., et al., The role of surface disinfection in infection prevention. GMS Hyg Infect Control, 2013. 8 (1): p. Doc10. Bloomfield, S.F., Importance of disinfection as a means of prevention in our changing world hygiene and the home. GMS Krankenhhyg Interdiszip, 2007. 2 (1): p. Doc25. Rincón Uribe, F.A., et al., Health knowledge, health behaviors and attitudes during pandemic emergencies: A systematic review. PLoS One, 2021. 16 (9): p. e0256731. Teyhen, D.S., USA, D. Robbins, and B.A. Ryan, USA, Promoting and Sustaining Positive Personal Health Behaviors – Putting the Person First. Military Medicine, 2018. 183 (suppl_3): p. 213-219. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4127253","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":286527855,"identity":"6d7df5cb-d200-4b59-89d6-4d550c07dc0c","order_by":0,"name":"Fitsum Dejene Delisho","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCUlEQVRIiWNgGAWjYBAC9mYwxczA2ACkJCpsgCRj4wF8WngOMyNpsTiTBtLSgF/LAagWMKhsOQym8Wth5z/8mTfHWo65vffgg5sN5+3Wth8G2lJjE41TCzMzmzTvtnRjxp5zyYYzd9xO3nYmEajlWFpuAw4t9kAtzLzbDic2zsgxk5Y8czvZ7ABQC2PDYZxagLYwfwZqqW+c/8b899+2c8lm5x8S1MIAdNjhBMYZPGYMkm0H7MxuELbFTHLutnTDxp4cYwmJM8kJZjeAtiTg8QsP/8HHH95us5Y3bD9j+EGiws7e7Hz6wwcfamxwaoEDQ6iKRDCdQEg5CMhDaXtiFI+CUTAKRsHIAgAH1GBSzt0S0AAAAABJRU5ErkJggg==","orcid":"","institution":"Arba Minch University","correspondingAuthor":true,"prefix":"","firstName":"Fitsum","middleName":"Dejene","lastName":"Delisho","suffix":""},{"id":286527856,"identity":"ae4a83de-911e-4170-a784-bcdba6582448","order_by":1,"name":"Saron Dereje Gorfu","email":"","orcid":"","institution":"Arba Minch University","correspondingAuthor":false,"prefix":"","firstName":"Saron","middleName":"Dereje","lastName":"Gorfu","suffix":""},{"id":286527858,"identity":"91f9f5f1-440a-4b21-9da6-e5e125145836","order_by":2,"name":"Dinka Ejeta Yambo","email":"","orcid":"","institution":"Arba Minch University","correspondingAuthor":false,"prefix":"","firstName":"Dinka","middleName":"Ejeta","lastName":"Yambo","suffix":""},{"id":286527859,"identity":"0fc67418-acfb-4340-a681-b5666e40fb93","order_by":3,"name":"Yonas Syraji Yahiya","email":"","orcid":"","institution":"Arba Minch University","correspondingAuthor":false,"prefix":"","firstName":"Yonas","middleName":"Syraji","lastName":"Yahiya","suffix":""}],"badges":[],"createdAt":"2024-03-19 04:43:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4127253/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4127253/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":54035780,"identity":"8d9953e6-3769-4f38-bb34-06afcc9f4a99","added_by":"auto","created_at":"2024-04-03 17:00:08","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":414636,"visible":true,"origin":"","legend":"\u003cp\u003eGoogle and Location Map of Arba Minch town and its business center (Source: Google Map)\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4127253/v1/9793415063bfaa13d823a4a8.jpg"},{"id":54035781,"identity":"26abb507-7a6d-4d48-aa68-36870c7bd9ca","added_by":"auto","created_at":"2024-04-03 17:00:08","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":531311,"visible":true,"origin":"","legend":"\u003cp\u003eA and B depicts: Microbial isolation, Microbial load analysis, and Antibiotic susceptibility of bacteria isolated from Ethiopian Birr notes. C depicts the potential of paper currency in transmitting communicable diseases caused by bacteria, fungi, protozoa, and helminths (sketch by Mind the Graph software).\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4127253/v1/e86d7610253790b4fc379231.jpg"},{"id":54035782,"identity":"582982a9-01ee-43d4-b964-f6a7082e2435","added_by":"auto","created_at":"2024-04-03 17:00:08","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":388023,"visible":true,"origin":"","legend":"\u003cp\u003eMean microbial counts (log CFU/cm\u003csup\u003e2\u003c/sup\u003e) of microbial groups isolated from paper currencies in Arba Minch town, southern Ethiopia (a total of 25 sample were collected from each sample code)\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4127253/v1/1321c08fb7160b0d815ead7e.jpg"},{"id":54037063,"identity":"355e9722-e4a5-4f11-90d6-8320c7a59faf","added_by":"auto","created_at":"2024-04-03 17:08:08","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":449846,"visible":true,"origin":"","legend":"\u003cp\u003ePrecautionary Measures and Perceived Importance of Proper Paper Currency Storage in Disease Transmission Prevention (A. Separate storage from coins/cards, B. preventing your paper currency from getting wet, crumpled, or damaged, C. Storage-related issues such as unpleasant odors or visible mold, D. Importance of proper storage).\u003c/p\u003e","description":"","filename":"4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4127253/v1/0d4afbc34f8f78dae6a5f68d.jpg"},{"id":54035783,"identity":"d9e3158f-71b4-4dff-8cf9-95035f3b90ba","added_by":"auto","created_at":"2024-04-03 17:00:08","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":281847,"visible":true,"origin":"","legend":"\u003cp\u003ePublic awareness towards paper currency regarding the potential for disease transmission related question.\u003c/p\u003e","description":"","filename":"5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4127253/v1/51847ffd88d2130a67291e6e.jpg"},{"id":65097782,"identity":"24ff5a08-ccbe-42ba-9d5b-7d90b230c4d1","added_by":"auto","created_at":"2024-09-23 14:54:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3121023,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4127253/v1/87cf61a2-5b97-4fda-8a37-424684d69898.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Public Awareness and Precautionary Measures for Disease Transmission Prevention: A Microbial Evaluation of Ethiopian Paper Currency in Circulation in Arba Minch Town, SNNPR","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eThe use of paper money originated in China around 1000 AD and has since become a widely circulated medium of economic exchange. However, despite efforts to disinfect currency notes, pathogens such as viruses, bacteria, and spirochetes have been found on paper money. This means that money can serve as a vehicle for potential pathogens, although this aspect is often overlooked [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Paper money has a large surface area and is frequently passed from one person to another during transactions, increasing the risk of transferring pathogenic organisms [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. When handling money, there is a possibility of microorganisms being transferred if the money becomes contaminated with microorganisms from the gastrointestinal or respiratory tract [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIt is common for some individuals to neglect washing or disinfecting their hands after coughing, sneezing, using public toilets, and engaging in other unhygienic practices. When these individuals handle money, the risk of contamination becomes very high. This supports previous reports that have found a high prevalence of microorganisms on banknotes and coins, increasing the likelihood of passing pathogens from one person to another [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Research has demonstrated that paper currency provides an ideal environment for microorganisms to thrive, for several reasons. Firstly, the large surface area of paper bills allows for the accumulation of organisms and organic debris [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Secondly, intentional folds or depressions incorporated into the design of bills as anti-counterfeiting measures serve as breeding grounds for both organisms and debris, enabling microorganisms to survive for extended periods [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Lastly, banknotes circulate within the population for many years before finally settling. Studies indicate a direct correlation between the age and denomination of a bill with the level of contamination observed (e.g., older bills had the highest contamination levels, while newer bills had the lowest) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe Ethiopian currency known as the \"Birr\" is the second most widely used currency in Africa, after the Nigerian \"Naira,\" for the exchange of goods and services, including food, in Ethiopia and other countries around the world [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Paper currency can become contaminated through physical contact with hands, surfaces, and the environment[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Paper currency is held and transferred by individuals from various socio-economic backgrounds. Any object that can spread communicable diseases among a diverse population should be considered a public health risk. Therefore, paper currency plays a significant role in the transmission of pathogenic microorganisms and poses a moderate risk to public health. Many people, such as market women, motorcyclists, bus drivers and conductors, butchers and meat sellers, and restaurant operators, do not store money in wallets and often squeeze paper currency. For example, women may place money underneath their bras where it can become moist with sweat, while men may hide it in their socks. Market vendors typically squeeze paper money and keep it in dirty pockets, which can introduce microbes to the notes. Furthermore, storing paper currency in polythene, cotton, or leather bags in humid and dark conditions can promote the growth of microorganisms [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAccording to reports made from several studies, many bacterial groups such as \u003cem\u003eCitrobacter\u003c/em\u003e sp., \u003cem\u003eMycobacterium lepirae\u003c/em\u003e, \u003cem\u003eSalmonella\u003c/em\u003e sp., \u003cem\u003eEscherichia coli, Staphylococcus aureus, Klebsiella\u003c/em\u003e sp, \u003cem\u003eStreptococcus\u003c/em\u003e spp. and \u003cem\u003ePseudomonas aeroginosa\u003c/em\u003e were found associated with paper currency notes [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Paper currencies were also reported contaminated with fungi including \u003cem\u003eAspergillus niger, A. flavus, A. paraziticus, Candida\u003c/em\u003e spp. \u003cem\u003ePenicillium\u003c/em\u003e spp. and \u003cem\u003eRhizopus\u003c/em\u003e spp., \u003cem\u003eAlternaria tenuis, Trichoderma\u003c/em\u003e spp., \u003cem\u003eFusarium\u003c/em\u003e spp., and \u003cem\u003eSporotrichum\u003c/em\u003e spp [\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAlthough the significance of hand hygiene in preventing the spread of diseases is widely recognized, there is a lack of research specifically focusing on the use of sanitizers after handling paper currency. Hand hygiene, encompassing hand washing with soap and water or the application of alcohol-based hand sanitizers, plays a crucial role in preventing the transmission of infectious diseases by reducing the spread of pathogens [\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Additionally, little is known about paper currency storage practices and their potential impact on microbial contamination and disease transmission. This study aims were to address these research gaps by investigating sanitizer usage and paper currency storage practices among Arba Minch town.\u003c/p\u003e \u003cp\u003eTo the best of our knowledge, this study was the first of its kind to evaluate the usage of sanitizers, the practices of storing paper currency, and public awareness regarding the risk of disease transmission after handling paper currency. Specifically, this study focused on Arba Minch town and its contribution to the broader scientific community. Previous studies had investigated the microbial contamination of paper currency in various regions worldwide, but no research had assessed public awareness, sanitizer usage, and storage practices in relation to disease transmission via contaminated paper currency. By exploring these aspects in the context of Arba Minch town, this study aimed to address a crucial knowledge gap and provide valuable insights into potential interventions for reducing the risk of disease transmission through contaminated paper currency. Furthermore, the findings of this study could serve as a foundation for future research and inform public health policies in similar settings. Therefore, the primary aim of this study was to assess public awareness and precautionary measures for disease transmission prevention, as well as examine the microbial load present on Ethiopian paper currency in circulation within Arba Minch city.\u003c/p\u003e"},{"header":"2 Methods and Materials","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study area, period and design\u003c/h2\u003e \u003cp\u003eLaboratory based cross sectional study was conducted at Arba Minch University in Microbiology and Parasitology Laboratory, from June-August, 2023. This study was conducted in Sikella Sub- city under Arba Minch Town. As shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, Arba Minch is located in Southern Nation, Nationalities and Peoples Region (SNNPR) regional zone and the administrative center of the Gamo Zone. It is located 504 km away from capital city Addis Ababa at 30\u0026deg;56\u0026prime;N of the equator and 37\u0026deg;44\u0026prime;E with a surface area of 2184 hectares with an average temperature of 30.6\u0026deg;C and annual rainfall of 575 mm [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Eligibility criteria\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003e2.2.1 Inclusion criteria\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003ePaper bill were collected where it is likely to circulate frequently or be mishandled, like food handlers or merchant, customers of this merchant.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePaper bill were randomly selected from a larger pool of eligible notes.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.2.2 Exclusion criteria\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eBanknotes exhibiting no signs of microbial contamination may not have been included in the sampling.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eFresh and new paper bill were not be selected.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Population\u003c/h2\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.3.1 Source population\u003c/h2\u003e \u003cp\u003eThe study gathered samples from various sources, including merchants working in vegetable shops, customers of these shops, fruit stalls, and mini-market owners in Sikella and secha sub city. For the interview portion of the study, shopkeepers, customers, and merchants were selected from the same location where the paper bills were collected.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e2.3.2 Study sample size and sampling method\u003c/h2\u003e \u003cp\u003eTo compare the condition of Ethiopian paper currency in different sectors, this study collected samples from selected merchants in the town using a systematic random sampling method. This approach ensures a representative sample of paper currency in circulation and minimizes the potential for bias in the selection process. The study specifically focused on sectors that are assumed to handle paper bills better, as well as those with conditions that may promote bacterial growth. The sample consisted of 150 notes, with notes collected from each of the following sectors: fruit stalls, vegetable shops, a minimarket, supermarket, cafeteria and from market customers. The samples were collected in a sterile manner by providing verbal questionnaires to food vendors and asking them to drop the paper currency into sterile capped test tubes in an ice box. The ice box was promptly sealed, and individuals were given a replacement note of the same denomination. The samples were immediately transported in an aseptic manner to the microbiology laboratory for microbial analysis.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Laboratory Procedure\u003c/h2\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e2.4.1 Bacterial Load Analysis\u003c/h2\u003e \u003cp\u003eThe collected samples of paper currency were analyzed to determine their microbial load and safety. To do this, 1 ml of each sample was transferred aseptically into 9 ml of buffered peptone water (BPW) and thoroughly mixed using a vortex. The resulting mixtures were then serially diluted from 10\u003csup\u003e\u0026minus;\u0026thinsp;1\u003c/sup\u003e to 10\u003csup\u003e\u0026minus;\u0026thinsp;6\u003c/sup\u003e. A 0.1 ml aliquot of each dilution was spread-plated in duplicate on pre-solidified plates of Plate Count Agar, MacConkey Agar, Violet Red Bile Agar, Mannitol Salt Agar, and Potato Dextrose Agar, which was also supplemented with 0.1 g of chloramphenicol. The plates were then incubated at the optimal temperature and time for counting gram positive bacteria, gram negative bacterial, yeasts, and molds, respectively. Colonies ranging from 30 to 300 were considered for counting. The counted colonies (mean values of duplicate plates) were expressed as colony forming units per square centimeter (CFU/cm2) of the sampled paper currencies and then converted into log colony forming units (log CFU/cm2) for data management [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003e2.4.2 Isolation and characterizations of Bacterial isolate\u003c/h2\u003e \u003cp\u003eAccording to [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], As shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, each paper currency was soaked separately in a test tube containing 10 ml of sterile buffered peptone water. The bottle was then vigorously shaken for 2 minutes. The currency was removed and the resulting peptone water solution and incubated for 24hours at of 37\u003csup\u003eo\u003c/sup\u003eC. The incubated test sample was then serially diluted and cultured by sterilized swab onto Nutrient Agar, MacConkey, and Mannitol Salt Agar. The plates were incubated aerobically overnight in an incubator at 37\u003csup\u003e0\u003c/sup\u003eC. Pure cultures were obtained by sub-culturing distinct colonies. Control samples underwent the same processes. According to Abdullah, Pure isolated colonies were identified using their morphology, Gram reaction as well as biochemical techniques such as the Indole, Motility, MRVP, Catalase, Triple sugar iron tests (sugar fermentation and gas production [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e \u003ch2\u003e2.4.3 Determination of Drug-Susceptibility of Bacterial isolates\u003c/h2\u003e \u003cp\u003e Bacteria were tested for susceptibility to antibiotics by the Kirby-Bauer disc diffusion technique following guidelines of the National Committee for Clinical and Laboratory Standards Institute. Fourteen different antibiotic discs representing used were; Ciprofloxacin (5\u0026micro;g) Ampicillin (AMP, 10 \u0026micro;g), Cotrimoxazole (SXT, 25 \u0026micro;g), Erythromycin (E, 15 \u0026micro;g), Gentamicin (CN, 10 \u0026micro;g), Tetracycline (TE, 30 \u0026micro;g) and Vancomycine (VA, 30 \u0026micro;g). Susceptibility assay was performed on Mueller\u0026ndash;Hinton agar plates. Briefly a suspension of the test organism was prepared to match the 0.5% McFarland standard. Plates were then swabbed with the cell suspension and allowed to dry for 10 minutes. Different antimicrobial discs were placed on the inoculated plates ensuring adequate contact of disc and medium. Plates were incubated at 37\u0026deg;C for 24 hours, examined and the diameter of the zone of inhibition measured using a graduated ruler. The diameters were then compared with recommended standards, which conform to those of the Clinical Laboratory Standard Institute (CSLI)[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section3\"\u003e \u003ch2\u003e2.4.4 Hygiene behaviors and sociodemographic traits\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted to gather data on the demographic characteristics of the participants, their practices for storing paper bills, their perceptions on disease transmission through paper currency, and their use of sanitizer after handling paper currency. The data was collected by means of a structured questionnaire, which was administered through face-to-face interviews conducted by trained researchers. The participants' responses were recorded on paper forms.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Data quality control\u003c/h2\u003e \u003cp\u003eData quality control was ensured from data collection up to final laboratory identification by following the prepared standard operating procedure (SOP). The performance of the prepared media was checked by inoculating control strains like \u003cem\u003eStaphylococcus aureus\u003c/em\u003e ATCC25923 and \u003cem\u003eEscherichia coli\u003c/em\u003e ATCC25922 which was obtained from Ethiopian Public Health Institute (EPHI).Culture media was prepared according to manufactures instruction, and the sterility was checked by incubating 5% of prepared media at 35\u0026ndash;37\u0026deg;C overnight and observing bacterial growth. Those batches of the media that showed the growth were discarded and re-prepared. Data quality control for Experimental Unit is Positive and Negative Control Unit.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Data Analysis\u003c/h2\u003e \u003cp\u003eData from all experiments was checked, cleaned, coded for completeness and entered into Microsoft Excel 2010 for analysis. Descriptive statistics such as mean and percentage were used to describe microbial load and percentage. The data were analyzed using a one-way ANOVA. Statistical analysis was performed using the post-hoc Tukey test with SPSS 25 statistical software version. A p-value of \u0026le;\u0026thinsp;0.05 was considered to indicate statistical significance.\u003c/p\u003e \u003c/div\u003e"},{"header":"3 Results","content":"\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Bacterial Load Assessment\u003c/h2\u003e \u003cp\u003eAll paper currency underwent an examination to determine the presence of bacterial contamination. The microbial load of each culture was quantified using the log (CFU/cm\u003csup\u003e2\u003c/sup\u003e) expression. As depicted in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, bacteria were detected in the entire sample collected from various sources. Figure\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e showcases the microbial loads of Gram-positive bacteria isolated from different sample codes. Notably, code 012 (fruit stalls note) displayed the highest concentration of gram-negative bacteria, whereas code 008 (supermarket note) exhibited the lowest concentration. Moreover, code 001(vegetable shops) had the highest concentration of gram-positive bacteria. Similarly, code 020 (cafeteria note) had a substantial microbial load of mold, while code 016 (market customers note) had a significant microbial load of yeast. Figure\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e highlights that gram-positive bacteria were the most prevalent microbial isolate, while yeast was the least prevalent.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Phenotypic and Microscopic identification\u003c/h2\u003e \u003cp\u003eFor this study, Microscopic, biochemical and phenotypic characterization were investigated, as shown in Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Based on the results from the table, bacteria, mold and yeast were isolated from code 001, 004, 008, 012, 016, and 020 samples. The phenotypic, microscopic, and biochemical characteristics of bacteria and fungi isolated from all sample code suggest that they are \u003cem\u003eKlebsiella\u003c/em\u003e spp, \u003cem\u003eE. coli\u003c/em\u003e, \u003cem\u003eStreptococcus\u003c/em\u003e spp, \u003cem\u003eBacillus\u003c/em\u003e spp and \u003cem\u003estaphylococcus aureus\u003c/em\u003e. Regarding the Fungal species, most of the isolated fungal species are more related with \u003cem\u003eAspergilus\u003c/em\u003e spp and yeast. Regarding the prevalence of bacterial spp, among the 200 isolated bacterial colonies, 70 (35%) were \u003cem\u003estaphylococcus aureus\u003c/em\u003e, 60 (30%) was \u003cem\u003estreptococcus\u003c/em\u003e spp. 50 (25%) were \u003cem\u003eBacillus\u003c/em\u003e spp, and 9 (4.5%) were \u003cem\u003eklebissela\u003c/em\u003e spp and 11 (5.5%) are \u003cem\u003eE. coli\u003c/em\u003e. Regarding the prevalence of fungal spp, among the 50 isolated fungal colonies, the prevalence of \u003cem\u003eAspergillus\u003c/em\u003e spp is around 20 (40%), and 30 (60%) for the yeast.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePhenotypic and Microscopic characterization of isolated bacteria\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIsolates\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo of Isolates\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eForm\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eColor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eElevation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMargin\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eGS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eGR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eGA\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCircular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePink\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eConvex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEntire\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eBacilli\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eChain\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIrregular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFlat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eUndulated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eBacilli\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eChain\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCircular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGolden\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFlat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEntire\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCocci\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eCluster\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCircular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eConvex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEntire\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCocci\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eChain\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCircular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eConvex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEntire\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eBacilli\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eshort chains\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIrregular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFlat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eUndulated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eBacilli\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eChain\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003eWhere; GR\u0026thinsp;=\u0026thinsp;Gram Reaction, GS\u0026thinsp;=\u0026thinsp;Gram Shape, GA\u0026thinsp;=\u0026thinsp;Gram Arrangement\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBiochemical characterizations of isolated bacteria (Isolated from code 001,004,008,012,016,020)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIsolates\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo of Isolates\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIndole\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMotility\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCatalase\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eH\u003csub\u003e2\u003c/sub\u003eS-P\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eGas-P\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMR-test\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eCU-Test\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e++\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003eWhere; H2S-P\u0026thinsp;=\u0026thinsp;Hydrogen sulfide production; Gas-P\u0026thinsp;=\u0026thinsp;Gas Production; MR-test\u0026thinsp;=\u0026thinsp;Methyl Red Test; CU-Test\u0026thinsp;=\u0026thinsp;Citrate Utilization Test;\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePhenotypic and Microscopic characterization of isolated Fungal (Isolated from code 008 and 020)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIsolates\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo of Isolates\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eST\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCP (Front view)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCP (Reverse view)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eARV\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eHN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eSS\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWoolly (Velvety)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYellowish green\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYellow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eFlat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMold\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eAseptate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eUniserate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eSpherical\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWoolly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDark brown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ebrown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRugose\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMold\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eAseptate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSeptate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003espherical\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003esmooth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYellow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eFlat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eYeast\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003eWhere; ST\u0026thinsp;=\u0026thinsp;Surface Texture, CP\u0026thinsp;=\u0026thinsp;Colony Pigmentation, ARV\u0026thinsp;=\u0026thinsp;Appearance of the Reverse view, NF\u0026thinsp;=\u0026thinsp;Nature of the fungus, HN\u0026thinsp;=\u0026thinsp;Hyphae Nature, SA\u0026thinsp;=\u0026thinsp;Spore Arrangement, SS\u0026thinsp;=\u0026thinsp;Spore shape\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003ePreliminary classification of the bacterial isolates, based on their phenotypic, microscopic and biochemical characteristics of Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, suggests that bacteria from isolate 1, 2, 3, 4, 5 and 6 may be identified as \u003cem\u003eEscherichia coli\u003c/em\u003e, \u003cem\u003eBacillus\u003c/em\u003e spp., \u003cem\u003eStaphylococcus aureus\u003c/em\u003e, \u003cem\u003eStreptococcus\u003c/em\u003e spp., \u003cem\u003eKlebsiella\u003c/em\u003e spp, respectively.\u003c/p\u003e \u003cp\u003eBased on the phenotypic and microscopic characteristics of Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, it is possible to tentatively classify isolates 1 and 2 as \u003cem\u003eAspergillus flavus\u003c/em\u003e, while isolate 3 is likely to be \u003cem\u003eSaccharomyces cerevisiae\u003c/em\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Antimicrobial susceptibility test profile of Isolates\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e illustrates the antimicrobial susceptibility patterns of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e and \u003cem\u003eStreptococcus\u003c/em\u003e spp., revealing diverse sensitivity and resistance profiles. Notably, both \u003cem\u003eStaphylococcus aureus\u003c/em\u003e and \u003cem\u003eStreptococcus\u003c/em\u003e spp. exhibited 100% sensitivity to the antibiotic vancomycin. Additionally, these two species displayed complete sensitivity to another antibiotic. In contrast, ampicillin showed relatively poor efficacy against the \u003cem\u003eStaphylococcus aureus\u003c/em\u003e isolate, while erythromycin also demonstrated limited effectiveness against Streptococcus spp. compared to other antibiotics tested.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAntimicrobial susceptibility test profile of \u003cem\u003eStaphylococcus aureus and Streptococcus spp\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAntibiotics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u003cem\u003eStaphylococcus aureus\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e\u003cem\u003eStreptococcus\u003c/em\u003e spp\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e% Resistance\u003c/p\u003e \u003cp\u003e(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SEM)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e% Sensitivity\u003c/p\u003e \u003cp\u003e(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SEM)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e% Resistance\u003c/p\u003e \u003cp\u003e(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SEM)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e% Sensitivity\u003c/p\u003e \u003cp\u003e(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SEM)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTetracycline (TE)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e16.6667\u0026thinsp;\u0026plusmn;\u0026thinsp;1.66667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e83.3333\u0026thinsp;\u0026plusmn;\u0026thinsp;1.66667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;2.88675\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e95.000\u0026thinsp;\u0026plusmn;\u0026thinsp;2.88675\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmpicillin (AMP)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e80.1667\u0026thinsp;\u0026plusmn;\u0026thinsp;.16667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e19.8333\u0026thinsp;\u0026plusmn;\u0026thinsp;.16667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e10\u0026thinsp;\u0026plusmn;\u0026thinsp;1.66667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e81.6667\u0026thinsp;\u0026plusmn;\u0026thinsp;1.66667\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVancomycine (VA)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;.00000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e100.0000\u0026thinsp;\u0026plusmn;\u0026thinsp;.00000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;.00000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e100\u0026thinsp;\u0026plusmn;\u0026thinsp;.00000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eErythromycin (ERY)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e40.3333\u0026thinsp;\u0026plusmn;\u0026thinsp;.33333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e59.6667\u0026thinsp;\u0026plusmn;\u0026thinsp;.33333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e20\u0026thinsp;\u0026plusmn;\u0026thinsp;1.45297\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e77.6667\u0026thinsp;\u0026plusmn;\u0026thinsp;1.45297\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eWhere; P\u0026thinsp;\u0026lt;\u0026thinsp;0.005, statistically significant, TE (30\u0026micro;g), AMP (10\u0026micro;g), VA (30 \u0026micro;g), ERY (15 \u0026micro;g)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e presents the results of the antimicrobial susceptibility test conducted on \u003cem\u003eKlebsiella\u003c/em\u003e spp and \u003cem\u003eE. coli\u003c/em\u003e. The antibiotics employed for this species included Ciprofloxacin, Ampicillin, Cotrimoxazole, and Gentamycin. Accordingly, \u003cem\u003eKlebsiella\u003c/em\u003e spp. demonstrated a higher sensitivity towards Ciprofloxacin, while exhibiting a lower sensitivity (6.6667\u0026thinsp;\u0026plusmn;\u0026thinsp;1.66667%) towards Ampicillin. Similarly, \u003cem\u003eE. coli\u003c/em\u003e demonstrated a higher sensitivity towards Ampicillin, while exhibiting a lower sensitivity (29.6667\u0026thinsp;\u0026plusmn;\u0026thinsp;.33333%) towards Gentamycin.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAntimicrobial susceptibility test profile of gram negative bacteria\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAntibiotics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u003cem\u003eKlebsiella spp\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e\u003cem\u003eEscherichia coli\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e% Resistance\u003c/p\u003e \u003cp\u003e(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SEM)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e% Sensitivity\u003c/p\u003e \u003cp\u003e(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SEM)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e% Resistance\u003c/p\u003e \u003cp\u003e(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SEM)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e% Sensitivity\u003c/p\u003e \u003cp\u003e(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SEM)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGentamycin (GEN)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e4.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.66667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e51.6667\u0026thinsp;\u0026plusmn;\u0026thinsp;1.66667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e70.3333% \u0026plusmn; .33333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e29.6667% \u0026plusmn; .33333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCiprofloxacin (CIP)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e15.000\u0026thinsp;\u0026plusmn;\u0026thinsp;2.88675\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e85.0000\u0026thinsp;\u0026plusmn;\u0026thinsp;2.88675\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e59.6667% \u0026plusmn; .33333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e40.3333% \u0026plusmn; .33333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmpicillin (AMP)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e93.333\u0026thinsp;\u0026plusmn;\u0026thinsp;1.66667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.6667\u0026thinsp;\u0026plusmn;\u0026thinsp;1.66667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e19% \u0026plusmn; 1.00000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e81.0000% \u0026plusmn; 1.00000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCotrimozazole (COT)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e55\u0026thinsp;\u0026plusmn;\u0026thinsp;2.88675\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e45.0000\u0026thinsp;\u0026plusmn;\u0026thinsp;2.88675\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e59.3333% \u0026plusmn; .66667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e40.6667% \u0026plusmn; .66667\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eWhere; P\u0026thinsp;\u0026lt;\u0026thinsp;0.005, statistically significant, GEN (10\u0026micro;g), AMP (10\u0026micro;g), COT (25 \u0026micro;g), CIP (5 \u0026micro;g)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eGenerally, when comparing the inhibition zones produced by antibiotics on the \u003cem\u003eStaphylococcus aureus\u003c/em\u003e isolate, there was a statistically significant difference between groups, as demonstrated by a one-way ANOVA (F (3, 8)\u0026thinsp;=\u0026thinsp;1658.321, p\u0026thinsp;=\u0026thinsp;.000). A Tukey post hoc test indicated that there was a significant difference between the groups. Similarly, when comparing the inhibition zones produced by antibiotics on the \u003cem\u003eStreptococcus\u003c/em\u003e isolate, there was a statistically significant difference between groups, as demonstrated by a one-way ANOVA (F (3, 8)\u0026thinsp;=\u0026thinsp;34.137, p\u0026thinsp;=\u0026thinsp;.000). A Tukey post hoc test indicated that there was a significant difference between the groups. However, there is no statistically significant difference between the antibiotics Tetracycline and Vancomycin, as well as between Ampicillin and Erythromycin.\u003c/p\u003e \u003cp\u003eGenerally, when comparing the inhibition zones produced by antibiotics on the \u003cem\u003eKlebsiella spp\u003c/em\u003e isolate, there was a statistically significant difference between groups, as demonstrated by a one-way ANOVA (F (3, 8)\u0026thinsp;=\u0026thinsp;185.792, p\u0026thinsp;=\u0026thinsp;.000). A Tukey post hoc test indicated that there was a significant difference between the groups except Cotrimozazole and gentamycin. Similarly, when comparing the inhibition zones produced by antibiotics on the \u003cem\u003eEscherichia coli\u003c/em\u003e isolate, there was a statistically significant difference between groups, as demonstrated by a one-way ANOVA (F (3, 8)\u0026thinsp;=\u0026thinsp;1230.111, p\u0026thinsp;=\u0026thinsp;.000). A Tukey post hoc test indicated that there was a significant difference between the groups. However, there is no statistically significant difference between the antibiotics Cotrimozazole and Ciprofloxacin.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Hygiene behaviors and sociodemographic traits\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e displays the results of a study involving 178 participants who all completed a survey. Among the participants, 77.5% were literate, 11.2% had completed primary education, 5.6% had completed secondary education, and 5.6% were illiterate. The majority of the participants, specifically 71.9%, were male, while 33.7% were female. The study found that 64% of the participants used pockets to store paper bills, while 20.2% used purses, 6.7% used other storage methods, and 9% used wallets. When it comes to the question \"How often do you clean or disinfect the place where you store your paper currency?\u0026rdquo; 40.4% of the participants rarely clean their storage, 36% clean it occasionally, 15.7% clean it often, and 7.9% clean it very often. For the question \"Are you aware of the potential growth of microorganisms from storing paper currency?\u0026rdquo; 36% of the participants were aware of this potential, 28.1% were somewhat aware, 12.4% were unsure, and 2.2% were not aware.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic traits and public awareness towards paper currency regarding paper storage\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategorical variables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003efrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e128\u003c/p\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71.9\u003c/p\u003e \u003cp\u003e33.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevel of education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIlliterate\u003c/p\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003cp\u003eLiterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003cp\u003e20\u003c/p\u003e \u003cp\u003e10\u003c/p\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.6\u003c/p\u003e \u003cp\u003e11.2\u003c/p\u003e \u003cp\u003e5.6\u003c/p\u003e \u003cp\u003e77.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u0026ndash;20\u003c/p\u003e \u003cp\u003e21\u0026ndash;30\u003c/p\u003e \u003cp\u003e31\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003cp\u003e80\u003c/p\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.7\u003c/p\u003e \u003cp\u003e45\u003c/p\u003e \u003cp\u003e21.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ.1.How do you typically store your paper currency?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWallet\u003c/p\u003e \u003cp\u003ePurse\u003c/p\u003e \u003cp\u003ePocket\u003c/p\u003e \u003cp\u003eOther storage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003cp\u003e36\u003c/p\u003e \u003cp\u003e114\u003c/p\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003cp\u003e20.2\u003c/p\u003e \u003cp\u003e64\u003c/p\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ.2.How often do you clean or disinfect the place where you store your paper currency?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery often\u003c/p\u003e \u003cp\u003eOften\u003c/p\u003e \u003cp\u003eOccasionally\u003c/p\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003cp\u003e28\u003c/p\u003e \u003cp\u003e64\u003c/p\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003cp\u003e15.7\u003c/p\u003e \u003cp\u003e36\u003c/p\u003e \u003cp\u003e40.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ.3. Are you aware of potential microorganism growth from storing paper currency?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, I am aware\u003c/p\u003e \u003cp\u003eSomewhat aware\u003c/p\u003e \u003cp\u003eUnsure\u003c/p\u003e \u003cp\u003eNo, I am not aware\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64\u003c/p\u003e \u003cp\u003e50\u003c/p\u003e \u003cp\u003e22\u003c/p\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36\u003c/p\u003e \u003cp\u003e28.1\u003c/p\u003e \u003cp\u003e12.4\u003c/p\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, Picture A, displays the results for the question, \"Do you store your paper currency separately from other items, such as coins or cards, to prevent cross-contamination?\" The data shows that 34.8% (62) of participants do not store their paper currency separately, 28.1% (50) store them separately, and 27% (48) sometimes store paper currency separately. Additionally, 10.1% (18) of respondents indicated that they do not use or store paper currency, making the question not applicable to them. Similarly, Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, Picture B, presents the results for the question, \"Do you take any precautions to prevent your paper currency from getting wet, crumpled, or damaged?\" The data indicates that 38.2% (68) of participants take several precautions, while 27% take some precautions, and 19.1% occasionally take precautions. Additionally, 15.7% of participants do not take any precautions.\u003c/p\u003e \u003cp\u003eIn response to the question, \"Have you ever experienced any issues with your paper currency, such as unpleasant odors or visible mold that could be related to storage conditions?\" 41.6% of participants reported experiencing unpleasant odors or visible mold that could be related to storage conditions. Additionally, 24.7% experienced minor issues, 19.1% have not experienced such issues, and 14.6% were unsure about this problem as reported in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, picture C. Figure\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, Picture D, shows the results for the question, \"How important do you think proper storage of paper currency is in preventing the transmission of diseases?\" The responses indicate that 50.6% considered proper storage very important, while 2.2% did not believe in its importance, 2.2% considered it less important, and 5.6% remained neutral on the question.\u003c/p\u003e \u003cp\u003eThe figure above demonstrates public awareness of the potential for disease transmission through paper currency. In Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, Picture D, 79.8% of participants were aware of the disease risk associated with handling paper currency, while 20.2% had no knowledge of this risk. In Picture C, Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows the precautions taken after handling paper currency. According to the figure, 53.9% of participants do not take any precautions, 36% wash their hands, and only 10.1% use hand sanitizer. In Figure B, participants' interest in using digital payment as a lower-risk alternative is shown. 44.9% strongly agree with using digital payment, 42.7% agree, 11.2% are neutral, and 1.1% strongly disagree. The final question asked whether providing information on disease transmission through paper currency should be part of public health campaigns. The responses were as follows: 47.2% agree, 37.1% strongly agree, 9% are neutral, 5.6% disagree, and 1.1% strongly disagree.\u003c/p\u003e \u003c/div\u003e"},{"header":"4 Discussion","content":"\u003cp\u003eIn this study, we looked into the amount of bacteria that were present in the collected sample. This study discovered that bacteria and fungi were present across the entire sample drawn from a variety of sources, according to our findings. Our findings demonstrate that all samples harbored bacterial contamination, emphasizing the ubiquity of microbes on frequently exchanged items, such as currency notes. This observation corroborates previous studies that have highlighted the potential role of paper currency in the transmission of pathogens [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan additionalcitationids=\"CR27 CR28\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Gram-positive bacteria were the most prevalent microbial isolate in our samples, possibly indicating their greater ability to survive on paper currency or a higher rate of contamination from common sources. This finding has important public health implications, as some gram-positive bacteria, including \u003cem\u003eStaphylococcus aureus\u003c/em\u003e and \u003cem\u003eStreptococcus pyogenes\u003c/em\u003e, are known to cause serious infections [\u003cspan additionalcitationids=\"CR31 CR32\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Although gram-negative bacteria, mold, and yeast were present at lower concentrations, they should not be disregarded, as these microorganisms can also cause infections, particularly in individuals with weakened immune systems [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Similar kind of finding in South Africa explore the contamination of banknotes and other surfaces with microorganisms [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Similarly, research from Jimma Town in Ethiopia indicates that paper money may act as a vehicle for the spread of pathogenic microbes [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Therefore, our study suggests that poor handling practices and personal hygiene of food vendors could contribute to these microbial counts.\u003c/p\u003e \u003cp\u003eIn this study, we employed microscopic, biochemical, and phenotypic characterization methods to identify and assess the prevalence of bacterial and fungal species in samples from various sources. Our results, as shown in Tables \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, revealed the presence of a diverse range of microorganisms, including \u003cem\u003eklebissesla\u003c/em\u003e spp., \u003cem\u003eStreptococcus\u003c/em\u003e spp., \u003cem\u003eBacillus\u003c/em\u003e spp., \u003cem\u003eE. coli\u003c/em\u003e, spp., \u003cem\u003eStaphylococcus aureus\u003c/em\u003e., \u003cem\u003eAspergillus\u003c/em\u003e spp., and yeast, across the sampled codes (001, 002, 005, 006, and 008). The microbial diversity observed in our samples underscores the potential public health implications of bacterial and fungal contamination. Notably, we identified gram-positive (\u003cem\u003eStreptococcus\u003c/em\u003e spp., \u003cem\u003eBacillus\u003c/em\u003e spp., and \u003cem\u003eStaphylococcus aureus\u003c/em\u003e) and gram-negative (\u003cem\u003eKlebsiella\u003c/em\u003e spp and \u003cem\u003eE. coli\u003c/em\u003e) bacteria, as well as mold (\u003cem\u003eAspergillus\u003c/em\u003e spp.) and yeast. This diverse array of microorganisms is consistent with previous studies reporting the presence of various bacterial and fungal species in environmental samples [\u003cspan additionalcitationids=\"CR38 CR39\" citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe prevalence of specific bacterial and fungal species varied across the samples. Among the 200 isolated bacterial colonies, \u003cem\u003eStaphylococcus aureus\u003c/em\u003e predominated (35%), followed by \u003cem\u003eStreptococcus\u003c/em\u003e spp (30%), \u003cem\u003eBacillus\u003c/em\u003e spp. (25%), and Enterobacteriaceae spp (10%). As for the 50 isolated fungal colonies, \u003cem\u003eAspergillus\u003c/em\u003e spp. accounted for 40%, while yeast accounted for 60%. The variation in prevalence across samples could be attributed to factors such as differences in environmental conditions, handling practices, or potential cross-contamination during sample collection and processing. Several of the identified microorganisms are known to have clinical and public health significance. For instance, \u003cem\u003eStaphylococcus aureus\u003c/em\u003e, \u003cem\u003eStreptococcus\u003c/em\u003e spp., and Enterobacteriaceae spp. have been implicated in various human infections [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Moreover, the presence of \u003cem\u003eAspergillus\u003c/em\u003e spp. and yeast may pose health risks, particularly for individuals with weakened immune systems or underlying respiratory conditions [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the study regarding the antibiotics susceptibility test, we investigated the antimicrobial susceptibility patterns of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e, \u003cem\u003eStreptococcus\u003c/em\u003e spp., \u003cem\u003eKlebissela\u003c/em\u003e spp and \u003cem\u003eE. coli\u003c/em\u003e. isolated from various samples. Our results, presented in Tables\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e and \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, demonstrate diverse patterns of sensitivity and resistance to the tested antibiotics. For \u003cem\u003eStaphylococcus aureus\u003c/em\u003e and streptococcus spp., our findings indicate high sensitivity towards certain antibiotics, such as Vancomycine and Tetracycline, suggesting that these may be effective treatment options for infections caused by these bacterial species. Conversely, Ampicillin exhibited relatively poor performance against these isolates, which may necessitate the consideration of alternative treatment options or further resistance testing when dealing with infections caused by \u003cem\u003eStaphylococcus aureus\u003c/em\u003e and \u003cem\u003eStreptococcus\u003c/em\u003e spp. A similar investigation was conducted in Nepal and Ghana, where it was found that all \u003cem\u003eStaphylococcus aureus\u003c/em\u003e isolate were resistant to Ampicillin. However, it was observed that all strains were sensitive to vancomycin [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. Similarly, study done in japan also demonstrate that Tetracyclines have emerged as a second choice of antibiotics to beta-lactams for the management of mastitis in dairy herds which is caused by Gram-positive bacteria [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e\u003cem\u003eKlebsiella\u003c/em\u003e spp. demonstrated higher sensitivity towards Ciprofloxacin, but showed a notably higher resistance rate (55%) to Cotrimoxazole, and Ampicillin. Zakia and his collegue also made a similar finding. They discovered that antimicrobial agents such as Ciprofloxacin and Gentamycin retained their antimicrobial activities against both strains of \u003cem\u003eE. coli\u003c/em\u003e (ZK9, ZK40, and ZK60) and \u003cem\u003eK. pneumoniae\u003c/em\u003e (ZK32 and ZK89). On the other hand, studies conducted in Gahana have shown that commonly recovered bacterial enterobacteriace isolates, such as \u003cem\u003eE. coli\u003c/em\u003e, \u003cem\u003eSalmonella\u003c/em\u003e spp, \u003cem\u003eklebissela\u003c/em\u003e spp have a high resistance to co-trimoxazole, and Gentamycin [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e].This finding raises concerns about the use of Cotrimoxazole and Gentamycin as an empirical treatment option for infections caused by \u003cem\u003eE. coli, Salmonella\u003c/em\u003e spp, \u003cem\u003eklebissela\u003c/em\u003e spp and emphasizes the importance of understanding the local antimicrobial resistance patterns when selecting appropriate treatment. Our findings underscore the significance of antibiotic stewardship in the face of growing antimicrobial resistance. The appropriate selection and use of antibiotics are crucial to minimizing the development of resistance and preserving the effectiveness of available treatments.\u003c/p\u003e \u003cp\u003eIn this study, we evaluated how aware the public is about the transmission of diseases through paper currency and the precautions they take after handling money. Our findings indicate that a significant majority of participants (79.8%) are aware of the potential risks associated with handling paper currency, while 20.2% are not. This suggests that, although many people recognize the possibility of disease transmission through paper currency, there is still a need for targeted education and awareness campaigns to reach those who are uninformed. While there have been no previous studies specifically focusing on the storage of paper currency and disease transmission, research on other objects, such as doorknobs and handrails, has demonstrated that contaminated surfaces can contribute to the spread of diseases [\u003cspan additionalcitationids=\"CR48\" citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. Given that paper currency can also serve as a potential vector for disease transmission, it is crucial to raise awareness about safe storage practices.\u003c/p\u003e \u003cp\u003eOur study discovered that a notable percentage of participants (53.9%) do not take any precautions after handling paper currency. In contrast, 36% of participants wash their hands and 10.1% utilize hand sanitizer. This discrepancy in adhering to proper hand hygiene practices is worrisome, considering that hand hygiene is widely recognized as a crucial preventive measure against infection transmission [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Several studies [\u003cspan additionalcitationids=\"CR53\" citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e] have emphasized the importance of hand washing or the use of hand sanitizers in reducing the transmission of diseases in various settings. However, limited research has specifically focused on hand hygiene practices after handling paper currency. Our findings suggest that public health campaigns should highlight the importance of hand hygiene, particularly in the context of handling money, to minimize potential health risks.\u003c/p\u003e \u003cp\u003eOur study examined participants' interest in digital payments as a safer alternative to paper currency, as well as their opinions on including information about disease transmission through paper currency in public health campaigns. A significant number of participants (44.9%) strongly agreed with the use of digital payments as a lower-risk alternative, while 42.7% agreed. Only 11.2% were neutral, and a mere 1.1% strongly disagreed. This high level of interest in digital payments can be attributed to the increasing global trend of adopting cashless payment methods, as pointed out by Rahul, Gardner, and their colleagues [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e], who emphasized the potential benefits of digital payments in terms of convenience, security, and reduced health risks. Our findings suggest that promoting digital payments could be an effective strategy for minimizing the potential disease transmission associated with handling paper currency.\u003c/p\u003e \u003cp\u003eA significant majority of participants (47.2% agree and 37.1% strongly agree) in our study emphasized the importance of including information on disease transmission through paper currency in public health campaigns. This finding is consistent with previous research that has highlighted the critical role of health communication in raising public awareness about disease prevention [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e]. While there may be limited studies specifically addressing the inclusion of information on disease transmission through paper currency in public health campaigns, our findings suggest that such initiatives would be well-received by the public. The strong support expressed by participants indicates a demand for more targeted and comprehensive health communication strategies that address various aspects of disease prevention, including those related to the handling of paper currency.\u003c/p\u003e \u003cp\u003eOur study revealed that a significant portion of participants (34.8%) do not store their paper currency separately from other items, while 28.1% do store them separately, and 27% sometimes store them separately. This finding is concerning, as it suggests that many individuals may not be following optimal practices to minimize the potential for cross-contamination between paper currency and other items. Although there may be limited research specifically addressing the storage of paper currency separately from other items, our findings can be contextualized within the broader literature on hygiene practices and disease transmission. Research has consistently shown that maintaining cleanliness and separating potentially contaminated items can reduce the risk of spreading diseases [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOur study showed that a significant percentage of participants (38.2%) take several precautions to prevent their paper currency from getting wet, crumpled, or damaged, while others take some precautions (27%) or occasionally take precautions (19.1%). However, 15.7% do not take any precautions, suggesting that a portion of the population may not be aware of or concerned about the potential risks associated with damaged or deteriorated paper currency. In line with the above sentence, Studies have shown that individuals' awareness of potential risks and their perception of the severity of these risks influence their likelihood of adopting preventive measures [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]. In this context, the lack of precautions taken by some participants might indicate a need for targeted education and awareness campaigns. Such initiatives should emphasize the potential risks associated with damaged or deteriorated paper currency, such as the increased likelihood of transmitting diseases, and promote the adoption of preventive measures to minimize these risks.\u003c/p\u003e \u003cp\u003eOur study revealed that 41.6% of participants have experienced issues with their paper currency, such as unpleasant odors or visible mold, which could be related to improper storage conditions. Additionally, 24.7% have experienced minor issues, while 19.1% have not encountered such problems, and 14.6% were unsure. These findings suggest that a significant proportion of people have encountered problems related to the storage of paper currency, which could indicate a need for better education on proper storage methods. Research has consistently shown that maintaining cleanliness and proper storage of various items can reduce the risk of spreading diseases and prevent spoilage or damage [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e, \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]. In light of this evidence, the issues encountered by participants in our study might indicate a need for targeted education and awareness campaigns. Such initiatives should emphasize the importance of proper paper currency storage to prevent potential health risks and maintain the integrity of the currency.\u003c/p\u003e \u003cp\u003eOur study found that most participants (50.6%) consider proper storage of paper currency very important for preventing disease transmission. However, small percentages (2.2%) do not believe in its importance, and another 2.2% consider it less important, with 5.6% remaining neutral. These findings suggest that while a majority of people recognize the importance of proper paper currency storage in disease prevention, there are still some who do not see it as a priority. Research on health beliefs and attitudes has shown that individuals' perceptions of the importance of various health-related behaviors can significantly influence their adherence to recommended practices [\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e]. In the context of our study, the varying perceptions of the importance of proper paper currency storage could be explained by differences in individuals' health beliefs and attitudes. In addition, resource variables, such as education level, personal health status, and social support, play moderating roles in perceptions of the importance of proper paper currency storage.\u003c/p\u003e \u003cp\u003eOur study found that 64% of participants stored paper bills in pockets, 20.2% used purses, 9% used wallets, and 6.7% used other storage methods. The predominant use of pockets for storing paper currency raises concerns about the potential for microbial contamination and disease transmission, as pockets may not provide a clean and protective environment for storing currency. Previous studies have shown that various surfaces and items, including money, can harbor microorganisms, including fungi, viruses and protozoa [\u003cspan additionalcitationids=\"CR65\" citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e]. The transfer of these microorganisms can occur when people touch contaminated surfaces and then touch their face, increasing the risk of infection [\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e]. In the context of our study, storing paper currency in pockets might increase the likelihood of contamination, as pockets can be exposed to various environmental factors and may not be regularly cleaned. Therefore, it is essential to consider alternative storage methods that provide better protection and minimize the risk of microbial transmission. Although there might be limited research specifically addressing the hygiene aspects of different paper currency storage methods, our findings suggest that promoting the use of cleaner and more protective storage options, such as wallets or purses, could contribute to better hygiene practices and reduce the potential for disease transmission.\u003c/p\u003e \u003cp\u003eOur study revealed that 40.4% of participants rarely cleaned or disinfected the storage place for their paper currency, while 36% did so occasionally, 15.7% often, and 7.9% very often. This suggests that a significant proportion of participants do not frequently clean or disinfect the areas where they store their paper currency, which could potentially create an environment conducive to microbial growth. Existing research emphasizes the importance of regular cleaning and disinfection of surfaces to minimize microbial contamination and reduce the risk of disease transmission [\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e]. Inadequate cleaning of surfaces can allow for the accumulation of microorganisms, some of which may be potentially harmful to human health. Our findings suggest that promoting more frequent cleaning and disinfection of these areas could contribute to better hygiene and lower the risk of microbial growth. Participants who rarely or occasionally clean their paper currency storage areas may benefit from targeted education on the importance of regular cleaning practices to maintain a cleaner and safer environment for storing their money.\u003c/p\u003e \u003cp\u003eOur study found that 36% of participants were aware of the potential for microorganism growth from storing paper currency, 28.1% were somewhat aware, 12.4% were unsure, and 2.2% were not aware. These findings suggest that while a significant proportion of participants have some awareness of the potential risks, there is still a need for further education and awareness campaigns to improve understanding and promote better paper currency storage practices. Existing research emphasizes the importance of public awareness and knowledge in promoting positive health behaviors [\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e]. Knowledge about potential health risks, such as microbial growth on paper currency, can encourage individuals to adopt preventive measures to protect their health and the health of others. Our findings suggest that targeted education campaigns could improve awareness and encourage better storage practices. By providing clear information about the potential risks and preventive measures, these campaigns could help individuals make more informed decisions about how they store and handle paper currency.\u003c/p\u003e"},{"header":"5 Conclusion","content":"\u003cp\u003eThis study presents a comprehensive analysis of microbial contamination in various samples of paper notes and the associated public health risks. In terms of microbial load, gram-positive bacteria had the highest average microbial counts, while yeast had the lowest. The bacteria and fungi isolated from the samples were identified as \u003cem\u003eKlebsiella\u003c/em\u003e spp, \u003cem\u003eE. coli, Streptococcus\u003c/em\u003e spp, \u003cem\u003eBacillus\u003c/em\u003e spp, \u003cem\u003eAspergillus\u003c/em\u003e spp, and \u003cem\u003eStaphylococcus aureus\u003c/em\u003e based on their phenotypic, microscopic, and biochemical characteristics. The antimicrobial susceptibility patterns of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e and \u003cem\u003eStreptococcus\u003c/em\u003e spp were determined, and both showed 100% sensitivity to Vancomycin and good sensitivity to Tetracycline antibiotics. Similarly, \u003cem\u003eKlebsiella\u003c/em\u003e spp showed higher sensitivity to Ciprofloxacin while exhibiting a lower sensitivity rate (6.6667%) to Ampicillin. In contrast, Ampicillin showed higher activity on the \u003cem\u003eE. coli\u003c/em\u003e isolates. Socio-demographic factors were found to influence awareness and practices related to disease transmission through paper currency, highlighting the importance of targeted public education campaigns. The study revealed that while some participants are aware and take preventive measures, additional education and awareness campaigns are required to encourage improved handling and storage habits of paper currency. In general, the study affirms that paper bills provide an ideal environment for bacterial growth and could potentially contribute to infections, especially among individuals with compromised immune systems. Thus, it emphasizes the necessity of raising awareness about the potential risks associated with improper handling of paper currency in all food establishments.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding: No\u003c/strong\u003e sources of fund for this study\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest/Competing interests:\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e Ethical approval is applicable and has been obtained for this study from the Institutional Review Board (IRB) of Arba Minch University, ensuring compliance with established ethical standards and guidelines. Moreover, Informed consent was obtained from all individual participants included in the study. Participants were informed about the objectives of the study, the procedures, the potential risks and benefits, and their right to withdraw from the study at any time without negative consequences. The consent forms were signed by all participants before data collection began.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e Written informed consent for the publication of study findings was obtained from all participants who contributed to the research through questionnaires. The participants have been informed that their identity will remain anonymous, and no personal identifying information will be disclosed in the publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability:\u003c/strong\u003e The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials availability:\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCode availability:\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Contributions:\u0026nbsp;\u003c/strong\u003eF.D. played a central role in all phases of the study, including research design, data collection and monitoring in the laboratory, data analysis, interpretation, and the write-up of the manuscript. D.E., Y.S., and S.D. were involved in designing the study project, supervised the research, and critically revised the manuscript for publication. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u0026nbsp;\u003c/strong\u003eThe authors would like to sincerely thank Arba Minch University for their invaluable support and resources.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAlemu, A., Microbial contamination of currency notes and coins in circulation: a potential public health hazard. \u003cem\u003eBiomedicine and biotechnology,\u003c/em\u003e 2014. \u003cstrong\u003e2\u003c/strong\u003e(3): p. 46-53.\u003c/li\u003e\n\u003cli\u003eAngelakis, E., et al., Paper money and coins as potential vectors of transmissible disease. Future Microbiol, 2014. \u003cstrong\u003e9\u003c/strong\u003e(2): p. 249-61.\u003c/li\u003e\n\u003cli\u003eAngelakis, E., et al., Paper money and coins as potential vectors of transmissible disease. \u003cem\u003eFuture microbiology\u003c/em\u003e, 2014. \u003cstrong\u003e9\u003c/strong\u003e(2): p. 249-261.\u003c/li\u003e\n\u003cli\u003eAkoachere, J.-F.T.K., et al., Public health implications of contamination of Franc CFA (XAF) circulating in Buea (Cameroon) with drug resistant pathogens. \u003cem\u003eBMC research notes\u003c/em\u003e, 2014. \u003cstrong\u003e7\u003c/strong\u003e: p. 1-13.\u003c/li\u003e\n\u003cli\u003eGedik, H., T.A. Voss, and A. Voss, Money and transmission of bacteria. \u003cem\u003eAntimicrobial resistance and infection control\u003c/em\u003e, 2013. \u003cstrong\u003e2\u003c/strong\u003e: p. 1-4.\u003c/li\u003e\n\u003cli\u003eMoosavy, M.-H., et al., Bacterial contamination of Iranian paper currency. \u003cem\u003eIranian journal of public health\u003c/em\u003e, 2013. \u003cstrong\u003e42\u003c/strong\u003e(9): p. 1067.\u003c/li\u003e\n\u003cli\u003eAyandele, A. and S. Ayandele, Prevalence and antimicrobial resistance pattern of microorganisms isolated from Naira notes in Ogbomoso North, Nigeria. \u003cem\u003eJournal of research in Biology\u003c/em\u003e, 2011. \u003cstrong\u003e1\u003c/strong\u003e(8): p. 587-593.\u003c/li\u003e\n\u003cli\u003eLamichhane, J., et al., Risk of handling paper currency in circulation chances of potential bacterial transmittance. \u003cem\u003eNepal Journal of Science and Technology,\u003c/em\u003e 2009. \u003cstrong\u003e10\u003c/strong\u003e: p. 161-166.\u003c/li\u003e\n\u003cli\u003ePradeep, N., et al., Microbial contamination of Indian currency notes in circulation. \u003cem\u003eJournal of Research in Biology\u003c/em\u003e, 2012. \u003cstrong\u003e2\u003c/strong\u003e(4): p. 377-382.\u003c/li\u003e\n\u003cli\u003eGirma, G., T. Ketema, and K. Bacha, Microbial load and safety of paper currencies from some food vendors in Jimma Town, Southwest Ethiopia. \u003cem\u003eBMC Research Notes\u003c/em\u003e, 2014. \u003cstrong\u003e7\u003c/strong\u003e(1): p. 843.\u003c/li\u003e\n\u003cli\u003eSaripalli, H., et al., Assessment of microbial contamination of ethiopian currency notes. \u003cem\u003eResearch Journal of Pharmaceutical, Biological and Chemical Sciences\u003c/em\u003e, 2014. \u003cstrong\u003e5\u003c/strong\u003e: p. 510-515.\u003c/li\u003e\n\u003cli\u003eAhmed, M.S.U., et al., Evaluation of the microbial contamination of Bangladesh paper currency notes (Taka) in circulation. \u003cem\u003eAdvances in biological research\u003c/em\u003e, 2010. \u003cstrong\u003e4\u003c/strong\u003e(5): p. 266-271.\u003c/li\u003e\n\u003cli\u003eKuria, J., et al., Profile of bacteria and fungi on money coins. East African medical journal, 2009. \u003cstrong\u003e86\u003c/strong\u003e(4).\u003c/li\u003e\n\u003cli\u003eGirma, G., Health risk associated with handling of contaminated paper currencies in circulation: A review. \u003cem\u003eAm Sci Res J Eng Technol Sci,\u003c/em\u003e 2014. \u003cstrong\u003e10\u003c/strong\u003e(1): p. 40-53.\u003c/li\u003e\n\u003cli\u003eBorah, D., P. Parida, and T. Kumar, Paper currencies, a potential carrier of pathogenic microorganisms. International Journal of Applied Biology and Pharmaceutical Technology, 2012. \u003cstrong\u003e3\u003c/strong\u003e(1): p. 23-25.\u003c/li\u003e\n\u003cli\u003eAwe, S., et al., Bacteriological quality of some Nigerian currencies in circulation. \u003cem\u003eAfrican journal of Microbiology research\u003c/em\u003e, 2010. \u003cstrong\u003e4\u003c/strong\u003e(21): p. 2231-2234.\u003c/li\u003e\n\u003cli\u003eAlwakeel, S.S. and L.A. Nasser, Bacterial and fungal contamination of Saudi Arabian paper currency and cell phones. 2011.\u003c/li\u003e\n\u003cli\u003eSingh, P., et al., Hand sanitizer an alternative to hand washing\u0026mdash;a review of literature. \u003cem\u003eJournal of Advanced Oral Research, \u003c/em\u003e2020. \u003cstrong\u003e11\u003c/strong\u003e(2): p. 137-142.\u003c/li\u003e\n\u003cli\u003eAbuga, K. and N. Nyamweya, Alcohol-based hand sanitizers in COVID-19 prevention: a multidimensional perspective. \u003cem\u003ePharmacy\u003c/em\u003e, 2021. \u003cstrong\u003e9\u003c/strong\u003e(1): p. 64.\u003c/li\u003e\n\u003cli\u003eAllegranzi, B. and D. Pittet, Role of hand hygiene in healthcare-associated infection prevention. \u003cem\u003eJournal of hospital infection,\u003c/em\u003e 2009. \u003cstrong\u003e73\u003c/strong\u003e(4): p. 305-315.\u003c/li\u003e\n\u003cli\u003eDejene, F., B. Regasa Dadi, and D. Tadesse, In vitro antagonistic effect of lactic acid bacteria isolated from fermented beverage and finfish on pathogenic and foodborne pathogenic microorganism in Ethiopia. \u003cem\u003eInternational journal of microbiology,\u003c/em\u003e 2021. \u003cstrong\u003e2021\u003c/strong\u003e.\u003c/li\u003e\n\u003cli\u003eGirma, G., T. Ketema, and K. Bacha, Microbial load and safety of paper currencies from some food vendors in Jimma Town, Southwest Ethiopia. \u003cem\u003eBMC research notes,\u003c/em\u003e 2014. \u003cstrong\u003e7\u003c/strong\u003e: p. 1-8.\u003c/li\u003e\n\u003cli\u003eJalgaonkar, S., et al., Currency as fomites? \u003cem\u003eIndian Journal of Community Medicine\u003c/em\u003e, 2007. \u003cstrong\u003e32\u003c/strong\u003e(2): p. 157-158.\u003c/li\u003e\n\u003cli\u003eAbdulla, S.M., Isolation and Identification of causative agents from some Iraqi Banknote currency. \u003cem\u003eIbn AL-Haitham Journal For Pure and Applied Science,\u003c/em\u003e 2017. \u003cstrong\u003e26\u003c/strong\u003e(1): p. 75-81.\u003c/li\u003e\n\u003cli\u003eChauwa, A., et al., Assessment of Bacteriological Contamination of the Zambian Paper Currency in Circulation in Selected Areas of Lusaka City, Zambia. \u003cem\u003eInternational Journal of Research,\u003c/em\u003e 2020. \u003cstrong\u003e6\u003c/strong\u003e(2): p. 14-21.\u003c/li\u003e\n\u003cli\u003eYazah, A.J., J. Yusuf, and A. Agbo, Bacterial contaminants of Nigerian currency notes and associated risk factors. 2012.\u003c/li\u003e\n\u003cli\u003eNeel, R., Isolation of pathogenic microorganisms from contaminated paper currency notes in circulation from different market places in Korogwe and Mombo towns in Tanzania. 2012.\u003c/li\u003e\n\u003cli\u003ePal, K., N. Das, and S. Bhattacharya, Bacteriological profile of Indian currency circulating in a tertiary care hospital in rural Bengal. \u003cem\u003eIJRRMS\u003c/em\u003e, 2013. \u003cstrong\u003e3\u003c/strong\u003e(2): p. 23-30.\u003c/li\u003e\n\u003cli\u003eSadawarte, K., H. Mahobe, and G. Saxena, Microbial contamination of Indian currency notes in Bhopal. \u003cem\u003eJournal of Evolution of Medical and Dental Sciences, \u003c/em\u003e2014. \u003cstrong\u003e3\u003c/strong\u003e(6): p. 1379-1384.\u003c/li\u003e\n\u003cli\u003eThapaliya, D., et al., Epidemiology of necrotizing infection caused by Staphylococcus aureus and Streptococcus pyogenes at an Iowa hospital. \u003cem\u003eJournal of infection and public health\u003c/em\u003e, 2015. \u003cstrong\u003e8\u003c/strong\u003e(6): p. 634-641.\u003c/li\u003e\n\u003cli\u003eDel Giudice, P., Skin infections caused by Staphylococcus aureus. Acta dermato-venereologica, 2020. \u003cstrong\u003e100\u003c/strong\u003e(9).\u003c/li\u003e\n\u003cli\u003eWong, S.S. and K.-Y. Yuen, Streptococcus pyogenes and re-emergence of scarlet fever as a public health problem. \u003cem\u003eEmerging Microbes \u0026amp; Infections\u003c/em\u003e, 2012. \u003cstrong\u003e1\u003c/strong\u003e(1): p. 1-10.\u003c/li\u003e\n\u003cli\u003eWatanabe, S., et al., Severe invasive streptococcal infection by Streptococcus pyogenes and Streptococcus dysgalactiae subsp. equisimilis. \u003cem\u003eMicrobiology and immunology\u003c/em\u003e, 2016. \u003cstrong\u003e60\u003c/strong\u003e(1): p. 1-9.\u003c/li\u003e\n\u003cli\u003eKraft, S., L. Buchenauer, and T. Polte, Mold, Mycotoxins and a Dysregulated Immune System: A Combination of Concern? Int J Mol Sci, 2021. \u003cstrong\u003e22\u003c/strong\u003e(22).\u003c/li\u003e\n\u003cli\u003eLuis Enrique Jerez, P., Fungal Infections in Immunosuppressed Patients, in Immunodeficiency, M. Krassimir, Editor. 2012, IntechOpen: Rijeka. p. Ch. 6.\u003c/li\u003e\n\u003cli\u003eIgumbor, E., et al., Microbiological analysis of banknotes circulating in the Venda region of Limpopo province, South Africa: research in action. \u003cem\u003eSouth African Journal of Science\u003c/em\u003e, 2007. \u003cstrong\u003e103\u003c/strong\u003e(9): p. 365-366.\u003c/li\u003e\n\u003cli\u003eSu, G.L.S., et al., Bacteriological and parasitological assessment of currencies obtained in selected markets of Metro Manila. \u003cem\u003eAsian Pacific Journal of Tropical Disease\u003c/em\u003e, 2015. \u003cstrong\u003e5\u003c/strong\u003e(6): p. 468-470.\u003c/li\u003e\n\u003cli\u003eAorkwagh, M., et al., Isolation And Identification of Bacteria Prevalent Among Nigerian Currency Notes In Selected Areas In and Around Akperan Orshi College Of Agriculture, Yandev. Journal of Scientific and Industrial Studies, 2015. \u003cstrong\u003e13\u003c/strong\u003e(3): p. 74-81.\u003c/li\u003e\n\u003cli\u003eOluduro, A., et al., Antibiotic resistance and public health perspective of bacterial contamination of Nigerian currency. \u003cem\u003eAdvances in Life Science and Technology, \u003c/em\u003e2014. \u003cstrong\u003e24\u003c/strong\u003e: p. 4-9.\u003c/li\u003e\n\u003cli\u003eAl-Tarjuman, J.K., F.N. Mula Abed, and F.K. Al-Dulaimi, Study on fungal contamination of Iraqi paper currency. Biochemical \u0026amp; Cellular Archives, 2020. \u003cstrong\u003e20\u003c/strong\u003e(1).\u003c/li\u003e\n\u003cli\u003eDougnon, V., et al., Enterobacteria responsible for urinary infections: a review about pathogenicity, virulence factors and epidemiology. Journal of Applied Biology and Biotechnology, 2020. \u003cstrong\u003e8\u003c/strong\u003e(1): p. 117-124.\u003c/li\u003e\n\u003cli\u003eHaenni, M., A. Lupo, and J.-Y. Madec, Antimicrobial resistance in Streptococcus spp. Microbiology spectrum, 2018. \u003cstrong\u003e6\u003c/strong\u003e(2): p. 10.1128/microbiolspec. arba-0008-2017.\u003c/li\u003e\n\u003cli\u003ePandey, S., M. Raza, and C. Bhatta, Prevalence and antibiotic sensitivity pattern of methicillin-resistant-Staphylococcus aureus in Kathmandu Medical College-Teaching Hospital. Journal of Institute of Medicine Nepal (JIOM Nepal), 2012. \u003cstrong\u003e34\u003c/strong\u003e(1): p. 13-17.\u003c/li\u003e\n\u003cli\u003eYar, D.D., Bacterial contaminants and antibiogram of Ghana paper currency notes in circulation and their associated health risks in asante-mampong, Ghana. International Journal of Microbiology, 2020. \u003cstrong\u003e2020\u003c/strong\u003e: p. 1-8.\u003c/li\u003e\n\u003cli\u003eKuang, Y., et al., Effect of milk on antibacterial activity of tetracycline against Escherichia coli and Staphylococcus aureus isolated from bovine mastitis. Applied microbiology and biotechnology, 2009. \u003cstrong\u003e84\u003c/strong\u003e: p. 135-142.\u003c/li\u003e\n\u003cli\u003eAl-Nazawi, M.H., Resistance and residues of antibacterial in dairy farm and dairy production in Al-Hassa Region, Saudi Arabia. 2006.\u003c/li\u003e\n\u003cli\u003eStephens, B., et al., Microbial exchange via fomites and implications for human health. Current Pollution Reports, 2019. \u003cstrong\u003e5\u003c/strong\u003e: p. 198-213.\u003c/li\u003e\n\u003cli\u003eOlise, C. and I. Simon-Oke, Fomites: Possible vehicle of nosocomial infections. Journal of Public Health and Nutrition, 2018. \u003cstrong\u003e1\u003c/strong\u003e(1).\u003c/li\u003e\n\u003cli\u003eChu, D.-T., et al., Transmission of SARS-CoV-2 infections and exposure in surfaces, points and wastewaters: A global one health perspective. Case Studies in Chemical and Environmental Engineering, 2022. \u003cstrong\u003e5\u003c/strong\u003e: p. 100184.\u003c/li\u003e\n\u003cli\u003eToney-Butler, T.J., A. Gasner, and N. Carver, Hand Hygiene, in StatPearls. 2024, StatPearls Publishing Copyright \u0026copy; 2024, StatPearls Publishing LLC.: Treasure Island (FL) ineligible companies. Disclosure: Adi Gasner declares no relevant financial relationships with ineligible companies. Disclosure: Niki Carver declares no relevant financial relationships with ineligible companies.\u003c/li\u003e\n\u003cli\u003eHoang, D., et al., Video didactic at the point of care impacts hand hygiene compliance in the neonatal intensive care unit (NICU). Journal of Healthcare Risk Management, 2018. \u003cstrong\u003e37\u003c/strong\u003e(4): p. 9-15.\u003c/li\u003e\n\u003cli\u003eRoy, A., S.P. Parida, and V. Bhatia, Role of disinfection and hand hygiene: a COVID-19 perspective. Int. J. Community Med. Public Health, 2020. \u003cstrong\u003e7\u003c/strong\u003e: p. 2845.\u003c/li\u003e\n\u003cli\u003eGupta, M.K. and S.R. Lipner, Hand hygiene in preventing COVID-19 transmission. J Am Acad Dermatol, 2020. \u003cstrong\u003e82\u003c/strong\u003e: p. 1215-1216.\u003c/li\u003e\n\u003cli\u003eMarumure, J., et al., Effectiveness of hand sanitizers in the prevention of COVID-19 and related public health concerns: A review. Cogent Public Health, 2022. \u003cstrong\u003e9\u003c/strong\u003e(1): p. 2060904.\u003c/li\u003e\n\u003cli\u003eDe\u0026rsquo;, R., N. Pandey, and A. Pal, Impact of digital surge during Covid-19 pandemic: A viewpoint on research and practice. International Journal of Information Management, 2020. \u003cstrong\u003e55\u003c/strong\u003e: p. 102171.\u003c/li\u003e\n\u003cli\u003eGardner, B., Dirty banknotes may be spreading the coronavirus, WHO suggests. Daily Telegraph, 2020. \u003cstrong\u003e8\u003c/strong\u003e.\u003c/li\u003e\n\u003cli\u003eBadr, E., Public health communication: some lessons for effectiveness. Sudanese Journal of Public Health, 2009. \u003cstrong\u003e4\u003c/strong\u003e(3): p. 313.\u003c/li\u003e\n\u003cli\u003eJ, S., et al., Health communication and its role in the prevention and control of communicable diseases in Europe Current evidence, practice and future developments. 2014.\u003c/li\u003e\n\u003cli\u003eOrganization, W.H., Infection prevention and control of epidemic-and pandemic-prone acute respiratory infections in health care. Annex G, use of disinfectants: alcohol and bleach. 2014. 2020.\u003c/li\u003e\n\u003cli\u003eWeinstein, N.D. and W.M. Klein, Resistance of personal risk perceptions to debiasing interventions. Health Psychol, 1995. \u003cstrong\u003e14\u003c/strong\u003e(2): p. 132-40.\u003c/li\u003e\n\u003cli\u003eOrganization, W.H., Cleaning and disinfection of environmental surfaces in the context of COVID-19: interim guidance, 15 May 2020. 2020, World Health Organization.\u003c/li\u003e\n\u003cli\u003eRosenstock, I.M., The health belief model and preventive health behavior. Health education monographs, 1974. \u003cstrong\u003e2\u003c/strong\u003e(4): p. 354-386.\u003c/li\u003e\n\u003cli\u003eAjzen, I., The theory of planned behavior. Organizational Behavior and Hu‐man Decision Processes, 50, 179\u0026ndash;211. De Young, 1991. \u003cstrong\u003e50\u003c/strong\u003e(2): p. 509-526.\u003c/li\u003e\n\u003cli\u003eKramer, A. and O. Assadian, Survival of Microorganisms on Inanimate Surfaces. Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections. 2014 Jul 12:7-26. doi: 10.1007/978-3-319-08057-4_2.\u003c/li\u003e\n\u003cli\u003eKatzenberger, R.H., A. R\u0026ouml;sel, and R.-P. Vonberg, Bacterial survival on inanimate surfaces: a field study. BMC Research Notes, 2021. \u003cstrong\u003e14\u003c/strong\u003e: p. 1-10.\u003c/li\u003e\n\u003cli\u003eObinna, C.N., Q.C. Somachi, and D.K.-A. Olushola. Hygiene Assessment of Paper Currency and Fomites Handled by Food Vendors in Covenant University. in IOP Conference Series: Earth and Environmental Science. 2022. IOP Publishing.\u003c/li\u003e\n\u003cli\u003eCasta\u0026ntilde;o, N., et al., Fomite Transmission, Physicochemical Origin of Virus-Surface Interactions, and Disinfection Strategies for Enveloped Viruses with Applications to SARS-CoV-2. ACS Omega, 2021. \u003cstrong\u003e6\u003c/strong\u003e(10): p. 6509-6527.\u003c/li\u003e\n\u003cli\u003eGebel, J., et al., The role of surface disinfection in infection prevention. GMS Hyg Infect Control, 2013. \u003cstrong\u003e8\u003c/strong\u003e(1): p. Doc10.\u003c/li\u003e\n\u003cli\u003eBloomfield, S.F., Importance of disinfection as a means of prevention in our changing world hygiene and the home. GMS Krankenhhyg Interdiszip, 2007. \u003cstrong\u003e2\u003c/strong\u003e(1): p. Doc25.\u003c/li\u003e\n\u003cli\u003eRinc\u0026oacute;n Uribe, F.A., et al., Health knowledge, health behaviors and attitudes during pandemic emergencies: A systematic review. PLoS One, 2021. \u003cstrong\u003e16\u003c/strong\u003e(9): p. e0256731.\u003c/li\u003e\n\u003cli\u003eTeyhen, D.S., USA, D. Robbins, and B.A. Ryan, USA, Promoting and Sustaining Positive Personal Health Behaviors \u0026ndash; Putting the Person First. Military Medicine, 2018. \u003cstrong\u003e183\u003c/strong\u003e(suppl_3): p. 213-219.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Bacteria, Fungi, Microbial contamination, Paper currency","lastPublishedDoi":"10.21203/rs.3.rs-4127253/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4127253/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eMoney bills are handled by the public every day, which means they can carry microorganisms that can be passed from person to person through direct contact. This study aims to assess the public awareness and evaluate the bacterial contamination on Ethiopian paper currency in circulation in Arba Minch Town, SNNPR, Ethiopia.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted at the microbiology and parasitology laboratory at Arba Minch University, Ethiopia. A total of 150 Ethiopian paper currency samples were collected aseptically from different sectors in Arba Minch town for microbial analysis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe most common microorganisms isolated from the samples were gram-positive bacteria, with yeast being the least common. These microorganisms were identified as \u003cem\u003eklebissela\u003c/em\u003e spp, \u003cem\u003eE. coli\u003c/em\u003e, \u003cem\u003eStreptococcus\u003c/em\u003e spp, \u003cem\u003eBacillus\u003c/em\u003e spp, \u003cem\u003eAspergillus\u003c/em\u003e spp, and \u003cem\u003eStaphylococcus aureus\u003c/em\u003e based on their characteristics observed through phenotypic, microscopic, and biochemical analysis. The antimicrobial susceptibility patterns of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e and \u003cem\u003eStreptococcus\u003c/em\u003e spp. were evaluated, and both showed higher sensitivity to Vancomycin and Tetracycline antibiotics. Similarly, \u003cem\u003eKlebsiella\u003c/em\u003e spp showed higher sensitivity to Ciprofloxacin while exhibiting a lower sensitivity rate (6.6667%) to Ampicillin. In contrast, Ampicillin showed higher activity on the \u003cem\u003eE. coli\u003c/em\u003e isolates. Regarding the transmission of diseases through paper currency, a significant majority of participants (79.8%) were aware of the associated risk. However, it is worth noting that more than half of the participants (53.9%) reported that they do not take any precautions after handling paper currency.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eOverall, the study confirms that paper bills are a suitable environment for bacterial growth and could potentially contribute to infections. Therefore, it emphasizes the importance of raising awareness about the potential risks associated with mishandling paper currency in all food establishments.\u003c/p\u003e","manuscriptTitle":"Public Awareness and Precautionary Measures for Disease Transmission Prevention: A Microbial Evaluation of Ethiopian Paper Currency in Circulation in Arba Minch Town, SNNPR","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-03 17:00:03","doi":"10.21203/rs.3.rs-4127253/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6f3eccd0-0997-4bc4-a233-778130c28541","owner":[],"postedDate":"April 3rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-09-23T14:54:10+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-03 17:00:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4127253","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4127253","identity":"rs-4127253","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}