Water, sanitation and schistosomiasis mansoni: a study based on the Brazilian National Prevalence Survey (2011-2015).

This study aimed to explore the association between water, sanitation, and the prevalence of schistosomiasis mansoni in students aged 7 to 17 years from all 27 federative units in Brazil. It was a cross-sectional study conducted based on data on the prevalence of schistosomiasis mansoni referring to 197,567 students from 521 Brazilian municipalities, who participated in the National Survey on the Prevalence of Schistosomiasis Mansoni and Soil-transmitted Helminth Infections (2011-2015). Univariable and multivariable generalized linear models of the negative binomial type were adjusted using 25 and 5% significance levels, respectively, considering municipalities as the unit of analysis. While a protective association was found between access to filtered water in schools and schistosomiasis mansoni prevalence, sanitation in schools was indicated as a risk factor. The collection of wastewater through a network is not universal in Brazil, and even when present, it is not necessarily carried out by the treatment of collected effluents, thus often resulting in the direct discharge of raw sewage into water resources. Regarding septic tanks, only the presence of infrastructure alone does not guarantee its correct use by the population.

Proposition and application of an environmental salubrity index in rural agglomerations.

OBJECTIVE: Propose an Índice de salubridade ambiental (ISARural - environmental salubrity index) that expresses the conditions experienced in rural agglomerations, including indicators and subindicators for its subsequent application in rural communities in the state of Goiás. METHODS: We developed the research in three phases: 1) previous analysis for the proposition of an ISARural, with the participation of seven specialists; 2) proposition of the ISARural by means of the Delphi method, starting with 168 specialists from 26 federative units of Brazil and Distrito Federal; and 3) application of the ISARural in 43 rural communities in the state of Goiás. RESULTS: The proposed ISARural resulted in the composition of eight indicators, four of which related to basic sanitation, and the others to health, socioeconomic conditions, public services offered, and housing conditions. The weight assigned to each indicator ranged from 22.82% for the water supply indicator to 6.35% for the service indicator, it is possible to apply the ISARural fully or to evaluate each indicator individually. The application of ISARural in communities of Goiás classified 86% of them with low salubrity, highlighting the worst conditions for quilombola communities. The sanitary sewage had the lowest score among the ISARural indicators, requiring greater attention from public authorities. CONCLUSIONS: This study contributed to the proposition of an index in line with the concept of environmental salubrity, useful in the scope of public policies as a conditioner for the prioritization of actions needed to improve the salubrity conditions identified. The proposed ISARural can be fully applied or used in the individual evaluation of each indicator of its composition. The results of its application made it possible to identify the communities with the worst environmental salubrity conditions and the indicators that require greater priority attention in the communities studied.

Proposition and application of an environmental salubrity index in rural agglomerations / Proposição e aplicação de um índice de salubridade ambiental em aglomerados rurais

ABSTRACT OBJECTIVE Propose an Índice de salubridade ambiental (ISARural - environmental salubrity index) that expresses the conditions experienced in rural agglomerations, including indicators and subindicators for its subsequent application in rural communities in the state of Goiás. METHODS We developed the research in three phases: 1) previous analysis for the proposition of an ISARural, with the participation of seven specialists; 2) proposition of the ISARural by means of the Delphi method, starting with 168 specialists from 26 federative units of Brazil and Distrito Federal; and 3) application of the ISARural in 43 rural communities in the state of Goiás. RESULTS The proposed ISARural resulted in the composition of eight indicators, four of which related to basic sanitation, and the others to health, socioeconomic conditions, public services offered, and housing conditions. The weight assigned to each indicator ranged from 22.82% for the water supply indicator to 6.35% for the service indicator, it is possible to apply the ISARural fully or to evaluate each indicator individually. The application of ISARural in communities of Goiás classified 86% of them with low salubrity, highlighting the worst conditions for quilombola communities. The sanitary sewage had the lowest score among the ISARural indicators, requiring greater attention from public authorities. CONCLUSIONS This study contributed to the proposition of an index in line with the concept of environmental salubrity, useful in the scope of public policies as a conditioner for the prioritization of actions needed to improve the salubrity conditions identified. The proposed ISARural can be fully applied or used in the individual evaluation of each indicator of its composition. The results of its application made it possible to identify the communities with the worst environmental salubrity conditions and the indicators that require greater priority attention in the communities studied.

RESUMO OBJETIVO Propor um índice de salubridade ambiental que expresse as condições vividas em aglomerados rurais (ISARural), englobando indicadores e subindicadores para sua posterior aplicação em comunidades rurais do estado de Goiás. MÉTODOS A pesquisa foi desenvolvida em três fases: 1) análise prévia para proposição de um ISARural, contando com a participação de sete especialistas; 2) proposição do ISARuralpor meio do método Delphi, iniciando com 168 especialistas das 26 unidades federativas do Brasil e do Distrito Federal; e 3) aplicação do ISARuralem 43 comunidades rurais do estado de Goiás. RESULTADOS O ISARuralproposto resultou na composição de oito indicadores, sendo quatro relacionados ao saneamento básico, e os demais à saúde, às condições socioeconômicas, aos serviços públicos ofertados e às condições de moradia. O peso atribuído para cada indicador variou de 22,82%, para indicador de abastecimento de água, a 6,35%, para o indicador de serviços, podendo o ISARuralser aplicado na sua totalidade ou para avaliação de cada indicador individualmente. A aplicação do ISARuralem comunidades de Goiás evidenciou que 86% se classificam com baixa salubridade, destacando as piores condições para as comunidades quilombolas. Dentre os indicadores do ISARural, o de esgotamento sanitário foi caracterizado com a menor pontuação, o que demanda uma maior atenção do poder público. CONCLUSÕES Esse estudo cumpriu o papel de contribuir com a proposição de um índice em consonância com o conceito de salubridade ambiental, podendo ser empregado no âmbito das políticas públicas como um condicionante para a priorização das ações necessárias à melhoria das condições de salubridade identificadas. O ISARuralproposto pode ser aplicado na sua totalidade ou ainda na avaliação individual de cada indicador de sua composição. Os resultados da sua aplicação possibilitaram identificar as comunidades com piores condições de salubridade ambiental e os indicadores que requerem maior atenção prioritária nas comunidades estudadas.

Higienización y eliminación fúngica en instalaciones industriales para la disminución de riesgos ocupacionales / Sanitization and fungal elimination in industrial facilities to reduce occupational risks

Se ha comprobado que la exposición a bioaerosoles se asocia con varios efectos sobre la salud, como enfermedades pulmonares y alergias. El presente estudio transversal tuvo como objetivo investigar la contaminación por hongos en varias superficies pertenecientes a dos industrias de alimentos. La toma de muestra se realizó en tres semanas, inmediatamente después de realizada la limpieza y desinfección y antes de iniciar la producción. Se recolectaron 400 muestras de superficie (vidrio, acero inoxidable, aluminio, goma y plástico), también se evaluó la eficacia del programa de higienización en el control de la población de hongos. Todas las muestras presentaron recuentos fúngicos <10 ufc/cm2, sin haber diferencias significativas entre los tipos de superficie, sin embargo, las superficies plásticas exhibieron mayor crecimiento logarítmico de los hongos. Se determinó que 49,60% de las especies identificadas correspondieron al género Penicillium. Aunque los niveles de hongos en las industrias estudiadas fueron inferiores a los niveles recomendados por la Organización Mundial de la Salud, algunas medidas de salud ambiental como lavar y desinfectar las superficies después de cada turno de trabajo, y se recomiendan inspecciones periódicas para garantizar la seguridad de los trabajadores y de los productos que allí se manufacturan(AU)

It has been proven that exposure to bioaerosols is associated with several health effects, such as pulmonary diseases and allergies. The present crosssectional study aimed to investigate fungal contamination on various surfaces belonging to two food industries. The sampling was carried out in three weeks, immediately after cleaning and disinfection and before starting production. 400 surface samples were collected (glass, stainless steel, aluminum, rubber and plastic), the effectiveness of the sanitation program in controlling the fungal population was also evaluated. All the samples presented fungal counts <10 cfu / cm2, with no significant differences between the types of surfaces, however, the plastic surfaces exhibited higher logarithmic growth of the fungi. It was determined that 49.60% of the identified species corresponded to the Penicillium genus.Although the levels of fungi in the studied baths were lower than the levels recommended by the World Health Organization, some environmental health measure ssuch as washing and disinfecting surfaces after each working shift and periodic inspections are recommended ensuring the safety of the workers and the products that are manufactured there(AU)

Integration of municipal state, society and university efforts for sanitary risk prevention associated with Aedes aegypti mosquito in the metropolitan area of Buenos Aires, Argentina.

The sanitary problem of Aedes aegypti mosquito acquires relevance around the world because it is the vector of dengue, zika, chikungunya and yellow fever. The vector is adapting to southern regions faster, and the propagation of these diseases in urban areas is a complex problem for society. We aimed to contribute to the risk prevention of disease transmission in the Metropolitan Area of Buenos Aires, through monitoring Aedes aegypti population levels and developing education campaigns with government agencies and society participation. Monitoring activities aimed to diagnose the presence of the vector and its ecology behaviour, and to generate education and prevention politics to avoid its propagation. The results show that (1) the mosquito is in the territory and it is spreading, (2) prevention activities of the municipalities are insufficient to generate an effective sanitary response and (3) it is necessary to improve the education programmes to the population about the life cycle of the vector. The integration of university, government and society improved the work of the team because it combined knowledge about vector ecology, diseases and territory characteristics.

Cleaning and disinfection programmes in food establishments: a literature review on verification procedures.

In food establishments, cleaning and disinfection programmes contribute to provide the environmental conditions that are necessary for the production of safe and healthy food. Compliance with validated programmes is evaluated through verification activities, in order to establish, through objective evidence, if they are implemented as they were written and if they are effective, achieving continuous improvement of the sanitation programmes. In accordance with the specific guidelines of each country, food companies set up their technical specifications and develop their own cleaning and disinfection programmes. Depending on the analytical method used, one of the main challenges was to establish a reasonable limit of acceptability according to the impact that each surface has on the safety and hygiene of the food that is prepared. This review was focused on the procedures implemented to verify the cleaning and disinfection programmes in food establishments. In particular, this study examines the methodologies used (audits and analytical methods), sites for the collection of samples, acceptance criteria and main findings. The results of the analysed studies constitute a scientific basis for designing or improving sanitation procedures and their verification in food companies, and also provide relevant information for food safety authorities.

Clove essential oil in the sanitation of fertile eggs.

The aim of this study was to evaluate the efficacy of sanitizing fertile eggs with clove essential oil as an alternative to paraformaldehyde; effects on the reduction in eggshell microbial count, incubation yield, and neonatal chick quality were measured. A total of 1,460 brown fertile eggs with a mean weight of 58.64 ± 0.49 g (from 37-wk-old CPK [Pesadão Vermelho] breeder hens) were collected under aseptic conditions and randomly distributed into 4 treatments (nonsanitized and sanitized with grain alcohol, clove essential oil, and paraformaldehyde) before incubation. The count of total aerobic mesophilic bacteria was significantly lower after spraying with clove essential oil (2.30 ± 0.24 log10 CFU/mL) than on nonsanitized eggs (3.49 ± 0.34 log10 CFU/mL) or on eggs sprayed with grain alcohol (3.09 ± 0.14 log10 CFU/mL) but did not differ significantly from the count in the paraformaldehyde group (2.23 ± 0.29 log10 CFU/mL). The hatchability of fertile eggs differed significantly between the studied treatments. The mean values for the eggs treated with clove essential oil (84.69 ± 1.65%) and paraformaldehyde (81.87 ± 3.92%) were statistically similar but were higher than the negative control (74.03 ± 3.58%) and grain alcohol (73.59 ± 2.87%) values. In the Pasgar© score assessment, it was determined that the clove essential oil (9.21 ± 0.89%) had a superior effect on the physical quality of the chicks compared with the effects of the other treatments. Clove essential oil is effective and safe for eggs intended for incubation. Its use as an alternative to paraformaldehyde in the sanitation of fertile eggs is strongly recommended.

Molecular Viral Diagnosis and Sanitation of Yam Genetic Resources: Implications for Safe Yam Germplasm Exchange.

Yam (Dioscorea spp.) is an important crop in tropical and subtropical regions. Many viruses have been recently identified in yam, hampering genetic conservation and safe international exchanges of yam germplasm. We report on the implementation of reliable and cost-effective PCR-based detection tools targeting eight different yam-infecting viruses. Viral indexing of the in vitro yam collection maintained by the Biological Resources Center for Tropical Plants (BRC-TP) in Guadeloupe (French West Indies) unveiled a high prevalence of potyviruses, badnaviruses, Dioscorea mosaic associated virus (DMaV) and yam asymptomatic virus 1 (YaV1) and a high level of coinfections. Infected yam accessions were subjected to a combination of thermotherapy and meristem culture. Sanitation levels were monitored using PCR-based and high-throughput sequencing-based diagnosis, confirming the efficacy and reliability of PCR-based detection tools. Sanitation rates were highly variable depending on viruses. Sixteen accessions were successfully sanitized, paving the way to safe yam germplasm exchanges and the implementation of clean seed production programs worldwide.

Antibiotic use and hygiene interact to influence the distribution of antimicrobial-resistant bacteria in low-income communities in Guatemala.

To examine the effects of poor sanitation and hygiene on the prevalence of antimicrobial-resistant bacteria, we surveyed households in two rural and two urban communities in Guatemala (N = 196 randomly selected households). One adult (≥ 18-years old) and, when available, one child (≤ 5 years-old) provided a stool sample. Up to 48 presumptive Escherichia coli isolates were collected from each stool sample (n = 21,256 total) and were subjected to breakpoint assays for ten antibiotics. Mixed-effects logistic models were used to identify potential factors influencing the likelihood of harboring antibiotic-resistant bacteria. For nine out of ten antibiotics, the odds of detecting resistant bacteria decreased by ~ 32% (odds ratios, OR 0.53-0.8, P < 0.001) for every unit of improvement of a hygiene scale. Hygiene differences between households had a greater impact on prevalence compared to antibiotic use differences. The likelihood of detecting resistant isolates was lower for five antibiotics among households that boiled raw milk before consumption (OR 0.31-0.69), and higher for nine antibiotics in urban households (OR > 1.89-9.6). Poor hygiene conditions likely obscure effects of individual antibiotic use, presumably due to enhanced microbial transmission. Consequently, efforts to improve antibiotic stewardship should be coupled with improving hygiene conditions.

Lineamientos para el manejo de cadáveres Coronavirus COVID- 19 / Guidelines for the management of corpses Coronavirus COVID- 19

Establece los lineamientos a seguir durante en el proceso del manejo de cadáveres infectados con el Coronavirus COVID-19 en todo el territorio nacional. Describe procedimientos para servicios de salud y funerarias, en el trato de los cuerpos.

Lineamientos para el manejo de cadáveres Coronavirus COVID- 19: 03 de abril 2020 / Guidelines for the management of corpses Coronavirus COVID- 19

Versión 03 de abril 2020. Establece los lineamientos a seguir durante en el proceso del manejo de cadáveres infectados con el Coronavirus COVID-19 en todo el territorio nacional. Describe procedimientos para servicios de salud y funerarias, en el trato de los cuerpos.

Fecal Contamination of Drinking Water Was Associated with Diarrheal Pathogen Carriage among Children Younger than 5 Years in Three Peruvian Rural Communities.

Drinking water contamination is a frequent problem in developing countries and could be associated with bacterial pathogen carriage in feces. We evaluated the association between the risk of drinking water and bacterial carrier status in children younger than 5 years in a cross-sectional study conducted in 199 households from three Peruvian rural communities. Fecal samples from children were screened for pathogenic Aeromonas, Campylobacter, and Vibrio species, as well as for Enterobacteriaceae, including pathogenic Escherichia coli. The drinking water risk was determined using E. coli as an indicator of contamination. Nineteen (9.5%) children were colonized with pathogens and classified as carriers, all without diarrhea symptoms. Of 199 drinking water samples, 38 (19.1%) were classified as very high risk because of high fecal contamination (> 100 E. coli/100 mL). Shared-use water sources, daily washing of containers, and washing using only water were associated with higher prevalence of bacterial carriage, whereas there was no association between households reporting boiling and chlorination of water and carrier status. The prevalence of carriage in children exposed to very high-risk water was 2.82 (95% CI: 1.21-6.59) times the prevalence of those who consumed less contaminated water, adjusted by the water source and daily washing. Our results suggest that household drinking water plays an important role in the generation of carriers with diarrheal pathogens. Our findings also highlight the importance of interventions to ensure the safety of drinking water. Further studies are needed to validate the observed association and determine its significance with respect to diarrhea in the community.

GIS-based spatial analysis: basic sanitation services in Parana State, Southern Brazil.

The objective of this study is to provide a view of the geographic distribution of basic sanitation services offered in Parana, Brazil. Temporal distributions, spatial patterns, and clusters were determined using 2000, 2010, and 2016 data. Tabular data of the percentages of households receiving water supply, waste collection, and sanitary sewage treatments were used as the basic inputs of the study. Time series maps were created using geographic information systems (GIS) for the visualization of the temporal changes in basic sanitation rates. The spatial variation in sanitation services was measured using Moran's Global Index (Moran's I), while the Local Indicators of Spatial Association (LISA) and Getis-Ord Gi*(d) were used to identify the presence of possible clusters and hot spots in the percentage of households with sanitation services. The study showed strong evidence that the service rates for sanitary sewage were significantly lower than those for water supply and waste collection. Waste collection proved to have the highest service rate in the study area. Waste collection was also the service that increased the most in the study period, followed by the water supply service. Identification of the most vulnerable municipalities was performed using LISA and the local Getis-Ord Gi*(d) statistic. Most of the low value clusters and cold spots were detected in the southern and west-central regions, while the high value hot spots and clusters were detected in the northern and northeastern regions of the state of Parana.

Recomendaciones para los viajeros y público en general / Recommendations for travelers and the general public

Guía básica e inicial sobre los cuidados de higiene personal y ambiental que había que tener durante los primeros momentos de la pandemia.

Sustainable Sanitation Management Tool for Decision Making in Isolated Areas in Brazil.

There is a worldwide range of technical sanitation guidelines focusing on small or traditional and isolated communities for ecological alternatives at the household level. However, a computational tool (software) that has a database and connects these guidelines in a single reference for resource-oriented sanitation concept decision making is still lacking. In this regard, an easy-to-use tool was developed using a participatory approach for the decision-making process from a choice of technical solutions to a type of system management. The results obtained from a pilot study indicate that the proposed tool in this paper will help with the decision-making process to aid in not only choosing sustainable sanitation solutions, but also sustainable operation and maintenance options for the systems. When presenting and discussing the tool with research groups and technicians, the potential for participatory application was noticed. The proposed tool can be used in the elaboration of municipal sanitation plans, assisting local technicians and environmental licensing agencies, designers and engineering students, among others. The software can be applied with other management tools, such as 5W2H and Canvas business model.

Evaluating the effectiveness of a community-based hygiene promotion program in a rural Salvadoran setting.

There has been considerable progress in the reduction of diarrheal disease among children under five through health and nutrition interventions. However, diarrheal disease is still the second leading cause of child death worldwide. There is growing recognition that comprehensive hygiene behavior improvements should be integral to prevention efforts, but the effectiveness of different approaches for hygiene promotion is still being established. Hygiene risk practices vary across settings, suggesting that prevention strategies should be adapted to local contexts using community-based approaches. We planned, implemented, and evaluated a hygiene promotion intervention using the hygiene cluster framework. The two-year, multi-level intervention was implemented by local health promoters who were involved in identifying and addressing disease transmission risks at the household, school, and community levels. The intervention was evaluated using a quasi-experimental pretest-posttest design with repeated follow-up assessments to determine changes in hygiene knowledge and behavior. A household survey instrument was administered at three time points in the intervention ( n = 480) and comparison ( n = 271) communities to assess two hygiene knowledge and eleven hygiene behavior outcome variables. We used one-way analysis of variance with post hoc analysis using Tukey's HSD for multiple comparisons to examine change and differences over time. We also fit a linear regression model to identify statistically significant differences. Study results demonstrated improvements in the areas of: knowledge of disease transmission and key times for handwashing, water container hygiene, sanitation practices, personal hygiene and food hygiene. The hygiene cluster framework is useful for hygiene promotion intervention planning and evaluation, and we recommended continued testing of this framework across contexts. We also recommend local community participatory approaches, as well as in-depth formative behavioral assessments by hygiene cluster that also consider environmental barriers to behavior change.

The teaching of sanitary surveillance in the training of nurses. / O ensino de vigilância sanitária na formação do enfermeiro.

OBJECTIVE: To investigate the teaching of sanitary surveillance in undergraduate nursing courses in Brazil, seeking to know how this theme is addressed during the training of nurses. METHOD: The universe of study was composed of Political-Pedagogical Projects, syllabi and curricula of nursing undergraduate courses from Brazilian public institutions. The quantitative analysis was developed through descriptive and inferential statistics, and for the qualitative part, a software was used to analyze the documents. RESULTS: A total of 153 public institutions' websites were analyzed. Of these, only 98 presented a Political-Pedagogical Project, a syllabus or a curriculum for on-line consultation, and only 2.04% of these programs had a specific discipline focused on teaching sanitary surveillance. CONCLUSION: The findings indicate that the contents related to the teaching of sanitary surveillance in nursing courses of public higher education institutions in Brazil, when present, are inserted, mostly, in other curricular components.