Menstrual hygiene management practice and associated factors among secondary school girls in eastern Ethiopia: The influence of water, sanitation and hygiene facilities.

BACKGROUND: Inadequate water supply, poor sanitation and hygiene (WASH) facilities in schools, insufficient puberty education and a lack of hygienic menstrual hygiene management (MHM) items (absorbents) cause girls in developing countries like Ethiopia to view menstruation as shameful and uncomfortable. However, there was little evidence of female MHM practice and associated factors among secondary school girls in eastern Ethiopia. OBJECTIVE: To assess MHM practice and associated factors among secondary school girls in eastern Ethiopia. DESIGN: Institutional-based cross-sectional study design was conducted. METHODS: A total of 473 secondary schoolgirls were selected using a stratified sampling technique. Data were collected using a self-administered structured questionnaire, double-entered to Epidata version 3.1 and exported to SPSS version 26 for analysis. Descriptive analysis was computed using frequency, percentage, mean and standard deviations. Multivariable logistic regression was applied to assess the association of the school water, sanitation and hygiene facilities with MHM. Adjusted odd ratio (AOR) with its 95% confidence interval was computed to show the strength of the association between dependent and independent variables. The goodness of fit of the model was tested by the Hosmer-Lemeshow goodness of fit test. RESULTS: Out of 473 study participants, 72.93% of them (95% CI: 68.74-76.76) reported good MHM practices. The study also found that availability of continuous water supply (AOR = 2.40, 95% CI: (1.42-4.01)); types of toilet (AOR = 2.01, 95% CI: (1.20-3.40)), confined space (AOR = 3.02, 95% CI: (1.49-4.76)) and having females' toilets alone inside in the school (AOR = 2.70, 95% CI: (1.20-4.40)) were significantly associated with female students' good MHM practice. CONCLUSION: The survey revealed that some of the secondary schoolgirls practiced poor menstrual hygiene management (MHM), which needs further improvement. The study also found that the availability of continuous water supply in the school, types of toilet facility in the school, availability of private space to manage periods at school, learning about MHM in schools and availability of female toilets kept locked inside were factors significantly associated with MHM practice of students, which require integration of Zonal Health and education bureau to jointly work towards the improvement of school WASH facilities.

Assessment of water, sanitation and hand hygiene practices in rural households of Tamil Nadu: A cross-sectional study.

Context: Water is a basic human right essential to all for sustainable development. Sanitation is one of the determinants of quality of life and the human development index. Drinking unsafe water impairs health through illnesses such as diarrhoea, and untreated excreta contaminates ground waters and surface waters used for drinking, bathing and household purposes. Aims: To assess the existing facilities and practices related to drinking water, sanitation, and hygiene among household members in the rural population of Tamil Nadu and to assess whether accessibility and availability of safe drinking water and adequate sanitation under sustainable development goal 6 is being achieved in the rural population of Tamil Nadu. Methodology: This community-based cross-sectional study was carried out among 200 households in the rural field practice area of the Medical College and Hospital, Thiruvallur district, Tamil Nadu. The participants were interviewed using a predesigned semi-structured questionnaire on their existing water, sanitation, and hand washing facilities and practices. Results: Our study observed that 71.5% of households had piped water supply into their dwellings, 82% were using sanitary latrines and 28% had closed drainage for draining wastewater. Twenty-eight percent were using soap and water for hand-washing before food, and 82.5% were doing hand-washing with soap after using the toilet. In our study, the association between sanitary practices and education, occupation and socioeconomic status was statistically significant. Conclusions: Our study emphasized the need for strengthening health education and behaviour change communication regarding sanitation and hand hygiene practices.

Characterization of bacterial diversity in rhizospheric soils, irrigation water, and lettuce crops in municipalities near the Bogotá river, Colombia.

The use of wastewater in agricultural practices poses a potential risk for the spread of foodborne diseases. Therefore, this study aimed to characterize the bacterial biodiversity in rhizospheric soil, irrigation water, and lettuce crops in three municipalities adjacent to the Bogotá River, Colombia. Samples were collected in Mosquera, Funza, and Cota municipalities, including rhizospheric soil, lettuce leaves, and irrigation water. The total DNA extraction was performed to analyze bacterial diversity through high-throughput sequencing of the 16S ribosomal RNA genes, utilizing the Illumina HiSeq 2500 PE 300 sequencing platform. A total of 198 genera from the rhizospheric soil were detected including a higher abundance of zOTUs such as Bacillus, Streptomyces, and clinically relevant genera such as Mycobacterium and Pseudomonas. In lettuce, the detection of 26 genera of endophytic bacteria showed to Proteobacteria and Firmicutes as the predominant phyla, with Staphylococcus and Bacillus as the most abundant genera. Notably, Funza's crops exhibited the highest abundance of endophytes, approximately 50 %, compared to Cota (20 %). Furthermore, the most abundant bacterial genera in the irrigation water were Flavobacterium and Pseudomonas. The most prevalent Enterobacteriaceae were Serratia, Enterobacter, Citrobacter, Klebsiella, Yersinia, Shigella, Escherichia, and Erwinia. The Bacillus genus was highly enriched in both rhizospheric soils and lettuce crops, indicating its significant contribution as the main endophytic bacterium.

Integration of IPC/WASH critical conditions into quality of care and quality improvement tools and processes: Bangladesh case study.

Unsafe patient care in hospitals, especially in low- and middle-income countries, is often caused by poor infection prevention and control (IPC) practices; insufficient support for water, sanitation, and hygiene (WASH); and inadequate waste management. We looked at the intersection of IPC, WASH, and the global initiative of improving health care quality, specifically around maternal and newborn care in Bangladesh health facilities. We identified 8 primary quality improvement and IPC/WASH policy and guideline documents in Bangladesh and analyzed their incorporation of 30 subconditions under 5 critical conditions: water; sanitation; hygiene; waste management/cleaning; and IPC supplies, guidelines, training, surveillance, and monitoring. To determine how Bangladesh health care workers implemented the policies, we interviewed 33 informants from 16 public and private facilities and the national level. Bangladesh's 8 primary guidance documents covered 55% of the 30 subconditions. Interviews showed that Bangladesh health facility staff generally rely on eight tools related to quality improvement (five); IPC (two); and supportive supervision (one) plus a robust supervision mechanism. The stakeholders identified a lack of human resources and environmental hygiene infrastructure and supplies as the main gaps in providing IPC/WASH services. We concluded that the Bangladesh government had produced substantial guidance on using quality improvement methods to improve health services. Our recommendations can help identify strategies to better integrate IPC/WASH in resources including standardizing guidelines and tools within one toolkit. Strategizing with stakeholders working on initiatives such as universal health coverage and patient safety to integrate IPC/WASH into quality improvement documents is a mutually reinforcing approach.

Florence Nightingale (1820-1910): The Founder of Modern Nursing.

Florence Nightingale, a pioneering figure in the field of nursing during the 19th century, revolutionized medical practices through her innovative approaches to healthcare and dedication to improving patient outcomes. Her advocacy for sanitation significantly reduced mortality rates among patients. Nightingale's pioneering use of data analysis in healthcare and her establishment of nursing education standards laid the foundation for the nursing profession as we know it today. Her contributions continue to resonate in the field of medicine to this day. This paper is a theoretical reflection on Florence Nightingale's contributions to health and nursing, based on a review of literature from PubMed and Google Scholar databases.

Wastewater Surveillance Pilot at US Military Installations: Cost Model Analysis.

Background: The COVID-19 pandemic highlighted the need for pathogen surveillance systems to augment both early warning and outbreak monitoring/control efforts. Community wastewater samples provide a rapid and accurate source of environmental surveillance data to complement direct patient sampling. Due to its global presence and critical missions, the US military is a leader in global pandemic preparedness efforts. Clinical testing for COVID-19 on US Air Force (USAF) bases (AFBs) was effective but costly with respect to direct monetary costs and indirect costs due to lost time. To remain operating at peak capacity, such bases sought a more passive surveillance option and piloted wastewater surveillance (WWS) at 17 AFBs to demonstrate feasibility, safety, utility, and cost-effectiveness from May 2021 to January 2022. Objective: We model the costs of a wastewater program for pathogens of public health concern within the specific context of US military installations using assumptions based on the results of the USAF and Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense pilot program. The objective was to determine the cost of deploying WWS to all AFBs relative to clinical swab testing surveillance regimes. Methods: A WWS cost projection model was built based on subject matter expert input and actual costs incurred during the WWS pilot program at USAF AFBs. Several SARS-CoV-2 circulation scenarios were considered, and the costs of both WWS and clinical swab testing were projected. Analysis was conducted to determine the break-even point and how a reduction in swab testing could unlock funds to enable WWS to occur in parallel. Results: Our model confirmed that WWS is complementary and highly cost-effective when compared to existing alternative forms of biosurveillance. We found that the cost of WWS was between US $10.5-$18.5 million less expensive annually in direct costs as compared to clinical swab testing surveillance. When the indirect cost of lost work was incorporated, including lost work associated with required clinical swab testing, we estimated that over two-thirds of clinical swab testing could be maintained with no additional costs upon implementation of WWS. Conclusions: Our results support the adoption of WWS across US military installations as part of a more comprehensive and early warning system that will enable adaptive monitoring during disease outbreaks in a more cost-effective manner than swab testing alone.

Evaluation of the long-term protection conferred by an organosilicon-based disinfectant formulation against bacterial contamination of surfaces.

AIMS: The aim of this work was to evaluate the efficacy of an organosilicon-based, commercially available antimicrobial formulation in the My-shield® product line against bacterial surface contamination. METHODS AND RESULTS: The antimicrobial product was tested in vitro for its long-term persistence on surfaces and effectiveness against Staphylococcus aureus biofilms in comparison to 70% ethanol and 0.1% or 0.6% sodium hypochlorite. Field testing was also conducted over 6 weeks at a university athletic facility. In vitro studies demonstrated the log reductions achieved by the test product, 70% ethanol, and 0.1% sodium hypochlorite were 3.6, 3.1, and 3.2, respectively. The test product persisted on surfaces after washing and scrubbing, and pre-treatment with this product prevented S. aureus surface colonization for up to 30 days. In comparison, pre-treatment with 70% ethanol or 0.6% sodium hypochlorite was not protective against S. aureus biofilm formation after seven days. The field test demonstrated that weekly applications of the test product were more effective at reducing surface bacterial load than daily applications of a control product. CONCLUSIONS: The test product conferred greater long-term protection against bacterial growth and biofilm formation by S. aureus than ethanol and sodium hypochlorite. Even with less frequent applications, the test product maintained a high level of antimicrobial activity.

[Four cases of occupational heatstroke among sanitation workers working in high temperature weather].

Through the report of 4 cases of occupational heatstroke among sanitation workers working in high-temperature weather, this study analyzes the risk of occupational heatstroke among workers in the environmental sanitation industry working in high-temperature weather, and provides scientific suggestions for standardizing occupational health management, safeguarding the health rights and interests of workers, and preventing the occurrence of occupational heatstroke in summer. Through case analysis, we aim to raise high awareness of the occupational health of sanitation workers in the whole society, in order to provide a scientific and healthy working environment for sanitation workers and promote their physical and mental health.

"A rare case of bladder myiasis mimicking radiation cystitis-A first case report".

Patients diagnosed with cancer post-treatment are prone to have recurrent disease. Regular follow-up of these patients enables early recognition and treatment. A tissue diagnosis before starting treatment is imperative to avoid misdiagnosis and management. Given their immunosuppression, maintaining good nutrition, body hygiene, and clean surroundings is essential to prevent the most common urinary tract infection to rare urinary myiasis infection. Cochliomyia hominivorax, Chrysomya bezziana, and Wohlfahrtia magnifica are the most prevalent flies causing myiasis in human beings. Risk factors for urinary myiasis are open or untreated wounds and debris around the genital area. Specific flies, ticks, and mosquitoes are responsible for myiasis in tropical or subtropical countries, when it is usually not transmitted from human to human. Flies lay their eggs near the urethra, and the larvae hatch and migrate to the bladder. Increased urinary frequency, haematuria, and lower abdominal pain are the most commonly found presenting symptoms. Simple preventive measures can avoid these complications. So, prevention is better than cure.

Global associations between the use of basic drinking water and sanitation services with diarrhoeal disease incidence in 200 countries and territories from 2000 to 2019.

OBJECTIVES: Globally, billions of people do not have access to safely managed drinking water and sanitation services. Interventions to improve drinking water, sanitation and hygiene could reduce the incidence of diarrhoea in low- and middle-income countries. This study aimed to investigate the association between these services and the incidence of diarrhoea. STUDY DESIGN: Worldwide, ecological observational study, utilising cross-sectional data. METHODS: Data from the Global Burden of Disease Study 2019 and World Bank were used in this study. Diarrhoeal disease episodes were defined as three or more loose bowel movements within 24 h. Estimated Annual Percentage Change was used to quantify trends in disease incidence over a specific time interval. Quasi-Poisson Generalised Linear Model was introduced to analyse the influence of basic drinking water and sanitation services on the incidence of diarrhoea. Subgroup analyses were carried out to determine potential variations in the incidence of diarrhoeal diseases according to sex, age and sociodemographic index (SDI) region. RESULTS: Between 2000 and 2019, the incidence rate of global diarrhoea remained consistent, with regional variations linked to SDIs. A 1% increase in access to basic drinking water was associated with a 0.41% (95% confidence interval [CI], 0.33%-0.50%) increase in the age-standardised incidence rate of diarrhoea; meanwhile, a 1% increase in sanitation service usage was associated with a 0.47% (95% CI, 0.40%-0.54%) reduction in the age-standardised incidence rate of diarrhoea. The correlation differed across SDI regions. The use of safely managed drinking water was associated with a reduction in diarrhoeal disease rates, but the effect was non-significant in High SDI regions. Higher diarrhoeal disease incidence was seen in younger and older populations. Individuals in the age groups 55-59 years and 10-14 years showed the greatest association of water service usage with diarrhoea, while an increase in sanitation service usage was related to decreased diarrhoea rates in most age groups, excluding children aged 5-14 years. CONCLUSIONS: Emphasising initiatives to enhance water quality, elevate the standards of drinking water safety management, and strengthening related infrastructure development in global health policies and development plans could have a positive impact on overall global health. Such comprehensive interventions have the potential to not only prevent waterborne diseases but also elevate the general health status of societies worldwide.

Fecal Sludge Management and Sanitation Safety: An Assessment in Addis Ababa, Ethiopia.

Background: Sanitation safety practices and risks associated with fecal sludge management are crucial for public health and the environment. This study assessed sanitation safety practices and risks in Addis Ababa, Ethiopia, at different stages of fecal sludge management. The research aimed to understand the current state of sanitation facilities, practices, and associated risks and identify areas for improvement. Materials and Methods: A mixed methods/approach was employed, utilizing household surveys, risk assessments, and sanitary inspections. A total of 384 study subjects were interviewed using face-to-face interviews and observations. Results: The findings revealed that the majority of households (97.7%) had consistent access to toilets, with flush/pour flush toilets being the most common type (47.4%). Factors such as odors in toilets or septic tanks, open defecation by children, and the use of untreated wastewater for food production were significantly associated with sociodemographic factors. Risk assessments indicated that 67% of households fell into the low-risk category, while 33% were classified as intermediate risk. The study identified non-compliance issues during sanitary inspections at transfer stations (45%), a wastewater treatment and disposal facility (61.5%), and in the management of wastewater and sludge in the sewer line (64%). These findings call for urgent actions to address improper feces disposal, inadequate maintenance of sanitation facilities, and unsafe practices in fecal sludge management. Conclusion: This study identified concerning issues in fecal sludge management, including improper feces disposal, inadequate facility maintenance, and non-compliance with safety standards during emptying, transport, treatment, and disposal. Urgent action is needed to address these risks. Promoting proper disposal techniques, improving facility maintenance, education programs, strengthening regulations, providing training and protective equipment, and investing in enhanced sanitation facilities and wastewater treatment methods are essential for improving sanitation safety practices.

Underweight associated with water, sanitation, and hygiene among women of reproductive age in Arba Minch Health and Demographic Surveillance Site, Southern Ethiopia.

Ethiopia is one of the sub-Saharan African countries where underweight among women of reproductive age is high, and it is predisposing to low birth weight, preterm birth, and reduced resistance to infections. Poor water, sanitation, and hygiene (WASH) and drinking water polluted with disease-causing microorganisms lead to undernutrition. Therefore, this study aimed to assess the association between WASH and underweight among women of reproductive age at Arba Minch Health and Demographic Surveillance Site (HDSS), Southern Ethiopia. A community-based cross-sectional study was conducted at Arba Minch HDSS, South Ethiopia, from April to May 2022. Women of reproductive age were included in the study. Data were collected using a pre-tested questionnaire and checklist. Multivariate analysis was conducted to assess the association separately for WASH indicators with underweight status of the women by adjusting for sociodemographic characteristics. Adjusted Odds Ratio (AOR) with a 95% confidence interval was used to assess the association. The prevalence of underweight and overweight/obesity among women of reproductive age was 7.82% (95% CI: 5.60, 10.81) and 12.32% (95% CI: 9.50, 15.83), respectively. Latrine hygiene and use were significantly associated with being underweight. The odds of being underweight among those who use clean latrine were 0.43 (95% CI: 0.20, 0.92) compared to those who use unclean latrine or do not have toilet facilities. The utilization of clean latrine facilities is negatively associated with being underweight among women of reproductive age. From WASH components, latrine utilization and keeping the latrine clean to use need to get focused on reducing the risk of being underweight among women of reproductive age.

Effect of a behavior change and hardware intervention on safe child feces management practices in rural Odisha, India: a cluster-randomized controlled trial.

BACKGROUND: Poor child feces management contributes to enteropathogen exposure and, consequently, is associated with diarrheal disease and negative impacts on child growth. Despite high latrine coverage, only 37% of Indian households safely dispose of their child's feces into a latrine or have the child use the latrine, with the lowest rate in the state of Odisha at 12%. We evaluated a behavior change and hardware intervention designed to improve caregiver safe disposal of child feces and child latrine use. METHODS: We conducted a cluster-randomized controlled trial among 74 villages in rural Odisha, India. Eligible villages previously participated in a water and sanitation infrastructure program. Following a baseline survey, half the villages were assigned to intervention and half to control. Caregivers of children < 5 years old from households with a latrine were eligible to participate. The intervention included five behavior change activities. Hardware was provided at the first activity, based on child age, to aid safe disposal and latrine training (wash basin and bucket with lid for children < 7 months old; latrine training mat platform with removable tray for children 7 to 48 months old). The primary outcome was caregiver reported 'safe disposal' as defined by the WHO/UNICEF Joint Monitoring Programme (JMP) which encompasses two behaviors: caregiver disposal of child's feces into a latrine and child latrine use. Safe disposal was measured four to six months after intervention delivery (endline). RESULTS: Endline analysis included 665 intervention caregivers (840 children) and 634 control caregivers (785 children). Prevalence of JMP-defined safe disposal was 1.16 times greater in the intervention arm compared to control (77.7% vs. 65.9%; prevalence ratio [PR] 1.16, 95% CI 1.04-1.29), with higher prevalence of caregiver safe disposal (18.6% vs. 13.6%; PR 1.46, 95% CI 1.12-1.92) but no significant difference in child latrine use (59.0% vs. 52.2%; PR 1.06, 95% CI 0.95-1.18). When restricted to children < 3 years old, JMP-defined safe disposal was 1.42 times greater (67.5% vs. 46.7%; PR 1.42 95% CI 1.21-1.67) with higher prevalence of both caregiver safe disposal (34.6% vs. 25.7%; PR 1.44, 95% CI 1.11-1.86) and child latrine use (32.9% vs. 20.9%; PR 1.41, 95% CI 1.08-1.83). CONCLUSIONS: The intervention increased JMP-defined safe disposal, with substantial improvements in both caregiver safe disposal and child latrine use among children < 3 years old. While future research is needed to demonstrate sustainability of these effects, our results suggest a potentially scalable intervention for improving child feces disposal and reducing disease. TRIAL REGISTRATION: This trial was retrospectively registered at ISRCTN15831099 on 18/02/2020, which was approximately two months after the first participant was recruited for the baseline survey on 02/12/2019.

Integrated Eco-Health approach significantly reduces helminth infections in endemic Khong islands with emphasis on Schistosoma mekongi.

BACKGROUND: Helminth infections, including Opisthorchis viverrini, hookworm, and Trichuris trichiura, are prevalent in Khong district, Champasack province, southern Lao People's Democratic Republic (PDR). Schistosomiasis caused by Schistosoma mekongi is of public health concern on the islands of the Khong district. This study aimed to assess the impact of an Eco-Health/One-Health approach in combination with mass drug administration (MDA) to reduce these helminth infections. METHODS: We conducted a community intervention using a stepped-wedge trial approach on two endemic islands (Donsom and Donkhone) of the Khong district, Champasack province, Lao PDR, between April 2012 and March 2013. In each study village, 30-40 households were randomly selected. All members of selected households, who were at home during the study period were invited to participate in the study. A baseline study was conducted to assess helminth infections, knowledge attitudes and practices toward Schistosoma mekongi infection, behavior of open defecation and availability of latrine at home. After the baseline (T0), the Eco-Health/One-Health approach was implemented on Donsom (intervention) and Donkhone island (control). An assessment was conducted in 2014 (T1), one year after the completion of intervention implementation, to assess the short-term impact of the Eco-Health/One-Health approach on helminth infections and compare intervention and control islands. Later in 2015, the Eco-Health/One-Health approach was implemented on control island (Donkhone). After the implementation of intervention, the parasitological assessments were conducted annually in humans in 2015 (T2), in 2016 (T3) and in 2017 (T4), and in dogs in 2017 (T4) to evaluate the long-term impact of the intervention on helminth infections. Frequency was used to describe the prevalence of helminth infections. Logistic regression was applied to associate the KAP (knowledge, attitudes, and practices and open defecation behavior) and the reduction of helminth infections between intervention and control islands. The reduction in prevalence pre- and post-intervention was associated using a McNemar test. A two-independent sample t-test was applied to compare the mean eggs per gram (EPG) of helminth infections between control and intervention islands. A paired t-test test was used to compare the mean EPG of stool samples before (baseline) and after (follow-up) interventions for the two islands separately. A P-value lower than 0.05 was considered statistically significant. RESULTS: Eco-Health/One-Health approach appears to be associated with reduction in prevalence of S. mekongi by 9.0% [odds ratio (OR) = 0.49, P = 0.003] compared to the use of mass drug administration alone (control island). Additionally, this intervention package significantly reduced O. viverrini infection by 20.3% (OR = 1.92, P < 0.001) and hookworm by 17.9% (OR = 0.71, P = 0.045), respectively. Annual parasitological assessments between 2012 and 2017 showed that the Eco-Health/One-Health approach, coupled with MDA, steadily reduced the prevalence of S. mekongi on the intervention island from 29.1% to 1.8% and on the control island from 28.4% to 3.1%, respectively. CONCLUSIONS: The study findings suggest that the Eco-Health/One-Health approach appears to be associated with a significant reduction in prevalence of S. mekongi and helminth co-infections, particularly hookworm and T. trichiura. Therefore, implementing the Eco-Health/One-Health approach in schistosomiasis-endemic areas could accelerate the achievement of national goals for transmission interruption by 2025 and elimination by 2030.

Psychological and socio-cultural factors affecting latrine ownership and usage in rural South India.

The levels of latrine utilization were lower than the levels of latrine ownership in rural areas owing to certain psycho-social barriers hindering latrine construction and consistent utilization. The study was aimed to identify the proportion of latrine construction and usage and to explore the psychological, socio-cultural and structural factors influencing latrine ownership and utilization. A community-based cross-sectional study was carried out at the four villages of Villupuram district for three months. After IEC clearance, information was collected from a representative sample of 422 households. Direct observation of the latrines was employed along with surveys. The data were entered and analysed in MS Excel. Categorical variables were expressed as frequencies and percentages. Further, the reasons were categorized into psychological, socio-cultural and structural factors. About 54.7% households owned a latrine and among them 46.8% were using it. Psycho-social factors such as convenience, habitual nature, privacy and space constraints in open defecation influenced latrine ownership. Fear of snakes and insects, safety and protection, time saving and proper functioning latrines with availability of water facilitated latrine utilization are of concern. A multi-faceted strategy employing context-specific behaviour change communication along with Government's financial support would improve both latrine construction and utilization.

Comparative life cycle assessment of excreta management systems through composting and biomethanization: Case of a low-income tropical country.

Low-income tropical regions, such as Haiti, grapple with environmental issues stemming from inadequate sanitation infrastructure for fecal sludge management. This study scrutinizes on-site sanitation systems in these regions, evaluating their environmental impacts and pinpointing improvement opportunities. The focus is specifically on systems integrating excreta valorization through composting and/or anaerobic digestion. Each system encompasses toilet access, evacuation, and sludge treatment. A comparative life cycle assessment was undertaken, with the functional unit managing one ton of excreta in Haiti over a year. Six scenarios representing autonomous sanitation systems were devised by combining three toilet types (container-based toilets (CBTs), ventilated improved pit (VIP) latrines, and flush toilets (WC)) with two sludge treatment processes (composting and biomethanization). Biodigester-based systems exhibited 1.05 times higher sanitary impacts and 1.03 times higher ecosystem impacts than those with composters. Among toilet types, CBTs had the lowest impacts, followed by VIP latrines, with WCs having the highest impacts. On average, WC scenarios were 3.85 times more impactful than VIP latrines and 4.04 times more impactful than those with CBTs regarding human health impact. Critical variables identified include the use of toilet paper, wood shavings, greenhouse gas emissions, and construction materials.

Upcycling waste polyethylene terephthalate (PET) bottles into high-performance activated carbon for electrochemical desalination.

Upcycling waste polyethylene terephthalate (PET) bottles has attracted intensive research interests. This simultaneously alleviates plastic pollution and achieves a waste-to-resource strategy. Waste PET water bottles were used to fabricate value-added activated carbon (AC) electrodes for capacitive deionization (CDI). The KOH activation temperature (greater than 700 °C) prominently affected the physi-chemical properties and desalination performance of PET-derived activated carbons (PET-AC). Profiting from a large Brunauer-Emmet-Teller specific surface area (1448 m2 g-1) with a good mesoporous structure (the ratio of the mesopore volume to the total pore volume was 41.3%), PET-AC-1000 (activated at 1000 °C) possessed a huge specific capacitance of 108 F g-1 for capacitive ion storage. Moreover, when utilized as the electrode material in single-pass CDI, PET-AC-1000 exhibited a maximum electrosorption capacity of 10.82 ± 0.11 mg g-1 and a low level of energy consumption (0.07 kWh mol-1), associated with good electrochemical charging-discharging cyclic stability. The results provide a promising facile approach to tackle the challenge of plastic pollution and promote the advancement of electrode materials for economic affordable and energy-efficient electrochemical desalination process, which meets the United Nations (UN) sustainable development goals (SDGs).

Water, environment, and health nexus: understanding the risk factors for waterborne diseases in communities along the Tano River Basin, Ghana.

Freshwater pollution is a major concern in Ghana, directly impacting human health. However, the underlying drivers of exposure and risks are not comprehensively understood, emphasizing the severity and impact of these diseases. This study assessed the interaction between water and human health, specifically focusing on the risk factors for waterborne diseases and the drivers of water pollution among residents near the Tano River Basin, Ghana. A sample size of 400 households was selected from five communities within the basin based on their proximity to the Tano River. In addition, the study combined both spatial and non-spatial data sources to map potential flood zones for the basin. The study found that inadequate sanitation, poor hygiene practices, and contamination from illegal mining were the primary causative factors of waterborne diseases. Additionally, floods and improper waste management significantly contributed to disease outbreaks. The flood susceptibility analysis indicated that areas highly susceptible to flooding cover 21.2% of the basin, predominantly in the southern part. The results highlight the urgent need for comprehensive interventions to address the drivers of waterborne diseases. This study will contribute to the local authorities in developing plans to prevent waterborne diseases and mitigate their economic and public health impacts.

Shared sanitation facilities and risk of respiratory virus transmission in resource-poor settings: A COVID-19 modeling case study.

Water supply and sanitation are essential household services frequently shared in resource-poor settings. Shared sanitation can increase the risk of enteric pathogen transmission due to suboptimal cleanliness of facilities used by large numbers of individuals. It also can potentially increase the risk of respiratory disease transmission. As sanitation is an essential need, shared sanitation facilities may act as important respiratory pathogen transmission venues even with strict control measures such as stay-at-home recommendations in place. This analysis explores how behavioral and infrastructural conditions surrounding shared sanitation may individually and interactively influence respiratory pathogen transmission. We developed an individual-based community transmission model using COVID-19 as a motivating example parameterized from empirical literature to explore how transmission in shared latrines interacts with transmission at the community level. We explored mitigation strategies, including infrastructural and behavioral interventions. Our review of empirical literature confirms that shared sanitation venues in resource-poor settings are relatively small with poor ventilation and high use patterns. In these contexts, shared sanitation facilities may act as strong drivers of respiratory disease transmission, especially in areas reliant on shared facilities. Decreasing dependence on shared latrines was most effective at attenuating sanitation-associated transmission. Improvements to latrine ventilation and handwashing behavior were also able to decrease transmission. The type and order of interventions are important in successfully attenuating disease risk, with infrastructural and engineering controls being most effective when administered first, followed by behavioral controls after successful attenuation of sufficient alternate transmission routes. Beyond COVID-19, our modeling framework can be extended to address water, sanitation, and hygiene measures targeted at a range of environmentally mediated infectious diseases.

Multisectoral approach for the control of cholera outbreak - lessons and challenges from Lusaka district - Zambia, October 2023 - February 2024.

Introduction: on October 18, 2023, the Ministry of Health declared an outbreak of cholera in the Lusaka district. Public health interventions were implemented using a multisectoral approach in the Lusaka district and other hotspots in the country. We documented the multisectoral response efforts and their impacts on the cholera epidemic in the Lusaka district of Zambia. We highlighted the major challenges and their associated impacts on the epidemiologic patterns of disease in hotspot areas. Methods: we conducted a descriptive observational study of cholera response activities in the Lusaka district. We used quantitative and qualitative non-participant techniques using the Centers for Disease Prevention and Control's direct in-person observation tool in healthcare settings. We reviewed surveillance records to estimate the magnitude of the outbreak, and characterized cases by person, place, and time. We documented the response interventions and challenges using situation reports. Results: during the 2023 - 2024 cholera outbreak, Lusaka district was the most affected district with 13,122 cases and 498 deaths as of 12th February 2024. Despite having a well-established system for coordinating technical support and resource mobilization, inadequate sanitation and limited access to clean water remained potential risks for cholera outbreaks in Lusaka district. Conclusion: Lusaka district may have experienced one of the most severe cholera epidemics in the nation's history, as indicated by its rapid spread and increased mortality reported from both the community and treatment centers. A multisectoral coordination for improved sanitary systems, access to clean water, health education strategies, and vaccination campaigns contributed to the decline in cholera cases.