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1.
Sci Total Environ ; 698: 134185, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31505354

RESUMO

Drinking water quality has been regulated in most European countries for nearly two decades by the drinking water directive 98/83/EC. The directive is now under revision with the goal of meeting stricter demands for safe water for all citizens, as safe water has been recognized as a human right by the United Nations. An important change to the directive is the implementation of a risk-based approach in all regulated water supplies. The European Union Framework Seventh Programme Aquavalens project has developed several new detection technologies for pathogens and indicators and tested them in water supplies in seven European countries. One of the tasks of the project was to evaluate the impact of these new techniques on water safety and on water safety management. Data were collected on risk factors to water safety for five large supplies in Denmark, Germany, Spain and the UK, and for fifteen small water supplies in Scotland, Portugal and Serbia, via a questionnaire aiming to ascertain risk factors and the stage of implementation of Water Safety Plans, and via site-specific surveys known as Sanitary Site Inspection. Samples were collected from the water supplies from all stages of water production to delivery. Pathogens were detected in around 23% of the 470 samples tested. Fecal contamination was high in raw water and even in treated water at the small supplies. Old infrastructure was considered a challenge at all the water supplies. The results showed that some of the technique, if implemented as part of the water safety management, can detect rapidly the most common waterborne pathogens and fecal pollution indicators and therefore have a great early warning potential; can improve water safety for the consumer; can validate whether mitigation methods are working as intended; and can confirm the quality of the water at source and at the tap.

2.
Soc Sci Med ; 245: 112561, 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31790879

RESUMO

BACKGROUND: Lack of access to clean water has well known implications for communicable disease risks, but the broader construct of water insecurity is little studied, and its mental health impacts are even less well understood. METHODS AND FINDINGS: We conducted a mixed-methods, whole-population study in rural Uganda to estimate the association between water insecurity and depression symptom severity, and to identify the mechanisms underlying the observed association. The whole-population sample included 1776 adults (response rate, 91.5%). Depression symptom severity was measured using a modified 15-item Hopkins Symptom Checklist for Depression. Water insecurity was measured with a locally validated 8-item Household Water Insecurity Access Scale. We fitted multivariable linear and Poisson regression models to the data to estimate the association between water insecurity and depression symptom severity, adjusting for age, marital status, self-reported overall health, household asset wealth, and educational attainment. These models showed that water insecurity was associated with depression symptom severity (b = 0.009; 95% confidence interval [CI], 0.004-0.15) and that the estimated association was larger among men (b = 0.012; 95% CI, 0.008-0.015) than among women (b = 0.008; 95% CI, 0.004-0.012. We conducted qualitative interviews with a sub-group of 30 participants, focusing on women given their traditional role in household water procurement in the Ugandan context. Qualitative analysis, following an inductive approach, showed that water insecurity led to "choice-less-ness" and undesirable social outcomes, which in turn led to emotional distress. These pathways were amplified by gender-unequal norms. CONCLUSIONS: Among men and women in rural Uganda, the association between water insecurity and depression symptom severity is statistically significant, substantive in magnitude, and robust to potential confounding. Data from the qualitative interviews provide key narratives that reveal the mechanisms through which women's lived experiences with water insecurity may lead to emotional distress.

3.
Am J Hum Biol ; : e23358, 2019 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-31746081

RESUMO

OBJECTIVES: The Galápagos provides an important setting to investigate the health impacts of a new drinking water treatment plant (DWTP) in a limited resource environment. We examine how household perceptions and practices affect the relationship between water quality and infections before and after DWTP. METHODS: Ethnographic data and self-reported infections were collected from 121 mothers and 168 children ages 2 to 10 from Isla San Cristóbal. Household tap water samples were tested for levels of fecal contamination. Community level infection rates were estimated using discharge records from the Ministry of Public Health. The effects of the new DWTP and fecal contamination levels on infections were tested using logistic and Poisson models. RESULTS: Perceptions of water quality and household practices influenced exposures to contaminated tap water. We found minimal change in drinking water sources with 85% of mothers sampled before the DWTP and 83% sampled after using bottled water, while >85% from the pooled sample used tap water for cooking and hygiene practices. The DWTP opening was associated with lower odds of fecal contamination in tap water, reported urinary infections, and community level rates of urinary and gastrointestinal infections. The household practice of recently washing the cistern contributed to higher contamination levels after the DWTP opened. CONCLUSIONS: To ensure access to clean water, public health works need to consider how household perceptions and practices influence tap water use and quality, in addition to infrastructure improvements. Exposures to contaminated tap water contribute to the burden of infectious disease in environments with inadequate water infrastructure.

4.
Pan Afr Med J ; 33: 244, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692810

RESUMO

Introduction: Access to drinking water and sanitation has been a long-standing issue between many States. However, it represents a daily struggle for hundreds of thousands of city dwellers who live mainly in the developing countries. The government of Cameroon with the assistance of providers of funds have implemented strategies to make sanitation and access to safe drinking water a reality. We have therefore decided to assess sanitation and access to drinking water in Douala V sub division. Method: We conducted a cross-sectional descriptive study from May to June 2018. We used a two-stage random sampling. Data were collected using a questionnaire. The analysis was conducted using Epi Info Version 7.1.3.3. Results: Our study shows that 22.47% of subjects discharged waters into the natural environment after use. Then, 65,55% (493/752) of households consumed borehole water; 53.69% of households rode between 1 to 5 km, 49.25% walked more than 15 minutes to collect water and 85,50% of households did not use a water treatment method. Only 14.49% of subjects used a water treatment method. No household used solar water disinfection (SODIS); 2/752 households (0.26%) had no latrine. Most of the households (54.52%; 410/752) discharged domestic wastes onto the street. Conclusion: The creation of decentralized units: the drillings, waste disposal systems and water treatment education to meet basic needs are essential.


Assuntos
Água Potável/normas , Saneamento/normas , Abastecimento de Água/normas , Camarões , Estudos Transversais , Países em Desenvolvimento , Desinfecção/métodos , Características da Família , Feminino , Humanos , Masculino , Inquéritos e Questionários , Toaletes/estatística & dados numéricos
5.
Aust Health Rev ; 2019 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-31751211

RESUMO

ObjectiveThe aim of this study was to identify the challenges anticipated by clinical staff in two Melbourne health services in relation to the legalisation of voluntary assisted dying in Victoria, Australia.MethodsA qualitative approach was used to investigate perceived challenges for clinicians. Data were collected after the law had passed but before the start date for voluntary assisted dying in Victoria. This work is part of a larger mixed-methods anonymous online survey about Victorian clinicians' views on voluntary assisted dying. Five open-ended questions were included in order to gather text data from a large number of clinicians in diverse roles. Participants included medical, nursing and allied health staff from two services, one a metropolitan tertiary referral health service (Service 1) and the other a major metropolitan health service (Service 2). The data were analysed thematically using qualitative description.ResultsIn all, 1086 staff provided responses to one or more qualitative questions: 774 from Service 1 and 312 from Service 2. Clinicians anticipated a range of challenges, which included burdens for staff, such as emotional toll, workload and increased conflict with colleagues, patients and families. Challenges regarding organisational culture, the logistics of delivering voluntary assisted dying under the specific Victorian law and how voluntary assisted dying would fit within the hospital's overall work were also raised.ConclusionsThe legalisation of voluntary assisted dying is anticipated to create a range of challenges for all types of clinicians in the hospital setting. Clinicians identified challenges both at the individual and system levels.What is known about the topic?Voluntary assisted dying became legal in Victoria on 19 June 2019 under the Voluntary Assisted Dying Act 2017. However there has been little Victorian data to inform implementation.What does this paper add?Victorian hospital clinicians anticipate challenges at the individual and system levels, and across all clinical disciplines. These challenges include increased conflict, emotional burden and workload. Clinicians report concerns about organisational culture, the logistics of delivering voluntary assisted dying under the specific Victorian law and effects on hospitals' overall work.What are the implications for practitioners?Careful attention to the breadth of staff affected, alongside appropriate resourcing, will be needed to support clinicians in the context of this legislative change.

6.
Midwifery ; 79: 102541, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31581000

RESUMO

OBJECTIVE: The objective of this study was to explore the views, experiences, perceptions of and access to water immersion for labor and birth in Australia. DESIGN: A sequential exploratory mixed methods study commenced in 2016. The first phase involved an online survey. The second phase is due to commence in 2019 and will involve focus groups and interviews. This paper presents a subset of results from phase one that asked women to self-rate the benefits and risks associated with water use on Likert-scales and for those who had a previous birth not involving water, how the two experiences compared. PARTICIPANTS: A total of 740 Australian women who had used water immersion for labor and/or birth rated the benefits against 7-point Likert scales and 736 responded to 5-point Likert scales relating to commonly cited concerns surrounding the option. RESULTS: Women highly rated water immersion against all benefits. Benefits that were most highly rated (by numbers of 'entirely agree' on 7-point Likert scales) included sense of safety (80.14%), an alert baby (75.00%), a positive birth experience (72.70%), water as soothing (72.03%) and freedom of movement (71.35%). Women were most concerned (by selecting 'somewhat' to 'extremely concerned' on 5-point Likert scales) about being told to get out of the water when they did not want to (n = 120/736, 16.30%), their contractions going away (n = 76/736, 10.33%) and unsupportive staff (n = 65/736, 8.83%). More than 90% (n = 682/740) of women mostly to entirely agreed that they would recommend water immersion to others. Women rated water immersion as more comfortable, more satisfying and more relaxing when compared to previous births that they had that did not involve water. KEY CONCLUSIONS: Women value water immersion for labor and birth. They have very little to no concern for the most common adverse events as documented in the literature. IMPLICATIONS FOR PRACTICE: The results add to the growing evidence base surrounding water immersion for labor and birth. Whilst there remains ongoing debate about the safety of water immersion, women's experiences should be considered alongside outcome data. The results of this study may assist policy makers and clinicians in their advocacy and support of women who choose water immersion. ETHICAL CONSIDERATIONS: The Human Research Ethics Committee of the University of South Australia approved the research.

7.
Artigo em Inglês | MEDLINE | ID: mdl-31600942

RESUMO

Stunting is a global burden affecting nearly 160 million children younger than five years of age. Whilst the linkages between nutrition and stunting are well recognized, there is a need to explore environmental factors such as water and sanitation, which may influence feeding practices and result in potential infection pathways. This paper explores the linkages between stunting and water, sanitation and hygiene (WASH) factors in Ethiopia, which is a relatively understudied context. The research draws upon baseline data for children under the age of five from 3200 households across four regions in Ethiopia as part of a wider study and integrated program led by the United Nations Children's Fund (UNICEF). Using World Health Organization (WHO) z-scoring, the average stunting rate in the sample is 47.5%. This paper also takes into account demographic and social behavioural factors such as the age, gender of children, and gender of the primary caregiver, in addition to handwashing behaviour and drinking water facilities. The evidence recommends efforts to improve handwashing behaviour for mothers and children with a focus on access to clean water. Higher stunting rates with an increase in the age of children highlight the need for continued interventions, as efforts to improve nutrition and WASH behaviours are most effective early on in promoting long-term health outcomes for children.

8.
Artigo em Inglês | MEDLINE | ID: mdl-31614511

RESUMO

Residents in the Eastern Region, Ghana with access to improved water sources (e.g., boreholes and covered wells) often choose to collect water from unimproved sources (e.g., rivers and uncovered wells). To assess why, we conducted two field studies to coincide with Ghana's rainy and dry seasons. During the rainy season, we conducted semi-structured in-depth interviews among a convenience sample of 26 women in four rural communities (including one woman in the dry season). We asked each participant about their attitudes and perceptions of water sources. During the dry season, we observed four women for ≤4 days each to provide context for water collection and water source choice. We used a grounded theory approach considering the multiple household water sources and uses approach to identify three themes informing water source choice: collection of and access to water, water quality perception, and the dynamic interaction of these. Women selected water sources based on multiple factors, including season, accessibility, religious/spiritual messaging, community messaging (e.g., health risks), and ease-of-use (e.g., physical burden). Gender and power dynamics created structural barriers that affected the use of unimproved water sources. A larger role for women in water management and supply decision-making could advance population health goals.

9.
PLoS One ; 14(10): e0223557, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31603926

RESUMO

BACKGROUND: The critical importance of safe and affordable access to water, sanitation and hygiene (WASH) is highlighted in Goal 6 of the Sustainable Development Goals, which seeks to achieve universal and equitable access for all by 2030. However, people with disabilities-who comprise 15% of the global population-frequently face difficulties meeting their WASH needs. Unmet WASH needs amongst people with disabilities may not be captured through current approaches to tracking progress towards Goal 6, which focus on household- rather than individual-level access. OBJECTIVE: To evaluate access to safe water, sanitation and hygiene (WASH), at the individual- and household-level, amongst people with disabilities in the Tanahun district of Nepal. METHODS: A population-based survey of disability was conducted from August-October 2016 to evaluate access to improved water and sanitation facilities between households with members with disabilities (n = 198) and those without (n = 1,265) in the Tanahun district of Nepal. A nested case-control then compared individual-level access between cases aged 15 and above with disabilities (n = 192) and age-sex-location matched controls without disabilities (n = 189), using the newly developed 21-item "Quality of WASH Access" questionnaire. Multivariate regression was used to compare household- and individual-level indicators between people and households with and without disabilities. In-depth interviews with 18 people with disabilities and their caregivers was conducted to assess the acceptability and appropriateness of the "Quality of WASH Access" questionnaire. FINDINGS: There were no significant differences between households with and without members with disabilities in access to an improved sanitation facility or water source. However, at the individual-level, people with disabilities experienced significantly greater difficulties accessing water, sanitation and hygiene compared to people without disabilities (p<0.001 for all three scores). Amongst people with disabilities, water difficulty scores were associated with having a physical impairment and greater disability severity; sanitation difficulty scores were associated with lower socioeconomic status and physical or self-care limitations; and hygiene difficulty scores were positively associated with self-care limitations and lower socioeconomic status, and inversely associated with hearing impairments. Qualitative research found the "Quality of WASH Access" questionnaire was well understood by participants and captured many of the challenges they faced. Additional challenges not covered by the tool included: (1) time spent on WASH, (2) consistency of access, (3) sufficiency of access, and (4) dignity of access. CONCLUSION: People with disabilities face substantial challenges to meeting their WASH needs, particularly in using services autonomously, consistently, hygienically, with dignity and privacy, and without pain or fear of abuse. These challenges are not captured through household-level data, and so individual-level WASH access are needed to monitor progress towards universal WASH access. The Quality of WASH Access questionnaire may provide a useful data collection tool.

10.
Parasit Vectors ; 12(1): 491, 2019 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-31627736

RESUMO

BACKGROUND: Giardiasis is a common diarrhoeal disease caused by the protozoan Giardia duodenalis. It is prevalent in low-income countries in the context of inadequate access to water, sanitation and hygiene (WASH), and is frequently co-endemic with neglected tropical diseases such as soil-transmitted helminth (STH) infections. Large-scale periodic deworming programmes are often implemented in these settings; however, there is limited evidence for the impact of regular anthelminthic treatment on G. duodenalis infection. Additionally, few studies have examined the impact of WASH interventions on G. duodenalis. METHODS: The WASH for WORMS cluster randomised controlled trial was conducted in remote communities in Manufahi municipality, Timor-Leste, between 2012 and 2016. All study communities received four rounds of deworming with albendazole at six-monthly intervals. Half were randomised to additionally receive a community-level WASH intervention following study baseline. We measured G. duodenalis infection in study participants every six months for two years, immediately prior to deworming, as a pre-specified secondary outcome of the trial. WASH access and behaviours were measured using questionnaires. RESULTS: There was no significant change in G. duodenalis prevalence in either study arm between baseline and the final study follow-up. We found no additional benefit of the community-level WASH intervention on G. duodenalis infection (relative risk: 1.05, 95% CI: 0.72-1.54). Risk factors for G. duodenalis infection included living in a household with a child under five years of age (adjusted odds ratio, aOR: 1.35, 95% CI: 1.04-1.75), living in a household with more than six people (aOR: 1.32, 95% CI: 1.02-1.72), and sampling during the rainy season (aOR: 1.23, 95% CI: 1.04-1.45). Individuals infected with the hookworm Necator americanus were less likely to have G. duodenalis infection (aOR: 0.71, 95% CI: 0.57-0.88). CONCLUSIONS: Prevalence of G. duodenalis was not affected by a community WASH intervention or by two years of regular deworming with albendazole. Direct household contacts appear to play a dominant role in driving transmission. We found evidence of antagonistic effects between G. duodenalis and hookworm infection, which warrants further investigation in the context of global deworming efforts. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12614000680662. Registered 27 June 2014, retrospectively registered. https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366540 .

11.
Sci Total Environ ; 690: 1203-1217, 2019 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-31470483

RESUMO

The unregulated oil exploitation in the Northern Ecuadorian Amazon Region (NEAR), mainly from 1964 to the 90's, led to toxic compounds largely released into the environment. A large majority of people living in the Amazon region have no access to drinking water distribution systems and collects water from rain, wells or small streams. The concentrations of major ions, trace elements, PAHs (polycyclic aromatic hydrocarbons) and BTEX (benzene, toluene, ethylbenzene, xylenes) were analyzed in different water sources to evaluate the impacts of oil extraction and refining. Samples were taken from the NEAR and around the main refinery of the country (Esmeraldas Oil Refinery/State Oil Company of Ecuador) and were compared with domestic waters from the Southern region, not affected by petroleum activities. In most of the samples, microbiological analysis revealed a high level of coliforms representing significant health risks. All measured chemical compounds in waters were in line with national and international guidelines, except for manganese, zinc and aluminum. In several deep-water wells, close to oil camps, toluene concentrations were higher than the natural background while PAHs concentrations never exceeded individually 2 ng·L-1. Water ingestion represented 99% of the total exposure pathways for carcinogenic and non-carcinogenic elements (mainly zinc) in adults and children, while 20% to 49% of the Total Cancer Risk was caused by arsenic concentrations. The health index (HI) indicates acceptable chronic effects for domestic use according the US-EPA thresholds. Nevertheless, these limits do not consider the cocktail effects of metallic and organic compounds. Furthermore, they do not include the social determinants of human exposure, such as socio-economic living conditions or vulnerability. Most (72%) of interviewed families knew sanitary risks but a discrepancy was observed between knowledge and action: religious beliefs, cultural patterns, information sources, experience and emotions play an important role front to exposure.


Assuntos
Água Potável/química , Exposição Ambiental/análise , Poluição por Petróleo/estatística & dados numéricos , Percepção Social , Poluição da Água/estatística & dados numéricos , Equador , Exposição Ambiental/estatística & dados numéricos , Monitoramento Ambiental , Humanos , Compostos Orgânicos , Poluição por Petróleo/análise , Hidrocarbonetos Policíclicos Aromáticos , Rios , Poluentes Químicos da Água , Poluição da Água/análise , Qualidade da Água
12.
Soc Sci Med ; 238: 112520, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31473576

RESUMO

Living in poverty significantly elevates risk of common mental disorders, but the underlying mechanisms are poorly specified. The stress of coping with household food insecurity is posed as one fundamental driver. While much less tested, the stress of failing to meet household water needs may also matter. We test (a) a hypothesized direct influence of household water insecurity (as household access to water sources and quality/quantity of water available in the household) on anxiety and depression symptoms. We also test (b) if there are indirect (mediated) effects of these aspects of water insecurity on common mental disorder symptom levels via household food insecurity, and (c) via their association with sanitation insecurity (lack of toilet). Data were collected in Haiti in June-July 2016 from 4,055 geographically-sampled households representing three distinct low-resource communities, purposefully differentiated as urban, town, and rural. We confirm that household water insecurity exerts a direct, strong independent effect on anxiety and depression levels, even once food insecurity and household assets are taken into account. Additionally, household water insecurity appears to have an indirect effect on anxiety and depression levels through its influence on household food insecurity. In the rural community sample, there is also support for the proposition of additional influence of household water on anxiety through its association with lack of sanitation. This Haitian case supports theories posing a central, influential role for household water insecurity as a potential driver of common mental illness in low-resource households via direct and indirect (food insecurity, sanitation) pathways.

13.
BMC Vet Res ; 15(1): 275, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375096

RESUMO

BACKGROUND: The primary objective of this study was to assess the disposition of furosemide in Thoroughbred horses treated intravenously with 1 mg/kg of furosemide 4 and 24 h before supramaximal treadmill exercise without and with controlled access to water, respectively. Another objective was to determine whether furosemide was detectable in the plasma of horses after exposure to supramaximal treadmill exercise. Thoroughbred horses (n = 4-6) were administered single intravenous doses of 1 mg/kg of furosemide at 4 and 24 h before supramaximal exercise on a high-speed treadmill, with controlled and free access to water, respectively. Plasma furosemide concentrations were determined using liquid chromatography. RESULTS: Furosemide was detected in all the horses, regardless of whether they were treated 24 h or 4 h before excersice. In both treatment sequence groups of 2 horses, the concentration time profiles of furosemide during the first 4 h after its administration were relatively similar. The average maximum observed concentrations, AUC0-1.5h, and AUC0-3h, of both groups of horses were not different (p > 0.05). There were no significant differences in systemic clearance based on the geometric mean (95% confidence interval) (409 (347-482) mL/h/kg) for 4 h and 320 (177-580) mL/h/kg) for 24 h) between horses that were exercised 4- and 24-h post-furosemide administration. The plasma concentration of furosemide in all the horses fell below the limit of quantification (25 ng/mL) within 12 h after drug administration. In the group treated 24 h before exercise, none of the horses had detectable furosemide at the time of supramaximal treadmill exercise. In the group treated 4 h before exercise, furosemide was detected 1 h before and 2 h after supramaximal treadmill exercise in 4/4 and 3/4 horses, respectively. The mean AUC3-last h of both groups of horses were not different (p > 0.05). CONCLUSIONS: Water restriction did not exert any apparent effect on the disposition of furosemide. It remains to be determined, however, whether the attained plasma concentration of furosemide in combination with other controlled water access protocols have any direct or indirect pharmacological effect that may affect the athletic performance of the horse.

14.
Sci Total Environ ; 696: 133830, 2019 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-31454599

RESUMO

Nationally representative household surveys are the main source of data for tracking drinking water, sanitation and hygiene (WASH) coverage. However, all survey point estimates have a certain degree of error that must be considered when interpreting survey results for policy and decision making. In this article, we develop an approach to characterize and quantify uncertainty around WASH estimates. We apply it to four countries - Bolivia, Gambia, Morocco and India - representing different regions, number of data points available and types of trajectories, in order to illustrate the importance of communicating uncertainty for temporal estimates, as well as taking into account both the compositional nature and non-linearity of JMP data. The approach is found to be versatile and particularly useful in the WASH sector, where the dissemination and analysis of standard errors lag behind. While it only considers the uncertainty arising from sampling, the proposed approach can help improve the interpretation of WASH data when evaluating trends in coverage and informing decision making.

15.
Artigo em Inglês | MEDLINE | ID: mdl-31426604

RESUMO

This study was undertaken to highlight the social disparity between rural and urban areas in terms of housing patterns, provision of safe drinking water, access to sanitation facilities, education, employment rate and health-related to diarrhoeal episodes in Ugu District Municipality of KwaZulu-Natal Province of South Africa. To achieve this aim, a survey was conducted using a structured questionnaire. Drinking water samples were collected from the point of supply and the storage containers to assess the microbiological quality of drinking water in both rural and urban areas. Results of this study revealed prominent residential segregation between rural and urban communities, whereby the houses in the rural areas were generally constructed with corrugated iron sheets, or mud brick and mortar whereas conventional brick-and-mortar construction was used to build those in the urban areas. All of the urban households had flush toilets in their houses (100%), while 98.2% of the rural households were relying on pit latrines and 1.8% were reported to defecate in an open field. The District unemployment rate was at 58.1% in rural areas and none among the urban community. Results also showed that only 13.6% of the rural dwellers completed their secondary education compared to 70.4% of the urban areas. The diarrhoeal episodes were high in rural areas (34.1%) while none of these episodes was reported in urban areas. Great disparity in the water supply persists between rural and urban communities. For the former, the standpipes located outside their homes (90.9%) remain the sole mode of access to drinking water, while in the urban area, all households had pipes/taps inside their houses. Assessment of the drinking water quality revealed only the stored drinking water used by the rural community of Ugu District was contaminated. High prevalence of E. coli ranging from 63.3 % to 66.7% was recorded only in stored water after the sequencing of 16S rRNA genes. Species-specific PCR primers exposed the presence of enteropathogenic Escherichia coli at a rate ranging between 1.4% and 3.7% in this water Overall, this study has been able to highlight the disparity left by the legacy of racial segregation in the Ugu Municipality District. Therefore, the local government must intervene in educating homeowners on safe water storage practices.

16.
Water Res ; 165: 114984, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31465997

RESUMO

Reservoir operations affect both the quantity and quality of stored and discharged water. Hedging rules (HRs) are commonly used in water supply reservoir operations to ration water delivery and decrease water shortage risk. However, the increased carryover storage with hedging may aggravate reservoir eutrophication through complex effects on hydrodynamic, temperature, light, nutrient, and sediment conditions. The influencing mechanisms are unclear and require further investigation. This study applies a mathematical modeling approach to comparing the effects of standard operation policy (SOP) and HR, discussing the processes and driving factors, and exploring the relationship between water shortage and water quality indicators. We simulate reservoir operation by SOP and optimize HR to generate water supply schedules, and run a quasi-3D water quality model to simulate reservoir hydrodynamic conditions, nutrient cycles, water-sediment exchanges, and algal dynamics under various water supply schedules. The Danjiangkou Reservoir, the water source for China's South-North Water Transfer Project, is used as a case study. The HR for this reservoir decreases its water shortage risk from 22% under SOP to 8%. Modeling results find that the HR increases sediment phosphorus (P) release by 285.3 tons (5.7%) annually as a consequence of extended reservoir submerged area and aggravated hypolimnetic hypoxia. Increased P release can support algal growth, but this effect is set off by the enhancement of light limiting effect caused by higher storages under HR, consequently decreasing the annual mean chlorophyll a concentration in the deep reservoir by 18%. The HR also improves the horizontal mixing of water by changing the hydraulic retention time and flow velocity field, which mitigates algal bloom risks in the surrounding shallow-water zones but deteriorates water quality of the release to downstream. The water quality analysis offers implications for reservoir managers to coordinate their efforts in mitigating risks of water shortage and water quality degradation.


Assuntos
Qualidade da Água , Água , China , Clorofila A , Eutrofização , Fósforo , Abastecimento de Água
17.
Public Health Nurs ; 36(6): 800-805, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31465129

RESUMO

OBJECTIVES: Access to clean water is a global concern. For women living in developing countries, the lack of clean water increases their risk of bacterial infections, such as a urinary tract infection (UTI). The purpose of this study was to examine if the location of water source has a relationship with the rate of UTIs in women who lived in the Léogâne area of Haiti. DESIGN: Descriptive, correlational, retrospective chart review used de-identified data from medical intake flow sheets. SAMPLE: A total of 311 medical intake flowsheets with 32.4% of the sample were treated for a UTI. The majority of women were between the ages of 20 and 44 years. RESULTS: The youngest group, ages 10-14 years, were more likely (83.3%) to be diagnosed with a UTI (X2  = 7.956, df = 3, p < .05) when compared to the other age groups. The location of water source also had a relationship with UTI, with women who reported using pump water more likely to be treated for a UTI than those who reported using short-well water (X2  = 4.318, df = 1, p < .05). CONCLUSIONS: Although the study only involved Haitian women, the concepts of access to clean water, reducing bacterial infections such as a UTI, and health promotion are useful for any provider practicing in or going to a developing country.

18.
Clin Nutr ESPEN ; 33: 47-56, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31451275

RESUMO

BACKGROUND: The major landslide of 2010 in Bududa district in Eastern Uganda is the most catastrophic natural disaster in Uganda's recorded history. An estimated 350 people died and some of the affected were resettled in Kiryandongo district. We assessed housing, water and sanitation practises of affected households and controls to establish possible implications on food insecurity and diet diversity. METHODS: This cross-sectional study assessed 1078 affected and control households in Bududa and Kiryandongo districts. The head of the households were either affected, selected from landslide disaster-affected communities, or controls from a random sub-county bordering the affected. Structured interviews were used and entries were tested statistically to report crude estimates based on the Pearson x2 and ANOVA, while adjusted analysis used multivariate analysis of co-variance (MANCOVA) and Wald's Odds Ratio (OR) of Binary Logistic Regression at the 95% CI. RESULTS: On adjusting for the disaster and covariates, households who had insufficient access to water scored higher mean (SE) on food insecurity than those who reported sufficient access: 13.1 (0.4) vs. 9.5 (0.3) (P < 0.01). Intriguingly, households who owned a toilet and those who reported always using soap to wash hands scored higher food insecurity than their counterparts: 11.1 (0.3) vs. 9.0 (0.6) (P < 0.01) and 11.3 (0.3) vs. 9.1 (0.5) (P < 0.01), respectively. However, not owning a toilet increased the likelihood of being food insecure (OR 3.43; 95% CI 1.31, 8.97; P = 0.02). In Kiryandongo, affected households scored higher food insecurity than controls: 9.5 (0.5) vs. 5.4 (0.5) (P < 0.01) and higher diet diversity scores (DDS): 6.7 (0.2) vs. 6.2 (0.2) (P = 0.04). Type of housing also predicted food insecurity (P < 0.01) and DDS (P = 0.03). Like Bududa, households with insufficient water access scored higher food insecurity while those owning toilet scored higher DDS. Uniquely, only number of rooms was linked to a high likelihood of being food insecure (OR 1.60; 95% CI 1.19, 2.15; P < 0.05). CONCLUSION: Disaster, food security and diet were sensitive to housing, water and sanitation and were integral to an adequate standard of living of victims of this landslide.

19.
Chemosphere ; 233: 966-974, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31340424

RESUMO

The lower stretch of the perennial transboundary river Ganga is known as the Hooghly River (HR) in India. Despite the strict ban, HR has been evidenced with residues of pesticidal persistent organic pollutants (POPs) from primary and secondary sources. Hence surface water sampling and passive air sampling (PAS) were conducted along the urban and suburban transects and discharge points to study the fate of pesticidal (POPs along the HR. Excluding the discharge points, the mean concentration of hexachlorocyclohexane (HCH), dichlorodiphenyltrichloroethane (DDT) and endosulfan (ENDO) were 6 ng/L, 4 ng/L and 36 ng/L in surface water and 888 pg/m3, 1689 pg/m3 and 429 pg/m3 in atmosphere respectively. Percentage composition and diagnostic ratios strongly suggest ongoing use of technical HCH, DDT and endosulfan. Elevated endosulfan in surface water has been related to its usage during fishing. Except for p,p'-DDE, α-Endo and ß-Endo, fluxes at the air-water interface showed net deposition from air to water for all the OCPs in urban and suburban transects. The estimated eco-toxicological risk assessment showed risk on lower trophic organisms due to DDT and lindane mostly at the discharge points. Endosulfan can pose potential risk to the edible fishe species in the HR.


Assuntos
Poluentes Atmosféricos/análise , Monitoramento Ambiental , Praguicidas/análise , Rios/química , Poluentes Químicos da Água/análise , Atmosfera/química , DDT/análise , Diclorodifenil Dicloroetileno/análise , Endossulfano/análise , Hexaclorocicloexano/análise , Índia , Água/química
20.
Salud Publica Mex ; 61(4): 486-494, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31314208

RESUMO

OBJECTIVE: We tested the effectiveness of the I prefer plain water educational strategy used to increase water consumption in elementary school children. MATERIALS AND METHODS: A community intervention trial was performed in eight public elementary schools in Mexico City. The schools were randomized into an intervention (IG) and a control (CG) group. Each school was provided water dispensers inside the classrooms. The IG received the educational strategy. The strategy was considered effective if the students increased their water consumption by ≥220 ml. RESULTS: Water consumption in the IG increased 167 ml vs. 37 ml in CG (p < 0.001). The goal of the educational strategy for water consumption was achieved in 166/413 children in the IG and 95/364 children in the CG (p < 0.001). CONCLUSIONS: I prefer plain water, associated with free access to water inside the classrooms, proved to be effective to increase water consumption.

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