RESUMO
Rapid urbanization in developing countries has imposed threats and challenges to basic urban infrastructures like drinking water, transportation, and energy systems. The existing urban drinking water systems (UDWS) are highly stressed and unsustainable, particularly under changing hydroclimatic conditions, population growth, changing socioeconomic conditions, government decisions, and various policies. This study focuses on the complexities of UDWS in Sub-Saharan African countries, especially in Ethiopia. The objective of this study is to investigate the issues and challenges of urban drinking water systems (UDWS) in Ethiopia, specifically, to assess the gap between water supply and demand, water loss/non-revenue water, environmental, technical, institutional, and governance, etc. and propose sustainable interventions to deal with such issues so as to improve. For this purpose, a mix of methods involving primary data (including key informant interviews, field observations, and field measured data) and secondary data (including published articles, books, various reports, and design documents), as well as various computer-aided applications (mainly, ArcGIS and WaterGEMS) are used to collect data. The issues are deliberated through the UDWSs of Addis Ababa, Adama, Mekelle, and Dire Dawa cities in Ethiopia. Complexities like water shortage, high and low pressure in the water distribution network (WDN), non-revenue water (NRW)/water loss, source pollution, ineffective policies and governance, and weak institutions are the main challenges to Ethiopian cities' water utilities. Further, the case study noticed that in Addis Ababa alone, potable water is only accessible to 66% of the city population. A significant water supply deficit was observed in Mekelle city, where only half of the city population has access to potable water from the system. Additionally, in Addis Ababa, Adama, Mekelle, and Dire Dawa, above 35% of the freshwater produced is either NRW, unaccounted for, or lost, which is significantly higher than the upper 25% limit suggested by the World Bank. Therefore, it is recommended to adopt certain sustainable interventions, such as integrated water resource management, installing appurtenances like pressure-reducing valves, check valves in the WDN, controlling and monitoring of WDN through supervisory control and data acquisition and Internet of Things, effective and long-term planning and policy, etc. It is felt that the study will help the decision-makers and the operators of the UDWS utilities to run the water supply schemes in a sustainable manner. Supplementary Information: The online version contains supplementary material available at 10.1007/s10668-022-02901-7.
RESUMO
BACKGROUND: Granisetron is a safe and effective prophylaxis for nausea and vomiting associated with moderate to highly emetogenic chemotherapy. Few trials have been conducted to determine the optimal effective dose of granisetron in children with cancer. The objective of this report was to compare two doses of granisetron in patients with optic pathway tumors receiving moderately emetogenic doses of carboplatin. PATIENTS AND METHODS: In this double-blind, crossover, randomized study, antiemetic efficacy and tolerability of two dose levels (10 and 40 microg/kg) of granisetron in the prevention of acute and delayed nausea/emesis were compared in children and young adults. A total of 18 patients (13 boys) aged 1-23 years (median 7.7 years) treated with a moderately emetogenic dose of carboplatin were randomly assigned to receive either 10 or 40 microg/kg of slow granisetron intravenous (i.v.) infusions at alternating cycles of chemotherapy in a blinded fashion until the end of the study period or until their chemotherapy regimen ended. In this way, the patients acted as their own controls. RESULTS: Patients in the granisetron 10 and 40 microg/kg groups received 104 and 121 cycles of chemotherapy, respectively. There was no significant difference in antiemetic efficacy in terms of nausea and emesis between the dose groups in the first 5 days of chemotherapy. The treatment was well tolerated. CONCLUSION: We conclude that granisetron 10 and 40 microg/kg have comparable efficacy in controlling carboplatin-induced acute and delayed nausea/emesis and is well tolerated in children and young adults.
