Eliminating Trachoma in Africa: The Importance of Environmental Interventions.

Subsequent to the failure of the World Health Organisation (WHO) of achieving their target to eliminate trachoma by the year 2020, the most effective strategy in eliminating trachoma must be re-examined to accomplish the new target of eradication by the year 2030. Whilst antibiotic therapy is a core foundation of this elimination strategy, another important factor is the state of the environmental conditions in trachoma endemic countries. This manuscript aimed to identify the impact of environmental improvement strategies on the prevalence of trachoma and the significance of environmental improvement alongside the use of antibiotic treatment to achieve trachoma elimination. Two independent literature searches were conducted up until the 5th of July 2021. Two main databases were used to carry out these literature searches, namely, Ovid EMBASE and Ovid MEDLINE. All of the relevant references were found using MeSH and free text terms. Key terms used were 'trachoma', 'water', 'sanitation', 'hygiene' and 'environmental Improvement'. The exclusion criteria included non-African-based studies, review papers, protocols and case reports. A total of 17 studies were included for this review. Living within a close range of a water source was significantly associated with reduced risk of trachoma infection. Water obtained from piped water sources was associated with the lowest rates of active trachoma. Studies on facial cleanliness evidenced a strong association with reduced prevalence of trachoma. Whilst the provision of latrine facilities found was significantly associated with reduced prevalence of trachoma, there was no significant difference between the use of private latrine facilities over communal latrine facilities. The use of repeated scheduled antibiotic treatments over single-use antibiotic distribution had a greater impact both short term and long term on the prevalence rates of trachoma. Nonetheless, prevalence rates increased again following the commencement of treatment. Mass antibiotic treatment has been proven to have a greater impact on lowering the prevalence of trachoma initially, but this impact is not sustainable due to the rise in prevalence rates following the completion of treatment. A holistic approach, therefore, must be implemented with evidence showing that an emphasis on longer-term environmental methods should be implemented to compliment antibiotic distribution. Prioritisation of specific interventional measures should be tailored according to local epidemiology; nonetheless, these measures form the backbone of a trachoma elimination strategy to eliminate trachoma by the year 2030.

The impact of public awareness, infrastructure, and technological development with economic growth on solid waste management of European countries: does governance quality matters.

Solid waste generation is a significant problem affecting the ecosystem, human health, and safety. However, the issue is not given the attention it truly deserves. Consequently, this study is aimed at assessing the impact of various factors, such as economic growth, public awareness, infrastructure, and technological advancements, on generating municipal waste in the European Union (EU) for the period 1995-2020. Furthermore, the study incorporated the mediating effect of economic growth and government effectiveness with public awareness, infrastructure, and technological development to reduce waste generation. By employing the bias-corrected method of moments, the study finds that overall waste generation does not decrease over time in EU economies. Furthermore, Denmark is the top-ranked country among the sampled countries to generate waste. However, Finland is at the top in government effectiveness. The empirical findings showed that economic growth is the significant reason for the increase in solid waste production. Additionally, the interaction effects of economic growth with public awareness, infrastructure, and technological development are positive. However, the individual impact of public awareness, infrastructure, and technological development is positive in reducing waste generation. Governance effectiveness is a significant tool to lower waste generation in European economies.

The Socioeconomic Factors of Street Food Vending in Developing Countries and Its Implications for Public Health: A Systematic Review.

The sale of ready-to-eat (RTE) street food represents an important source of income in many developing countries. However, these foods are frequently implicated in outbreaks of gastrointestinal diseases. Street food vendors face several constraints that hamper improvement in the microbiological quality of their products. The aim of this review was to update knowledge about the main causes of foodborne illnesses in developing countries, including the growing concern with the microbial transmission of antibiotic resistance. Following PRISMA guidelines, this systematic review was conducted on original articles published from January 2010 to July 2023. The search was carried out using Scopus, PubMed, Web of Science, Food Science and Technology Abstracts (FSTA), the International Information System for Agricultural Sciences and Technology (AGRIS), as well as isolated searches of relevant articles from Google Scholar. The initial search identified 915 articles, 50 of which were included in this systematic review. The results indicate that, in the majority of the 15 countries examined, women constitute the predominant segment of street food vendors, representing more than 55% of the total number of these vendors. In 11 countries, street food vendors under the age of 18 were identified. Most vendors had a low level of education and, consequently, were unaware of good hygiene practices when handling food. The combination of factors such as poor hygiene practices on the part of food handlers and the lack of facilities, namely, the absence of available potable water, were frequently listed as the main causes of food contamination. Enterobacteriaceae such as Escherichia coli (61.9%), Salmonella (30.1%), and Shigella spp. (9.5%), as well as Staphylococcus aureus (30.1%) and Listeria monocytogenes (14.3%), were the most common pathogens found in RTE street foods. In 22 studies from 13 developing countries, 59% (13/22) reported high multidrug resistance in Enterobacteriaceae (40% to 86.4% in E. coli, 16.7 to 70% in Salmonella, and 31 to 76.4% in S. aureus). To address the challenges faced by street vendors and improve their economic activities, it is necessary for government entities, consumers, and vendors to work together collaboratively.

Towards a successful implementation of environmental sanitation policy in Ghana: An assessment of key impeding factors.

Environmental sanitation policy implementation is a vital factor that ensures that citizens are kept healthy and productive. The study sought to assess key factors impeding the implementation of environmental sanitation policy in Ghana. Using an explanatory design, a sample of 384 respondents was selected from the population of Accra through a simple random sampling technique. The questionnaire was the main instrument used to collect the data. The Partial Least Square-Structural Equation Modeling (PLS-SEM) technique was used to analyse the hypothesised path models. Based on the results, government approach, community representation, and lack of citizens' commitment were found to be statistically significant. The study also revealed that the government approach partially mediated the relationship between community representation and environmental sanitation policy implementation, and lack of citizens' commitment and environmental sanitation policy implementation. The study has contributed to knowledge in the research endeavour by demonstrating that the implementation of public policy can easily be realised when the government uses the right approach in involving its citizens in policy decision-making and enhance their commitment to policy implementation.

Survey of Residents' Satisfaction with the Environmental Sanitation of Key Public Places Under the Background of National Healthy City - China, 2021.

What is already known about this topic?: Sanitation of public places has been the focus of environmental sanitation construction in China for many years. It is critical to achieving the goal of building national healthy cities and counties. What is added by this report?: The results showed that in all types of areas, residents' satisfaction with the sanitation of railway stations and other places of transportation ranked first, and farmers' markets ranked last. What are the implications for public health practice?: This study provides a suitable reference for government decision-makers to effectively improve the sanitation situation of key public places and to further construct national healthy cities and counties.

Câncer de colo de útero e componentes de saneamento nos municípios do estado do Mato Grosso do Sul: seria uma questão de má qualidade da água? / Cervical cancer and sanitation components in the municipalities of the state of Mato Grosso do Sul: would it be a question of poor water quality?

Resumo Este artigo investiga relações entre a incidência de câncer de colo de útero (ICC) e os componentes e indicadores de qualidade da água nos municípios do Mato Grosso do Sul, entre 2014 e 2017, por correlação estatística (Determinante de Pearson) e espacial (agrupamentos por k-médias). Houve maior resposta estatística de ICC em relação à tarifa média dos serviços de abastecimento praticado (-36,28%) e de água (-34,15%); à quantidade de suas interrupções sistemáticas (28,3%) e paralizações (22,28%); ao consumo médio per capita de água (20,74%) e à quantidade de serviços executados (-17,98%), todas as respostas sob p-valor ≤ 0,001. Em Costa Rica, cidade sob maior ICC média, os agrupamentos espaciais identificaram maior efeito daquelas interrupções (z-valor = 8,741) e das paralizações (z = 7,6097); enquanto em Rochedo, também sob alta ICC, houve maior efeito à incidência de análises com resultados fora do padrão para coliformes totais (z = 8,6803) e turbidez (z = 5,7427), sob correlação estatística de 12,05% (p-valor = 0,032) e 15,18% (p-valor = 0,007), respectivamente. Dados do SISAGUA revelaram a presença de coliformes e de altos níveis de turbidez, por exemplo, em Antônio João e Tacuru, cidades sob altas ICC médias. Recomenda-se maiores investigações sobre as relações aqui apresentadas entre ICC e água.

Abstratct This article investigates relationships between the incidence of cervical cancer (CCI) and the water components and quality indicators, in the municipalities of Mato Grosso do Sul, between 2014 and 2017, by statistical (Pearson's Determinant) and spatial (k-means Clustering) correlation. There was a greater statistical response of CCI in relation to the average tariff of the practiced supply (−36.28%) and water (−34.15%) services; the number of their systematic interruptions (28.3%) and outages (22.28%); the average per capita consumption of water (20.74%); and the number of services performed (−17.98%), all answers under p-value ≤ 0.001. In Costa Rica, city with the highest average CCI, the spatial clustering identified a greater effect of those interruptions (z-value = 8.741) and outages (z = 7.6097); whereas, in Rochedo, also under high CCI, the analyses showed greater effect with non-standard results for total coliforms (z = 8.6803) and turbidity (z = 5.7427), under a statistical correlation of 12.05% (p-value = 0.032) and 15.18% (p-value = 0.007), respectively. Data from SISAGUA revealed the presence of coliforms and high levels of turbidity, for example, in Antônio João and Tacuru, cities with high average ICC. We recommend further investigation into the relationships presented here between CCI and water.

Does Fecal-Oral Transmission of SARS-CoV-2 Due to Low Sanitation Conditions Contribute to Low Mortality Rates From COVID-19.

BACKGROUND:  The novel coronavirus disease 2019 (COVID-19) is a global pandemic generated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The primary infection site is mucosal surfaces, mainly the lungs and the intestine, where epithelial cells can be infected. COVID-19 has spread throughout the world, causing millions of deaths and hundreds of millions of confirmed infections. Despite the global spread of SARS-CoV-2, there are extreme differences between countries in mortality rates and confirmed infections. METHODS:  Pearson correlations and a t-test were performed on data from 137 countries in order to test the correlation between number of deaths from diarrheal diseases (pre-COVID-19 pandemic data) as a marker for countries' sanitation level, and the number of confirmed COVID-19 cases and deaths per million. RESULTS:  It was found that countries' prevalence of confirmed COVID-19 cases and deaths per million are statistically correlated with their sanitation level. CONCLUSIONS:  The hypothesis proposed in this article is that the low mortality rates from COVID-19 in countries where the level of sanitation is low are due to fecal-oral infection of the population by SARS-CoV-2, rather than infection of the respiratory system. This hypothesis is supported by the protective effect of the low sanitation level presented in this work and the fact that lung infection by SARS-CoV-2 can cause severe pathology, while infection in the intestine generally causes minor or no symptoms.

Simultaneous annihilation of microorganisms and volatile organic compounds from municipal solid waste storage rooms with slightly acidic electrolyzed water.

Great deal pathogenic bacteria and malodorous gases are hidden in municipal solid waste (MSW), which poses excellent environmental sanitation risks for sanitation workers and residents, and preventive measures should be implemented. In this study, the simultaneous annihilation of microorganisms and volatile organic compounds (VOCs) with slightly acidic electrolyzed water (SAEW) was investigated in an MSW storage room of a residential community in Shanghai, China. The microbial population of airborne, surfaces and handles of waste bins, hands of sanitation workers and the main components of VOCs were measured. The results indicated that the bacterial reduction efficiencies of SAEW with an available chlorine concentration (ACC) of 50-100 mg/L on surfaces and handles of waste bins and sanitation workers' hands were 22.7%-84.1%. Also, SAEW effectively reduced the average population of airborne bacteria and fungi by 358 and 378 colony-forming units (CFU)/m3 and decreased the detection rates of coliforms by 14.2%-51.9%. The concentrations of most VOCs were reduced by 21.4%-88.3% after spraying SAEW. And the accumulated values of carcinogenic and noncarcinogenic risks also tended to decrease with spraying SAEW. These findings imply that SAEW has significant application potential to control environmental sanitation risks in MSW storage rooms.

Cholera knowledge, socioeconomic and WaSH characteristics in Aden - Yemen, 2017: a community-based comparative survey.

OBJECTIVES: To improve prevention and control response to the cholera outbreak, we sought to assess and compare the community's cholera awareness and needs in high and low epidemic areas in Aden. METHODS: A community-based comparative survey was conducted in 2017. We used multi-stage cluster sampling. Eligible household heads in high and low epidemic areas were interviewed. The data collected from both areas using a pretested questionnaire. RESULTS: Cholera cases and mortality were higher in high epidemic areas compared with low epidemic areas. Socioeconomic, water, sanitation, and hygienic conditions were poorer in high epidemic areas compared with low epidemic areas. Knowledge of cholera transmission and prevention was sub-optimal in both areas. We found a mismatch between the delivered education and distributed preventive materials. CONCLUSIONS: Stakeholders should tailor the design, content, and implementation of future cholera prevention and control methods to meet the needs of the community. Future educational camping should focus on the transmission prevention, including vaccination. Education and sustainable interventions should be implemented to improve the water, sanitation, and hygiene.

[Rural environmental sanitation in the central, southern and northern regions of Shaanxi Province in 2018].

OBJECTIVE: To understand the rural sanitary conditions in different geographical areas of Shaanxi Province. METHODS: According to the stratified random sampling method, 30 agriculture-related counties were selected(The central area includes 13 counties in Xi'an, Tongchuan, Weinan, Xianyang and Baoji cities. The southern area includes 10 counties in Hanzhong, Ankang, Shangluo cities. The northern area includes 7 counties in Yulin, Yan'an cities. ). Five townships were selected randomly in each county(excluding Chengguan Town), and 4 administrative villages were selected randomly in each township as survey villages, which were collected the soil samples for testing lead, cadmium and chromium in each subject village, and 5 households were randomly selected in each villages as survey households. The data was obtained through data reading, interviews, on-site observations, and laboratory testing, etc. The detection of soil lead and cadmium was carried out according to the Measurement of Soil Quality Lead and Cadmium by Graphite Furnace Atomic Absorption Spectrophotometry(GB/T 17141-1997), and the detection of chromium was carried out according to the Determination of Total Chromium in Soil by Flame Atomic Absorption Spectrometry(HJ 491). The data was statistically analyzed and evaluated according to the central, southern and northern regions. RESULTS: The population coverage of rural centralized water supply in the three regions(central、southern and northern area) was 92. 86%, 75. 49% and 70. 41%, respectively. The penetration rate of sanitary toilets was 28. 18%, 45. 38% and 9. 90%, respectively. The proportion of villages where domestic garbage was randomly stacked was 0. 38%, 4. 00% and 32. 86%, respectively. The proportion of villages where domestic sewage was randomly discharged was 30. 38%, 40. 00% and 60. 00%, respectively. The heavy metals exceeding the standard in the soil were mainly cadmium. The over-standard rates were 4. 62%, 21. 50% and 0. 71%, respectively. The three regional differences of the above result were statistically significant(χ~2=57 676. 74, 18 143. 94, 124. 86, 33. 15 and 54. 12, P<0. 01). CONCLUSION: There was still some decentralized water supply population in the province. The coverage rate of the centralized water supply population and the proportion of drinking water after complete treatment projects were both higher in the central area than in the southern area and northern area. Sanitation toilets have a low penetration rate in the province, which was higher in the southern area than in the central area and the northern area. The domestic garbage was randomly discarded, and domestic sewage was randomly discharged, which was more in the northern area than in the central area and the southern area. Soil cadmium pollution was relatively heavy, mainly in the southern area.

Parásitos intestinales en poblaciones infantojuveniles; ambiente y comportamiento social / Prevalence of intestinal parasites in child and youth populations; environment and social behavior

Introduction: The decreasing prevalence of parasitosis from north to south in Argentina has led the scientific community to focus the epidemiological studies on the most vulnerable areas and, consequently, neglect the populations of Patagonia (South Argentina). The objectives of the present study were (i) to determine the prevalence of intestinal parasites in children and youth of Puerto Madryn (Chubut province, Patagonia), and (ii) to evaluate the parasitic infections found concerning socio-environmental factors and hygiene practices of the population. Materials and methods: Serial stool samples were processed using modified Ritchie and FLOTAC dual pellet techniques, and samples of anal swabs were examined by sedimentation. Socio-environmental variables and hygiene practices of the participants were surveyed using a semi-structured questionnaire. Results: Of all examined participants, 39.1% (68/174) were parasitized. A total of 6 parasite species were found and the most prevalent were Blastocystis sp (19.0%), Enterobius vermicularis (17.8%), and Giardia lamblia (6.3%). The risk of parasitosis and infection for Blastocystis sp was greater in participants who lived in houses without piped water (OR = 2.9 and OR = 3.2, respectively). The risk of infection for G. lamblia was positively associated with the lack of public waste collection service (OR = 5.6). Infection for E. vermicularis was higher in participants whose parents had a basic level of education (OR = 5.0). Conclusion: The parasitic infections observed reflect the environmental conditions of Patagonia and the need to focus studies on populations from peripheral areas to urban centers that are exposed to greater socio-economic vulnerability.

Introducción: La prevalencia de parasitosis decreciente de norte a sur en la Argentina, ha llevado a la comunidad científica a enfocar sus estudios epidemiológicos hacia las zonas más vulnerables y desatender a las poblaciones de la Patagonia (sur de Argentina). Los objetivos del presente estudio fueron: determinar la prevalencia de parásitos intestinales en niños y jóvenes de Puerto Madryn (Chubut, Patagonia), y evaluar las infecciones parasitarias en relación con los factores socioambientales y las prácticas de higiene de la población. Materiales y métodos: Se procesaron muestras seriadas de materia fecal mediante las técnicas Ritchie modificada y FLOTAC dual pellet, y muestras de escobillado anal por sedimentación. Se relevaron las variables socioambientales y las prácticas de higiene de los participantes mediante cuestionarios semiestructurados. Resultados: El 39.1% (68/174) de la población analizada estuvo parasitado. Se halló un total de 6 especies parásitas, las más prevalentes de las cuales fueron Blastocystis sp (19.0%), Enterobius vermicularis (17.8%) y Giardia lamblia (6.3%). El riesgo de parasitosis y de infección por Blastocystis sp fue mayor en los participantes que no poseían agua de red (odds ratio [OR] = 2.9 y OR = 3.2, respectivamente). La infección por G. lamblia se asoció de manera positiva con la falta de recolección pública de residuos (OR = 5.6). La infección por E. vermicularis fue superior en los participantes con padres que tenían un nivel de estudios primario (OR = 5.0). Conclusión: Las infecciones parasitarias observadas reflejan las condiciones ambientales de la Patagonia y la necesidad de orientar los estudios a poblaciones periféricas de los centros urbanos, las cuales están expuestas a mayor vulnerabilidad socioeconómica

Common Gastrointestinal Symptoms and Associated Factors Among Under-5 Children in Rural Dembiya, Northwest Ethiopia: A Community-Based Cross-Sectional Study.

BACKGROUND: Gastrointestinal (GI) symptoms such as abdominal discomfort, abdominal cramp, nausea, vomiting, gas in the GI tract, changes in bowel habits (e.g. diarrhea), or heartburn are common in the community. However, these symptoms may be misinterpreted and their impact and significance misunderstood, especially in the rural communities. This study was, therefore, conducted to assess common GI symptoms among children in rural Dembiya, northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted in May 2017 among 225 randomly selected under-5 children. We primarily used mothers' report to assess GI symptoms. Health professionals also diagnosed for some symptoms. Direct stool examination technique was used to identify parasitic infections. Bacteriological analysis of drinking water was done to determine the quality of drinking water. Food safety, environmental sanitation, and hygiene condition of children were assessed using observation checklists. Multivariable binary logistic regression analysis was employed to identify factors associated with GI symptoms on the basis of adjusted odds ratio (OR) with 95% confidence interval (CI) and P < .05. RESULTS: The current study depicted that 139 of 225(61.8%) of the children had GI symptoms. Abdominal discomfort (137 of 139 [98.7%]), abdominal cramp (125 of 139 [89.9%]), and diarrhea (118 of 139 [84.9%]) were the highest GI symptoms reported. GI symptoms were significantly associated with childhood intestinal parasitic infections (OR = 13.69, 95% CI = 3.31-56.59), unclipped and unclean finger nails (OR = 2.28, 95% CI = 1.02-5.10), inadequate living environment sanitation (OR = 2.37, 95% CI = 1.08-5.18), unclean living houses (OR = 9.06, 95% CI = 2.60-31.54), and owning livestock (OR = 4.68, 95% CI = 1.82, 12.03). CONCLUSION: The prevalence of GI symptoms among under-5 children in rural Dembiya, northwest Ethiopia, was found to be high. GI symptoms were significantly associated with childhood intestinal parasitic infections, hand hygiene condition of children, and sanitation condition of the living environment. Therefore, preventing intestinal parasitic infections, improving hand hygiene condition, and promoting environmental sanitation will have overriding contributions to prevent symptoms among children in rural Dembiya.

Environmental planning crisis in urban Ghana: Local responses to nature's call.

Worldwide, there is increasing acknowledgement of the dangers of improper human waste management, particularly open defecation, on the environment and human wellbeing. With about 85.7% of Ghana's population without access to decent toilet facilities as of 2017, Ghana ranks highly in the world among countries with poor human waste management practices. Focusing on urban Ghana, the purpose of this article is twofold: first, to analyze the social, economic, institutional and cultural factors inhibiting the provision of household toilet facility in urban Ghana; and second, to assess how urban residents are coping with the absence of in-house toilet facilities, and the urban planning implications. Using Wa municipality as a case study, household survey and key informant interviews were conducted. Findings indicate that provision of in-house toilet facilities is influenced by complex interactions of socio-economic (e.g. income and educational levels) and cultural (community belief system in relation to toilet provision) factors as well as distortions in the urban planning regime (e.g. limited monitoring systems, inadequate logistics and personnel). Findings from a regression analysis between residents' attitudes to provision of toilet facilities and the benefits they receive or derive from the availability and/use of in-house toilet facilities indicated a positive correlation (correlation coefficient 0.750; degrees of freedom 13; p value 0.001), yet residents have resorted to the use of communal toilet facilities, open defecation and 'perching' (i.e. sharing with friends' with in-house toilet facilities). Implications of the findings for environmental planning are discussed.

Urban sanitation in Nigeria: the past, current and future status of access, policies and institutions.

Though rated among the largest economies in sub-Saharan Africa, Nigeria is currently grappling with enormous socio-economic challenges such as high poverty rate, power and water supply shortages, large-scale unemployment ratio, economic recession and underperforming agricultural sector. Judging by the scale of urgent political and economic importance, urban sanitation definitely ranks low among the government's priorities. No wonder political slogans and manifestos of political parties feature provision of water supply while sanitation is conspicuously usually omitted. This is suggestive of the opinion that having not critically understood the status, challenges and opportunities associated with sanitation in the country's urban areas might be partly responsible for this. Thus, the current work presents a detailed review of the past, current and future status of urban sanitation in Nigeria in terms of access coverage, policies, institutions and future challenges and opportunities. The past status was difficult to evaluate because of the absence of data and unclear definitions of the term 'sanitation'. The current status shows among other findings that water supply issues receive domineering attention than sanitation, mainly due to merging together of discussions, policies and implementation of the two issues together. In cases where sanitation crops up in the agenda, rural areas are favored more than the urban areas. This pattern is also common in the literature. But the future of urban sanitation in Nigeria is double-edged depending on actions or inactions of the government and other stakeholders. The study further makes recommendations for - balanced and sustainable urban development planning, restructuring of land and housing policies and creation of enabling market environment that could trigger a viable sanitation industry - as the way forward.

Status assessment on rural environmental hygiene in Pukou District of Nanjing in 2017 / 上海预防医学

Objective To ascertain the level and dynamic changes of environmental health hazards in the rural areas of Pukou, Nanjing, to objectively evaluate the situation of rural environmental sanitation, providing basis and support for formulating policies and measures by the higher authorities. Methods According to the requirements of the rural environmental sanitation monitoring program of Jiangsu Province in 2017, 5 streets, 20 administrative villages were selected as monitoring points and 100 families used as monitoring objects.The monitoring data were obtained through interviews, access data, field records and laboratory tests. Results Centralized water supply was realized by 20 monitoring points.The rate of collection and centralized disposal of domestic waste was 95.00%.The sewage disposal sites were mainly discharged into sewage treatment plants and harmless sanitary toilets, accounting for 41.00% and 42.00% respectively.The coverage rate of sanitary toilets was 95.54%.Those who did the work of killing rats, flies and mosquitoes accounted for 40.00% and those who did the work of killing cockroaches 25.00%.And 98.00% of the families used fuel for gas, 98.00% of the families never burned straw in the fields, 88.00% of the families did not use the film, and the membrane recycling rate was 91.67%.It was found that 100% of the households drank boiled water, and 90.00% of the respondents developed the habit of washing hands before and after meals.The detection rate of Ascaris eggs was 20.00% in 20 soil samples, and the contents of Pb, CD and Cr were all within the normal range. Conclusion Although some achievements have been made in the rural environmental sanitation in Pukou, the management of pollution of rural sewage, waste and feces should be further strengthened, and the dangerous factors that affect the health of rural residents should be decreased and four pests removal activities actively carried out.

Status assessment on rural environmental hygiene in Pukou District of Nanjing in 2017 / 上海预防医学

Objective To ascertain the level and dynamic changes of environmental health hazards in the rural areas of Pukou, Nanjing, to objectively evaluate the situation of rural environmental sanitation, providing basis and support for formulating policies and measures by the higher authorities. Methods According to the requirements of the rural environmental sanitation monitoring program of Jiangsu Province in 2017, 5 streets, 20 administrative villages were selected as monitoring points and 100 families used as monitoring objects.The monitoring data were obtained through interviews, access data, field records and laboratory tests. Results Centralized water supply was realized by 20 monitoring points.The rate of collection and centralized disposal of domestic waste was 95.00%.The sewage disposal sites were mainly discharged into sewage treatment plants and harmless sanitary toilets, accounting for 41.00% and 42.00% respectively.The coverage rate of sanitary toilets was 95.54%.Those who did the work of killing rats, flies and mosquitoes accounted for 40.00% and those who did the work of killing cockroaches 25.00%.And 98.00% of the families used fuel for gas, 98.00% of the families never burned straw in the fields, 88.00% of the families did not use the film, and the membrane recycling rate was 91.67%.It was found that 100% of the households drank boiled water, and 90.00% of the respondents developed the habit of washing hands before and after meals.The detection rate of Ascaris eggs was 20.00% in 20 soil samples, and the contents of Pb, CD and Cr were all within the normal range. Conclusion Although some achievements have been made in the rural environmental sanitation in Pukou, the management of pollution of rural sewage, waste and feces should be further strengthened, and the dangerous factors that affect the health of rural residents should be decreased and four pests removal activities actively carried out.

The role of social identification for achieving an open-defecation free environment: A cluster-randomized, controlled trial of Community-Led Total Sanitation in Ghana.

Unsafe sanitation practices are a major source of environmental pollution and are a leading cause of death in countries of the Global South. One of the most successful campaigns to eradicate open defecation is "Community-Led Total Sanitation" (CLTS). It aims at shifting social norms towards safe sanitation practices. However, the effectiveness of CLTS is heterogeneous. Based on social identity theory, we expect CLTS to be most effective in communities with stronger social identification, because in these communities individuals should rather follow social norms. We conducted a cluster-randomized controlled trial with 3,216 households in 132 communities in Ghana, comparing CLTS to a control arm. Self-reported open defecation rates and social identification were assessed pre-post. Generalized Estimating Equations showed that CLTS achieved lower open defecation rates compared to controls. This effect was significantly stronger for communities with stronger average social identification. The results confirm the assumptions of social identity theory. They imply that pre-existing social identification needs to be considered for planning CLTS, and strengthened beforehand if needed.

Sustainable Environmental Sanitation from a multi-layered approach: the case of Costa Rica (2005-2015) / El Saneamiento Ambiental desde un enfoque múltiple: el caso de Costa Rica

Abstract Analyzes Costa Rica's recent efforts to achieve a sustainable environmental sanitation. Mainly, it is based on a reference that integrates the notion of environmental sanitation practices at multiple levels: both at the macro level (environmental and social policies) and at the micro level (community actions and individual daily practices), using the theoretical perspective of the social resilience. To carry out the study, a mixed methodology was used, the qualitative data were obtained from in-depth interviews with national authorities, local, community leaders, and head of households. The quantitative data were obtained from the application of a survey to three different communities with rural, urban, and semi-urban characteristics. At the national level, the main result is a paradigm shift in the conception of health, where the joint production of healthy environments should be paramount, within the framework of the right to live in a healthy and sustainable environment. At the community level, local efforts to protect their natural resources for tourism or productive purposes are highlighted; at the individual level, a mixture of reactive and proactive daily practices have been identified.

Resumen Se analizan recientes esfuerzos en Costa Rica por alcanzar un saneamiento ambiental sostenible. Principalmente, se parte de un referente que integra la noción de prácticas de saneamiento ambiental en múltiples niveles: tanto a nivel macro (políticas ambientales y sociales) como a nivel micro (acciones comunitarias y prácticas cotidianas individuales), utilizando la perspectiva teórica de la resiliencia social. Para la realización del estudio se empleó una metodología mixta, los datos cualitativos se obtuvieron de entrevistas en profundidad a autoridades nacionales, locales, líderes comunales, y jefaturas de hogar. Los datos cuantitativos se obtuvieron de la aplicación de una encuesta a tres comunidades distintas con características rurales, urbanas, y semi-urbanas. A nivel nacional, como principal resultado, se resalta un cambio de paradigma en cuanto a la concepción de salud, donde lo primordial debe ser la producción conjunta de ambientes saludables, en el marco del derecho a vivir en un ambiente sostenible. A nivel comunal, se resaltan los esfuerzos locales por proteger sus recursos naturales con fines turísticos o productivos; y, a nivel individual, se resalta una mixtura entre prácticas cotidianas reactivas y proactivas.

Investigation on rural environmental sanitation and summer diarrhea among rural residents in Zhejiang Province / 预防医学

Objective @#To understand the status of rural environmental sanitation and summer diarrhea among rural residents in Zhejiang Province,and to provide evidence for improvement of rural environmental sanitation and prevention and control of summer diarrhea. @*Methods @#The stratified random sampling method was used. Five or six counties each were selected from the east,middle and west of Zhejiang Province;five townships（excluded Chengguan Town）were selected from each selected county;four villages were selected as field survey points from each township;five households were selected from each survey point;one family member（householder or housewife）was selected from each selected household. The information about the environmental sanitation status and prevalence of summer diarrhea were obtained by literature review,interviews,questionnaire suvey,field investigation and laboratory tests. Logistic regression model was used to analyze the influencing factors for occurrence of summer diarrhea among rural residents. @*Results @#There were 2 000 households surveyed. In the past two weeks,108 households had families with diarrhea and the prevalence of diarrhea was 5.40%. A total of 1 828 households disposed the household waste in the garbage bins or pools,accounting for 91.40%. There were 1 926 households with organized sewage discharge,accounting for 96.30%. There were 768 households with nymphs found in the kitchen,accounting for 38.40%;404 households with live egg sheaths found,accounting for 20.20%;592 households with cockroach traces found,accounting for 29.60%;564 households with rat traces found,accounting for 28.20%;and 1 206 households with flies found,accounted for 60.30%. There were 1 314 households with disease vectors around the house,accounting for 65.70%. There were 1 944 household with sanitary toilets,accounting for 97.20%. A total of 1 915 households had habits of drinking boiled water,accounting for 96.57%. The results of multivariate logistic regression analysis showed that rat traces found in the kitchen（OR=2.026,95%CI: 1.362-3.013）were a risk factor for summer diarrhea in rural residents,while drinking boiled water（OR=0.272,95%CI: 0.091-0.811）was a protective factor. @*Conclusion @#The sanitary environment and family health habits of rural residents were related to the prevalence of diarrhea in summer. Paying attention to kitchen hygiene and drinking boiled water could prevent summer diarrhea.

Análise descritiva de vistorias da vigilância ambiental em saúde nas escolas de Porto Alegre / Descriptive analysis of environmental health surveillance surveys in Porto Alegre schools

Nas últimas décadas as atividades humanas que alteram o meio ambiente, associadas à ausência ou inadequação de saneamento podem levar ao aumento da incidência de doenças e agravos e à redução da expectativa e da qualidade de vida das populações. Neste contexto as Doenças Relacionadas ao Saneamento Ambiental Inadequado (DRSAI) assim como os acidentes envolvendo escorpiões tem aumentado de frequência. As crianças de até 6 anos de idade são o grupo etário mais vulnerável às diarreias além de serem também as mais sensíveis ao veneno do escorpião-amarelo (Tityus serrulatus), neste sentido o estabelecimento da Vigilância Ambiental na área da saúde busca mitigar estes riscos. Este trabalho analisou o banco de dados contendo fichas de vistorias da fiscalização ambiental em saúde nas escolas do município ocorridas entre agosto de 2018 e março de 2019. Através da territorialização das escolas por Gerências Distritais de Saúde se buscou identificar áreas da cidade mais vulneráveis aos riscos ambientais relacionados à saúde de escolares com o propósito de sugerir e subsidiar as ações dos gestores públicos. O estudo apontou que ações de educação em saúde sobre o escorpião-amarelo devem continuar priorizando as GDS CENTRO e PLP. Nas regiões com renda per capta inferior foram assinaladas as maiores cargas de DRSAI. (AU)

In the last decades human activities that alter the environment associated with the lack or inadequate sanitation may lead to an increase on the incidence of diseases and sickness with reduction quality and expectation of life in populations. On this context Diseases Related to Poor Environmental Sanitation (DRSAI in Portuguese) as the scorpion accidents have frequency increased. Children up to 6 years old are the age range most vulnerable to diarrhea and are also most sensitive to the yellow scorpion (Tityus serrulatus) poison. In this sense, the establishment of Environmental Surveillance on the health area comes to mitigate those risks. This study analyzed the database containing survey sheets of environmental health inspections on the Porto Alegre schools that occurred between August 2018 and March 2019. Through the territorializing schools by Health Management District (GDS in Portuguese) we sought to identify most vulnerable areas of the city related to these risks using the student's health as parameter in order to suggest and subsidize of the public managers actions. It was identified that health education actions related to yellow scorpions should continue to prioritize the CENTRO and PLP areas. Overall the study found that regions with the worst per capita income and sanitation indicators also suffer most from DRSAI-related issues. (AU)