A method to describe attenuation of river contamination under peak flows: Can the public water supply from Paraopeba River finally return after the Brumadinho dam disaster?

Tailings dams' disasters begin a stage of river water contamination with no endpoint at first sight. But when the river was formerly used for public water supply and the use was suspended as consequence of a dam break, a time window for safe suspension lift must be anticipated to help water managers. The purpose of this study was to seek for that moment in the case of Brumadinho dam disaster which occurred in 2019 and injected millions of cubic meters of iron- and manganese-rich tailings into the Paraopeba River, leading to the suspension of public water supply to Belo Horizonte metropolitan region with this resource, until now. To accomplish the proposed goal, an assemblage of artificial intelligence and socio-economic development models were used to anticipate precipitation, river discharge and metal concentrations (iron, manganese) until 2033. Then, the ratios of metal concentrations between impacted and non-impacted sites were determined and values representing extreme events of river discharge were selected for further assessment. A ratio ≈1 generally indicates a similarity between impacted and non-impacted areas or, put another way, a return of impacted areas to a pre-rupture condition. Moreover, when the ratio is estimated under the influence of peak flows, then a value of ≈1 indicates a return to pre-rupture conditions under the most unfavorable hydrologic regimes, thus a safe return. So, the extreme ratios were plotted against time and fitted to a straight line with intercept-x representing the requested safe time. The results pointed to 6.57 years after the accident, while using iron as contaminant indicator, or 8.71 years when manganese was considered. Despite of being a relatively low-risk timeframe, the suspension lift should be implemented in phases and monitored for precaution of potential sporadic contamination events, while dredging of the tailings from impacted areas should continue and be accelerated.

Consumption of Tap Water and Sociodemographic-Associated Characteristics: A Nationwide Cross-Sectional Study.

Safe water is a global public health concern amid increasing scarcity and pollution. Bottled water production and consumption contribute to these problems. This study examines tap water consumption in Italy, assessing associated sociodemographic factors and related health outcomes such as obesity and self-perceived health status. Data from the Italian National Statistics Institute's "Aspects of daily life" survey (N = 45,597) were analyzed. Covariates included education, age, gender, economic status, region, concerns about waste and climate change, consumption of carbonated drinks excluding water, alcohol consumption, consumption of vegetables, consumption of snacks, body mass index, and self-perceived health status. Bivariate analyses and mixed-effect logistic regression models explored the associations. People who drink tap water made up 19,674, with a higher prevalence in people aged 45 to 59 old, people with a graduate/post-graduate degree diploma, with optimal economic resources, people concerned about waste production and climate change, and those coming from the north-east regions of Italy. Underweight people showed a higher prevalence of TW consumption as well as those who less than occasionally drank carbonated drinks, drank alcohol, consumed vegetables more than once a day and snacks less than once a week, dairy products more than once a day, sweet less than once a week, cured meat less than once a week, and chicken meat less than once a week, those with no consumption of sheep meat, consumption of beef meat less than once a week and consumption of pork meat less than once a week, and those with a satisfactory level of perceived health status. Regressions showed that all other age classes are less likely to drink tap water than people younger than 20 years old. The category with "inadequate" economic resources is more likely to consume tap water. Low educational classes show a low likelihood of consuming tap water as well as islands. A concern about waste production and climate change is associated with an increased likelihood of consuming tap water. Tap water consumption was negatively associated with obesity but not with a satisfactory self-perceived health status. Insights from this study can inform public health strategies.

Application of Artificial Intelligence in the Management of Drinking Water: A Narrative Review.

Waterborne illnesses are a significant concern worldwide. The management of water resources can be facilitated by artificial intelligence (AI) with the help of data analytics, regression models, and algorithms. Achieving the Sustainable Development Goals (SDGs) of the 2030 Agenda for Sustainable Development of the United Nations depends on understanding, communicating, and measuring the value of water and incorporating it into decision-making. Various barriers are used from the source to the consumer to prevent microbiological contamination of drinking water sources or reduce contamination to levels safe for human health. Infrastructure development and capacity-building policies should be integrated with guidelines on applying AI to problems relating to water to ensure good development outcomes. Communities can live healthily with such technology if they can provide clean, economical, and sustainable water to the ecosystem as a whole. Quick and accurate identification of waterborne pathogens in drinking and recreational water sources is essential for treating and controlling the spread of water-related diseases, especially in resource-constrained situations. To ensure successful development outcomes, policies on infrastructure development and capacity building should be combined with those on applying AI to water-related problems. The primary focus of this study is the use of AI in managing drinking water and preventing waterborne illness.

Improving Access to Safe Water in Rural Schools of Kenya: Qualitative Multisectoral Insights.

BACKGROUND: Comprehensive strategies in water, sanitation, and appropriate hygiene behaviors can improve school enrolment and improve gender parity disparities. Lack of safe drinking water negatively impacts the social capital of people, especially school-going children in rural areas. In this study, we systematically evaluated and documented evidence on the barriers and facilitators in the access and adoption of safe water practices in rural schools in Laikipia County, Kenya. METHODS: An ethnographic formative, collaborative implementation research design was used in an iterative and participatory process to evaluate community, socio-economic, and health system-related factors affecting water, hygiene, and sanitation strategies. Qualitative data was collected using key informant interviews (n=5) and focus groups (n=3) from various multisectoral participants. Directed content analysis was used to develop codes, categories, and themes from textual data. Data was organized according to the Promoting Action on Research Implementation in Health Services framework. RESULTS: The findings were classified and described under three key elements: context, evidence, and facilitation. Contextual elements showed an association of diarrhea outbreaks with unsafe hygiene practices compounded by water scarcity. The evidence elements were indicative of the applicability of water backpacks in strengthening handwashing, storage, and transport of water. Facilitation elements indicated evidence of gaps in synergy between the school health and public health systems, necessitating multisectoral collaboration and social capital capacity building. CONCLUSION: The national and county governments play an imperative role in ensuring access and continuous supply of safe drinking water in schools. This is fundamental in efforts towards reducing social inequalities of health among school-going children and building their social capital. Participatory, collaborative, multisectoral interventions and decision-making are crucial, leveraging on creating local ownership, in meeting the water consumption needs of children and communities in water-scarce regions.

Mathematical and Statistical Evaluation of Reverse Osmosis in the Removal of Manganese as a Way to Achieve Sustainable Operating Parameters.

Manganese is the Earth's crust's third most abundant transition metal. Decades of increased mining activities worldwide have inevitably led to the release of large amounts of this metal into the environment, specifically in water resources. Up to a certain level, manganese acts as an essential micronutrient to maintain health and support the growth and development of microorganisms, plants, and animals, while above a specific limit, manganese can cause toxicity in aquatic and terrestrial ecosystems. There are conventional ways to remove manganese from water, such as chemical precipitation, sorption, and biological methods. However, other treatments have yet to be studied much, such as reverse osmosis (RO), which has demonstrated its effectiveness in the removal of heavy metals and could be a suitable alternative for manganese removal if its energy consumption is reduced. This research presents mathematical and statistical modeling of the behavior of a system in laboratory-scale RO. The principal finding was that it is possible to remove Mn using the RO operated with low pressures without decreasing the sustainable removal efficiency. Reducing the operating costs of RO opens the possibility of implementing RO in different contexts where there are problems with water contamination and economic limitations.

COVID-19 pandemic and socio-environmental inequality: A narrative review.

Background and Aims: The COVID-19 pandemic has provided preliminary evidence of the existence of health, social, and environmental inequalities. This inequality encompasses inadequate access to safe water, clean air, and wastewater management, as well as limited socioeconomic and educational opportunities. These issues have not received sufficient attention during the pandemic. The purpose of this narrative review is to provide a comprehensive summary and analysis of the existing literature on a specific topic, ultimately leading to a conclusion based on the evidence presented. Methods: The search methodology for this study involved conducting comprehensive searches of scientific databases, including PubMed, ScienceDirect, LILACS, and Google Scholar, from 2019 to 2023. The study focused on a specific theme and its relevant aspects related to global environmental health and society. Keywords such as COVID-19, inequities, and environmental health were used for searching. Additionally, the Boolean operator "AND" was used to combine these descriptors. Results: Unequal exposure to air pollution has been reported in Africa, as well as in large parts of Asia and Latin America, according to the data that has been obtained. The pandemic has also resulted in a surge in healthcare waste generation, exacerbating the environmental impact of solid waste. Furthermore, there is evidence indicating significant disparities in the severe lack of access to sanitation services between developing nations and low-income regions. The issues related to water availability, accessibility, and quality are subject to debate. It has been reported that SARS-CoV-2 is present not only in untreated/raw water, but also in water bodies that act as reservoirs. Moreover, insufficient education, poverty, and low household income have been identified as the most significant risk factors for COVID-19 infection and mortality. Conclusion: It is evident that addressing socio-environmental inequality and striving to narrow the gap by prioritizing vulnerable populations are imperative.

The Association Between Rainfall, Temperature, and Reported Drinking Water Source: A Multi-Country Analysis.

Climate change may alter access to safe drinking water, with important implications for health. We assessed the relationship between temperature and rainfall and utilization of basic drinking water (BDW) in The Gambia, Mozambique, Pakistan, and Kenya. The outcomes of interest were (a) whether the reported drinking water source used in the past 2 weeks met the World Health Organization definition of BDW and (b) use of a BDW source that was always available. Temperature and precipitation data were compiled from weather stations and satellite data and summarized to account for long- and short-term weather patterns and lags. We utilized random forests and logistic regression to identify key weather variables that predicted outcomes by site and the association between important weather variables and BDW use. Higher temperatures were associated with decreased BDW use at three of four sites and decreased use of BDW that is always available at all four sites. Increasing rainfall, both in the long- and short-term, was associated with increased BDW use in three sites. We found evidence for interactions between household wealth and weather variables at two sites, suggesting lower wealth populations may be more sensitive to weather-driven changes in water access. Changes in temperature and precipitation can alter safe water use in low-resource settings-investigating drivers for these relationships can inform efforts to build climate resilience.

A PLS-SEM Analysis to Check Public Willingness to Use Water from Filtration Plants Installed by Public Own Organizations; a Study of Psychological Behavior Toward Sustainable Development.

Introduction: Water is the basic need of human beings and there is no substitute for water. This research was conducted to analyze public willingness to use water from filtration plants installed by public own Organizations and which psychological factors may help them to decide to use safe water. Methods: There ought to be some nudges in the right direction to encourage people to use water filters. A questionnaire was adopted from the literature for this research. PLS-SEM is used to evaluate data to check the connection among variables since it is the most recommended way for assessing and predicting explained variables to account for the largest latent variance, and PLS-SEM is one of the most effective approaches for predicting outcomes. Results: PLS-SEM direct path analysis revealed that hypotheses H1-H6 were accepted and the gender and levels of education of the respondents as control variables, gender and education showed insignificant relationships with WUFWFP. Age showed a substantial relationship as a moderator variable between WQK*Age, and HC*Age with a willingness to use filter water from filtration plants=WUFWFP, while the rest of the variables showed an insignificant relationship. Discussion: As per our results, H1a and H3a have a significant relationship as moderator variables between IV and DV, while H2a, H4a, H5a, and H6a did not show any relationship as moderator variables between IV and DV. Hence H1a and H3a were accepted while the rest of the moderator was rejected under this research. This study would be helpful for the decision-makers and planners to take proper sustainable measures to address the repercussions of urbanization and land use changes to protect the ecosystem.

Safe water supply challenges for hand hygiene in the prevention of COVID-19 in Southern Nations, Nationalities, and People's Region (SNNPR), Ethiopia.

BACKGROUND: Proper hand hygiene practices are critical in disease prevention and control, including preventing the spread of the COVID-19 pandemic, but according to a recent global report, three billion people lack access to basic hand washing facilities (soap and water) at home. Therefore, this study aimed to determine the challenges related to safe and adequate water provision for hand hygiene in the prevention of COVID-19 in Gedeo Zone, SNNPR, Ethiopia. METHODS: An institutional-based cross-sectional study design was used to assess the challenges associated with safe water supply in the prevention of COVID-19 in Gedeo Zone. Simple random sampling was used. The water sector's challenges were assessed using in-depth interviews with key informants. Water samples were collected from hand washing stations using a sterile bottle and the standard tap water sampling procedure. Bacterial analysis was carried out using membrane filtration techniques. The Wagtech Palin test and the Delagua portable water testing kit procedure was used to analyze World Health Organization (WHO) critical physicochemical parameters. RESULT: The physicochemical analysis of the sample water from the hand washing facilities reveals that the pH (6.5-8) is within the WHO guideline in all samples except Gedeb town (11.1%). The residual chlorine in the samples was less than 0.2 mg/l, which is below the standard in all towns, but 15.8% of the samples in Wonago town were between 0.2-0.5mg/l. Faecal coliforms were not found in 27.5%, 21.0%, 16.6%, and 40.7% of the samples collected in Dilla, Wonago, Yirgachefe, and Gedeb town, respectively. The remaining samples were all positive for faecal coliforms. Unbalanced demand versus supply, inaccessibility, supply interruptions, financial constraints, a scarcity of competent human resources, a lack of regular water quality assessments, and a lack of stakeholder support were all identified as major challenges by all water sectors of the study towns. The majority of hand washing water samples from all of the study towns were bacteriologically unsafe. The water sector must work hard to ensure that the community has safe drinking water. All responsible bodies and potential stakeholders must support the water sectors in the Gedeo zone.

Carbapenem Resistance among Marine Bacteria-An Emerging Threat to the Global Health Sector.

The emergence of antibiotic resistance among pathogenic microorganisms is a major issue for global public health, as it results in acute or chronic infections, debilitating diseases, and mortality. Of particular concern is the rapid and common spread of carbapenem resistance in healthcare settings. Carbapenems are a class of critical antibiotics reserved for treatment against multidrug-resistant microorganisms, and resistance to this antibiotic may result in limited treatment against infections. In addition to in clinical facilities, carbapenem resistance has also been identified in aquatic niches, including marine environments. Various carbapenem-resistant genes (CRGs) have been detected in different marine settings, with the majority of the genes incorporated in mobile genetic elements, i.e., transposons or plasmids, which may contribute to efficient genetic transfer. This review highlights the potential of the marine environment as a reservoir for carbapenem resistance and provides a general overview of CRG transmission among marine microbes.

Integrated Approach in Addressing Undernutrition in Developing Countries: A Scoping Review of Integrated Water Access, Sanitation, and Hygiene (WASH) + Nutrition Interventions.

A scoping review of integrated water access, sanitation, and hygiene (WASH) plus nutrition interventions was conducted mainly to describe different components of intervention and examine their effectiveness in improving nutritional outcomes among children. Of the 8 small- to large-scale interventions, 6 were conducted in sub-Saharan Africa and the remaining 2 in South Asia. All the interventions were done in rural settings; the majority involved sanitation and hygiene deliverables along with the nutrition strategies, such as distribution of nutrition supplements. In assessing effectiveness, no significant improvements were seen in growth indicators; reduction in diarrheal rate among children was also not universal across interventions. Further strengthening of WASH, especially an improvement in "W", or water access, is warranted to ensure uptake of sanitation and hygiene behaviors and prevent the fecal-oral route among children. Improved water access will also enhance the effectiveness of nutrition initiatives, such as promoting vegetable gardening and utilization of child nutrient supplements.

Bacteriological and physico-chemical quality of household drinking water in Kisii Town, Kisii County, Kenya.

Water is a basic human need which is required in many operations especially in households. However, this essential commodity in most cases does not meet the generally accepted safety standards. The study was designed to investigate the physico-chemical and bacteriological quality of drinking water used in households in Kisii town, Kenya. Analytical cross-sectional study was conducted to obtain information concerning household drinking water quality and safety. Stratified random sampling was used to obtain 422 drinking water samples at the point of consumption from the 4 zones of Kisii town for analysis. From the study it was revealed that TDS and electrical conductivity of the analyzed water samples were within the recommended standards of less than 1000 ppm and 1500 µSCM-1 respectively. Further, it was found that 69.4% of the samples had pH range of between 6.5-8.5, 91.9% had turbidity of less than 5NTU, 3.8% had temperature below 15 °C and 31.2% of the chlorinated samples had chlorine residue above 0.2 ppm. In terms of bacteriological analysis, 39.3% of the samples were contaminated with total coliforms and 17.5% with E. coli. The main finding from the study was that the household water samples were contaminated with bacteria and unfit for human consumption because both total coliforms and E. coli exceeded the recommended Kenya Bureau of Standards (KEBS) and WHO standards. Therefore, public health officers should not only collect water samples from sources but also from households regularly to ascertain its quality and provide water safety promotion education to the general public. There was a strong relationship between bacterial contamination and temperature as well as chlorine residue. The study recommends Gusii Water and Sanitation Company (GWASCO) whose treatment and distribution capacity is expected to increase 4.5 times the current capacity to improve on their chlorine dosage at the treatment plant to ensure a minimum chlorine residue of 0.2 ppm at the household and community taps.

Evidence-based chlorination targets for household water safety in humanitarian settings: Recommendations from a multi-site study in refugee camps in South Sudan, Jordan, and Rwanda.

The current Sphere guideline for water chlorination in humanitarian emergencies fails to reliably ensure household water safety in refugee camps. We investigated post-distribution chlorine decay and household water safety in refugee camps in South Sudan, Jordan, and Rwanda between 2013-2015 with the goal of demonstrating an approach for generating site-specific and evidence-based chlorination targets that better ensure household water safety than the status quo Sphere guideline. In each of four field studies we conducted, we observed how water quality changed between distribution and point of consumption. We implemented a nonlinear optimization approach for the novel technical challenge of modelling post-distribution chlorine decay in order to generate estimates on what free residual chlorine (FRC) levels must be at water distribution points, in order to provide adequate FRC protection up to the point of consumption in households many hours later at each site. The site-specific FRC targets developed through this modelling approach improved the proportion of households having sufficient chlorine residual (i.e., ≥0.2 mg/L FRC) at the point of consumption in three out of four field studies (South Sudan 2013, Jordan 2014, and Rwanda 2015). These sites tended to be hotter (i.e., average mid-afternoon air temperatures >30°C) and/or had poorer water, sanitation, and hygiene (WASH) conditions, contributing to considerable chlorine decay between distribution and consumption. Our modelling approach did not work as well where chlorine decay was small in absolute terms (Jordan 2015). In such settings, which were cooler (20 to 30°C) and had better WASH conditions, we found that the upper range of the current Sphere chlorination guideline (i.e., 0.5 mg/L FRC) provided sufficient residual chlorine for ensuring household water safety up to 24 hours post-distribution. Site-specific and evidence-based chlorination targets generated from post-distribution chlorine decay modelling could help improve household water safety and public health outcomes in refugee camp settings where the current Sphere chlorination guideline does not provide adequate residual protection. Water quality monitoring in refugee/IDP camps should shift focus from distribution points to household points of consumption in order to monitor if the intended public health goal of safe water at the point of consumption is being achieved.

The quality of drinking and domestic water from the surface water sources (lakes, rivers, irrigation canals and ponds) and springs in cholera prone communities of Uganda: an analysis of vital physicochemical parameters.

BACKGROUND: Water is the most abundant resource on earth, however water scarcity affects more than 40% of people worldwide. Access to safe drinking water is a basic human right and is a United Nations Sustainable Development Goal (SDG) 6. Globally, waterborne diseases such as cholera are responsible for over two million deaths annually. Cholera is a major cause of ill-health in Africa and Uganda. This study aimed to determine the physicochemical characteristics of the surface and spring water in cholera endemic communities of Uganda in order to promote access to safe drinking water. METHODS: A longitudinal study was carried out between February 2015 and January 2016 in cholera prone communities of Uganda. Surface and spring water used for domestic purposes including drinking from 27 sites (lakes, rivers, irrigation canal, springs and ponds) were tested monthly to determine the vital physicochemical parameters, namely pH, temperature, dissolved oxygen, conductivity and turbidity. RESULTS: Overall, 318 water samples were tested. Twenty-six percent (36/135) of the tested samples had mean test results that were outside the World Health Organization (WHO) recommended drinking water range. All sites (100%, 27/27) had mean water turbidity values greater than the WHO drinking water recommended standards and the temperature of above 17 °C. In addition, 27% (3/11) of the lake sites and 2/5 of the ponds had pH and dissolved oxygen respectively outside the WHO recommended range of 6.5-8.5 for pH and less than 5 mg/L for dissolved oxygen. These physicochemical conditions were ideal for survival of Vibrio. cholerae. CONCLUSIONS: This study showed that surface water and springs in the study area were unsafe for drinking and had favourable physicochemical parameters for propagation of waterborne diseases including cholera. Therefore, for Uganda to attain the SDG 6 targets and to eliminate cholera by 2030, more efforts are needed to promote access to safe drinking water. Also, since this study only established the vital water physicochemical parameters, further studies are recommended to determine the other water physicochemical parameters such as the nitrates and copper. Studies are also needed to establish the causal-effect relationship between V. cholerae and the physicochemical parameters.

Diarrhoeal disease knowledge among diarrhoea patient housholds: findings from the randomised controlled trial of the Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) mobile health program.

OBJECTIVE: The objective of this study was to evaluate the impact of the Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) handwashing with soap and water treatment mobile health (mHealth) program on diarrhoeal disease knowledge among diarrhoea patients and their household members in urban Dhaka, Bangladesh. METHODS: A cluster-randomised controlled trial of the CHoBI7 mHealth program was conducted among diarrhoea patient households in Dhaka, Bangladesh. Patients were randomised to three arms: standard recommendation on oral rehydration solution use; health facility delivery of CHoBI7 plus mHealth (weekly voice and text messages) (no home visits); and health facility delivery of CHoBI7 plus two home visits and mHealth. An open-ended questionnaire was administered to 1468 participants 12 years of age or older on diarrhoeal disease transmission and prevention. These items were combined to form a diarrhoeal disease knowledge score measured at baseline and at a 1 week, 6 month and 12 month follow-up. RESULTS: At baseline, when participants were asked to report three ways diarrhoeal diseases were spread 37% (546/1468) of participants reported by water, 13% (187/1468) by lack of handwashing and 4% (53/1468) by food not being covered properly. At baseline when asked to name three ways diarrhoeal diseases could be prevented, 35% (515/1468) of participants reported safe water, and 16% (228/1468) reported handwashing with soap. At the 12-month follow-up, the overall diarrhoeal disease knowledge score was significantly higher in the mHealth with no home visits arm (score coefficient: 0.69, 95% Confidence Interval: 0.36, 1.01, P < 0.0001) and the mHealth with two home visits arm (score coefficient: 1.18, 95% CI: 0.87, 1.49, P < 0.0001) compared with the standard recommendation arm. CONCLUSION: The CHoBI7 mHealth program significantly increased knowledge of diarrhoeal disease transmission and prevention among diarrhoea patients and their household members 12 months after in-person visits for program delivery were conducted.

OBJECTIF: L'objectif de cette étude était d'évaluer l'impact du programme CHoBI7 (Cholera-Hospital-Based-Intervention-for-7-days) de santé mobile (mHealth) sur la connaissance sur les maladies diarrhéiques chez les patients atteints de diarrhée et les membres de leur ménage dans la ville de Dhaka, au Bangladesh. MÉTHODES: Un essai contrôlé randomisé par grappes du programme mHealth CHoBI7 a été mené auprès de ménages de patients atteints de diarrhée à Dhaka, au Bangladesh. Les patients ont été randomisés dans trois groupes: recommandation standard sur l'utilisation de solutions de réhydratation orale; délivrance du programme CHoBI7 dans les services de santé plus mHealth (pas de visites à domicile); et délivrance du programme CHoBI7 dans les services de santé plus deux visites à domicile et mHealth. Un questionnaire ouvert a été administré à 1.468 participants âgés de 12 ans ou plus sur la transmission et la prévention des maladies diarrhéiques. Ces éléments ont été combinés pour former un score de connaissance sur les maladies diarrhéiques mesuré au départ et à 1 semaine, 6 mois et 12 mois. RÉSULTATS: Au départ, lorsqu'il a été demandé aux participants d'indiquer trois modes de propagation des maladies diarrhéiques, 37% (546/1468) des participants ont indiqué que ces maladies étaient transmises par l'eau, 13% (187/1468) par le manque de lavage des mains et 4% (53/1468) par le fait que les aliments n'étaient pas correctement couverts. Au départ, lorsqu'on leur a demandé de citer trois moyens de prévention des maladies diarrhéiques, 35% (515/1468) des participants ont cité l'accès à l'eau potable et 16% (228/1468) ont cité le lavage des mains avec du savon. Lors du suivi à 12 mois, le score global de connaissance sur la diarrhée était significativement plus élevé dans le bras mHealth sans visites à domicile (coefficient de score: 0,69, intervalle de confiance à 95%: 0,36-1,01; P < 0,0001) et le volet mHealth avec deux visites à domicile (coefficient de score: 1,18; IC 95%: 0,87-1,50; P < 0,0001) par rapport au bras de recommandation standard. CONCLUSION: Ces résultats suggèrent que le programme mHealth de CHoBI7 présente une approche prometteuse pour accroître les connaissances sur les maladies diarrhéiques dans les ménages de patients atteints de diarrhée.

Pretreatment using Opuntia cochenillifera followed by household slow sand filters: technological alternatives for supplying isolated communities.

Household slow sand filter (HSSF) performance in continuous and intermittent flows was evaluated when influent water was treated with a natural coagulant extracted from Opuntia cochenillifera. The water under study, used as influent, had a turbidity of 111 ± 17.3 NTU. When clarifying the water with O. cochenillifera, the best condition obtained was 30  mg L-1 in natural pH (without correction), generating clarified water with turbidity satisfactory to filters operation (7.83 ± 2.32 NTU). The results indicated a better performance of continuous flow HSSF in turbidity removal (79.2% ± 8.39%) and higher efficiency of intermittent flow HSSF in the removal of E. coli (2.86 log ± 0.79 log for 12  h pause period and 2.41 log ± 0.42 log for 4  h pause period). For the sake of comparison, the evaluated HSSFs had the same production (60 L day-1). The impact on the interruption of the 96-h feed into the HSSFs was analysed and the results indicated a significant change in the quality of the filtered water after resuming the operation. This fragility of technology must be considered when it is implemented as lack of water can be a reality in the target communities. Acute toxicological assays with C. xanthus larvae showed no toxicity for pretreated and filtered water; however, more testing should be performed.

State-Level Policies Concerning Private Wells in the United States.

Currently, no federal policies exist in the United States regarding private wells; this authority is devolved to states. This study inventoried state-level policies governing private wells in the United States in order to identify the topics addressed by each state, division of responsibilities across state agencies, and geographic differences in policy comprehensiveness. From May to August 2016, two independent reviewers conducted an online search followed by directly contacting state agencies (98% response) to identify all state-level policies in the United States that directly reference private wells. The search, updated in April 2018, confirmed the existing water policy list and identified 23 additional policies. Policies were then coded according to nine not-mutually-exclusive classifications. The results indicate that all states had at least one policy addressing private well drilling or construction. Significant geographic differences exist in maintenance-related policies. In conclusion, although drilling and construction safety are addressed by each state, some policy domains are addressed inconsistently across states, and other policy domains are absent in most states.

Knowledge and practices of households on safe water chain maintenance in a slum community in Kampala City, Uganda.

BACKGROUND: More than half of the disease burden in Uganda can be prevented through improving water, sanitation, and hygiene (WASH). In slum communities, water supply is insufficient but also highly contaminated; therefore, ensuring that the safe water chain is maintained by households is paramount to preventing water-related diseases. This study aimed at assessing knowledge and practices of households on safe water chain maintenance in slum communities in Kampala City, Uganda. METHODS: This was a community-based cross-sectional study carried out among 395 households in slum communities in Kampala, Uganda. Data were collected using a semi-structured questionnaire. Prevalence ratios (PRs) and their 95% confidence intervals were used as a measure of association between safe water chain management and associated knowledge and practice factors. The PRs were obtained using a multivariable modified Poisson regression with logarithm as the link function, with robust standard errors. RESULTS: Majority (76.7%, 303/395) of the households collected their water from a piped water system and paid for the water (72.9%, 288/395). Almost all (97.2%, 384/395) of the participants said that they knew the dangers associated with drinking unsafe water, boiled their drinking water (95.4%, 377/395), and used storage containers that minimize contamination (97.0%, 383/395). However, only (32.4%, 128/395) of the households satisfactorily maintained the safe water chain. Female- (adjusted PR = 1.82, 95% CI (1.19-2.78)) and student-led households (adjusted PR = 1.58, 95% CI (1.03-2.41)) and those whose heads had attained post-primary education (adjusted PR = 1.48, 95% CI (1.02-2.17)) were more likely to satisfactorily maintain the safe water chain. This was similar among members who thought most contamination occurs during storage (adjusted PR = 1.47, 95% CI (1.10-1.97)). CONCLUSION: Only a third of the households maintained the safe water chain satisfactory. Female-led, student-led, and post-primary educated-led household and household that thought most contamination occurs during storage were more likely to maintain the safe water chain. There is a need to improve the level of awareness about the importance of the safe water chain among slum dwellers.