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1.
BMC Res Notes ; 12(1): 472, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31370868

RESUMO

OBJECTIVES: Salmonella is the most important causes of foodborne illness especially from poultry and poultry products. So the aim of this study was to carryout phenotypic characterization, antimicrobials susceptibility pattern and risk factors of Salmonella isolates from farms and markets eggs, cloacae swabs of chickens and stool of egg collectors. A cross-sectional study was conducted from January 2018 to September 2018. Samples were, processed; Salmonella was isolated, phenotypically identified by OmniLog and antimicrobials susceptibility were carried out. RESULT: Over all; 11 (2.65%) of Salmonella enterica were phenotypically characterized out of 415 samples from farms egg content (n = 83), farms eggshell (n = 83), cloacae (n = 83), market eggshell (n = 83) and market egg contents (n = 83) with 2.4%, 0%, 2.4%, 4.8% and 3.6% prevalence, respectively. Out of isolates, 8 (72.72%) displayed multidrug resistance. All isolates showed susceptibility to Gentamicin, Kanamycin and Streptomycin. Lack of separating cracked eggs, washing hand, eggs stay longer unsold, and mixing excreta with feed were associated risk factors for Salmonella presence (P-value < 0.05). The presence of drug resistant Salmonella enterica within egg/and chicken can pose serious health problem. Good hygienic practices are important to reduce risk factors of Salmonella contamination.


Assuntos
Criação de Animais Domésticos/ética , Doenças das Aves Domésticas/epidemiologia , Salmonelose Animal/epidemiologia , Salmonella enterica/isolamento & purificação , Animais , Antibacterianos/farmacologia , Galinhas , Estudos Transversais , Ovos/microbiologia , Etiópia/epidemiologia , Fazendeiros , Fazendas , Fezes/microbiologia , Gentamicinas/farmacologia , Humanos , Higiene/educação , Canamicina/farmacologia , Testes de Sensibilidade Microbiana , Doenças das Aves Domésticas/microbiologia , Doenças das Aves Domésticas/transmissão , Prevalência , Fatores de Risco , Salmonelose Animal/microbiologia , Salmonelose Animal/transmissão , Salmonella enterica/efeitos dos fármacos , Estreptomicina/farmacologia
2.
Nutrients ; 11(7)2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31373314

RESUMO

Optimal nutrition improves child development, and impaired development is associated with maternal depression symptoms, in particular in low resource settings. In this follow-up of an open cluster-randomized education trial, we examined its effects among mothers in rural Uganda on their depression symptoms and the association of these symptoms to child development. The education comprised complementary feeding, stimulation, and hygiene. We assessed 77 intervention mothers and 78 controls using Beck Depression Inventory-II (BDI-II) and Center for Epidemiologic Studies Depression Scale (CES-D) scores. Child development was assessed with Bayley Scales of Infant and Toddler Development-III (BSID-III) composite scores for cognitive, language and motor development. Compared to controls, the intervention reduced depression symptoms' scores with mean (95% CI) differences: -8.26 (-11.49 to -1.13, p = 0.0001) and -6.54; (-8.69 to -2.99, p = 0.004) for BDI II at 20-24 and 36 months, respectively. Similar results were obtained with CES-D. There was a negative association of BDI-II scores and BSID-III cognitive and language scores at 20-24 (p = 0.01 and 0.008, respectively) and 36 months (p = 0.017 and 0.001, respectively). CES-D associations with BSID-III cognitive and language scores showed similar trends. BSID-III motor scores were associated with depression scores at 36 months for both BDI-II and CES-D (p = 0.043 and 0.028, respectively). In conclusion, the group education was associated with reduced maternal depression scores. Moreover, the depression scores were inversely associated with child cognitive and language development outcomes.


Assuntos
Desenvolvimento Infantil , Depressão/psicologia , Relações Mãe-Filho/psicologia , Mães/educação , Mães/psicologia , Adulto , Atitude Frente a Saúde , Pré-Escolar , Depressão/epidemiologia , Feminino , Seguimentos , Educação em Saúde/métodos , Inquéritos Epidemiológicos , Humanos , Higiene/educação , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Pobreza , Escalas de Graduação Psiquiátrica , População Rural , Uganda/epidemiologia , Adulto Jovem
3.
J Glob Health ; 9(2): 020402, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31360445

RESUMO

Background: Water, sanitation, and hygiene (WASH) in schools is promoted by development agencies as a modality to improve school attendance by reducing illness. Despite biological plausibility, the few rigorous studies that have assessed the effect of WASH in schools (WinS) interventions on pupil health and school attendance have reported mixed impacts. We evaluated the impact of the Laos Basic Education, Water, Sanitation and Hygiene Programme - a comprehensive WinS project implemented by UNICEF Lao People's Democratic Republic (Lao PDR) in 492 primary schools nationwide between 2013 and 2017 - on pupil education and health. Methods: From 2014-2017, we conducted a cluster-randomized trial among 100 randomly selected primary schools lacking functional WASH facilities in Saravane Province, Lao PDR. Schools were randomly assigned to either the intervention (n = 50) or comparison (n = 50) arm. Intervention schools received a school water supply, sanitation facilities, handwashing facilities, drinking water filters, and behavior change education and promotion. Comparison schools received the intervention after research activities ended. At unannounced visits every six to eight weeks, enumerators recorded pupils' roll-call absence, enrollment, attrition, progression to the next grade, and reported illness (diarrhea, respiratory infection, conjunctivitis), and conducted structured observations to measure intervention fidelity and adherence. Stool samples were collected annually prior to de-worming and analyzed for soil-transmitted helminth (STH) infection. In addition to our primary intention-to-treat analysis, we conducted secondary analyses to quantify the role of intervention fidelity and adherence on project impacts. Results: We found no impact of the WinS intervention on any primary (pupil absence) or secondary (enrollment, dropout, grade progression, diarrhea, respiratory infection, conjunctivitis, STH infection) impacts. Even among schools with the highest levels of fidelity and adherence, impact of the intervention on absence and health was minimal. Conclusions: While WinS may create an important enabling environment, WinS interventions alone and as currently delivered may not be sufficient to independently impact pupil education and health. Our results are consistent with other recent evaluations of WinS projects showing limited or mixed effects of WinS.


Assuntos
Absenteísmo , Diarreia/prevenção & controle , Helmintíase/prevenção & controle , Infecções Respiratórias/prevenção & controle , Serviços de Saúde Escolar , Animais , Criança , Diarreia/epidemiologia , Fezes/parasitologia , Feminino , Helmintíase/epidemiologia , Helmintíase/transmissão , Helmintos/isolamento & purificação , Humanos , Higiene/educação , Higiene/normas , Laos/epidemiologia , Masculino , Avaliação de Programas e Projetos de Saúde , Infecções Respiratórias/epidemiologia , Saneamento/normas , Solo/parasitologia , Abastecimento de Água/normas
4.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 1025-1030, jul.-set. 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005844

RESUMO

Objetivo: Descrever as condições do estilo de vida e riscos à saúde de um grupo de adolescentes e jovens participantes de um Núcleo de Atenção à Saúde do Adolescente (NASA). Métodos: Estudo descritivo de abordagem qualitativa realizado com 13 adolescentes e jovens cadastrados no NASA de um município da Baixada Litorânea do estado do Rio de Janeiro, por meio de questionários padronizados autoaplicáveis. Resultados: Foram identificados hábitos alimentares inadequados; precocidade das relações sexuais e uso irregular de preservativo; ausência de atividade física e situações constrangedoras vivenciadas na escola. Conclusão: O estudo aponta situações de riscos à saúde que demandam estratégias preventivas, sobretudo de promoção da saúde. Faz-se necessária a implementação de ações intersetoriais locais voltadas para a redução de vulnerabilidades com ênfase nos eixos temáticas de alimentação, sexualidade, atividade física, prevenção da violência e cultura da paz


Introduction: The occurrence of transmissible and non-communicable diseases related to lifestyle has acquired relevance in the juvenile phase. The objective was to describe aspects of the lifestyle of participants of a Teen Health Care Center. Materials and methods: Descriptive study of qualitative approach carried out with 13 adolescents and young people registered in the Adolescent Health Care Center of a city of Baixada Litorânea, state of Rio de Janeiro, Brazil, using standardized self-administered questionnaires. Results: Inappropriate eating habits; Precocity of the onset of sexual intercourse and irregular use of condoms; Absence of regular physical activity and embarrassing situations experienced at school were identified. Discussion: The commitment in these aspects of lifestyle indicates that there are situations of health risks that demand new preventive strategies besides the educational actions with the young public. Conclusions: There is a need for planning and implementation of local intersectoral actions at primary and secondary health care levels aimed at reducing youth vulnerabilities on inadequate feeding, sexual precocity, irregular physical activity and school violence


Introducción: La aparición de las enfermedades transmisibles y no transmisibles relacionadas con el estilo de vida ha obtenido relevancia en la fase juvenil. El objetivo fue describir aspectos del estilo de vida de participantes de un Núcleo de Atención a la Salud del Adolescente. Materiales y métodos: Estudio descriptivo del abordaje cualitativo realizado con 13 adolescentes y jóvenes registrados en el Núcleo de Atención a la Salud del Adolescente de un municipio de la Baixada Litoral del estado de Río de Janeiro, Brasil, por medio de cuestionarios estandarizados autoaplicables. Resultados: Se identificaron hábitos alimenticios inadecuados; Precocidad del inicio de las relaciones sexuales y uso irregular de preservativo; Ausencia de actividad física regular y situaciones embarazosas vivenciadas en la escuela. Discusión: El compromiso en estos aspectos del estilo de vida apunta que existen situaciones de riesgos a la salud que demandan nuevas estrategias preventivas además de las acciones educativas con el público joven. Conclusiones: Hay necesidad de planificación y realización de acciones intersectoriales locales en niveles de atención primaria y secundaria en salud que estén dirigidas a reducir las vulnerabilidades juveniles sobre alimentación inadecuada, precocidad sexual, actividad física irregular y violencia escolar


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Fatores de Risco , Saúde do Adolescente , Estilo de Vida , Comportamento Sexual , Drogas Ilícitas , Higiene/educação , Comportamento Alimentar , Promoção da Saúde
5.
Glob Health Action ; 12(1): 1560115, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31154995

RESUMO

Problems in growth and undernutrition manifest in early infancy, with suboptimal breastfeeding and inadequate complementary feeding remaining strong risk factors for chronic undernutrition in infants. No published studies exist on educational interventions to improve infant feeding practices among refugees or displaced persons in low and middle-income (LMIC) settings. The objective of this study was to create and pilot educational materials for home-based counseling of refugee mothers along the Thailand-Myanmar border to improve appropriate infant feeding and water, sanitation, and hygiene (WASH) behaviors. Mothers of infants received counseling on appropriate infant feeding and WASH practices on a monthly basis for a total of six months from infant age three months until nine months. Educational materials were designed to feature a basic script for health workers and photos of locally available, appropriate foods. Of the 20 mothers participating in this pilot, infant feeding and WASH behaviors improved within 1 to 2 months of the first visit, including exclusive breastfeeding, minimum acceptable diet, and safe disposal of infant stool. This pilot demonstrates improvement in maternal infant feeding and WASH practices in a small set of refugee mothers, providing evidence for counseling measures to improve infant health in vulnerable populations.


Assuntos
Aconselhamento/métodos , Comportamento Alimentar/psicologia , Higiene/educação , Saúde do Lactente , Mães/educação , Mães/psicologia , Refugiados/educação , Adulto , Aleitamento Materno , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Estudos Longitudinais , Mianmar , Saneamento , Seio Sagital Superior , Tailândia
6.
Matern Child Nutr ; 15 Suppl 3: e12757, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31148398

RESUMO

There is inconsistent evidence on the efficacy of agriculture programmes at improving women and children's anaemia and nutritional status. The primary aim of this study was to evaluate the impact of a nutrition-sensitive enhanced homestead food production (EHFP) programme on anaemia in women (18-45 years) and children (6-59 months) in rural Cambodia. Secondary outcomes were women's micronutrient status and women and children's anthropometry. In this cluster-randomized controlled trial, 900 households from 90 villages (clusters) were randomized to either (a) home gardens and behaviour change communication (BCC) on nutrition, hygiene, women's empowerment, and marketing (EHFP); (b) home gardens plus fishponds and BCC (EHFP + F); or (c) control (no intervention). Haemoglobin concentration and anthropometry were measured in women and children at baseline and at 22 months. Venous blood samples were collected in a subset of women (n = 450) at baseline and at 22 months. Generalized linear mixed effect models with repeated measures were used to evaluate the difference across groups and the change from baseline to end of study. Ninety clusters, 552 women, and 754 children completed the trial. Compared with control, we found a statistically significant impact on anaemia prevalence in children (-14.0 percentage points; P = 0.02) and retinol binding protein concentrations in women (difference in difference: 0.34; P = 0.02) randomized to EHFP and EHFP + F groups, respectively. No other statistically significant effects on anaemia, nutritional biomarker concentrations, or anthropometry were observed. Future research is needed to examine longer term impacts of EHFP on anthropometry in women and children and into the nutritional causes of anaemia among children in Cambodia.


Assuntos
Anemia/dietoterapia , Anemia/prevenção & controle , Dieta/classificação , Micronutrientes/administração & dosagem , Estado Nutricional , Adolescente , Adulto , Antropometria , Aquicultura , Camboja/epidemiologia , Pré-Escolar , Análise por Conglomerados , Produtos Agrícolas , Feminino , Jardinagem , Comportamentos Relacionados com a Saúde , Humanos , Higiene/educação , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Fenômenos Fisiológicos da Nutrição Materna , Micronutrientes/deficiência , Pessoa de Meia-Idade , População Rural , Adulto Jovem
7.
BMC Med Educ ; 19(1): 157, 2019 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-31113419

RESUMO

BACKGROUND: Proper hygienic practices are important in preventing nosocomial infection. This study aimed to determine knowledge, attitudes and practices (KAP) on hand, attire and equipment hygiene during clinical training among medical students at a State Medical Institution in Sri Lanka. METHODS: This cross-sectional study was conducted among 3rd, 4th and final (5th) year medical students of the Faculty of Medicine, University of Colombo, who had undergone at least 6 months of clinical training. KAP on hand hygiene (HH), attire hygiene (AH) and equipment hygiene (EH) were assessed using a pre-tested, self-administered questionnaire with a Likert-type scale. KAP scores were graded as follows: good ≥75; moderate:74.9-50; unsatisfactory:49.9-25; poor:< 25%. KAP based on duration of training and gender were compared using independent samples t-tests. RESULTS: Three hundred thirty-three students participated (mean age 24 ± 1.1 years, male: female = 1: 1.2). Combined KAP scores on hand and attire hygiene were moderate (HH:73%, AH:65%) while equipment hygiene was unsatisfactory (EH:47%). Senior students (5th year) had higher combined KAP and knowledge (K) on hand hygiene (HH KAP 75% vs. 72%, p = 0.01; K:72% vs. 67%, p = 0.001) and equipment hygiene (EH KAP 50% vs. 44%, p = 0.001; K:47% vs. 35%, p = 0.001) compared to junior students (3rd/ 4th years). However, they had lower KAP and P scores on attire hygiene (AH KAP 63% vs. 67%, p = 0.006; P:60% vs. 67%, p = 0.004). Female students had better AH compared to male students (KAP:67% vs. 64% p = 0.01; K 71% vs. 66%, p = 0.048; P:66% vs. 62%, p = 0.05). CONCLUSIONS: Overall, hand hygiene was moderate among medical students and improved with progression of training. Attire hygiene was also graded as moderate but to a lesser extent compared to hand hygiene, lower in males, and declined over time, indicating need for better reinforcement of attire hygiene practices with progression of clinical training. Equipment hygiene was unsatisfactory among most medical students and thus needs to be highlighted as a potential area to be improved during clinical training. This study suggests that knowledge, attitudes and practices on equipment and attire hygiene among medical students was less satisfactory and needs to receive greater emphasis during medical clinical training.


Assuntos
Infecção Hospitalar/prevenção & controle , Fidelidade a Diretrizes/estatística & dados numéricos , Higiene/normas , Estudantes de Medicina , Grupo com Ancestrais do Continente Asiático , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Higiene/educação , Masculino , Sri Lanka/epidemiologia , Adulto Jovem
8.
GMS J Med Educ ; 36(2): Doc15, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30993173

RESUMO

Objective: Insufficient hygiene knowledge increases the risk of hospital-acquired infections through insufficient compliance and therefore poses a potential risk to patient safety. Therefore in 2015 the teaching project "OT Training" was introduced at the Faculty of Medicine (MF) Leipzig and a restructuring of the series of lectures and practical training on the topic of "Hygiene" was developed and integrated in the medical study curriculum. Methodology: The "OT Training" in the pre-clinical component and the didactic restructuring of the hygiene workshops in the hospital semester were comprehensively developed by means of the currently applicable learning objective catalogues and have already been tested in existing teaching (per year N=320 students; 2015-17: N= 960). The "OT Training" and the series of lectures and practical training are evaluated externally by the Faculty of Medicine. In addition a self-developed questionnaire (for "OT Training") and an internal evaluation (for practical stations as part of the practical training series) were used. Results: Overall the "OT Training" was evaluated as "very good" (N=492; RR=51%). Alongside the high importance of hygiene in the hospital and operating area (Overallhospital=97% and OverallOperative area=98%) the salient feature of hygiene for self-protection and in particular for patient safety was also recognised at an early stage. Through the series of lectures and practical training which were also evaluated positively, the self-reported level of knowledge and the importance of hygiene for the students improved significantly (level of knowledge Mbefore=2.8 vs. Mafter=3.9; p>0.000; importance Mbefore=3.3 vs. Mafter=4.2; p>0.000; 5 point Likert scale; t-Test). Conclusion: Hygiene errors constitute a potential risk to patients. Consequently the early and continuous focus on hygiene in student education makes a contribution to increasing patient safety in the healthcare sector.


Assuntos
Educação Médica/normas , Higiene/educação , Competência Clínica/normas , Currículo/tendências , Humanos , Higiene/normas , Controle de Infecções/métodos , Controle de Infecções/normas , Segurança do Paciente/normas , Inquéritos e Questionários
9.
Int Marit Health ; 70(1): 68-75, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30931521

RESUMO

BACKGROUND: Microbiological monitoring of surfaces used for food preparation, as required by the Hazard Analysis and Critical Control Points (HACCP) plan, is important in risky conditions as those observed in the kitchens of ships. Limits to introduce a classification of risk levels and methods to adopt in conditions as those occurring in tankers have not been investigated. This paper presents the results of the "Healthy Ship" project on HACCP monitoring of surfaces used in food preparation on Italian flag tankers. MATERIALS AND METHODS: Microbiological monitoring was carried out on 19 tankers between 2013 and 2017. Food handlers were also trained on board ship according to HACCP standards. Contact plates (ISO 18593:2004 compliant) were used to determine the colonies and bacterial charge according to the Wirtanen and Salo's method. RESULTS: A total of 1074 samples, 108 before the first course, 168 after the first course, 390 during the period of refresher (2015-2016), and 408 after the refresher training, were obtained from the three main kitchen surfaces: the worktop, cutting board, and kitchen sink. A good level of hygiene was observed in 56.9% of all samples, 0.1% were classified as adequate, and the remaining 43% as poor. The highest contamination was observed on the cutting board and kitchen sink and involved the total aerobic count. The only surface with inadequate levels of hygiene was the worktop. A reduction of contaminated samples was noted after training. CONCLUSIONS: Our results suggest that continuous training should be provided for personnel responsible for handling foodstuffs on board ships.


Assuntos
Manipulação de Alimentos/métodos , Microbiologia de Alimentos/estatística & dados numéricos , Inocuidade dos Alimentos , Navios , Carga Bacteriana/estatística & dados numéricos , Humanos , Higiene/educação , Itália , Medicina Naval/métodos
12.
Am J Trop Med Hyg ; 100(4): 988-997, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30834885

RESUMO

Feeding of infant formula using contaminated bottles may be an important transmission pathway of enteric pathogens during early life. Determinants of suboptimal bottle hygiene and the feasibility and acceptability of intervention strategies have not been well assessed. We evaluated the extent of bottle contamination, its contributing factors, and options for promoting improved bottle hygiene in a Peruvian shantytown. During Phase 1, we sampled from bottles and caregiver hands (n = 48) and processed for enumeration of total coliform and Escherichia coli colony-forming units. A semi-structured questionnaire captured bottle use and hygiene practices. Phase 2 involved the identification of candidate practices to recommend to caregivers. Phase 3 consisted of a behavioral trial in which 14 caregivers were educated about improved practices for bottle disinfection and later reported on their experiences implementing them. Fecal bacteria were detected in 43.8% of bottles sampled during Phase 1 and in 21.7% of hands. Caregivers overall did not use effective methods for disinfecting bottles, displayed misunderstandings surrounding hygienic practices, and few had ever discussed bottle hygiene with a health provider. Findings from the behavioral trial indicated that the improved practice of brushing the bottle with dish detergent for 30 seconds after every use is preferable to boiling the bottle for several minutes daily as caregivers reported that the brush was simple to use, efficient, and practical. The promotion of a bottle brush and detergent is a feasible and acceptable intervention strategy in peri-urban settings, and future research should evaluate its long-term effectiveness for reducing bottle contamination.


Assuntos
Alimentação Artificial/instrumentação , Cuidadores/educação , Desinfecção/métodos , Contaminação de Equipamentos/prevenção & controle , Higiene/normas , Adolescente , Adulto , Estudos de Coortes , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/prevenção & controle , Fezes/microbiologia , Feminino , Humanos , Higiene/educação , Lactente , Fórmulas Infantis/microbiologia , Mães , Adulto Jovem
13.
Environ Health Prev Med ; 24(1): 16, 2019 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-30851729

RESUMO

BACKGROUND: Soil-transmitted helminthes (STH) infections are among the most common infections worldwide and affect the most deprived communities. Adequate water, sanitation, and hygiene (WASH) prevents environmental contamination, thereby preventing transmission of STH. Cognizant of this, WASH education was implemented in rural Dembiya to reduce intestinal parasitic infections. This study was, therefore, conducted to assess the impacts of the intervention on households' WASH conditions and prevalence of intestinal parasitic infections. METHOD: An uncontrolled before-and-after intervention study was used. Cross-sectional studies were done before and after the intervention. Two hundred twenty-five and 302 under five children were recruited randomly at the baseline and endline, respectively. Data were collected using a structured questionnaire and observational checklists. Direct stool examination and Kato-Katz methods were used to identify parasites in the stool. We used percent point change and prevalence ratio (PR) to see the effects of the intervention on WASH conditions and prevalence of intestinal parasitic infections respectively. Pearson chi-squared and Fisher's exact tests were used to test for statistically significant percentage point changes of WASH conditions. The effect of the intervention on intestinal parasitic infections was statistically tested on the basis of PR with 95% confidence interval (CI). RESULTS: The baseline prevalence of intestinal parasitic infections was 25.8%, and the endline prevalence was 23.8%. The prevalence of intestinal parasitic infections was not significantly decreased at the endline compared with the baseline [PR = 0.92, 95% CI = (0.62, 1.38)]. Ascaris Lumbricoides was the most prevalent parasitic infection both at the baseline and endline. The proportion of children who had good hygienic condition increased from 1.3% at the baseline to 34.4% at the end line (p <  0.05). The percentage of mothers/care givers who washed hands at different pick times was significantly increased from 24.4% at the baseline to 68.2% at the endline (p <  0.001). The proportion of households who practiced home-based water treatment was significantly increased from 7.6% at the baseline to 47% at the endline (p <  0.001). The proportion of households who used sanitary latrine was increased from 32% at the baseline to 49% at the endline (p <  0.05). CONCLUSION: This before-and-after intervention study found that households' WASH performance was significantly improved at the endline compared with the baseline. The endline prevalence of intestinal parasitic infections was slightly lower than the baseline prevalence; however, the reduction was not statistically significant. The local health office needs to strengthen the WASH education program, mobilize the community to construct WASH facilities, and support the community to sustain households' WASH performance.


Assuntos
Água Potável/normas , Educação em Saúde , Helmintíase/prevenção & controle , Higiene , Enteropatias Parasitárias/prevenção & controle , Saneamento , Adulto , Pré-Escolar , Estudos Transversais , Água Potável/parasitologia , Etiópia/epidemiologia , Características da Família , Fezes/parasitologia , Feminino , Comportamentos Relacionados com a Saúde/fisiologia , Conhecimentos, Atitudes e Prática em Saúde , Helmintíase/epidemiologia , Humanos , Higiene/educação , Lactente , Enteropatias Parasitárias/epidemiologia , Masculino , Prevalência , População Rural , Solo/parasitologia , Inquéritos e Questionários
14.
PLoS Negl Trop Dis ; 13(1): e0006449, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30703087

RESUMO

School health and nutrition (SHN) programmes are recognized as a significant contributor to both health and education sector goals. The school system offers an ideal platform from which to deliver basic health interventions that target the most common health conditions affecting school-age children (SAC) in low-income countries, leading to improved participation and learning outcomes. However, governments require evidence to cost, design, and implement these programmes. In Ethiopia, prevalent health conditions affecting SAC's education participation and learning outcomes include infection with soil-transmitted helminths (STHs), hunger, and malnutrition. In recognition of the multiple issues affecting the health and education of SAC, the government has taken a proactive approach, coordinating an integrated SHN programme designed to be implemented in partnership and monitored and financed through a single, integrated mechanism. The programme, known as the Enhanced School Health Initiative (ESHI), integrates three complimentary health interventions: deworming; school feeding; and provision of a water, sanitation, and hygiene (WASH) package in schools, which in delivery aim to maximize the benefits of each of the individual components. Operational research surrounding the ESHI programme includes both qualitative and quantitative analyses. Here, we present an overview of the ESHI programme and its genesis. We also introduce three additional supporting papers that provide in-depth analyses of key findings, including the baseline situational analysis, the costs, and community perceptions of the programme. The findings from ESHI provide initial evidence to develop an understanding of the related costs and synergies of integrating multiple health interventions onto a single platform. The work has translated into strengthened institutional capacity and improved cross-sectoral coordination. The government is now committed to supporting 25 million school children in Ethiopia through SHN. The ESHI model serves as a reference point for other countries looking to scale up targeted SHN interventions.


Assuntos
Helmintíase/prevenção & controle , Higiene/educação , Avaliação de Programas e Projetos de Saúde , Serviços de Saúde Escolar , Animais , Criança , Pré-Escolar , Etiópia/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Helmintíase/epidemiologia , Helmintos/isolamento & purificação , Humanos , Estado Nutricional , Saneamento , Instituições Acadêmicas , Solo/parasitologia , Inquéritos e Questionários
15.
N Engl J Med ; 380(7): 638-650, 2019 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-30763195

RESUMO

BACKGROUND: Hospitalized patients who are colonized with methicillin-resistant Staphylococcus aureus (MRSA) are at high risk for infection after discharge. METHODS: We conducted a multicenter, randomized, controlled trial of postdischarge hygiene education, as compared with education plus decolonization, in patients colonized with MRSA (carriers). Decolonization involved chlorhexidine mouthwash, baths or showers with chlorhexidine, and nasal mupirocin for 5 days twice per month for 6 months. Participants were followed for 1 year. The primary outcome was MRSA infection as defined according to Centers for Disease Control and Prevention (CDC) criteria. Secondary outcomes included MRSA infection determined on the basis of clinical judgment, infection from any cause, and infection-related hospitalization. All analyses were performed with the use of proportional-hazards models in the per-protocol population (all participants who underwent randomization, met the inclusion criteria, and survived beyond the recruitment hospitalization) and as-treated population (participants stratified according to adherence). RESULTS: In the per-protocol population, MRSA infection occurred in 98 of 1063 participants (9.2%) in the education group and in 67 of 1058 (6.3%) in the decolonization group; 84.8% of the MRSA infections led to hospitalization. Infection from any cause occurred in 23.7% of the participants in the education group and 19.6% of those in the decolonization group; 85.8% of the infections led to hospitalization. The hazard of MRSA infection was significantly lower in the decolonization group than in the education group (hazard ratio, 0.70; 95% confidence interval [CI], 0.52 to 0.96; P=0.03; number needed to treat to prevent one infection, 30; 95% CI, 18 to 230); this lower hazard led to a lower risk of hospitalization due to MRSA infection (hazard ratio, 0.71; 95% CI, 0.51 to 0.99). The decolonization group had lower likelihoods of clinically judged infection from any cause (hazard ratio, 0.83; 95% CI, 0.70 to 0.99) and infection-related hospitalization (hazard ratio, 0.76; 95% CI, 0.62 to 0.93); treatment effects for secondary outcomes should be interpreted with caution owing to a lack of prespecified adjustment for multiple comparisons. In as-treated analyses, participants in the decolonization group who adhered fully to the regimen had 44% fewer MRSA infections than the education group (hazard ratio, 0.56; 95% CI, 0.36 to 0.86) and had 40% fewer infections from any cause (hazard ratio, 0.60; 95% CI, 0.46 to 0.78). Side effects (all mild) occurred in 4.2% of the participants. CONCLUSIONS: Postdischarge MRSA decolonization with chlorhexidine and mupirocin led to a 30% lower risk of MRSA infection than education alone. (Funded by the AHRQ Healthcare-Associated Infections Program and others; ClinicalTrials.gov number, NCT01209234 .).


Assuntos
Antibacterianos/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Clorexidina/uso terapêutico , Desinfecção , Staphylococcus aureus Resistente à Meticilina , Mupirocina/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Administração Intranasal , Adulto , Idoso , Portador Sadio , Comorbidade , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Seguimentos , Hospitalização/estatística & dados numéricos , Humanos , Higiene/educação , Controle de Infecções/métodos , Masculino , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Infecções Estafilocócicas/prevenção & controle , Infecções Estafilocócicas/transmissão
17.
Dev Neurorehabil ; 22(5): 329-337, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30060690

RESUMO

OBJECTIVE: This paper contributes to research investigating the effectiveness of video game intervention in shower training of children with autism spectrum disorders. Previous studies have supported the use of video games in special education. METHODS: We employed the Kinect sensor to gamify shower training. Specifically, a non-concurrent multiple baseline design was adopted to demonstrate the relation between game-based intervention and taking a shower independently. Six children in a special education class at a regular elementary school participated in the experiment. RESULTS: Data showed that the percentage of correct task steps significantly increased among all six participants; motivation to engage in training was enhanced as well, thus improving task performance during the intervention and maintenance phases. CONCLUSIONS: Although the game is a promising and highly accepted training tool for school-use, it currently remains error-prone, and the requested demand exceeds the support that can be provided by special education teachers. A more technically robust system, combined with additional attractive games, will likely result in higher participant motivation and superior task performance.


Assuntos
Transtorno Autístico/reabilitação , Higiene/educação , Reabilitação Neurológica/métodos , Autocuidado/métodos , Jogos de Vídeo , Criança , Humanos , Motivação
18.
J Infect Public Health ; 12(1): 70-76, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30262191

RESUMO

BACKGROUND: Workplaces are a common location for infectious disease transmission among adults. To provide recommendations regarding appropriate health promotion programs, we evaluated the impact of three different interventions on factory workers. METHODS: In a prospective intervention study carried out from October 2012 to June 2013, three factories were selected and each was assigned a different intervention method (i.e. self-study group, manager training group and interactional group discussion group). Participants were scored on their knowledge, behavior, and hygienic practices related to infectious disease prevention both before and after the intervention. RESULTS: A total of 1154 participants completed the survey before the intervention and 1111 completed the survey after. The sum infectious disease knowledge score in the manager training group was higher after the intervention (9.09/12) than before (8.63/12, t=4.47, p<0.05). There was no significant difference in sum infectious disease knowledge score pre and post intervention for both the self-study group and the interactional group discussion. CONCLUSIONS: Overall, change in health behaviors and hygiene practices were not as affected compared to changes in knowledge after interventions related to infectious disease health promotion. Training managers who then interact with workers may be an effective and efficient way of educating workers on health issues.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Controle de Infecções/métodos , Recursos Humanos , Adulto , Grupo com Ancestrais do Continente Asiático , China , Doenças Transmissíveis/transmissão , Feminino , Comportamentos Relacionados com a Saúde , Promoção da Saúde/estatística & dados numéricos , Humanos , Higiene/educação , Masculino , Instalações Industriais e de Manufatura , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários , Local de Trabalho , Adulto Jovem
19.
São Paulo; s.n; 2019. 190 p.
Tese em Português | LILACS, BDS | ID: biblio-987478

RESUMO

Esta pesquisa mostra o caminho percorrido pelo Instituto de Higiene de São Paulo para a sua consolidação no campo científico e político, entre 1916 e 1951. O personagem principal é o seu 3º diretor: o farmacêutico e médico Geraldo Horácio de Paula Souza, que teve destacada atuação nas negociações com a Fundação Rockefeller para a concretização do Instituto e, no gerenciamento daquele que se transformaria na Faculdade de Higiene e Saúde Pública da Universidade de São Paulo em 1945. A periodização é delimitada pelos primeiros acordos entre a Fundação Rockefeller e a Faculdade de Medicina e Cirurgia de São Paulo (1916) para a instalação do laboratório de higiene e a morte precoce de Paula Souza (1951), encerrando seus quase trinta anos à frente do antigo Instituto de Higiene. Esta consolidação se deu em três frentes de atuação: o ensino da higiene, a pesquisa científica na área e o atendimento à população, campos que deixaram legados para a saúde pública brasileira.


This research depicts the path taken by Instituto de Higiene de São Paulo, between 1916 and 1951, to consolidate itself in the scientific and political field. Our main character is the Institute's third director: Geraldo Horácio de Paula Souza. Being a pharmacist and a doctor, he played a major role negotiating with the Rockefeller Foundation for the consolidation of the Institute in Brazil, and also in the management of what would become the Faculdade de Higiene e Saúde Pública of the Universidade de São Paulo, in 1945. The timeline of our research is defined by the first agreements between the Rockefeller Foundation and the Faculdade de Medicina e Cirurgia de São Paulo (1916), for the creation of the laboratory of hygiene, and Paula Souzas's early death (1951) after leading the former Instituto de Higiene for almost thirty years. Such consolidation had three main areas of action: the teaching of hygiene, the scientific research on this field and providing healthcare for the population. Those three main areas left important legacies for the Brazilian public health.


Assuntos
Saúde Pública/história , Educação Superior , Instituições de Ensino Superior , Higiene/educação , Higiene/história
20.
Ann Ig ; 30(5 Supple 2): 1-6, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30374506

RESUMO

Although hospital hygiene has a long history in Italy it is necessary to reflect about it because of the innovation in healthcare systems and because of the evolution due to European Union related activities. Different traditions exist in European countries about hospital hygiene and European Centre for Disease Prevention and Control (ECDC) adopted the term of "infection control and hospital hygiene" which includes all the engaged European healthcare professionals. We propose to modify hospital hygiene as "healthcare organisation hygiene" in order to focalise the attention to all care settings not only hospitals and to adopt the following definition: "all activities aimed to guarantee, in an appropriate, scientifically sound and efficient way, that structures and processes support healthcare practices in a safe comfortable and healthy environment both for patients, caregivers and healthcare workers". Hospital hygiene and its professionals, besides the long tradition, still remain a relevant pillar in guaranteeing quality and safety of healthcare in Italy.


Assuntos
Infecção Hospitalar/prevenção & controle , Instalações de Saúde , Higiene , Controle de Infecções/organização & administração , Programas Nacionais de Saúde/organização & administração , Europa (Continente) , União Europeia , Humanos , Higiene/educação , Controle de Infecções/métodos , Itália , Terminologia como Assunto
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