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1.
BMC Public Health ; 19(1): 1680, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842809

RESUMO

BACKGROUND: Access to usable water, sanitation and hygiene provision in schools is included within indicators in the Sustainable Development Goals. Progress towards these indicators is dependent on developing an understanding of which intervention components are most effective to operate and maintain usable services. This study aimed to determine the impact of a school toilet operation and management intervention in the Philippines on toilet usability and student and teacher satisfaction, adjusted for clustering at school level. METHODS: In a non-blinded cluster randomised controlled trial, we compared improvements in usability and cleanliness of school toilets among those schools receiving a low-cost, replicable intervention. Toilet usability was measured based on Sustainable Development Goal indicators related to school sanitation defined by the UNICEF/WHO Joint Monitoring Programme for Water, Sanitation and Hygiene. Intervention schools received consumables, support kits, and structured tools designed to facilitate operation and maintenance of sanitation facilities. The primary outcome, toilet usability and cleanliness, was compared through a difference-in-difference analysis of toilet usability. Secondary outcomes of student and teacher satisfaction were measured through a survey at endline. All outcomes were adjusted for clustering at school level. RESULTS: 20 eligible schools in the Batangas region of the Philippines were randomly selected and allocated to either control or intervention group. We found that non-classroom toilets were 48% more likely to meet quality benchmarks in intervention schools, but this was not statistically significant. When including in-classroom toilets in the analysis, there were no significant differences in toilet usability - defined as accessible, functional, private and of high quality - between intervention and control schools. When stratified by toilet location, children in the intervention group clusters expressed a minor, but statistically significant increase in overall satisfaction with sanitation facilities (p = 0.035). CONCLUSION: Water, sanitation and hygiene interventions in schools focusing on operation and maintenance showed potential to improve toilet usability, but universal achievement of SDG targets may require additional efforts addressing toilet infrastructure. TRIAL REGISTRATION: ClinicalTrials.gov NCT03204175, June 2017 prior to participant enrolment.


Assuntos
Serviços de Saúde Escolar/organização & administração , Toaletes/normas , Criança , Feminino , Humanos , Higiene/normas , Masculino , Satisfação Pessoal , Filipinas , Avaliação de Programas e Projetos de Saúde , Saneamento/normas , Professores Escolares/psicologia , Instituições Acadêmicas , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Desenvolvimento Sustentável , Abastecimento de Água/normas
2.
Parasit Vectors ; 12(1): 503, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31665080

RESUMO

BACKGROUND: National deworming programmes rely almost exclusively on mass drug administration (MDA) to children to control morbidity caused by these parasitic infections. The provision of other interventions, consisting of preventive chemotherapy at high population level coverage together with water, sanitation and hygiene (WaSH) and changes in risk behaviour, should enable sustainable control of soil-transmitted helminths (STH) and schistosomiasis and ultimately interrupt transmission. METHODS/DESIGN: Two interventions will be implemented by the project: (i) community-wide biannual albendazole and annual praziquantel treatment with a target of 80-90% treatment coverage ("expanded MDA"); and (ii) provision of WaSH with behaviour change communication (BCC), within the Wolaita zone, Ethiopia. The project has three study arms: (i) expanded community-wide MDA, WaSH and BCC; (ii) expanded community-wide MDA only; and (iii) annual school-based MDA (the current National STH/schistosomiasis Control Programme). The impact of these interventions will be evaluated through prevalence mapping at baseline and endline (after four rounds of MDA), combined with annual longitudinal parasitological surveillance in defined cohorts of people to monitor trends in prevalence and reinfection throughout the project. Treatment coverage and individual compliance to treatment will be monitored by employing fingerprint biometric technology and barcoded identification cards at treatment. WaSH utilisation will be evaluated through school and household level observations and annual WaSH assessment survey. Complementary qualitative surveys will explore practices, cultural and social drivers of risk behaviours, uptake of WaSH and treatment, and assessing the impact of the BCC. DISCUSSION: The study has the potential to define an 'End Game' for STH and schistosomiasis programmes through provision of multiple interventions. Interrupting transmission of these infections would eliminate the need for long-term repeated MDA, lead to sustained health improvements in children and adults, thereby allowing health systems to focus on other disease control priorities.


Assuntos
Albendazol/administração & dosagem , Anti-Helmínticos/administração & dosagem , Helmintíase/prevenção & controle , Praziquantel/administração & dosagem , Esquistossomose/prevenção & controle , Adolescente , Criança , Pré-Escolar , Análise Custo-Benefício , Estudos Transversais , Demografia , Etiópia/epidemiologia , Comportamentos Relacionados com a Saúde , Helmintíase/epidemiologia , Helmintíase/transmissão , Humanos , Higiene/normas , Lactente , Estudos Longitudinais , Administração Massiva de Medicamentos/economia , Modelos Biológicos , Doenças Negligenciadas/prevenção & controle , Prevalência , Saneamento/normas , Esquistossomose/epidemiologia , Esquistossomose/transmissão , Instituições Acadêmicas , Solo/parasitologia , Inquéritos e Questionários , Abastecimento de Água/normas
3.
Artigo em Inglês | MEDLINE | ID: mdl-31581438

RESUMO

The purpose of this study was to identify and analyze consumer choices and service quality in university canteens in Warsaw. Our study consists of two parts. The first part of our research was conducted using a sample of 1250 adult respondents in 25 university canteens located at five higher education institutions. The reasons and frequency for using canteens, types of selected dishes and opinions on a given catering facility management system were analyzed. The second part of the study was conducted as an inspection to assess internal control and reliability of information. The respondents' opinions are not in line with inspection assessments. This may be due to the fact that students do not pay attention to the quality of services in university canteens or have little knowledge about service, quality of services or hygiene aspects. For a detailed analysis of consumer choices and service quality assessment, we used Analysis of Variance (ANOVA) test and multi-dimensional cluster analysis. We identified four clusters regarding the type of meals and consumed frequency of consumption in university canteens, and five profiles in relation to evaluation of canteen interior, service and menu. In the correspondence analysis performed using the multidimensional Multiple Correspondence Analysis (MCA) method, we identified five clusters of consumers based on nine features, i.e., canteen location, frequency of using the canteen, gender of respondents, dwelling place, financial status of respondents. Our research on the functioning of university canteens is one of the first not only in Poland, but also in the countries of Central and Eastern Europe. The evaluation of the quality of nutrition in canteens should be continued in order to prevent diet-related diseases. Based on the results of our research, we postulate to introduce an evaluation guide for university canteens taking into account various aspects of services.


Assuntos
Comportamento do Consumidor/estatística & dados numéricos , Serviços de Alimentação/organização & administração , Estudantes/psicologia , Universidades , Adulto , Feminino , Inocuidade dos Alimentos , Serviços de Alimentação/normas , Humanos , Higiene/normas , Masculino , Polônia , Reprodutibilidade dos Testes , Fatores Sexuais , Fatores Socioeconômicos
4.
Artigo em Inglês | MEDLINE | ID: mdl-31590312

RESUMO

Background: The Bishesta campaign is a menstrual hygiene management (MHM) intervention developed to meet the specific needs of people with intellectual impairments and their carers. It was designed and delivered in the Kavre district, Nepal. This paper explores the campaign's feasibility and acceptability. Methods: The Bishesta campaign was delivered to ten people with an intellectual impairment and their eight carers. Data on the feasibility and acceptability of the intervention was collected through: Structured questionnaire to participants before and after the intervention, process monitoring data, post-intervention in-depth interviews with all carers, observation of people with intellectual impairments, key informant interviews with all facilitators and staff involved in the campaign, as well as ranking of the perceived appropriateness and acceptability of campaign components by carers and facilitators. Results: The Bishesta campaign was acceptable for the target groups, facilitators, and implementers. It was largely delivered with fidelity. Participants used most of the campaign components; these made the target behaviours attractive and enabled participants to carry them out with ease. There were improvements across all target behaviours. The focus of this study was feasibility, not limited-efficancy; however, indicative positive outcomes from this small sample were observed, such as an increase in young people's levels of confidence, comfort, and autonomy during menstruation. Conclusion: Within the sample, the Bishesta campaign appears to be a feasible intervention to ensure that one of the groups most vulnerable to exclusion from MHM interventions is not left behind.


Assuntos
Cuidadores/educação , Educação de Pessoa com Deficiência Intelectual/organização & administração , Higiene/normas , Menstruação , Adolescente , Analgésicos/uso terapêutico , Países em Desenvolvimento , Estudos de Viabilidade , Feminino , Produtos de Higiene Feminina , Humanos , Nepal , Adulto Jovem
5.
BMC Public Health ; 19(1): 1066, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391023

RESUMO

BACKGROUND: Soil-transmitted helminth infection (STH) is one of the neglected tropical disease that affects approximately 2 billion people globally. School children represent the age group that is most commonly infected with STHs, resulting in poor school performance, impaired cognitive function, and many other detrimental effects. The transmission of STH is determined by many factors, such as hygiene and sanitation. Understanding the factors that influence disease transmission in a particular area is key to effective STH control. The objective of this study was to determine the prevalence of STH in North Sumatera and to identify the associated risk factors among school children. METHODS: A cross-sectional study was carried out among primary school children in Suka village, Tigapanah subdistrict. Stool samples were processed using a single Kato-Katz method. The potential risk factors analyzed were parent education and occupation, hand washing habits, latrine usage, footwear usage and contact with soil. The Chi-square test was performed to identify an association between risk factors and parasitological results. Logistic regression analysis was used to measure the strength of association. RESULTS: We enrolled 468 school children between 6 and 12 years of age. Among those children, 268 children (57.24%) were positive for one or more STH infections. Approximately 62.39% of children played with soil/dirt every day, and only 50% regularly washed their hands after activities. Most of the children wore shoes/slippers when going outside (87.82%) and used a latrine for defecation (85.04%). Playing with soil/dirt have been shown to increase the risk of STH infections 7.53 times, while hand washing habits and latrine usage decreased the risk of STH infections 0.16 times each. CONCLUSION: The prevalence of STH infection in school children in Suka village, Tigapanah subdistrict is still high. Playing with soil/dirt increased the risk of infection, while hand washing habits and latrine usage decreased the risk of infection. The combined strategies of improving the personal hygiene of children and biannual deworming can reduce the risk of STH infection in school children in Suka village, Tigapanah subdistrict.


Assuntos
Agricultura , Helmintíase/epidemiologia , Helmintíase/transmissão , Características de Residência/estatística & dados numéricos , Solo/parasitologia , Criança , Estudos Transversais , Fezes/parasitologia , Feminino , Humanos , Higiene/normas , Indonésia/epidemiologia , Masculino , Prevalência , Fatores de Risco , Toaletes/estatística & dados numéricos
6.
Health Res Policy Syst ; 17(1): 77, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382967

RESUMO

The Sanitation and Hygiene Applied Research for Equity (SHARE) Research Programme consortium is a programme funded by the United Kingdom Department for International Development (DFID) that aims to contribute to achieving universal access to effective, sustainable, and equitable sanitation and hygiene worldwide. The capacity development component is an important pillar for this programme and different strategies were designed and implemented during the various phases of SHARE. This paper describes and reflects on the capacity-building strategies of this large multi-country research consortium, identifying lessons learnt and proposing recommendations for future global health research programmes. In the first phase, the strategy focused on increasing the capacity of individuals and institutions from low- and middle-income countries in conducting their own research. SHARE supported six PhD students and 25 MSc students, and organised a wide range of training events for different stakeholders. SHARE peer-reviewed all proposals that researchers submitted through several rounds of funding and offered external peer-review for all the reports produced under the partner's research platforms. In the second phase, the aim was to support capacity development of a smaller number of African research institutions to move towards their independent sustainability, with a stronger focus on early and mid-career scientists within these institutions. In each institution, a Research Fellow was supported and a specific capacity development plan was jointly developed.Strategies that yielded success were learning by doing (supporting institutions and postgraduate students on sanitation and hygiene research), providing fellowships to appoint mid-career scientists to support personal and institutional development, and supporting tailored capacity-building plans. The key lessons learnt were that research capacity-building programmes need to be driven by local initiatives tailored with support from partners. We recommend that future programmes seeking to strengthen research capacity should consider targeted strategies for individuals at early, middle and later career stages and should be sensitive to other institutional operations to support both the research and management capacities.


Assuntos
Academias e Institutos/organização & administração , Fortalecimento Institucional/organização & administração , Higiene/normas , Pesquisa/organização & administração , Saneamento/métodos , África , Ásia , Países em Desenvolvimento , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Cooperação Internacional , Saneamento/normas , Reino Unido
7.
BMC Public Health ; 19(1): 1039, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375074

RESUMO

BACKGROUND: Interventions in India to improve menstrual health and hygiene management (MHHM) have been implemented at the national, state, district and school level. However, evaluations of these interventions have been scarce. The objective of the study was to determine if a social and behavioral change communication (SBCC) intervention (GARIMA) had a relationship with knowledge, attitudes, interpersonal communication, restrictions and MHHM using a comparison group post-test only design among 2206 adolescent girls. METHODS: Intervention villages and adolescent girls were selected through stratified random sampling based on where GARIMA was implemented. Villages and adolescent girls in comparison villages were matched socio-demographically to intervention villages and adolescent girls. Multi-level logistic regressions assessed the relationship between the encoded exposure, mediators and MHHM. RESULTS: The results showed that the encoded exposure predicted all behaviors corresponding to MHHM. Additionally, adolescent girls in the high encoded exposure group had significantly higher knowledge about puberty and reproductive parts (AOR: 2.03 (95% CI: 1.31 - 3.15)), positive attitudes towards gender (AOR: 1.48 (95% CI: 1.02 - 2.16)) and higher levels of some discussion and dialogue (AOR: 1.41 (95% CI: 1.04 - 1.92)). CONCLUSIONS: Future programs should use SBCC to improve MHHM behavior but involve families, peers and community members to a greater extent in order to improve attitudes towards menstruation, attitudes towards restrictions, attitudes towards absorbent use and reduce restrictions within the community.


Assuntos
Comunicação , Promoção da Saúde/métodos , Higiene/normas , Menstruação/psicologia , Mudança Social , Adolescente , Criança , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Índia , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários
8.
BMC Res Notes ; 12(1): 478, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375135

RESUMO

OBJECTIVE: Absence of latrine remains a common public health problem in most of the Sub-Saharan Africa countries. A cross-sectional study was conducted to assess the effect of community-led total sanitation and hygiene approach implementation and associated factors among villages of Laelai Maichew District, Tigray, and North Ethiopia. RESULTS: This study revealed that the rate of latrine use in the rural community of Laelai-Maichew district was about 46.8%. The majority, 71.1% of households in CLTSH implemented Villages and 93.5% of households in CLTSH non-implemented Villages did not have hand washing facility around their latrine. Community-led to total sanitation and hygiene non-implemented villages were 49% times less likely to utilize their latrine compared to those community-led total sanitation implemented villages [AOR = 0.51 95% CI (0.35, 0.75)]. Households owned latrines for two and above years were 1.5 more likely to utilize their latrine [AOR = 1.50 95% CI (1.21, 2.59)] than those of owning latrines for less than 2 years. In this study, latrine use rate was low. As a result, the local, national governmental and non-governmental organization should design programs to create behavioral changes on the community's attitude towards latrine utilization.


Assuntos
Higiene/normas , Saúde Pública/normas , População Rural/estatística & dados numéricos , Saneamento/normas , Adulto , Estudos Transversais , Etiópia , Feminino , Desinfecção das Mãos/métodos , Desinfecção das Mãos/normas , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , Saneamento/métodos , Inquéritos e Questionários , Toaletes/normas , Toaletes/estatística & dados numéricos
9.
BMC Public Health ; 19(1): 1028, 2019 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366398

RESUMO

BACKGROUND: The Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7) is a handwashing with soap and water treatment intervention program delivered by a health promoter bedside in a health facility and through home visits to diarrhea patients and their household members during the 7 days after admission to a health facility. In a randomized controlled trial among cholera patient households in Bangladesh, the 7-day CHoBI7 program resulted in a significant reduction in cholera among household members of cholera patients and sustained improvements in drinking water quality and handwashing with soap practices 12 months post-intervention. In an effort to take this intervention to scale across Bangladesh in partnership with the Bangladesh Ministry of Health and Family Welfare, this study evaluates the feasibility and acceptability of mobile health (mHealth) programs as a low-cost, scalable approach for CHoBI7 program delivery. METHODS: Formative research for the development of the CHoBI7 mHealth intervention included 40 semi-structured interviews, 4 mHealth workshops, 2 group discussions, and a pilot study of 52 households to assess the feasibility and acceptability of the developed mHealth program. Thematic analysis of the interviews and group discussions was conducted by two individuals separately based on emergent themes, and then themes were compared and discussed. RESULTS: A theory- and evidence-based approach using qualitative research methods was implemented to design the CHoBI7 mHealth program. Semi-structured interviews with government stakeholders identified perceptions and preferences for scaling the CHoBI7 mHealth program. Group discussions and semi-structured interviews with diarrhea patients and their family members identified beneficiary perceptions of mHealth and preferences for CHoBI7 mHealth program delivery. mHealth workshops were conducted as an interactive approach to draft and refine mobile message content based on stakeholder preferences. The pilot findings indicate that the CHoBI7 mHealth program has high user acceptability and is feasible to deliver to diarrhea patients that present at health facilities for treatment in Bangladesh. Both text and voice messages were recommended for program delivery. Dr. Chobi, the sender of mHealth messages, was viewed as a credible source of information that could be shared with others. CONCLUSION: This study presents a theory- and evidence-based approach that can be implemented for the development of future water, sanitation, and hygiene mHealth programs in low-resource settings.


Assuntos
Cólera/prevenção & controle , Diarreia/terapia , Higiene/normas , Desenvolvimento de Programas , Saneamento/normas , Telemedicina/organização & administração , Qualidade da Água/normas , Bangladesh , Características da Família , Estudos de Viabilidade , Feminino , Desinfecção das Mãos , Hospitais , Humanos , Masculino , Projetos Piloto , Pesquisa Qualitativa , Projetos de Pesquisa , Sabões
10.
Biomed Res Int ; 2019: 3868537, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31467889

RESUMO

Introduction: Personal hygiene is essential to the current paradigm shift towards predictive, preventive, and personalized medicine, which enables the prediction and prevention of infectious disease outbreaks. Objective: The aim of this paper was to evaluate the personal hygiene practices among university students aiming at providing a basis for preventive and predictive medical interventions and to make future efforts improve target interventions for young people. Methods: The study was conducted using a cross-sectional study. Validated instruments that related personal hygiene practices were used to obtain quantitative data from 412 tertiary students from seven universities in Accra, Ghana. The resulting data were analyzed with IBM-SPSS, version 23. Results: There were more female respondents (54.4%) in the study than male respondents (45.6%). Respondents between the age group of 19-24 years constituted majority (59.7%) of the respondents in the study. Respondents from urban areas exhibited good hygiene practice compared to those from urban residences. There was a significant association between residence and hygiene practice (χ 2=17.8, P≤0.001). We also observed that those respondents within the upper class in society had a poor hygiene practice, compared to the Lower Class and Middle Class respondents. Lack of education (63.1%) was observed as the main barrier to personal hygiene among the respondents. Future of the society depends on the health of its youth. Conclusion: A significant number of students are not actively practicing good hygiene. There is a need for deployment of preventive medicine interventions targeted at young people. It calls for improvement in methods of hygiene education for young people in tertiary institutions and the inclusion of hygiene in school curricula.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Higiene/normas , Estudantes , Universidades , Adulto , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Masculino , Autoavaliação , Inquéritos e Questionários , Adulto Jovem
11.
Ital J Pediatr ; 45(1): 77, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31272479

RESUMO

BACKGROUND: Under nutrition is linked with poor water, sanitation and hygiene (WASH) condition. However, there is conflicting evidence on the effect of WASH on nutritional status of children. This review was, therefore, conducted to estimate the pooled effect of WASH interventions on child under nutrition. METHODS: All published and unpublished cluster-randomized, non-randomized controlled trials, and before and after intervention studies conducted in developing countries were included. Relevant articles were searched from MEDLINE/PubMed, Cochrane Collaboration's database, Web of Science, WHO Global Health Library, Google Scholar, Worldcat and ProQuest electronic databases. The methodological quality of the included studies was assessed using JBI critical appraisal checklist for randomized and non-randomized controlled trials. The risk of bias was assessed using the Cochrane Collaboration's tool for assessing risk of bias in randomized trials. The treatment effect was expressed as standardized mean differences (SMD) with 95% confidence interval (CI). RESULTS: This meta-analysis of 10 studies including 16,473 children (7776 in the intervention and 8687 in the control group) indicated that WASH interventions significantly associated with increased pooled mean height-for-age-z-score (SMD = 0.14, 95% CI = (0.09, 0.19); I2 = 39.3%]. The effect of WASH on HAZ was heterogeneous in age and types of interventions. WASH intervention had more effect on HAZ among under two children [SMD = 0.20, 95% CI = (0.11, 0.29); I2 = 37%]. Children who received combined WASH interventions grew better compared with children who received single interventions [SMD = 0.15, 95% CI = (0.09, 0.20); I2 = 43.8%]. CONCLUSION: WASH interventions were significantly associated with increased mean height-for-age-z score in under 5 years old children. The effect of WASH on linear growth is markedly different with age and types of interventions, either single or combined. Implementing combined WASH interventions has a paramount benefit to improve nutritional status of children.


Assuntos
Desinfecção das Mãos/normas , Higiene/normas , Desnutrição/prevenção & controle , Estado Nutricional , Saneamento/normas , Qualidade da Água/normas , Abastecimento de Água/normas , Criança , Pré-Escolar , Países em Desenvolvimento , Humanos , Lactente , Recém-Nascido
12.
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
13.
BMC Health Serv Res ; 19(1): 458, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286934

RESUMO

BACKGROUND: The risk of cholera outbreak remains high in Cameroon. This is because of the persistent cholera outbreaks in neighboring countries coupled with the poor hygiene and sanitation conditions in Cameroon. The objective of this study was to assess the readiness of health facilities to respond to cholera outbreak in four cholera-prone districts in Cameroon. METHODOLOGY: A cross-sectional study was conducted targeting all health facilities in four health districts, labeled as cholera hotspots in Cameroon in August 2016. Data collection was done by interview with a questionnaire and by observation regarding the availability of resources and materials for surveillance and case management, access to water, hygiene, and sanitation. Data analysis was descriptive with STATA 11. PRINCIPAL FINDINGS: A total of 134 health facilities were evaluated, most of which (108/134[81%]) were urban facilities. The preparedness regarding surveillance was limited with 13 (50%) health facilities in the Far North and 22(20%) in the Littoral having cholera case definition guide. ORS for Case management was present in 8(31%) health facilities in the Far North and in 94(87%) facilities in the littoral. Less than half of the health facilities had a hand washing protocol and 7(5.1%) did not have any source of drinking water or relied on unimproved sources like lake. A total of 4(3.0%) health facilities, all in the Far North region, did not have a toilet. CONCLUSIONS: The level of preparedness of health facilities in Cameroon for cholera outbreak response presents a lot of weaknesses. These are present in terms of lack of basic surveillance and case management materials and resources, low access to WaSH. If not addressed now, these facilities might not be able to play their role in case there is an outbreak and might even turn to be transmission milieus.


Assuntos
Cólera/epidemiologia , Cólera/prevenção & controle , Surtos de Doenças/prevenção & controle , Instalações de Saúde/normas , Camarões/epidemiologia , Administração de Caso , Estudos Transversais , Desinfecção das Mãos/normas , Pesquisa sobre Serviços de Saúde , Humanos , Higiene/normas , Observação , Saneamento/normas , Inquéritos e Questionários , Abastecimento de Água/normas
14.
BMC Res Notes ; 12(1): 399, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31300042

RESUMO

OBJECTIVE: Food borne diseases are predominant in all parts of the world especially in urban areas and are the main source for food borne illness. The aim of this study is to assess sanitation status and its determinants among food establishments in Adwa town, North Ethiopia from March to June 2017. RESULTS: A total of 391 (95.4%) subjects were included in this study. Around 53.3% of food establishments in the study area were in a poor sanitary status. Presence of trained managers on hygiene and sanitation (AOR = 2.6, 95% CI 1.7-4.1); inspection by regulatory personnel (AOR = 1.95, 95% CI 1.36-22.4) and being licensed (AOR = 1.2 95% CI 1.11-2.51) were associated factors which affect sanitary status sanitary of the establishments. The overall sanitary status of the establishments in the study area was found unhygienic. Managers should gain trainings on food hygiene and sanitation to follow and improve the sanitary status of the establishments.


Assuntos
Manipulação de Alimentos/normas , Doenças Transmitidas por Alimentos/diagnóstico , Desinfecção das Mãos/normas , Saneamento/normas , Adulto , Idoso , Estudos Transversais , Etiópia/epidemiologia , Feminino , Alimentos/normas , Alimentos/estatística & dados numéricos , Manipulação de Alimentos/métodos , Manipulação de Alimentos/estatística & dados numéricos , Serviços de Alimentação/legislação & jurisprudência , Serviços de Alimentação/normas , Serviços de Alimentação/estatística & dados numéricos , Doenças Transmitidas por Alimentos/epidemiologia , Desinfecção das Mãos/métodos , Humanos , Higiene/normas , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Saneamento/estatística & dados numéricos , Inquéritos e Questionários , População Urbana/estatística & dados numéricos
15.
BMC Res Notes ; 12(1): 393, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31300055

RESUMO

OBJECTIVE: The study aimed to assess the sanitary condition of services and its implication for intestinal parasitic infections among prison inmates in eastern Tigrai, northern Ethiopia. RESULTS: We have assessed the availability and sanitary condition of services at Adigrat prison. Frequent water cuts and unavailability of soap in the prison have challenged prisoners and food handlers to maintain their hygiene. The living rooms were overcrowded and poorly ventilated besides to unsatisfactory kitchen rooms. The prevalence of intestinal parasites among the participants was 40% (108/270). The dominant parasite was Entamoeba histolytica/dispar (60, 22.2%) followed by Giardia lamblia, 39 (14.4%). The mixed infections of Entamoeba histolytica/dispar and Giardia lamblia were detected among 17 (6.3%) of the participants. In multivariate analysis, participants who were feeding in groups were more likely to harbor intestinal parasites than those who were feeding alone (AOR: 2.1; CI 1.05-4.3). Intestinal parasites are significant health problems to the prisoners of Adigrat prison with poor sanitation of services. Therefore, provision of necessary facilities such as hand washing basins, soaps, disinfectants, disinfestations, and food utensils could significantly reduce the burden of intestinal parasites in the prison.


Assuntos
Enteropatias Parasitárias/diagnóstico , Prisioneiros/estatística & dados numéricos , Prisões , Saneamento/normas , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Fezes/parasitologia , Feminino , Desinfecção das Mãos/métodos , Humanos , Higiene/normas , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Adulto Jovem
16.
Br J Nurs ; 28(13): 890-891, 2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31303049

RESUMO

Emeritus Professor Alan Glasper, University of Southampton, discusses strategies used to keep patients in hospital safe from infection.


Assuntos
Infecção Hospitalar/prevenção & controle , Controle de Infecções/métodos , Segurança do Paciente , Inglaterra , Armazenamento de Alimentos/normas , Serviço Hospitalar de Limpeza/normas , Humanos , Higiene/normas , Medicina Estatal
17.
BMC Public Health ; 19(1): 801, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31226957

RESUMO

BACKGROUND: Unimproved water, sanitation, and hygiene (WASH) behaviors are key drivers of infectious disease transmission and influencers of mental well-being. While WASH is seen as a critical enabler of health, important knowledge gaps related to the content and delivery of effective, holistic WASH programming exist. Corresponding impacts of WASH on mental well-being are also underexplored. There is a need for more robust implementation research that yields information regarding whether and how community-based, demand-side interventions facilitate progressive and sustained adoption of improved sanitation and hygiene behaviors and downstream health impacts. The purpose of this protocol is to detail the rationale and design of a cluster-randomized trial evaluating the impact of a demand-side sanitation and hygiene intervention on sustained behavior change and mental well-being in rural and peri-urban Amhara, Ethiopia. METHODS: Together with partners, we developed a theoretically-informed, evidence-based behavioral intervention called Andilaye. We randomly selected and assigned 50 sub-districts (kebeles) from three purposively selected districts (woredas); half to receive the Andilaye intervention, and half the standard of care sanitation and hygiene programming (i.e., community-led total sanitation and hygiene [CLTSH]). During baseline, midline, and endline, we will collect data on an array of behavioral factors, potential moderators (e.g., water and sanitation insecurity, collective efficacy), and our primary study outcomes: sanitation and hygiene behaviors and mental well-being. We will perform a process evaluation to assess intervention fidelity and related attributes. DISCUSSION: While CLTSH has fostered sanitation and hygiene improvements in Ethiopia, evidence of behavioral slippage, or regression to unimproved practices in communities previously declared open defecation free exists. Other limitations of CLTSH, such as its focus on disgust, poor triggering, and over-saturation of Health Extension Workers have been documented. We employed rigorous formative research and practically applied social and behavioral theory to develop Andilaye, a scalable intervention designed to address these issues and complement existing service delivery within Ethiopia's Health Extension Program. Evidence from this trial may help address knowledge gaps related to scalable alternatives to CLTSH and inform sanitation and hygiene programming and policy in Ethiopia and beyond. TRIAL REGISTRATION: This trial was registered with clinicaltrials.gov ( NCT03075436 ) on March 9, 2017.


Assuntos
Comportamentos Relacionados com a Saúde , Promoção da Saúde/organização & administração , Higiene/normas , Saúde Mental/estatística & dados numéricos , População Rural , Saneamento/normas , População Suburbana , Adulto , Criança , Pré-Escolar , Etiópia , Feminino , Humanos , Lactente , Masculino , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa , População Rural/estatística & dados numéricos , População Suburbana/estatística & dados numéricos
19.
Ig Sanita Pubbl ; 75(1): 51-61, 2019.
Artigo em Italiano | MEDLINE | ID: mdl-31185490

RESUMO

The Authors present their two-year experience regarding an evaluation of the hygienic quality of ready-to-eat foods in a hospital foodservice, both for patients' meals and hospital staff, prepared by using the Cook Chill system. According to the microbiological parameters provided by International Guidelines, 23 of 27 food samples that were collected and analyzed were found to be satisfactory, one was acceptable and only three were unsatisfactory (two for aerobic colony count and one both for aerobic colony count and hygienic procedure). Escherchia coli, Staphylococcus aureus, Salmonella, Listeria monocytogenes, and Clostridium perfringens were absent in all of the analyzed products, The study results are encouraging and confirm the need to always verify that the different phases of production of hospital meals are correctly implemented, even when the foodservice is out-sourced. This has always been considered a priority in the study hospital, where the Health Department is at the forefront both in control and verification of food safety practices and in offering training activities, especially in view of the increased susceptibility of hospitalized patients.


Assuntos
Contaminação de Equipamentos , Contaminação de Alimentos/análise , Serviços de Alimentação , Hospitais Universitários , Microbiologia de Alimentos , Serviços de Alimentação/normas , Humanos , Higiene/normas , Itália
20.
Global Health ; 15(1): 39, 2019 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196092

RESUMO

BACKGROUND: Although various organizations working in developed countries established the standards and approaches used in occupational hygiene, occupational hygiene professional interests and needs continue to develop in a global context. There is thus an urgent need for expanded occupational hygiene models. For successful field implementation, these models should be based on several sets of criteria, including those related to international standards, various national requirements, and multidisciplinary approaches. This is particularly important for countries in which no occupational hygiene model has been developed. This study thus examined the consensus on occupational hygiene standards among stakeholders in Turkey regarding the development of a national model. A modified Delphi study was conducted among key occupational health experts in Turkey who could aid in the relevant implementation, policy-making, and educational processes for such a model. Participants were selected from various governmental institutions, non-governmental organizations, trade unions, universities, and occupational health practices. RESULTS: The first-round findings were obtained from open-ended questions. The results revealed several requirements, including the adoption of an international hygiene definition, the official recognition of professional and practical areas in Turkish occupational hygiene, hygienist training methods, priorities, and competent institutions. Second-round findings indicated a consensus rate of over 80% regarding the need for implementation standards, training and education standards, requirements and priorities, and competent institutions for professionals working in the field of occupational hygiene. A third-round and SWOT analysis was also conducted among the group to confirm the consensus issues. CONCLUSIONS: The search for solutions and developmental expectations increases when awareness of internationalization and the need for common global standards increase. This developmental process may provide the basis for an appropriate model in developing countries.


Assuntos
Consenso , Saúde Global/normas , Higiene/normas , Modelos Organizacionais , Saúde do Trabalhador/normas , Técnica Delfos , Humanos , Turquia
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