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1.
Pan Afr Med J ; 39: 193, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34603574

RESUMO

Introduction: in the recent past, cities in sub-Saharan Africa have reported serious cholera outbreaks that last for several months. Uganda is one of the African countries where cities are prone to cholera outbreaks. Studies on cholera in Bangladesh show increased risk of cholera for the immediate household members (contacts) yet the control interventions mainly target cases with little or no focus on contacts. This study aimed to describe the rapid control of cholera outbreaks in Kampala and Mbale cities, Uganda, using, "Cases and Contacts Centered Strategy (3CS)" that consisted of identification and treatment of cases, promotion of safe water, sanitation, hygiene (WaSH) and selective chemoprophylaxis for the contacts. Methods: a cross-sectional study was conducted in 2015-2016 in the Kampala and Mbale cities during cholera outbreaks. Cholera cases were treated and 816 contacts from 188 households were listed and given cholera preventive packages. Data were collected, cleaned, analysed and stored in spreadsheet. Comparison of categories was done using Chi-Square test. Results: a total of 58 and 41 confirmed cholera cases out of 318 and 153 suspected cases were recorded in Kampala and Mbale cities respectively. The outbreaks lasted for 41 days in both cities. Case fatality rates were high; 12.1% (5/41) for Mbale city and 1.7% (1/58) for Kampala city. Fifty-five percent (210/379) of stool samples were tested by culture to confirm V. choleraeO1. No contacts listed and given cholera preventive package developed cholera. Both sexes and all age groups were affected. In Kampala city, the males were more affected than the females in the age groups less than 14 years, p-value of 0.0097. Conclusion: this study showed that by implementing 3CS, it was possible to rapidly control cholera outbreaks in Kampala and Mbale cities and no cholera cases were reported amongst the listed household contacts. The findings on 3CS and specifically, selective antibiotic chemoprophylaxis for cholera prevention, could be used in similar manner to oral cholera vaccines to complement the core cholera control interventions (disease surveillance, treatment of cases and WaSH). However, studies are needed to guide such rollout and to understand the age-sex differences in Kampala city.


Assuntos
Cólera/epidemiologia , Surtos de Doenças/prevenção & controle , Higiene/normas , Saneamento/normas , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Cólera/prevenção & controle , Vacinas contra Cólera/administração & dosagem , Cidades , Estudos Transversais , Água Potável/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Uganda/epidemiologia , Adulto Jovem
2.
Nat Commun ; 12(1): 5096, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34413294

RESUMO

Nearly all mass gathering events worldwide were banned at the beginning of the COVID-19 pandemic, as they were suspected of presenting a considerable risk for the transmission of SARS-CoV-2. We investigated the risk of transmitting SARS-CoV-2 by droplets and aerosols during an experimental indoor mass gathering event under three different hygiene practices, and used the data in a simulation study to estimate the resulting burden of disease under conditions of controlled epidemics. Our results show that the mean number of measured direct contacts per visitor was nine persons and this can be reduced substantially by appropriate hygiene practices. A comparison of two versions of ventilation with different air exchange rates and different airflows found that the system which performed worst allowed a ten-fold increase in the number of individuals exposed to infectious aerosols. The overall burden of infections resulting from indoor mass gatherings depends largely on the quality of the ventilation system and the hygiene practices. Presuming an effective ventilation system, indoor mass gathering events with suitable hygiene practices have a very small, if any, effect on epidemic spread.


Assuntos
Poluição do Ar em Ambientes Fechados/prevenção & controle , COVID-19/transmissão , Higiene/normas , SARS-CoV-2/patogenicidade , Ventilação/métodos , Aerossóis , COVID-19/diagnóstico , COVID-19/virologia , Simulação por Computador , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação
3.
Pan Afr Med J ; 39: 48, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422171

RESUMO

Lockdowns and just recently, the COVID-19 vaccines, are amongst the disease containment measures instituted globally to check the spread of COVID-19. Prolonged lockdowns are however, not sustainable in low resource economies like Nigeria, where up to 70% of her population live on less than a dollar a day, with the majority, either unemployed, or working in the private/informal sector and depending on daily earnings for survival. If the lockdown remains sustained, it would not be long before the largely poor citizens starve to death. Also, spending over US $3.9 billion on COVID-19 vaccines for more than 200 million Nigerians, as intended by the Nigerian government, is not plausible, given that neglected tropical diseases (NTDs) like Lassa fever, and other more common causes of morbidity and mortality, continue to kill more Nigerians than COVID-19. Public enlightenment of the populace on the need to strictly adhere to non-pharmacologic preventive measures, including social distancing, use of face masks, good personal hygiene, covering of the mouth and nose when coughing and sneezing, frequent hand washing and sanitizing with alcohol-based hand-sanitizers and disinfection of surfaces, is what is sustainable, feasible and compatible with the economic reality in our setting. As Sir Robert Hutchison, the highly revered doyen of medicine, wrote in his petition over 85 years ago, "And from making the cure of the disease more grievous than the endurance of the same, Good Lord, deliver us", we must be careful not to make the cure of COVID-19 worse than COVID-19 itself.


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , COVID-19/economia , Vacinas contra COVID-19/economia , Controle de Doenças Transmissíveis/métodos , Países em Desenvolvimento , Humanos , Higiene/normas , Máscaras , Nigéria , Distanciamento Físico
4.
S Afr Fam Pract (2004) ; 63(1): e1-e3, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-34212751

RESUMO

In the wake of the coronavirus disease 2019 (COVID-19) pandemic, the links between poor hygiene, unclean environments and human health cannot be overemphasised, particularly in South Africa with its high incidence of infectious diseases and overburdened health system. One very controllable factor that is often overlooked is the poor disposal of litter and waste management and its adverse effects on public health. By wearing masks, regular handwashing and sanitising, as well as making sure that neighbourhoods and public spaces are clean and safe, the spread of COVID-19 and other diseases can be prevented.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis/organização & administração , Saúde Ambiental/organização & administração , Recuperação e Remediação Ambiental , Saúde Pública/métodos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Higiene/normas , Condições Sociais , Determinantes Sociais da Saúde , África do Sul/epidemiologia
6.
Pan Afr Med J ; 38: 293, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34178212

RESUMO

Introduction: following the global COVID-19 outbreak, the government of Benin implemented preventive measures to stall viral transmission. We sought to evaluate adherence of the Beninese people to these preventive measures, in order to identify predictors of poor adherence and adapt the national response to COVID-19. Methods: two consecutive online surveys were conducted between May and August 2020. Four hundred and sixty two and 507 adult participants aged 18 years and above responded to the first and second survey respectively, with >70% being males. Results: more than 98% of respondents reported wearing face masks. A five-point adherence score was constituted by scoring observance to key preventive measures (mask use, physical distancing, hand hygiene, coughing hygiene and avoiding to touch one´s face). We observed that the mean adherence scores were fairly stable over time, respectively 4.08 and 4.03 during the first and second survey (p=0.439). Increasing age (aOR=1.043, 95% CI: 1.026 - 1.061; p<0.001) and obtaining COVID-19 information from official sources (aOR=1.628, 95% CI: 1.275 - 2.081; p<0.001) were significantly associated with higher adherence scores in a multivariable model. Conclusion: these findings suggest that a wide dissemination of adequate information about COVID-19 would increase adherence, and that targeted efforts should be directed towards increasing the compliance to preventive measures among the younger age groups.


Assuntos
COVID-19/prevenção & controle , Fidelidade a Diretrizes/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Saúde Pública , Adulto , Fatores Etários , Benin/epidemiologia , COVID-19/epidemiologia , Estudos Transversais , Surtos de Doenças , Feminino , Humanos , Higiene/normas , Disseminação de Informação , Masculino , Inquéritos e Questionários , Adulto Jovem
7.
Int J Hyg Environ Health ; 235: 113756, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34004452

RESUMO

BACKGROUND: Schools, depending on their access to and quality of water, sanitation and hygiene (WASH) and the implementation of healthy behaviours, can be critical for the control and spread of many infectious diseases, including COVID-19. Schools provide opportunities for pupils to learn about the importance of hygiene and WASH-related practice, and build healthy habits and skills, with beneficial medium- and long-term consequences particularly in low- and middle-income countries: reducing pupils' absenteeism due to diseases, promoting physical, mental and social health, and improving learning outcomes. WASH services alone are often not sufficient and need to be combined with educational programmes. As pupils disseminate their acquired health-promoting knowledge to their (extended) families, improved WASH provisions and education in schools have beneficial effects also on the community. International organisations frequently roll out interventions in schools to improve WASH services and, in some cases, train pupils and teachers on safe WASH behaviours. How such interventions relate to local school education on WASH, health promotion and disease prevention knowledge, whether and how such knowledge and school books are integrated into WASH education interventions in schools, are knowledge gaps we fill. METHODS: We analyzed how Kenyan primary school science text book content supports WASH and health education by a book review including books used from class 1 through class 8, covering the age range from 6 to 13 years. We then conducted a rapid literature review of combined WASH interventions that included a behaviour change or educational component, and a rapid review of international policy guidance documents to contextualise the results and understand the relevance of books and school education for WASH interventions implemented by international organisations. We conducted a content analysis based on five identified thematic categories, including drinking water, sanitation, hygiene, environmental hygiene & health promotion and disease risks, and mapped over time the knowledge about WASH and disease prevention. RESULTS: The books comprehensively address drinking water issues, including sources, quality, treatment, safe storage and water conservation; risks and transmission pathways of various waterborne (Cholera, Typhoid fever), water-based (Bilharzia), vector-related (Malaria) and other communicable diseases (Tuberculosis); and the importance of environmental hygiene and health promotion. The content is broadly in line with internationally recommended WASH topics and learning objectives. Gaps remain on personal hygiene and handwashing, including menstrual hygiene, sanitation education, and related health risks and disease exposures. The depth of content varies greatly over time and across the different classes. Such locally available education materials already used in schools were considered by none of the WASH education interventions in the considered intervention studies. CONCLUSIONS: The thematic gaps/under-representations in books that we identified, namely sanitation, hygiene and menstrual hygiene education, are all high on the international WASH agenda, and need to be filled especially now, in the context of the current COVID-19 pandemic. Disconnects exist between school book knowledge and WASH education interventions, between policy and implementation, and between theory and practice, revealing missed opportunities for effective and sustainable behaviour change, and underlining the need for better integration. Considering existing local educational materials and knowledge may facilitate the buy-in and involvement of teachers and school managers in strengthening education and implementing improvements. We suggest opportunities for future research, behaviour change interventions and decision-making to improve WASH in schools.


Assuntos
Água Potável/normas , Educação em Saúde , Higiene/normas , Saneamento/normas , Adolescente , Criança , Controle de Doenças Transmissíveis , Doenças Transmissíveis/transmissão , Currículo/estatística & dados numéricos , Desinfecção das Mãos/normas , Comportamentos Relacionados com a Saúde , Educação em Saúde/estatística & dados numéricos , Promoção da Saúde , Humanos , Quênia , Instituições Acadêmicas , Livros de Texto como Assunto
8.
BMC Infect Dis ; 21(1): 495, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34049512

RESUMO

BACKGROUND: The literature examining healthcare-associated infections (HAI) points to two main problems in conforming to infection prevention and control (IPC) guidelines among healthcare professionals (HP). One is the discrepancy between HPs' behavioral intentions and their implementation in practice. The other refers to how HPs maintain these practices after the intervention stage ends. The method proposed in this study seeks to address both these issues by using the Positive Peviance (PD) approach to focus on the dissemination stage of interventions. The study seeks to offer a method for disseminating 27 PD practices to 135 HPs, among them nurses, nurse assistants and physicians, so as to help them maintain IPC guidelines, offer feedback on the dissemination process and examine the impact of the dissemination stage on changes in their behavior. METHODS: The theoretical model underlying this qualitative research was the Recognition-Primed dDecision (RPD) model, which we implemented in the field of healthcare-associated infections (HAIs). Moreover, we used the Discovery & Action Dialogue (DAD) and Think Aloud (TA) techniques to describe the methodological development of simulations for HPs. Feedback from the HP demonstrators underwent content analysis, while descriptive statistics were used to characterize behavioral changes. RESULTS: HPs' information processing regarding infection prevention shifts from peripheral/automatic processing to intuition and analytical/central processing, turning PD practices into positive norms. The HPs personally experienced finding a solution and made repeated corrections until they overcame the barriers. Most of the HPs (69.4%) reported that the practices were fully implemented, together with additional practices. CONCLUSIONS: Implementation of the dissemination stage indicates that in order for HPs to integrate and assimilate practices that are not in the official guidelines, merely observing simulations is not sufficient. Rather, each staff member must personally carry out the procedures.


Assuntos
Infecção Hospitalar/prevenção & controle , Fidelidade a Diretrizes , Pessoal de Saúde , Controle de Infecções/métodos , Guias de Prática Clínica como Assunto , Normas Sociais , Adulto , Idoso , Continuidade da Assistência ao Paciente/normas , Atenção à Saúde/normas , Feminino , Humanos , Higiene/normas , Masculino , Pessoa de Meia-Idade , Motivação , Pesquisa Qualitativa , Inquéritos e Questionários , Adulto Jovem
9.
PLoS One ; 16(4): e0250696, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33930036

RESUMO

BACKGROUND: While lactation is a physiological process requiring high energy demand to fulfill the nutrient requirements of the mother and the breastfeeding child, many factors affecting maternal nutrient intake can lead to nutritional deficits. Previous studies in Ethiopia have reported the prevalence of maternal and child undernutrition and related complications. However, qualitative studies exploring potential barriers to utilizing available nutrition interventions are limited. This study, therefore, sought to qualitatively explore barriers hindering the uptake of nutrition services among lactating mothers from rural communities in Tigray, northern Ethiopia. METHODS: We conducted 6 in-depth interviews, 70 key informant interviews, and 13 focus group discussions among purposively selected community groups, experts, and lactating mothers between November- 2017 and January- 2018. Audio records of all interviews and focus group discussions were transcribed verbatim (word-to-word) and translated into English. Then, translated data were analyzed thematically using qualitative data analysis software Atlas ti-version 7.4. RESULTS: The participants in this study perceived that lactating mothers in their study area are not properly utilizing available and recommended nutrition interventions, and as a result, their nutrient intake was reported as inadequate. Participants identified inadequate accessibility and availability of foods, feeding practices, cultural and religious influences, focus on agricultural production and productivity, barriers related to health services and poor access to water, sanitation and hygiene as major barriers hindering the uptake of nutrition interventions by lactating women in Tigray, northern Ethiopia. CONCLUSION: The uptake of nutrition intervention services was low among lactating mothers and was hindered by multiple socio-cultural and health service related factors requiring problem-specific interventions at community, health facility, and administrative levels to improve the nutritional status of lactating mothers in the study area.


Assuntos
Mães/psicologia , Estado Nutricional , Adulto , Carência Cultural , Atenção à Saúde , Etiópia , Feminino , Grupos Focais , Humanos , Higiene/normas , Entrevistas como Assunto , Conhecimento , Lactação , População Rural , Saneamento/normas
10.
Pediatr. aten. prim ; 23(89): 83-86, ene.-mar. 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-202619

RESUMO

La escabiosis o sarna es la infestación cutánea por el ácaro Sarcoptes scabiei var. hominis, cuyo diagnóstico generalmente es clínico, pudiendo confirmarse mediante el test de Müller o, de forma sencilla y fiable, mediante estudio dermatoscópico. Se presenta un caso representativo de escabiosis en lactante y los hallazgos dermatoscópicos patognomónicos en un lactante de 6 meses de edad. Con la sospecha de escabiosis se realizó estudio con dermatoscopia de luz polarizada, confirmando el diagnóstico al visualizar surcos acarinos y lesiones en ala delta. Además, se realizó el test de Müller, observando el ácaro en el examen directo al microscopio óptico tras raspado de piel lesionada. Con este caso se pretende recordar la clínica típica con las características distintivas de la escabiosis en lactantes, y los principales métodos que permiten confirmar el diagnóstico, con especial relevancia de la dermatoscópica como técnica sencilla e inocua


Scabies, a skin infestation caused by Sarcoptes scabiei var. hominis, is generally easy to diagnose because of its characteristic clinical features. The diagnosis can be confirmed by the Müller test or by dermoscopy, a non-invasive, painless, and highly accurate technique. We present a representative case of infantile scabies with pathognomonic dermoscopic findings, in a 6-month-old girl referred for evaluation of a 2-week dermatitis. Under suspicion of scabies, a dermoscopy examination was performed, confirming the diagnosis by showing a distinctive dermoscopic feature composed of a S-shaped furrow with a triangle on one of its endings, known as delta wing jet sign. In addition, Müller test was performed, observing the mite on direct microscope examination after scraping one of the skin injuries. This case is a reminder of the typical clinical presentation of scabies in infants and the main methods that allow us to confirm the diagnosis. We want to highlight the usefulness of dermoscopy, as it is a simple and innocuous technique


Assuntos
Humanos , Lactente , Escabiose/diagnóstico , Escabiose/tratamento farmacológico , Testes Cutâneos/métodos , Microscopia Óptica não Linear , Sarcoptes scabiei/parasitologia , Diagnóstico Diferencial , Prurido/etiologia , Prurido/parasitologia , Microscopia de Polarização/métodos , Permetrina/administração & dosagem , Creme para a Pele/administração & dosagem , Higiene/normas , Sensibilidade e Especificidade
11.
Vet Med Sci ; 7(4): 1254-1262, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33645902

RESUMO

The study was conducted from June to August 2014 in Isiolo Central division of Isiolo Sub-County and Sericho division of Garbatulla Sub-County and comprised two components: (i) a cross-sectional study on the milk-handling hygiene practices, where milk traders' households were the study units and (ii) a case-control study on the risk factors for Brucella spp. infection in humans. Results of the cross-sectional study showed that 26.74% of the respondents never washed their hands before milking, 60.47% never washed the udder before milking and 54.65% never withhold consumption of milk from animals under treatment with antibiotics. The case-control study included household units with previous cases of brucellosis (53.33%) and those without (46.67%) over the previous 5 years and identified drinking of raw milk as the main risk factor for infection (OR = 26.44; 95% CI: 8.04-86.99). Pastoralists' unhygienic handling of milk from production to market is suboptimal and this is due to poor knowledge on hygienic practices, poor knowledge on the risks associated with poor milk hygiene and lack of sufficient and potable water for cleaning of milk containers. Many pastoralists still consume milk raw and this is a major public health risk for milk-borne diseases.


Assuntos
Brucelose/veterinária , Fazendeiros/estatística & dados numéricos , Higiene/normas , Leite , Animais , Estudos de Casos e Controles , Estudos Transversais , Quênia/epidemiologia , Fatores de Risco
12.
Optom Vis Sci ; 98(3): 250-257, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33771954

RESUMO

SIGNIFICANCE: Scleral lenses have become a widely used treatment option for patients with irregular corneas and ocular surface disease. Successful wear entails use of a nonpreserved saline solution to fill the lens before application on the eye. PURPOSE: The purposes of this study were to evaluate solution from opened bottles of multidose preservative-free saline for microbiological growth and to better understand study participant hygiene habits while handling these bottles for scleral lens wear. METHODS: Eligible study participants in this single-center prospective study were patients who routinely used multidose preservative-free saline solution for scleral lens rinsing and filling. Study participants completed a 12-question survey regarding their scleral lens hygiene habits and donated their opened multidose preservative-free saline bottle (PuriLens Plus; The Lifestyle Company, Inc., Freehold, NJ), which was processed for bacterial and fungal cultures. RESULTS: Thirty-five participants (19 males, 16 females) with ages ranging from 6 to 81 years (mean, 47.9 years) were included. Indications for scleral lens wear included those with irregular corneas and ocular surface disease. The overall rate of microbial contamination among saline samples was 62.9% (n = 22). Twenty-one different microorganisms were identified. The survey responses did not differ significantly (P > .05) for any of the questions with regard to likelihood of positive culture. There were no significant age or sex differences between participants with positive or negative culture results. No significant differences were found between isolation of specific microorganisms and any of the survey responses. CONCLUSIONS: This study suggests that off-label multidose preservative-free saline commonly used to rinse and fill scleral lenses before application on the eye may become contaminated with microorganisms once the bottle has been opened. Eye care practitioners and scleral lens patients should be aware of these potential contaminations and prioritize lens, hand, and environmental hygiene to minimize the risk of ocular complications.


Assuntos
Bactérias/isolamento & purificação , Lentes de Contato , Contaminação de Medicamentos , Higiene/normas , Solução Salina , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Contagem de Colônia Microbiana , Soluções para Lentes de Contato , Feminino , Hábitos , Humanos , Masculino , Pessoa de Meia-Idade , Conservantes Farmacêuticos , Estudos Prospectivos , Esclera , Adulto Jovem
13.
BMC Public Health ; 21(1): 502, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33722207

RESUMO

BACKGROUND: There is a lack of research investigating the confluence of risk factors in urban slums that may make them accelerators for respiratory, droplet infections like COVID-19. Our working hypothesis was that, even within slums, an inverse relationship existed between living density and access to shared or private WASH facilities. METHODS: In an exploratory, secondary analysis of World Bank, cross-sectional microdata from slums in Bangladesh we investigated the relationship between intra-household population density (crowding) and access to private or shared water sources and toilet facilities. RESULTS: The analysis showed that most households were single-room dwellings (80.4%). Median crowding ranged from 0.55 m2 per person up to 67.7 m2 per person. The majority of the dwellings (83.3%), shared both toilet facilities and the source of water, and there was a significant positive relationship between crowding and the use of shared facilities. CONCLUSION: The findings highlight the practical constraints on implementing, in slums, the conventional COVID19 management approaches of social distancing, regular hand washing, and not sharing spaces. It has implications for the management of future respiratory epidemics.


Assuntos
COVID-19/transmissão , Aglomeração , Características da Família/etnologia , Áreas de Pobreza , Bangladesh/epidemiologia , Estudos Transversais , Humanos , Higiene/normas , Fatores de Risco , SARS-CoV-2 , Saneamento/normas , Toaletes/normas , População Urbana
14.
Asia Pac J Public Health ; 33(4): 378-387, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33593075

RESUMO

Toilet hygiene is an important preventive measure for infectious diseases, including severe acute respiratory syndrome (SARS) and COVID-19. This study explored public's opinions on improving toilet environment and hygiene practices in Hong Kong. A mixed-method approach was applied. We conducted 4 focus groups plus 3 individual interviews among the Hong Kong Chinese, followed by a questionnaire survey with 300 respondents recruited from various districts. Difference in response distributions between groups with different demographics was tested by Pearson χ2 test. Instead of advocating for advanced toilet facilities, respondents were mostly concerned about basic hygiene issues. Malfunctioning facilities resulting from poor toilet management, such as clogged toilets, stained facilities, and problematic flushing systems, were most cited as barriers to toilet hygiene practices. Three quarters of the survey respondents expressed concerns over worn and poorly maintained toilets, shortage of janitors, and cleansing supplies. However, respondents who were older (P < .001), less educated (P < .001), and had lower income (P = .001) were significantly more likely to find hygiene conditions in public toilets satisfactory. The findings reflected the substandard of the current provisions as a developed city in Asia. Enhanced efforts by the government to maintain basic toilet supplies and facilities is the key to improving public compliance to toilet hygiene practices.


Assuntos
Higiene/normas , Opinião Pública , Toaletes/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/prevenção & controle , Cidades , Controle de Doenças Transmissíveis , Feminino , Grupos Focais , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
15.
J Med Internet Res ; 23(3): e24804, 2021 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-33617458

RESUMO

BACKGROUND: The COVID-19 pandemic poses a major challenge to people's everyday lives. In the context of hospitalization, the pandemic is expected to have a strong influence on affective reactions and preventive behaviors. Research is needed to develop evidence-driven strategies for coping with the challenges of the pandemic. Therefore, this survey study investigates the effects that personality traits, risk-taking behaviors, and anxiety have on medical service-related affective reactions and anticipated behaviors during the COVID-19 pandemic. OBJECTIVE: The aim of this study was to identify key factors that are associated with individuals' concerns about hygiene in hospitals and the postponement of surgeries. METHODS: We conducted a cross-sectional, web-based survey of 929 residents in Germany (women: 792/929, 85.3%; age: mean 35.2 years, SD 12.9 years). Hypotheses were tested by conducting a saturated path analysis. RESULTS: We found that anxiety had a direct effect on people's concerns about safety (ß=-.12, 95% CI -.20 to -.05) and hygiene in hospitals (ß=.16, 95% CI .08 to .23). Risk-taking behaviors and personality traits were not associated with concerns about safety and hygiene in hospitals or anticipated behaviors. CONCLUSIONS: Our findings suggest that distinct interventions and information campaigns are not necessary for individuals with different personality traits or different levels of risk-taking behavior. However, we recommend that health care workers should carefully address anxiety when interacting with patients.


Assuntos
COVID-19/psicologia , Hospitais/normas , Higiene/normas , Adulto , COVID-19/epidemiologia , Estudos Transversais , Feminino , Humanos , Internet , Masculino , Pandemias , SARS-CoV-2/isolamento & purificação , Inquéritos e Questionários
16.
Eur J Med Res ; 26(1): 2, 2021 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-33390175

RESUMO

BACKGROUND: Despite the significant reductions in under-five mortality, campylobacteriosis has emerged as one of the most common causative agents of bacterial foodborne gastroenteritis in humans. We performed this systematic review and meta-analysis to estimate the pooled prevalence of Campylobacter species and associated risk factors among children less than 5 years of age in Ethiopia. METHODS: A systematic search was conducted on PubMed, Web of Science, EMBASE, Google Scholar and the Cochrane Library. All identified observational studies reporting the prevalence and determinants of diarrhea among children under 5 years of age in Ethiopia were included. Two authors independently extracted data and analyzed them using STATA Version 13 statistical software. A random-effects model was computed to estimate the pooled prevalence and the associations between determinant factors and campylobacteriosis. RESULTS: Out of 166 papers reviewed, 8 studies fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of Campylobacter species among children under 5 years of age in Ethiopia was 10% (95% CI: 7, 13). Contact with domestic animals (OR: 3.2, 95% CI: 2.0, 5.1), illiterate mothers (OR: 2.1, 95% CI: 1.1, 3.8), consumption of animal products (OR: 1.7, 95% CI: 0.7, 4.5), and status of mothers' personal hygiene (OR: 1.1, 95% CI: 0.7, 1.8) were significantly associated with the prevalence of Campylobacter species. CONCLUSION: In our study, Campylobacter species among children under 5 years of age in Ethiopia were significantly high. Contact with domestic animals, illiterate mothers and consumption of animal products were significantly associated with prevalence of Campylobacter species.


Assuntos
Campylobacter/patogenicidade , Diarreia/epidemiologia , Animais , Animais Domésticos/microbiologia , Campylobacter/isolamento & purificação , Pré-Escolar , Diarreia/microbiologia , Etiópia/epidemiologia , Feminino , Humanos , Higiene/normas , Lactente , Recém-Nascido , Mães , Fatores de Risco
17.
Lancet Glob Health ; 9(3): e361-e365, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33444550

RESUMO

The public health community has tried for decades to show, through evidence-based research, that safe water, sanitation, and hygiene (WASH) and clean cooking fuels that reduce household air pollution are essential to safeguard health and save lives in low-income and middle-income countries. In the past 40 decades, there have been many innovations in the development of low-cost and efficacious technologies for WASH and household air pollution, but many of these technologies have been associated with disappointing health outcomes, often because low-income households have either not adopted, or inconsistently adopted, these technologies. In this Viewpoint, we argue that public health researchers (ourselves included) have had an oversimplified understanding of poverty; our work has not focused on insights into the lived experience of poverty, with its uncertainties, stresses from constant scarcity, and attendant fears. Such insights are central to understanding why technologies for safe water or clean cooking are unused by so many households that could benefit from them. We argue that, rather than improved versions of household-scale delivery models, transformative investments in safe water and clean cooking for all require utility-scale service models. Until then, research should focus on interim safe water and clean cooking options that are directed towards the utility-scale service model.


Assuntos
Culinária/métodos , Países em Desenvolvimento , Água Potável , Higiene/normas , Saneamento/métodos , Poluição do Ar em Ambientes Fechados/prevenção & controle , Humanos
18.
JMIR Public Health Surveill ; 7(1): e19349, 2021 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-33443485

RESUMO

BACKGROUND: Water access, sanitation, and hygiene (WASH) remain a public health concern in Indonesia. Proper WASH practices can decrease risk of stunting, wasting, and disease in children under the age of 2. OBJECTIVE: The purpose of our study is to examine if using technology to access health information and services among Indonesian women affects knowledge and behaviors regarding handwashing and defecation practices. METHODS: Our study is an interview-based cross-sectional survey. Participants included 1734 mothers of children under 2 years of age. These women were randomly selected and interviewed as part of a 3-stage cluster sampling technique. Our study uses data regarding WASH knowledge which includes benefits of handwashing with soap, 5 critical times of handwashing, risks of open defecation, media of disease transmission, defecation locations, and risks of open defecation. Data regarding WASH behaviors were also included: handwashing with soap, type of latrine used at home, and where defecation took place. This investigation used adjusted and unadjusted logistic and linear regression models to determine differences in WASH outcomes between those who use technology to access health information and services and those who did not. RESULTS: One result is that Indonesian women with children under 2 years of age who use technology to access health information and services are more likely to know the advantages of proper handwashing (odds ratio [OR] 2.603, 95% CI 1.666-4.067) and know the 5 critical times of handwashing (OR 1.217, 95% CI 0.969-1.528). Women who use technology to access health information are also more likely to know the risks of open defecation (OR 1.627, 95% CI 1.170-2.264) and use a type of toilet (such as a gooseneck or squat toilet) that limits risk (OR 3.858, 95% CI 2.628-5.665) compared to women who did not use technology to access health information. CONCLUSIONS: Using technology to access health information and services was associated with an increase in handwashing and defecation knowledge. In the future, promoting mothers of children under 2 years of age to access health information through technology might be used to increase handwashing and defecation knowledge as well as safe defecation practices. However, further research should be done to determine how technology may increase the frequency of recommended handwashing behaviors.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Higiene/normas , Informática Médica , Saneamento/estatística & dados numéricos , Abastecimento de Água/estatística & dados numéricos , Estudos Transversais , Feminino , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/prevenção & controle , Humanos , Indonésia/epidemiologia , Lactente
19.
PLoS Med ; 18(1): e1003260, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33428636

RESUMO

BACKGROUND: The Gambia has high rates of under-5 mortality from diarrhoea and pneumonia, peaking during complementary-feeding age. Community-based interventions may reduce complementary-food contamination and disease rates. METHODS AND FINDINGS: A public health intervention using critical control points and motivational drivers, delivered February-April 2015 in The Gambia, was evaluated in a cluster randomised controlled trial at 6- and 32-month follow-up in September-October 2015 and October-December 2017, respectively. After consent for trial participation and baseline data were collected, 30 villages (clusters) were randomly assigned to intervention or control, stratified by population size and geography. The intervention included a community-wide campaign on days 1, 2, 17, and 25, a reminder visit at 5 months, plus informal community-volunteer home visits. It promoted 5 key complementary-food and 1 key drinking-water safety and hygiene behaviours through performing arts, public meetings, and certifications delivered by a team from local health and village structures to all villagers who attended the activities, to which mothers of 6- to 24-month-old children were specifically invited. Control villages received a 1-day campaign on domestic-garden water use. The background characteristics of mother and clusters (villages) were balanced between the trial arms. Outcomes were measured at 6 and 32 months in a random sample of 21-26 mothers per cluster. There were no intervention or research team visits to villages between 6 and 32 months. The primary outcome was a composite outcome of the number of times key complementary-food behaviours were observed as a proportion of the number of opportunities to perform the behaviours during the observation period at 6 months. Secondary outcomes included the rate of each recommended behaviour; microbiological growth from complementary food and drinking water (6 months only); and reported acute respiratory infections, diarrhoea, and diarrhoea hospitalisation. Analysis was by intention-to-treat analysis adjusted by clustering. (Registration: PACTR201410000859336). We found that 394/571 (69%) of mothers with complementary-feeding children in the intervention villages were actively involved in the campaign. No villages withdrew, and there were no changes in the implementation of the intervention. The intervention improved behaviour adoption significantly. For the primary outcome, the rate was 662/4,351(incidence rate [IR] = 0.15) in control villages versus 2,861/4,378 (IR = 0.65) in intervention villages (adjusted incidence rate ratio [aIRR] = 4.44, 95% CI 3.62-5.44, p < 0.001), and at 32 months the aIRR was 1.17 (95% CI 1.07-1.29, p = 0.001). Secondary health outcomes also improved with the intervention: (1) mother-reported diarrhoea at 6 months, with adjusted relative risk (aRR) = 0.39 (95% CI 0.32-0.48, p < 0.001), and at 32 months, with aRR = 0.68 (95% CI 0.48-0.96, p = 0.027); (2) mother-reported diarrhoea hospitalisation at 6 months, with aRR = 0.35 (95% CI 0.19-0.66, p = 0.001), and at 32 months, with aRR = 0.38 (95% CI 0.18-0.80, p = 0.011); and (3) mother-reported acute respiratory tract infections at 6 months, with aRR = 0.67 (95% CI 0.53-0.86, p = 0.001), though at 32 months improvement was not significant (p = 0.200). No adverse events were reported. The main limitations were that only medium to small rural villages were involved. Obtaining laboratory cultures from food at 32 months was not possible, and no stool microorganisms were investigated. CONCLUSIONS: We found that low-cost and culturally embedded behaviour change interventions were acceptable to communities and led to short- and long-term improvements in complementary-food safety and hygiene practices, and reported diarrhoea and acute respiratory tract infections. TRIAL REGISTRATION: The trial was registered on the 17th October 2014 with the Pan African Clinical Trial Registry in South Africa with number (PACTR201410000859336) and 32-month follow-up as an amendment to the trial.


Assuntos
Diarreia/prevenção & controle , Manipulação de Alimentos/normas , Doenças Transmitidas por Alimentos/prevenção & controle , Promoção da Saúde/métodos , Higiene/normas , Infecções Respiratórias/prevenção & controle , Diarreia/epidemiologia , Diarreia/microbiologia , Água Potável/microbiologia , Feminino , Doenças Transmitidas por Alimentos/epidemiologia , Gâmbia/epidemiologia , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Masculino , Motivação , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Saúde da População Rural , Microbiologia da Água
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