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1.
Sci Total Environ ; 738: 139495, 2020 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-32957261

RESUMO

Evidence of exposure to enteric pathogens through the air and associated risk of infection is scarce in the literature outside of animal- or human-waste handling settings. Cities with poor sanitation are important locations to investigate this aerial exposure pathway as their rapid growth will pose unprecedented challenges in waste management. To address this issue, simple surveillance methods are needed. Therefore, the objectives of this study were to optimize a community exposure bioaerosol surveillance strategy for urban outdoor locations with poor sanitation, and to determine which bioaerosols could contribute to exposure. Passive and active bioaerosol sampling methods were used to characterize the fate and transport of sanitation-related bioaerosols during the rainy and dry seasons in La Paz, Bolivia. Median coliform bacteria fluxes were 71 CFU/(m2 × h) during the rainy season and 64 CFU/(m2 × h) during the dry season, with 38% of the dry season samples testing positive for E. coli. Wind speed, relative humidity and UVB irradiance were identified as significant covariates to consider in bioaerosol transport models in La Paz. Active sampling yielded one positive sample (10%) for human adenovirus (HadV) and one sample (10%) for influenza A virus during the rainy season. HadV was detected at the site with the highest bacterial flux. Four samples (8%) were positive for influenza A virus in the dry season. These findings suggest that aerosols can contribute to community exposure to potentially pathogenic microorganisms in cities with poor sanitation. The use of passive sampling, despite its limitations, can provide quantitative data on microorganisms' viability within realistic timeframes of personal exposure.


Assuntos
Saúde Única , Saneamento , Aerossóis , Microbiologia do Ar , Animais , Bolívia , Cidades , Estudos Transversais , Escherichia coli , Humanos
2.
Water Sci Technol ; 82(3): 537-548, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32960798

RESUMO

The present paper deals with the improvement of infrastructure asset management of urban drainage systems (UDS). A numerical tool for assessing the existing management procedures is proposed. It is based on a participatory methodology for the construction of a set of performance indicators. This methodology consists of two phases. The first concerns the identification of priority objectives, criteria and indicators related to the management of the UDS infrastructure. The second phase concerns the assessment of the global performance for each identified objective. Performance measurement scales are first defined for all the elements of the proposed methodology. Then, the Fuzzy Analytical Hierarchy Process (FAHP) is used for the weighting stage, and the Weighted Sum Method is used for the aggregation of indicators and criteria. To illustrate this methodology, a case study concerning Bejaia City in northern Algeria was carried out. Two priority objectives are identified for this case, they are divided into 6 criteria and 31 indicators. The results of the application of the developed tool highlighted some weaknesses that need improvements in the actual management procedure applied by the local sanitation services.


Assuntos
Saneamento , Argélia , Cidades
3.
Infect Dis Poverty ; 9(1): 124, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867851

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) was confirmed in Brazil in February 2020. Since then, the disease has spread throughout the country, reaching the poorest areas. This study analyzes the relationship between COVID-19 and the population's living conditions. We aimed to identify social determinants related to the incidence, mortality, and case fatality rate of COVID-19 in Brazil, in 2020. METHODS: This is an ecological study evaluating the relationship between COVID-19 incidence, mortality, and case fatality rates and 49 social indicators of human development and social vulnerability. For the analysis, bivariate spatial correlation and multivariate and spatial regression models (spatial lag model and spatial error models) were used, considering a 95% confidence interval and a significance level of 5%. RESULTS: A total of 44.8% of municipalities registered confirmed cases of COVID-19 and 14.7% had deaths. We observed that 56.2% of municipalities with confirmed cases had very low human development (COVID-19 incidence rate: 59.00/100 000; mortality rate: 36.75/1 000 000), and 52.8% had very high vulnerability (COVID-19 incidence rate: 41.68/100 000; mortality rate: 27.46/1 000 000). The regression model showed 17 indicators associated with transmission of COVID-19 in Brazil. CONCLUSIONS: Although COVID-19 first arrived in the most developed and least vulnerable municipalities in Brazil, it has already reached locations that are farther from large urban centers, whose populations are exposed to a context of intense social vulnerability. Based on these findings, it is necessary to adopt measures that take local social aspects into account in order to contain the pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Determinantes Sociais da Saúde , Adolescente , Brasil/epidemiologia , Criança , Pré-Escolar , Intervalos de Confiança , Infecções por Coronavirus/mortalidade , Educação , Emprego , Humanos , Incidência , Renda , Longevidade , Análise Multivariada , Pandemias , Pneumonia Viral/mortalidade , Pobreza , Análise de Regressão , Saneamento , Esgotos , Condições Sociais , Análise Espacial , Abastecimento de Água/normas , Adulto Jovem
4.
Wei Sheng Yan Jiu ; 49(4): 540-545, 2020 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-32928345

RESUMO

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


Assuntos
Água Potável , Metais Pesados , Cidades , Humanos , Saneamento , Abastecimento de Água
5.
Ig Sanita Pubbl ; 76(2): 119-129, 2020.
Artigo em Italiano | MEDLINE | ID: mdl-32877396

RESUMO

The Authors present the results of an experience carried out in a University General Hospital, for the assessment of the sanitation of surfaces and instruments in the context of hospital refection. A specific procedure has been quarterly implemented in order to verify the correct execution of the sanitization procedures. In the time-period September 2016 - March 2020 Petri dishes and tampons were used in order to determine the following microbiological parameters and indicators: total bacterial load at 30 degrees C, Coliforms, Listeria monocytogenes, Salmonella spp, Staphylococcus aureus, Escherichia coli and mycetic load. Only 7 out of 82 sanitized surfaces (8.5% of the total) were found to be not complying, only for total bacterial load at 30 degrees C, mycetic load and Coliforms. The systematic application of this procedure and the results of the survey conducted, comforting as a whole, confirm the attention reserved to the hygienic level of surfaces, tools, equipment and utensils, in the context of the centralized catering service of the hospital, in which the Health Department, sharing with the UOC Hospital Hygiene the specific hygienic procedure, has always been at the forefront of the proposal of interventions, considering the increased susceptibility and vulnerability of the hospitalized patients.


Assuntos
Hospitais Universitários/normas , Higiene/normas , Saneamento/normas , Humanos , Listeria monocytogenes
6.
Artigo em Inglês | MEDLINE | ID: mdl-32927793

RESUMO

Public health has been under continuous threat worldwide in recent years. This study examined the impact of social support and social trust on the activities and efficacy of the public's risk response in the case of COVID-19. We conducted an online survey over eight days with 620 Korean adult participants. Data were analyzed using structural equation modelling and K-means cluster analysis. Our results showed that public support had a positive impact on response efficacy, while response efficacy had a positive impact on sanitation, distancing, and purchasing activities. In addition, social support positively moderated the impact of public and individual support on response efficacy, while response efficacy negatively moderated the impact on sanitation activities. These results suggest that, first, amid viral risk, governments should proactively supply tools and information for infection-prevention, and deliver messages that encourage and support infection-prevention activities among the public. Second, when viral risk occurs, governments, along with all other members of society, must engage in aggressive risk response measures. Third, there is a need for risk communication that further emphasizes the importance of personal sanitation activities in the face of viral risk.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Opinião Pública , Confiança , Adulto , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Humanos , República da Coreia , Saneamento , Isolamento Social , Inquéritos e Questionários
7.
Environ Res ; 189: 109936, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32980018

RESUMO

COVID-19 is an active pandemic that likely poses an existential threat to humanity. Frequent handwashing, social distancing, and partial or total lockdowns are among the suite of measures prescribed by the World Health Organization (WHO) and being implemented across the world to contain the pandemic. However, existing inequalities in access to certain basic necessities of life (water, sanitation facility, and food storage) create layered vulnerabilities to COVID-19 and can render the preventive measures ineffective or simply counterproductive. We hypothesized that individuals in households without any of the named basic necessities of life are more likely to violate the preventive (especially lockdown) measures and thereby increase the risk of infection or aid the spread of COVID-19. Based on nationally-representative data for 25 sub-Saharan African (SSA) countries, multivariate statistical and geospatial analyses were used to investigate whether, and to what extent, household family structure is associated with in-house access to basic needs which, in turn, could reflect on a higher risk of COVID-19 infection. The results indicate that approximately 46% of the sampled households in these countries (except South Africa) did not have in-house access to any of the three basic needs and about 8% had access to all the three basic needs. Five countries had less than 2% of their households with in-house access to all three basic needs. Ten countries had over 50% of their households with no in-house access to all the three basic needs. There is a social gradient in in-house access between the rich and the poor, urban and rural richest, male- and female-headed households, among others. We conclude that SSA governments would need to infuse innovative gender- and age-sensitive support services (such as water supply, portable sanitation) to augment the preventive measures prescribed by the WHO. Short-, medium- and long-term interventions within and across countries should necessarily address the upstream, midstream and downstream determinants of in-house access and the full spectrum of layers of inequalities including individual, interpersonal, institutional, and population levels.


Assuntos
Infecções por Coronavirus/epidemiologia , Armazenamento de Alimentos , Pneumonia Viral/epidemiologia , Saneamento , Abastecimento de Água , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , África do Sul , Água
8.
J UOEH ; 42(3): 237-249, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32879188

RESUMO

Access to water and sanitation remain a challenge in many developing countries, especially in pro-poor urban informal settlements where socioeconomic livelihoods are generally low. The aim of this study was to characterise the water and sanitation facilities in the informal settlements of Kisumu City and to evaluate their effect on community hygiene and health. The study focussed on the five urban informal settlements of Nyalenda A, Nyalenda B, Manyatta A, Manyatta B and Obunga, and the three Peri-urban informal settlements of Kogony, Usoma and Otonglo. Using descriptive techniques, the researcher surveyed 114 water sources and all sanitation facilities within 0-15 m and 15-30 m radii of the water sources. The findings revealed dominance of shallow wells and traditional pit latrines as the primary water sources and sanitation facilities, respectively. Out of the water sources studied, 87.7% (100) were shallow wells (mean depth 1.5 m), 9.6% (11) springs and 2.6% (3) boreholes. Most of these shallow wells (83%) were within the urban informal settlements where uses range from washing and cleaning, cooking, and even drinking (13.5%), despite the majority being unprotected. The analysis of the density of sanitation facilities near the water points showed that 32.3% existed within a 15 m radius of the nearest water sources, in violation of the recommended safe distance of 30 m. With an increased density of toilets near critical water sources and other sanitary practices, public health is highly compromised.


Assuntos
Planejamento em Saúde , Pobreza , Saneamento , Classe Social , Toaletes , Saúde da População Urbana , Abastecimento de Água , Humanos , Quênia
9.
PLoS One ; 15(7): e0236924, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735608

RESUMO

BACKGROUND: Soil-transmitted helminth (STH) infections have many negative health outcomes (e.g., diarrhea, nutritional deficiencies) that can also exacerbate poverty. These infections are generally highest among low-income populations, many of which are also undergoing market integration (MI; increased participation in a market-based economy). Yet the direct impact of MI-related social and environmental changes on STH infection patterns is poorly understood, making it unclear which lifestyle factors should be targeted to better control disease spread. This cross-sectional study examines if household infrastructure associated with greater MI is associated with lower STH burdens among Indigenous Ecuadorian Shuar. METHODS: Kato-Katz fecal smears were used to determine STH infection status and intensity (n = 620 participants; 308 females, 312 males, aged 6 months-86 years); Ascaris lumbricoides (ascarid) and Trichuris trichiura (whipworm) were the primary infection types detected. Structured interviews assessing lifestyle patterns (e.g., measures of household infrastructure) measured participant MI. Multilevel regression analyses and zero-inflated negative binomial regression models tested associations between MI measures and STH infection status or intensity, controlling for individual and community characteristics. RESULTS: Participants residing in more market-integrated households exhibited lower infection rates and intensities than those in less market integrated households. Parasite infection status and T. trichiura infection intensity were lower among participants living in houses with wood floors than those with dirt floors, while individuals using well or piped water from a spring exhibited lower A. lumbricoides infection intensities compared to those using river or stream water. Unexpectedly, latrine type was not significantly related to STH infection status or intensity. These results suggest that sources of exposure differ between the two helminth species. CONCLUSIONS: This study documents associations between household measures and STH infection among an Indigenous population undergoing rapid MI. These findings can help healthcare programs better target interventions and reduce STH exposure among at-risk populations.


Assuntos
Fezes/parasitologia , Helmintíase , Pobreza/estatística & dados numéricos , Solo/parasitologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Ascaríase/epidemiologia , Ascaríase/transmissão , Ascaris lumbricoides/isolamento & purificação , Criança , Pré-Escolar , Estudos Transversais , Equador/epidemiologia , Características da Família , Feminino , Helmintíase/epidemiologia , Helmintíase/transmissão , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Grupos Populacionais/estatística & dados numéricos , Prevalência , Fatores de Risco , Saneamento/estatística & dados numéricos , Inquéritos e Questionários , Toaletes/estatística & dados numéricos , Tricuríase/epidemiologia , Tricuríase/transmissão , Trichuris/isolamento & purificação , Adulto Jovem
10.
PLoS One ; 15(8): e0233325, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756562

RESUMO

Antibiotics discovery was a significant breakthrough in the field of therapeutic medicines, but the over (mis)use of such antibiotics (in parallel) caused the increasing number of resistant bacterial species at an ever-higher rate. This study was thus devised to assess the multi-drug resistant bacteria present in sanitation-related facilities in human workplaces. In this regard, samples were collected from different gender, location, and source-based facilities, and subsequent antibiotic sensitivity testing was performed on isolated bacterial strains. Four classes of the most commonly used antibiotics i.e., ß-lactam, Aminoglycosides, Macrolides, and Sulphonamides, were evaluated against the isolated bacteria. The antibiotic resistance profile of different (70) bacterial strains showed that the antibiotic resistance-based clusters also followed the grouping based on their isolation sources, mainly the gender. Twenty-three bacterial strains were further selected for their 16s rRNA gene based molecular identification and for phylogenetic analysis to evaluate the taxonomic evolution of antibiotic resistant bacteria (ARB). Moreover, the bacterial resistance to Sulphonamides and beta lactam was observed to be the most and to Aminoglycosides and macrolides as the least. Plasmid curing was also performed for multidrug resistant (MDR) bacterial strains, which significantly abolished the resistance potential of bacterial strains for different antibiotics. These curing results suggested that the antibiotic resistance determinants in these purified bacterial strains are present on respective plasmids. Altogether, the data suggested that the human workplaces are the hotspot for the prevalence of MDR bacteria and thus may serve as the source of horizontal gene transfer and further transmission to other environments.


Assuntos
Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Farmacorresistência Bacteriana Múltipla , Toaletes , Local de Trabalho , Bactérias/genética , Farmacorresistência Bacteriana Múltipla/genética , Microbiologia Ambiental , Feminino , Humanos , Higiene , Masculino , Exposição Ocupacional , Paquistão , Filogenia , Plasmídeos , Prevalência , Fatores R , RNA Ribossômico 16S/genética , Saneamento
11.
Washington, D.C.; PAHO; 2020-08-18.
em Inglês | PAHO-IRIS | ID: phr-52586

RESUMO

This document was inspired by the need to promote comprehensive actions in the management of water and sanitation services with a human rights focus within the Sustainable Development Goals (SDG) related to drinking water, sanitation and hygiene (WASH) in the countries of Latin America and the Caribbean; in addition, it ratifies the results reported in a PAHO study (2016) on the profound inequalities between urban and rural areas in access to water and sewage services, and the correlation with characteristics such as gender, age, income, education, among others. This report assumed this challenge using a methodology based on the Human Rights to Safe Drinking Water and Sanitation (HRWS) analytical framework. This report seeks to provide the most up-to-date overview of the SDG targets 6.1 and 6.2 situation in Latin America and the Caribbean. Besides outlining the general situation of countries, it presents some elements regarding human rights and the targets 6.1 and 6.2 that have been neglected in the initial monitoring of the 2030 Agenda, above all, the dimensions of inequality and affordability. This report presents four case studies, one per sub-regional block, with a more detailed characterization of the national and subnational situations of Colombia, Brazil, Mexico, and the Dominican Republic. The results of this study show that a significant proportion of the Latin American and Caribbean population still lacks adequate access to water and sanitation services. Only 65% of the population has access to safely managed water services, a percentage lower than that reported worldwide, which is 71%. With regard to safely managed sanitation services, the situation is even more critical, with an access level of 39% worldwide being reported, compared to 22% in our Region.


Assuntos
Desenvolvimento Sustentável , Equidade em Saúde , Saneamento , Indicadores de Desigualdade em Saúde , México , República Dominicana , Brasil , Colômbia , Distribuição da Água , Abastecimento de Água
12.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(8): 888-891, 2020 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-32842319

RESUMO

From June 2017 to June 2018, female sanitation workers engaged in road cleaning in a district of Urumqi City, as well as government and logistics women participating in national health examination in the same community were recruited as particulate matter 2.5 (PM2.5) exposure group and control group respectively. The contents of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in the PM2.5 exposed group were lower than those in the control group (all P values < 0.05). Further analysis showed that the content of FSH in the exposure group at the age of 35-39, 40-44 and 45-49 years old was lower than that of the control group (all P values < 0.05). The content of LH in the exposed group at the age of 35-39 and 45-49 years old was lower than that of the control group (all P values < 0.05). The content of FSH in the exposed group with the length of service less than 5, about 5-9 and more than 10 years was lower than that of the control group (all P values < 0.05). The content of LH in the exposed group with the length of service about 5-9 and more than 10 year was lower than that of the control group (all P values < 0.05).


Assuntos
Hormônio Luteinizante , Saneamento , Feminino , Hormônio Foliculoestimulante , Hormônios Esteroides Gonadais , Humanos , Material Particulado
14.
J Environ Manage ; 271: 111004, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32778289

RESUMO

To provide access to sustainable sanitation for the entire world population, novel technologies and systems have been developed. These options are often independent of sewers, water, and energy and therefore promise to be more appropriate for fast-growing urban areas. They also allow for resource recovery and and are adaptable to changing environmental and demographic conditions what makes them more sustainable. More options, however, also enhance planning complexity. Structured decision making (SDM) can help balance opposing interests. Yet, most of the current research focuses on the selection of a preferred option, assuming that a set of appropriate options is available. There is a lack of reproducible methods for the identification of sanitation system planning options that can consider the growing number of available technology and the many possible system configurations. Additionally, there is a lack of data, particularly for novel options, to evaluate the various sustainability criteria for sanitation.To overcome this limitation, we present a novel software supported approach: the SANitation sysTem Alternative GeneratOr (Santiago). To be optimally effective, Santiago is required to be integrated into an SDM approach. In this paper, we present all the elements that such an integration requires and illustrate these methods at the case of Arba Minch, a fast growing town in Ethiopia. Based on this example and experiences from other cases, we discuss the lessons learnt and present the advantages potentially brought by Santiago for sanitation planning The integration requires four elements: a set of technologies to be looked at, decision objectives for sustainable sanitation, screening criteria to evalute technology appropriateness, and about the technologies and the casea. The main output is a set of sanitation system options that is locally appropriate, diverse in order to reveal trade-offs, and of a manageable size. To support the definition of decision objectives, we developed a generic objective hierarchy for sustainable sanitation. Because one of the main challenges lies in the quantification of screening criteria, we established the data for 27 criteria and 41 technologies in a library.The case studies showed, that if the integration is successful, then Santiago can provide substantial benefits: (i) it is systematic and reproducible; (ii) it opens up the decision space with novel and potentially more appropriate solutions; (iii) it makes international data accessible for more empirical decision making; (iv) it enables decisions based on strategic objectives in line with the sustainable development goals; (v) it allows to prioritise appropriate and resource efficient systems right from the beginning (vi) and it contributes to a more citywide inclusive approach by birding strategic objectives with an area-based appropriateness assessment. The here presented approach enables the prioritisation of appropriate and resource efficient sanitation technologies and systems in strategic planning. Thereby this approach contributes to SDG 6.2, 6.3, and 11, sustainable sanitation for all.


Assuntos
Saneamento , Tecnologia , Cidades , Etiópia
16.
PLoS One ; 15(8): e0237696, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32822377

RESUMO

Reproductive tract infections (RTIs) are a public health concern in Ethiopia. However, the relationship between menstrual hygiene management (MHM) and water, sanitation, and hygiene (WASH) factors to RTIs have not been well addressed. A community-based cross-sectional study was conducted from January to March 2019 among 602 systematically selected reproductive-age women aged 15-49 years in Dessie City. Data were collected using a questionnaire and a direct observation checklist. RTIs were identified by the presence during one year before data collection of one or more signs of vaginal discharge, itching/irritation or ulcers/lesions around the vulva, pain during urination and sexual intercourse, and lower abdominal pain and lower back pain. Data were analyzed using multivariable logistic regression analysis with 95%CI (confidence interval). The self-reported prevalence of RTIs was 11.0%(95%CI:8.5-13.7%) during one year prior to the survey. The most commonly reported symptoms of RTI were burning micturition (9.1%) and vaginal discharge (6.1%). Three-fourths 443(75.0%) of households used traditional pit latrines and the majority of the study participants 527(89.2%) did not meet the basic access requirement of 20 liters of water per capita per day. The majority 562(95.1%) of the study participants did not have multiple sexual partners during the last year and 97.8% did not practiced sexual intercourse during menstruation. The most common type of blood-absorbent material used was a sanitary pad 497(84.8%) followed by cloth 89(15.2%). Factors significantly associated with RTIs were using unclean latrines (AOR: 4.20; 95%CI:2.00-8.80), not washing hands with soap before touching the genital area (AOR: 3.94; 95%CI:1.49-10.45), history of symptoms of RTIs in the past year (AOR: 5.88; 95%CI:2.30-14.98), having multiple sexual partners in the past year (AOR: 4.46; 95%CI:1.59-12.53), changing absorbent material only once per day (AOR: 8.99; 95%CI:4.51-17.92), and washing the genital area only once per day during menstruation (AOR: 5.76; 95%CI:2.07-16.05). The self-reported prevalence of RTI showed that one women experienced RTI among ten reproductive-age women. Designing a women's health policy that focuses on ensuring availability of WASH facilities and improving MHM at the community level is key for sustainably preventing RTIs.


Assuntos
Higiene , Infecções do Sistema Genital/epidemiologia , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Menstruação , Pessoa de Meia-Idade , Fatores de Risco , Saneamento , Parceiros Sexuais , Saúde da População Urbana , Qualidade da Água , Adulto Jovem
17.
PLoS Negl Trop Dis ; 14(8): e0008483, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32745095

RESUMO

BACKGROUND: Clonorchiasis, caused by the fish-borne trematode Clonorchis sinensis, is a neglected tropical disease and a public health issue in endemic countries. In Vietnam, an in-depth analysis of risk factors for the condition is missing up to now. This study aimed to determine the prevalence of C. sinensis infection and associated risk factors in rural communities in northern Vietnam. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional survey was conducted in 4 communes in Yen Bai and Thanh Hoa provinces where clonorchiasis is known to be present and raw fish consumption is a common. Using a simple random sampling approach, stool was collected from 841 participants over 6 years old for coprological examination, and a questionnaire measured knowledge, attitudes, and practices with regard to clonorchiasis in 757 participants over 15 years old. Univariable and multivariable logistic regression models were run to identify risk factors for infection with C. sinensis. The overall prevalence of C. sinensis infection was 40.4%, with commune prevalences ranging between 26.5% and 53.3%. In the final model, males were significantly more likely to be infected with C. sinensis (OR 2.00; 95% CI 1.31-3.05). Recent (i.e. last year) consumption of raw fish (OR 8.00, 95% CI 4.78-13.36), low education level (OR 5.57; 95% CI 2.37-13.07), lack of treatment (OR 1.82, 95% CI 1.15-2.89), being between 19 to 39 years old (OR 6.46; 95% CI 1.25-33.37), and the presence of an unhygienic toilet (OR 2.74, 95% CI 1.53-4.92) were significantly associated with C. sinensis infection. CONCLUSION/SIGNIFICANCE: This study demonstrated a high prevalence of C. sinensis infection in rural communities in northern Vietnam. Thus, control measures including, mass drug administration for those communes should be applied to reduce the prevalence. Moreover, specific health education activities should be developed for risk groups in C. sinensis endemic areas.


Assuntos
Clonorquíase/epidemiologia , Clonorchis sinensis , População Rural , Adolescente , Adulto , Animais , Clonorquíase/parasitologia , Fezes/parasitologia , Feminino , Peixes/parasitologia , Parasitologia de Alimentos , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , Saneamento , Fatores Socioeconômicos , Vietnã/epidemiologia , Adulto Jovem
18.
BMC Public Health ; 20(1): 1241, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32799826

RESUMO

BACKGROUND: Providing universal access to safe water, sanitation and hygiene (WASH) in remote Nepal remains challenging. We investigated WASH conditions and their association with children's nutritional status, intestinal parasitic infections and diarrhoea. METHODS: Data was collected through a cross-sectional survey of 1427 households, including questionnaires, observations, stool analysis, anthropometry, water quality measurements, and assessment of clinical signs of nutritional deficiencies. RESULTS: We found 55.5% of children were undernourished, 63.9% had clinical signs of nutritional deficiencies, 51.1% had intestinal parasitic infections and 52.2% had diarrhoea. Multivariate mixed logistic regression analysis revealed a statistically significant negative association between undernutrition and socio-economic level, with adjusted odds ratios (AOR) of 0.70 (95%-CI = 0.43-1.11) and 0.43 (95%-CI = 0.25-0.75) for high and intermediate levels compared to the lowest level. Undernutrition was negatively associated with regular deworming of children (AOR = 0.44, 95% CI = 0.20-0.94), food supplements (AOR = 0.57, 95% CI = 0.38-0.84), household's own food production (AOR = 0.67, 95% CI = 0.46-0.97) and personal hygiene (AOR = 0.83, 95% CI = 0.51-1.35). Nutritional deficiency was negatively associated with handwashing after cleaning a baby's bottom (AOR = 0.60, 95% CI = 0.40-0.92) and cleanliness of caregiver's hands (AOR = 0.61, 95% CI = 0.41-0.89) and positively associated with keeping animals inside the house overnight (AOR = 1.71, 95% CI = 1.17-2.51) and the presence of total coliforms in the drinking water source (AOR = 10.44, 95% CI = 1.61-67.4). Diarrhoea was positively associated with intermittent water supply (AOR = 2.72, 95% CI = 1.18-6.31) and the presence of a mud floor (AOR = 2.29, 95% CI = 1.20-4.37) and negatively associated with cleanliness of the toilet (AOR = 0.68, 95% CI = 0.47-0.98), and the cleanliness of children's hands (AOR = 0.62, 95% CI = 0.40-0.96). CONCLUSIONS: Our study found, more than half of the survey children were in a critical health condition. Results suggest that child health improvements are dependent on multiple public health improvements, including providing better nutrition, promoting adequate hygiene behaviour, such as handwashing, keeping the latrines clean, keeping the household environment free from animal faeces and assuring a reliable supply of safe water.


Assuntos
Diarreia/epidemiologia , Higiene , Enteropatias Parasitárias/epidemiologia , Estado Nutricional , Saúde da População Rural/estatística & dados numéricos , Saneamento/estatística & dados numéricos , Abastecimento de Água/estatística & dados numéricos , Adulto , Cuidadores/estatística & dados numéricos , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Nepal/epidemiologia
19.
Water Res ; 185: 116276, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32798895

RESUMO

For much of the world's urban population, centralized treatment plants and pipe networks built in the nineteenth and twentieth centuries provide homes with water and a means of disposing of the resulting wastewater. Due to the real or perceived inability of existing systems to deliver safe and palatable water, many users apply additional treatment prior to consumption. Where piped water supply is lacking, drinking water is obtained through water vendors at considerable cost. Despite economic inefficiencies and public health risks inherent in these two water supply systems, the high sunk costs of existing water infrastructure along with low returns on investment and the inflexible nature of the institutions involved in water provision have slowed down the diffusion of alternative approaches that may prove to be less expensive, more adaptable and safer than the current system. We advocate a third, complementary route: household-based personalized water systems. Initially, relatively affluent people expecting more functionality and sustainability from water systems will invest in personalized water systems that allow them to tailor their water to their personal preferences. This approach will tap into the tremendous creativity-base of individual users and entrepreneurs, facilitating the type of co-creation that accelerated the rapid development of consumer electronics. Competition among manufacturers and economies of scale that accrue as these systems become more popular will lead to rapid innovation that drives down costs, improves performance and expands access. These solutions complement emerging approaches for sanitation and resource recovery that do not rely upon sewers for the management of human waste.


Assuntos
Saneamento , Água , Humanos , Política , Saúde Pública , Abastecimento de Água
20.
Lancet Glob Health ; 8(9): e1162-e1185, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32827479

RESUMO

BACKGROUND: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. METHODS: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. FINDINGS: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4-40·7) to 50·3% (50·0-50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1-46·5) in 2017, compared with 28·7% (28·5-29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2-89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664-711) of the 1830 (1797-1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6-80·7) of countries from 2000 to 2017, and in 53·9% (50·6-59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. INTERPRETATION: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. FUNDING: Bill & Melinda Gates Foundation.


Assuntos
Países em Desenvolvimento , Água Potável , Saneamento/estatística & dados numéricos , Teorema de Bayes , Diarreia/epidemiologia , Mapeamento Geográfico , Humanos , Modelos Estatísticos , Fatores Socioeconômicos
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