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1.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(5): 729-734, 2021 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-34622584

RESUMO

Along with the economic and technological development and growing demand for high-quality drinking water, direct drinking water has gained general popularity in China. However, no authoritative policy has been issued, giving a clear definition of direct drinking water and existing standards and regulations concerning direct drinking water are not definitive in nature. Existing water quality parameters are not well supported and sometimes even contradict each other. We elaborated, in this paper, the history of direct drinking water in China and systematically reviewed the existing regulations and standards related to direct drinking water. We also compared and analyzed the important microbiology, toxicology, sensory perception and general chemistry parameters in the standards. This paper is the first ever attempt at an in-depth analysis of the chaotic state of the direct drinking water industry. We have also highlighted the problems in the current standards and regulations for direct drinking water. Our study provides a basis for market regulation and the supervision and management of direct drinking water. In addition, the paper provides helpful information for laying down a definition of direct drinking water, calling for and approving of project proposals concerning the establishment of national standards for direct drinking water, and actually formulating the standards. We have made a number of suggestions: A. defining direct drinking water clearly and formulating the national standards for direct drinking water as soon as possible; B. conducting research on water quality benchmarks to provide scientific support for the formulation of the national standards for direct drinking water; C. giving more attention to the formulation of standards concerning microbiology parameters and their limits and giving consideration to the inclusion of parameters concerning viruses.


Assuntos
Água Potável , Poluentes Químicos da Água , China , Saneamento , Poluentes Químicos da Água/análise , Qualidade da Água
2.
Ann Glob Health ; 87(1): 91, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34611520

RESUMO

COVID-19 has highlighted and exacerbated many global health inequities. Emerging evidence suggests that SARS-CoV-2 can spread through fecal aerosols, making sanitation a critical part of the COVID-19 mitigation strategy and providing an opportunity to reflect on current challenges and opportunities related to global sanitation at large. Global sanitation interventions continue to fall short of their target expectations, leading to millions of deaths and illnesses worldwide. Eurocentric approaches to sanitation fail to account for sociocultural determinants of sanitation behaviors and health, leading to low sanitation intervention uptake. Global public health needs to take a decolonial approach to our research and practice, and meaningfully involve local communities to progress towards global health equity.


Assuntos
COVID-19 , Equidade em Saúde , Saúde Global , Humanos , SARS-CoV-2 , Saneamento
3.
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
5.
Infect Dis Poverty ; 10(1): 116, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34507609

RESUMO

BACKGROUND: Soil-transmitted helminths (STH) infections still present a global health problem. Mass drug administration (MDA) is a widely applied strategy to reduce morbidity and mortality caused by STH. Yet, this approach has some shortcomings. In this study, we analyzed the impact of a multi-intervention integrated deworming approach including MDA, health education (HE), and environmental sanitation improvements (ESI) for sustained STH control in Jiangsu Province of China that was applied from 1989 to 2019. METHODS: Data, including infection rate of STH, medications used, coverage of the medication, non-hazardous lavatory rate, and household piped-water access rate in rural areas, and actions related to HE and ESI were collected (from archives) and analyzed in this retrospective descriptive study. Pearson's correlation analysis was applied to test correlations. RESULTS: There was a dramatic decline in the infection rate of STH from 1989 (59.32%) to 2019 (0.12%). From 1995 to 1999, MDA and HE were recommended in rural areas. A negative correlation was observed between infection rate and medication from 1994 to 1998 (r = - 0.882, P = 0.048). From 2000 to 2005, targeted MDA was given to high-risk populations with HE continuously promoting good sanitation behaviors. From 2006 to 2014, targeted MDA + HE and ESI were used to consolidate the control effect. ESI was strengthened from 2006, and a negative correlation was observed between the coverage rate of the non-hazardous lavatory and the infection rate from 2006 to 2019 (r = - 0.95, P < 0.001). The targeted MDA was interrupted in 2015, while continuous efforts like HE and ESI contributed in sustaining STH control. CONCLUSIONS: Multi-intervention integrated deworming strategy contributes to the reduction of STH infections. This approach is a valuable example of how different interventions can be integrated to promote durable STH control.


Assuntos
Anti-Helmínticos/uso terapêutico , Helmintíase/tratamento farmacológico , Helmintíase/epidemiologia , Helmintos/isolamento & purificação , Saneamento/métodos , Solo/parasitologia , Animais , China/epidemiologia , Estudos Transversais , Helmintíase/prevenção & controle , Helmintíase/transmissão , Helmintos/classificação , Humanos , Prevalência , Estudos Retrospectivos
6.
J Environ Manage ; 300: 113634, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34507059

RESUMO

Faecal Sludge (FS) produced in developing countries has become a significant source of water pollution. The optimal treatment of FS can lead to a sustainable economy. In India, the second phase of the open defecation free (ODF) initiative (energy recovery by providing city- or town-level centralised FS treatment plants) has begun from 2019 to sustain millions of toilets. However, to achieve this goal, India must address significant knowledge gaps such as the type of available on-site sanitation treatments (OSTs), optimal time of emptying the OSTs, and variations in the FS characteristics with age. Thus, the present study analysed FS samples collected from Vadgaon Maval, Maharashtra, India, to understand the inter- and intra-variation in FS characteristics. The pH, electrical conductivity, total solids (TS), specific gravity (SG), organic matter (OM), chemical oxygen demand (COD), and pathogen content of FS samples were observed to be in the range of 7-7.65, 1.19-4.01 mS/cm, 1-123 g/L, 0.88-1.26, 18.4%-100%, 960-6080 mg/L, and 105-109 number/L of FS, respectively. The inter-variation of FS characteristics exhibited that the pH, EC, TS, and SG increased, whereas OM, settling, and drying capacity decreased with an increase in age. Fresh FS (excreta degraded for ≤3 years) was yellowish-brown in colour and exhibited low TS, low SG, and high OM. On the other hand, older FS (excreta degraded for >3 years) was blackish-brown in colour and exhibited high TS, SG, and pathogen content. This observation indicates that FS vacuum pumping may be difficult in the sludge zone after 3 years of excreta degradation, which may encourage the manual scavenging practice. Additionally, the analysis of FS treatment plant (FSTP) process control parameters (settled sludge volume, sludge volume index, and sludge drying capacity) indicated that the treatment time required for older FS is long, which increases the FSTP cost. Furthermore, FS intra-variation in OST exhibited that effluent FS could be directly sent for effluent treatment without any solid-liquid separation process. Thus, the present study can help practitioners in establishing or modifying FS treatment systems for addressing conditions based on the variation in FS characteristics at the town level in India.


Assuntos
Saneamento , Esgotos , Fezes , Índia , Poluição da Água
7.
J Environ Manage ; 300: 113730, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34537558

RESUMO

In order to obviate the economic issues associated with pit latrine emptying and transport such as high water additions and rheologically difficult sludge properties, the implications of prompt solid/liquid separation were investigated. This was achieved through rheological characterisation of fresh human faeces and synthetic faeces, and comparison with aged faecal sludges. Shear yield stress, thixotropy and post-shear structural recovery were characterised for a total solids (TS) concentration range of 5-35% total solids (TS) and stickiness yield stress was determined for concentrations up to 100% TS. Fresh faeces rheology proved to be favourable when compared to aged matrices, evidenced by a lower shear yield stress and higher gel point solids concentration, suggesting that aging could alter the physico-chemical properties of faecal sludge. Fresh and synthetic faeces exhibited similar shear thinning, thixotropic behaviour with the majority of structural breakdown occurring at a low shear rate of 10 s-1, and the extent increasing with higher solids concentrations. At 32% TS, fresh faeces shear yield stress was permanently reduced by 80%, suggesting that low shear pumping could reduce the energy demand required for faeces transport. The sticky phase, which represents the region to avoid faecal transport and mechanical drying processes, was identified to range from 30 to 50% TS, with 25% TS as ideal to commence dewatering processes. This also coincides with the average solids concentration of faeces, which is achievable by source separation. This study has identified that handling of fresh faeces as opposed to aged faecal sludges would result in economic and environmental benefits, with energy, water and labour savings.


Assuntos
Saneamento , Esgotos , Idoso , Fezes , Humanos , Reologia , Toaletes
8.
BMC Health Serv Res ; 21(1): 912, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479549

RESUMO

BACKGROUND: Poor environmental conditions and hygiene practices at the time of childbirth is linked to life-threatening infections and death in mothers and babies. Improvements in water, sanitation, and hygiene (WASH) have been identified as a means through which the lives of mothers and babies could be saved. This study was carried out to explore WASH conditions and infection prevention and control (IPC) practices in traditional birth homes/centers in Abeokuta, Southwest Nigeria. A total of 50 traditional birth centers and attendants (TBAs) were enrolled in the study. Sociodemographic characteristics of the TBAs and features of the birth centers were obtained using a semi-structured questionnaire. Assessment of WASH conditions and IPC practices was based on established protocols. RESULTS: Findings revealed that majority of the centers operated under poor WASH conditions and IPC practices; none met with the WHO minimum standards for environmental health. CONCLUSIONS: Adequate WASH facilities and IPC practices remain a critical component of maternal and child health even in non-facility birth. As the transition to facility births continues in many countries, the large number of non-facility births demands their inclusion in WASH-related strategies, if global goals of reducing deaths of newborns and women deaths will be achieved.


Assuntos
Saneamento , Água , Criança , Feminino , Humanos , Higiene , Lactente , Recém-Nascido , Controle de Infecções , Nigéria , Gravidez
9.
Artigo em Inglês | MEDLINE | ID: mdl-34574575

RESUMO

Safe water and sanitation, which give rise to appropriate hygiene, are fundamental determinants of individual and social health and well-being. Thereby, assessing and widening access to sustainable, durable water and sanitation infrastructure remains a global health issue. Rural areas are already at a disadvantage. Poor access to water, sanitation, and hygiene (WASH) can have a major negative effect on students in rural schools. Thus, the paper aims to assess the current condition and the challenge to access WASH in rural Kazakh schools. The study was conducted in three rural schools in Central Kazakhstan. Data were gathered through a survey among pupils, observations of the WASH infrastructure and maintenance, and a face-to-face interview with school administrators. The mean survey response rate was 65% across schools. Results indicated there was no alternative drinking-water source in schools, and 15% of students said they had access to water only occasionally. Half of the students reported that the water was unsafe to drink because of a poor odor, taste, or color. The toilet in school 3 was locked with a key, and a quarter of the students reported there was no access to a key. Moreover, not having gender-separated toilet facilities was a challenge because of the traditional gender norms. Despite the effective regulations and measures of handwashing taken during COVID-19, 27.7% of the students answered that soap was not offered daily in classrooms. Additionally, warm water was only provided in school 2. About 75% of students did not have access to drying materials continuously. The study shows that having the schools' infrastructure is not enough when characteristics, such as availability, accessibility, maintenance, operation, quality of services, education, and practices, are ignored. Cooperation between local education authorities, school administration, and parents should be encouraged to the achievement of the sustainable development goals (SDGs) by 2030.


Assuntos
COVID-19 , Água Potável , Países em Desenvolvimento , Humanos , Higiene , Cazaquistão , SARS-CoV-2 , Saneamento , Instituições Acadêmicas , Abastecimento de Água
10.
J Environ Manage ; 300: 113799, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34560464

RESUMO

Given that the social and economic sustainability of rural areas is highly based on the protection of natural resources, biodiversity and human health, simple-operated and cost-effective wastewater treatment systems, like artificial constructed wetlands (CWs), are widely proposed for minimizing the environmental and human impact of both water and soil pollution. Considering that the optimization of wastewater treatment processes is vital for the reduction of effluents toxic potential, there is imperative need to establish appropriate management strategies for ensuring CW performance and operational efficiency. To this end, the present study aimed to assess the operational efficiency of a horizontal free water surface CW (HFWS-CW) located in a world heritage area of Western Greece, via a twelve-month duration Toxicity Identification Evaluation (TIE)-like approach, including both chemical and biological tracking tools. Conventional chemical tracking, by means of pH, conductivity, total COD, and nitrogen-derived components, like nitrates and ammonia-nitrogen, were monthly recorded in both influents and effluents to monitor whether water quality standards are maintained, and to assess potent CW operational deficiencies occurring over time. In parallel, Whole Effluent Toxicity (WET) bioassays were thoroughly applied, using freshwater algae and higher plant species (producers), crustaceans and rotifers (consumers), as well as human lymphocytes (in terms of Cytokinesis Block Micronucleus assay) to evaluate the acute and short-term toxic and hazardous potential of both influents and effluents. The integrated analysis of abiotic (physicochemical parameters) and biotic (toxic endpoints) parameters, as well as the existence of "cause-effect" interrelations among them, revealed that CW operational deficiencies, mainly based on poorly removal rates, could undermine the risk posed by treated sewage. Those findings reinforce the usage of WET testing, thus giving rise to the importance of applying appropriate water management strategies and optimization actions, like oxygen enrichment of surface and bottom of HFWS-CW basins, expansion of the available land, the enhancement of bed depth and seasonal harvesting of plants, for ensuring sewage quality, in favor of water resources protection and sustainable growth in rural areas.


Assuntos
Purificação da Água , Áreas Alagadas , Humanos , Saneamento , Eliminação de Resíduos Líquidos , Águas Residuárias
11.
Artigo em Inglês | MEDLINE | ID: mdl-34444063

RESUMO

A systematic review of published literature (2000-2019) evaluating the impact of sanitation interventions on the prevalence of disease, parasite infestation, and/or child growth using randomized controlled trials (RCTs) was done according to the PRISMA checklist. Earlier reviews indicated mixed evidence citing relatively poor quality evidence from mixed designs. Public health policy and practice appear to rely on evidence from RCTs. Records were searched in six electronic databases. The methodological quality of RCTs was assessed using the Cochrane collaboration risk of bias tool. Fifteen records (2.0%) were included for review. Impact trials were done in rural communities of African and Asian countries. The significant effect of sanitation-focus interventions was found in one trial for the prevalence of childhood diarrhea (14.3%), three trials for parasite infestation (37.5%), and two trials (25.0%) for child growth. Results indicate mixed quality evidence from RCT designs. Evidence is limited and suggestive of the impact of sanitation on parasite infestation and child growth. Further rigorous sanitation intervention trials under varying settings are needed to show what really works and under what settings. Future work may explore sanitation behavior change strategies and latrine options to address the challenges of poor latrine use under high sanitation coverage.


Assuntos
População Rural , Saneamento , Criança , Países em Desenvolvimento , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Toaletes
12.
J Environ Manage ; 298: 113456, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34364246

RESUMO

Sludge treatment is an integral part of faecal sludge management in non-sewered sanitation settings. Development of pyrolysis as a suitable sludge treatment method requires thorough knowledge about the properties and thermal decomposition mechanisms of the feedstock. This study aimed to improve the current lack of understanding concerning relevant sludge properties and their influence on the thermal decomposition characteristics. Major organic compounds (hemicellulose, cellulose, lignin, protein, oil and grease, other carbohydrates) were quantified in 30 faecal sludge samples taken from different sanitation technologies, providing the most comprehensive organic faecal sludge data set to date. This information was used to predict the sludge properties crucial to pyrolysis (calorific value, fixed carbon, volatile matter, carbon, hydrogen). Samples were then subjected to thermogravimetric analysis to delineate the influence of organic composition on thermal decomposition. Septic tanks showed lower median fractions of lignin (9.4%dwb) but higher oil and grease (10.7%dwb), compared with ventilated improved pit latrines (17.4%dwb and 4.6%dwb respectively) and urine diverting dry toilets (17.9%dwb and 4.7%dwb respectively). High fixed carbon fractions in lignin (45.1%dwb) and protein (18.8%dwb) suggested their importance for char formation, while oil and grease fully volatilised. For the first time, this study provided mechanistic insights into faecal sludge pyrolysis as a function of temperature and feedstock composition. Classification into the following three phases was proposed: decomposition of hemicellulose, cellulose, other carbohydrates, proteins and, partially, lignin (200-380 °C), continued decomposition of lignin and thermal cracking of oil and grease (380-500 °C) and continued carbonisation (>500 °C). The findings will facilitate the development and optimisation of faecal sludge pyrolysis, emphasising the importance of considering the organic composition of the feedstock.


Assuntos
Pirólise , Esgotos , Fezes , Saneamento , Toaletes
13.
Environ Sci Technol ; 55(17): 11667-11679, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34382777

RESUMO

Fecal source tracking (FST) may be useful to assess pathways of fecal contamination in domestic environments and to estimate the impacts of water, sanitation, and hygiene (WASH) interventions in low-income settings. We measured two nonspecific and two human-associated fecal indicators in water, soil, and surfaces before and after a shared latrine intervention from low-income households in Maputo, Mozambique, participating in the Maputo Sanitation (MapSan) trial. Up to a quarter of households were impacted by human fecal contamination, but trends were unaffected by improvements to shared sanitation facilities. The intervention reduced Escherichia coli gene concentrations in soil but did not impact culturable E. coli or the prevalence of human FST markers in a difference-in-differences analysis. Using a novel Bayesian hierarchical modeling approach to account for human marker diagnostic sensitivity and specificity, we revealed a high amount of uncertainty associated with human FST measurements and intervention effect estimates. The field of microbial source tracking would benefit from adding measures of diagnostic accuracy to better interpret findings, particularly when FST analyses convey insufficient information for robust inference. With improved measures, FST could help identify dominant pathways of human and animal fecal contamination in communities and guide the implementation of effective interventions to safeguard health.


Assuntos
Escherichia coli , Saneamento , Animais , Teorema de Bayes , Fezes , Humanos , Moçambique , Prevalência
14.
Bull World Health Organ ; 99(8): 583-592, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34354313

RESUMO

Water-related diseases such as diarrhoeal diseases from viral, bacterial and parasitic organisms and Aedes-borne arboviral diseases are major global health problems. We believe that these two disease groups share common risk factors, namely inadequate household water management, poor sanitation and solid waste management. Where water provision is inadequate, water storage is essential. Aedes mosquitoes commonly breed in household water storage containers, which can hold water contaminated with enteric disease-causing organisms. Microbiological contamination of water between source and point-of-use is a major cause of reduced drinking-water quality. Inadequate sanitation and solid waste management increase not only risk of water contamination, but also the availability of mosquito larval habitats. In this article we discuss integrated interventions that interrupt mosquito breeding while also providing sanitary environments and clean water. Specific interventions include improving storage container design, placement and maintenance and scaling up access to piped water. Vector control can be integrated into sanitation projects that target sewers and drains to avoid accumulation of stagnant water. Better management of garbage and solid waste can reduce the availability of mosquito habitats while improving human living conditions. Our proposed integration of disease interventions is consistent with strategies promoted in several global health frameworks, such as the sustainable development goals, the global vector control response, behavioural change, and water, sanitation and hygiene initiatives. Future research should address how interventions targeting water, sanitation, hygiene and community waste disposal also benefit Aedes-borne disease control. The projected effects of climate change mean that integrated management and control strategies will become increasingly important.


Assuntos
Aedes , Prestação Integrada de Cuidados de Saúde , Diarreia/prevenção & controle , Controle de Mosquitos , Mosquitos Vetores , Saneamento , Purificação da Água , Animais , Diarreia/epidemiologia , Gerenciamento Clínico , Humanos , Microbiologia da Água , Abastecimento de Água
15.
Water Res ; 204: 117526, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34461495

RESUMO

Non-sewered sanitation is currently dependant upon pit latrine emptying, the safety of which is compromised by the high costs of faecal sludge transport to centralised treatment facilities. Transport in turn is hindered by the complex rheology of pit latrine sludge. This study therefore characterised the compressional rheology of fresh faeces and modelled the implications for passive (gravity) or mechanical (forced) solid/liquid separation. This informs on the viability of decentralising dewatering for more efficient volume reduction and improving the economics of transportation. The gel point (ϕg) is the solids concentration where the material has a networked structure and signifies the point when mechanical intervention is required for further solid-liquid separation. For fresh faeces, ϕg ranged between 6.3 and 15.6% total solids (TS) concentration. This is significantly higher than the ϕg observed for wastewater sludge at centralised facilities, and it implies that passive gravity driven processes can suffice to improve localised dewatering. The kinetics of passive sedimentation of faecal material were modelled and illustrate thickening from 3 to 10% TS concentration in <0.5 h. This highlights that early intervention to thicken faeces while fresh can improve solid/liquid separation efficiency. Filtration of fresh faeces was characterised by lengthy cake filtration times and comparably short compression times, more similar to mineral slurries than to wastewater sludge. Consequently, fresh faeces presented improved dewatering characteristics, supporting higher final cake solids concentrations and improved dewatering kinetics. By complementing thickening with 300 kPa filtration, a 1.4 cm thick 25% TS product could be achieved in <24 h. Investigation of matrix properties highlighted that increased conductivity (e.g. exposure to urine) negatively influenced dewaterability, an effect which could be mitigated by introducing solid-liquid separation earlier. The thermodynamically favourable compressional rheology of fresh faeces has identified that focussing on localised dewatering could radically improve the economics of faecal sludge management, primarily through reducing transport costs.


Assuntos
Saneamento , Esgotos , Fezes , Reologia , Eliminação de Resíduos Líquidos , Águas Residuárias , Água
16.
PLoS One ; 16(8): e0256086, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34388184

RESUMO

BACKGROUND: Quality water, sanitation, and hygiene facilities act as barricades to the transmission of COVID-19 in health care facilities. These facilities ought to also be available, accessible, and functional in temporary treatment centers. Despite numerous studies on health care facilities, however, there is limited information on the status of WASH facilities in such centers. METHODS: The assessment of health care facilities for the COVID-19 response checklist and key informant interviews, were used for data collection. 35 treatment centers in Southern Ethiopia were surveyed. Eightkey informants were interviewed to gain an understanding of the WASH conditions in the treatment centers. The Quantitative data was entered using EPI-INFO 7 and exported to SPSS 20 for analysis. Results are presented using descriptive statistics. Open Code 4.02 was used for the thematic analysis of the qualitative data. RESULTS: Daily water supply interruptions occurred at 27 (77.1%) of the surveyed sites. Only 30 (85.72%) had bathrooms that were segregated for personnel and patients, and only 3 (3.57%) had toilets that were handicapped accessible. 20(57.2%) of the treatment centers did not have a hand hygiene protocol that satisfied WHO guidelines. In terms of infection prevention and control, 16 (45.71%) of the facilities lacked adequate personal protective equipment stocks. Between urban and rural areas, there was also a significant difference in latrine maintenance, hand hygiene protocol design and implementation, and incineration capacity. CONCLUSION: The results reveal crucial deficiencies in the provision of WASH in the temporary COVID-19 treatment centers. Efforts to improve WASH should offer priority to hygiene service interventions to minimize the risk of healthcare-acquired infections. The sustainable provision of hygiene services, such as hand washing soap, should also be given priority.


Assuntos
COVID-19/epidemiologia , Instalações de Saúde/estatística & dados numéricos , Higiene , Quarentena/estatística & dados numéricos , Saneamento/estatística & dados numéricos , Qualidade da Água , COVID-19/prevenção & controle , Etiópia , Instalações de Saúde/normas , Humanos , Garantia da Qualidade dos Cuidados de Saúde , Quarentena/normas , Saneamento/normas
17.
Artigo em Inglês | MEDLINE | ID: mdl-34360468

RESUMO

Domestic solid waste is rapidly increasing due to accelerated population growth and urbanization. Improper waste disposal poses potential health risks and environmental concerns. Here, we investigated waste disposal practices in relation to household/dwelling characteristics in South African low-income communities. Data for 2014 to 2019 from a community-orientated primary care program were analyzed using logistic regression. Families who reported living in a shack were more likely to dump waste in the street. Households who reported using non-electric sources of fuel for heating/cooking, those who lacked proper sanitation, and those who did not have access to piped water inside the dwelling were more likely to dispose of waste by dumping it in the street/in the yard or burying it. Families living in low-income settlements are at risk of solid waste exposure and this situation is exacerbated by poor access to piped water, proper sanitation, and electricity.


Assuntos
Pobreza , Eliminação de Resíduos , Características da Família , Humanos , Saneamento , África do Sul
18.
Artigo em Inglês | MEDLINE | ID: mdl-34360496

RESUMO

Sustainable Development Goal target 6.2 calls for universal access to adequate and equitable sanitation, setting a more ambitious standard for 'safely managed sanitation services'. On-site sanitation systems (e.g., septic tanks) are widely used in low- and middle-income countries (LMICs). However, the lack of indicators for assessing fecal exposure risks presents a barrier to monitoring safely managed services. Furthermore, geographic diversity and frequency of disasters require a more nuanced approach to risk-informed decision-making. Taking Indonesia as an example, the purpose of this paper is to provide insights into current status and practices for on-site sanitation services in the contexts of LMICs. Using a dataset from a national socio-economic survey (n = 295,155) coupled with village census (n = 83,931), we assessed (1) household sanitation practices across Indonesia stratified by city-level population density and meteorological factors, (2) factors associated with septic tank emptying practice, and (3) inequalities in potential fecal exposure as measured by population density and WASH access by wealth quintile. We found a high reliance on on-site sanitation facilities (80.0%), almost half of which are assumed to be 'uncontained' septic tanks and one in ten facilities discharging untreated waste directly into the environment. The most densely populated areas had the highest rates of septic tank emptying, though emptying rates were just 17.0%, while in the lowest population density group, emptying was rarely reported. Multivariate regression analysis demonstrated an association between flooding and drought occurrence and septic tank emptying practice. Higher groundwater usage for drinking among poorer households suggests unsafe sanitation may disproportionally affect the poor. Our study underscores the urgent need to strengthen the monitoring of on-site sanitation in LMICs by developing contextualized standards. Furthermore, the inequalities in potential fecal exposure require greater attention and tailored support mechanisms to ensure the poorest gain access to safely managed sanitation services.


Assuntos
Características da Família , Saneamento , Fezes , Humanos , Indonésia , Pobreza , Abastecimento de Água
19.
Artigo em Inglês | MEDLINE | ID: mdl-34360185

RESUMO

Community Health Workers (CHWs) can effectively implement maternal and child health interventions, but there is paucity of evidence on how to integrate child stimulation into these interventions, and their delivery at scale. In rural Bangladesh, CHWs implemented an intervention integrating psychosocial stimulation, nutrition, maternal mental health, water, sanitation, hygiene (WASH) and lead exposure prevention. In each of 16 intervention villages, one CHW worked with 20 households. CHWs bi-weekly held group meetings or alternated group meetings and home visits with pregnant women and lactating mothers. We assessed the intervention through five focus groups, four interviews and one group discussion with CHWs and their supervisors to explore success factors of implementation. CHWs' training, one-on-one supervision and introduction by staff to their own community, and adoption of tablet computers as job aids, enabled successful session delivery to convey behavioral recommendations. CHWs reported difficulties delivering session due to the complexity of behavioral recommendations and struggled with age-specific intervention material. Young children's attendance in group sessions generated distractions that undermined content delivery. We identified ways to minimize the difficulties to strengthen intervention-delivery during implementation, and scale-up. Iterative revisions of similarly integrated interventions based on qualitative evaluation findings could be delivered feasibly by CHWs and allow for implementation at scale.


Assuntos
Desenvolvimento Infantil , Agentes Comunitários de Saúde , Bangladesh , Criança , Pré-Escolar , Feminino , Humanos , Lactação , Gravidez , Saneamento
20.
Artigo em Inglês | MEDLINE | ID: mdl-34444615

RESUMO

In rural settings of Côte d'Ivoire, access to water, sanitation, and hygiene (WASH) at schools is often lacking. The purpose of this study was to assess the availability, quality, and use of WASH infrastructure in schools in the south-central part of Côte d'Ivoire, and to determine the hygiene practices of schoolchildren. A cross-sectional study was conducted in 20 primary schools with (n = 10) or without (n = 10) direct access to drinking water. The survey was comprised of a questionnaire directed at schoolchildren aged 8-17 years, an assessment of the WASH infrastructure, and the testing of drinking water samples for Escherichia coli and total coliforms. Overall, 771 schoolchildren were enrolled in the study. One out of four children (24.9%) reported that they used available toilets. Among those children not using toilets, more than half (57.5%) reported that they practised open defecation. Drinking water infrastructure was limited in most schools because of poor storage tanks, the low flow of water, or broken wells. All drinking water samples (n = 18) tested positive for total coliforms and 15 (83.3%) tested positive for E. coli. The lack of WASH infrastructures in primary schools in the south-central part of Côte d'Ivoire, in combination with poor hygiene practices, might govern disease transmission and absenteeism at school, especially among females.


Assuntos
Saneamento , Água , Criança , Costa do Marfim , Estudos Transversais , Escherichia coli , Feminino , Humanos
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