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1.
Cien Saude Colet ; 28(2): 363-372, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36651392

RESUMO

This study aimed to explore the association between water, sanitation, and the prevalence of schistosomiasis mansoni in students aged 7 to 17 years from all 27 federative units in Brazil. It was a cross-sectional study conducted based on data on the prevalence of schistosomiasis mansoni referring to 197,567 students from 521 Brazilian municipalities, who participated in the National Survey on the Prevalence of Schistosomiasis Mansoni and Soil-transmitted Helminth Infections (2011-2015). Univariable and multivariable generalized linear models of the negative binomial type were adjusted using 25 and 5% significance levels, respectively, considering municipalities as the unit of analysis. While a protective association was found between access to filtered water in schools and schistosomiasis mansoni prevalence, sanitation in schools was indicated as a risk factor. The collection of wastewater through a network is not universal in Brazil, and even when present, it is not necessarily carried out by the treatment of collected effluents, thus often resulting in the direct discharge of raw sewage into water resources. Regarding septic tanks, only the presence of infrastructure alone does not guarantee its correct use by the population.


Assuntos
Esquistossomose mansoni , Humanos , Esquistossomose mansoni/epidemiologia , Prevalência , Água , Brasil/epidemiologia , Saneamento/métodos , Estudos Transversais
2.
Cien Saude Colet ; 28(2): 547-559, 2023 Feb.
Artigo em Português, Inglês | MEDLINE | ID: mdl-36651406

RESUMO

Changes in the regulatory and legal framework for Brazil's water and sanitation sector (Law 14,026, July 15, 2020) require competitive bidding for service contracts, even in cases where the provision of services was previously delegated to state-owned utilities under program contracts. The aim of this study was to identify the actors who benefited from these changes to the legislation and assess the social effectiveness of the privatization of water supply and sewerage services in the state of Rio de Janeiro by investigating the auction of services provided by the public utility CEDAE in four blocks comprising 35 municipalities in April 2021. We conducted an exploratory analysis of secondary data and used the systemic integration method to identify the main actors involved in the concession process and the role they played. It is concluded that federal, state, and municipal governments, the Brazilian Development Bank, and the concessionaires have gained from the concessions, while the percentage of low-income populations connected to the sewage collection or drainage network is lower and tariffs are higher in municipalities served by the private sector when compared to the municipalities encompassed by the auction.


A alteração no marco legal do saneamento (Lei 14.026, de 15 de julho de 2020) passou a exigir licitação no Brasil, mesmo nos casos de prestação do serviço de saneamento antes delegada pelos municípios às companhias estaduais, mediante contrato de programa. O objetivo foi identificar os atores que se beneficiaram com a mudança na lei e observar a efetividade social do processo de desestatização, que ocorreu em abril de 2021 com o leilão dos serviços de abastecimento de água e esgotamento sanitário prestados pela Companhia Estadual de Águas e Esgotos do Rio de Janeiro (CEDAE) em 35 municípios do estado. Adotou-se a análise exploratória de dados secundários e a metodologia da integração sistêmica, que possibilita identificar o papel e a atuação de atores sociais na concessão dos serviços operados pela CEDAE no Rio de Janeiro. Concluiu-se que os governos federal, estadual e municipais, o Banco Nacional de Desenvolvimento Econômico e Social e grupos privados ganharam com as concessões, mas quanto à efetividade social dos serviços, observou-se que é menor a proporção de população de baixa renda com redes de afastamento do esgoto sanitário nos municípios do estado operados pela iniciativa privada e que as tarifas praticadas são em média maiores ao comparar com os municípios que participaram do leilão.


Assuntos
Saneamento , Abastecimento de Água , Humanos , Brasil , Cidades , Pobreza
3.
Sci Total Environ ; 857(Pt 1): 159178, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36202366

RESUMO

Urine diversion in a No-Mix Toilet is a promising approach for sustainable fertilizers and reduction of the nutrient load for wastewater treatment; however, user adoption remains a challenge. This study evaluates the Urine Trap, a passive No-Mix toilet design based on the teapot effect, wherein the urine stream inlet is invisible to the user and therefore it does not impact the user experience for increased adoption. This study evaluated the nutrient separation performance of a Urine Trap flush toilet in a bathroom shared by women in two sites in India. Over three different testing periods, 841 uses of this squat plate were recorded in 50 days. Analytical measurements found 36 % separation efficiency for total nitrogen (TN). While effective, the Urine Trap under test by users did not yield a 70-80 % TN separation efficiency observed under engineering characterization. High temporal resolution data from sensors on waste collection tanks, the opening of the bathroom door, and cleansing water flow were used to gain insights into hygiene practices. The data showed a frequent habit of wetting the squat plate during physiological excretion, a hygienic practice that eases cleaning but degrades the teapot separation effect of the Urine Trap design. By using sensors, we demonstrate a method to non-invasively gain quantitative insights into hygiene practices to inform sanitation technologies deployment strategies for improved outcomes.


Assuntos
Aparelho Sanitário , Purificação da Água , Feminino , Humanos , Toaletes , Saneamento , Purificação da Água/métodos , Fertilizantes , Nitrogênio , Urina
4.
Soc Sci Med ; 317: 115541, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36525786

RESUMO

The health burden of childhood diarrhea in India has been a major public health concern. This study examines the role of the individualism-collectivism dichotomy in the prevalence of diarrhea in children under the age of five in India. Using subnational data on rice suitability to measure collectivism, we provide evidence that collectivism is negatively associated with the prevalence of childhood diarrhea across 618 Indian districts. We find that the mechanism works through improvements in water and sanitation. Collectivism propagates values of interdependence, cooperation and collective action which increases safe water and sanitation practices, thereby reducing the prevalence of diarrhea in children.


Assuntos
Diarreia , Saneamento , Criança , Humanos , Diarreia/epidemiologia , Abastecimento de Água , Água , Índia/epidemiologia
5.
J Environ Sci (China) ; 127: 361-374, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36522068

RESUMO

Chinese government is vigorously promoting toilet renovation in rural areas to reduce the risk of human feces exposure, which would cause infectious diseases, especially antibiotic resistance genes (ARGs) and pathogens. However, the distribution of ARGs in human feces from different regions of China remained ill-defined. It is not yet known how the survival of ARGs after toilet treatment is associated with the regional infection rates. Here, we investigated the prevalence of ARGs in human feces in rural areas of China and their potential relationship with infectious diseases for the first large-scale. The results showed that there were still high ARGs residues in human feces after rural toilet treatment, especially tetM-01 and ermB with average relative abundance as high as 1.21 × 10-1 (Eastern) and 1.56 × 10-1 (Northern), respectively. At a large regional scale, the significant differences in human feces resistomes were mainly shaped by the toilet types, TN, NH3-N, and the bacterial community. A critical finding was that toilets still cannot effectively decrease the pathogenicity risk in human feces. The significant positive relationship (P<0.05) between infectious diseases and ARGs can infer that ARGs in human feces exposure might be a critical path for enhancing the incidence of diseases, as these ARGs hinder the effectiveness of antibiotics.


Assuntos
Antibacterianos , Doenças Transmissíveis , Humanos , Genes Bacterianos , Saneamento , Incidência , China/epidemiologia
6.
Int J Hyg Environ Health ; 247: 114069, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36423433

RESUMO

The previous paucity of data and research on water, sanitation and hygiene (WASH) in schools in Brazil have been preventing an assessment of how safe and healthy schools are to reopen during the COVID-19 pandemic. This study aimed first to assess the current situation of WASH in schools in Brazil and, second, to evaluate to what extent Brazilian schools have been making any progress in providing WASH since the beginning of the COVID-19 pandemic. Data on WASH conditions in schools in Brazil was retrieved from the 2020 and 2021 Brazilian National School Census (BNSC). For the first objective, frequencies of 31 variables were calculated for the whole country and regions, considering all 173,700 schools from BNSC of 2021. Five main variables were considered as indicators of adequate WASH infrastructure in schools. T-test and ANOVA were used to assess differences in these five variables according to the locality, management model and regions. For the second objective only schools presented in both datasets (n = 170,422) were considered to compare WASH in schools pre- and peri-COVID-19 pandemic. Frequencies of 31 variables were calculated for the whole country and regions before and during the pandemic. Paired t-tests were conducted when differences in variables across the years were observed. At the present moment, the majority of schools in Brazil have bathrooms (97%), drinking water with quality suitable for human consumption (95%), improved sanitation facilities (78%) and solid waste collection (70%). Between 2020 and 2021, there was a mix of improvements and deterioration in the school's WASH infrastructure in all regions of the country. Overall, solely considering the WASH infrastructure, schools in the South and Southeast regions of the country are better prepared for the safe reopening. Nevertheless, public schools, schools located in rural areas and the North and Northeast regions of the country, are more in need of WASH interventions. Results indicate that little progress was achieved, and schools in Brazil are still in need of improvements.


Assuntos
COVID-19 , Saneamento , Humanos , Pandemias , Brasil/epidemiologia , COVID-19/epidemiologia , Água , Higiene , Instituições Acadêmicas
7.
Environ Sci Technol ; 57(1): 549-560, 2023 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-36516327

RESUMO

Synanthropic filth flies transport enteric pathogens from feces to food, which upon consumption poses an infection risk. We evaluated the effect of an onsite sanitation intervention─including fly control measures─in Maputo, Mozambique, on the risk of infection from consuming fly-contaminated food. After enumerating flies at intervention and control sites, we cultured fecal indicator bacteria, quantified gene copies for 22 enteric pathogens via reverse transcription quantitative polymerase chain reaction (RT-qPCR), and developed quantitative microbial risk assessment (QMRA) models to estimate annual risks of infection attributable to fly-contaminated foods. We found that the intervention reduced fly counts at latrine entrances by 69% (aRR = 0.31, [0.13, 0.75]) but not at food preparation areas (aRR = 0.92, [0.33, 2.6]). Half of (23/46) of individual flies were positive for culturable Escherichia coli, and we detected ≥1 pathogen gene from 45% (79/176) of flies, including enteropathogenic E. coli (37/176), adenovirus (25/176), Giardia spp. (13/176), and Trichuris trichiura (12/176). We detected ≥1 pathogen gene from half the flies caught in control (54%, 30/56) and intervention compounds (50%, 17/34) at baseline, which decreased 12 months post-intervention to 43% (23/53) at control compounds and 27% (9/33) for intervention compounds. These data indicate flies as a potentially important mechanical vector for enteric pathogen transmission in this setting. The intervention may have reduced the risk of fly-mediated enteric infection for some pathogens, but infrequent detection resulted in wide confidence intervals; we observed no apparent difference in infection risk between groups in a pooled estimate of all pathogens assessed (aRR = 0.84, [0.61, 1.2]). The infection risks posed by flies suggest that the design of sanitation systems and service delivery should include fly control measures to prevent enteric pathogen transmission.


Assuntos
Dípteros , Saneamento , Animais , Escherichia coli , Moçambique , Bactérias , Fezes
8.
Soc Sci Med ; 317: 115621, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36542928

RESUMO

Gender-based violence resulting from water, sanitation and hygiene (WASH) insecurity is a major public health problem. WaSH gender-based (WaSH-GBV) is a spatio-temporal experience and has disproportionate health and wellbeing impacts on women and girls. However, the global community of WaSH practitioners and policymakers is yet to adequately address women's vulnerability to violence in relation to WaSH access. Informed by the feminist political ecology of health framework, we conducted in-depth interviews (n = 27, 16 women and 11 men) with Ghanaian immigrants to Canada to explore perceptions of WaSH experiences over lifecourse. Results revealed that participants' perceptions and experiences of GBV are both socially and context dependent, organized around four dimensions: structural, physical, psychological, and sexual. These muti-scalar dimensions of diasporans' WaSH experiences and perceptions in Ghana are discussed along with their implications for policy and practice, specifically in enhancing health equity and water security.


Assuntos
Violência de Gênero , Saneamento , Masculino , Humanos , Feminino , Água , Gana , Abastecimento de Água , Higiene , Dor
9.
Am J Trop Med Hyg ; 108(1): 195-199, 2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36509049

RESUMO

In disaster situations, cholera outbreaks represent a public health emergency due to their high fatality rates and high spreading risk through camps for refugees and internally displaced persons (IDPs). The aim of this study is to examine water, sanitation, and hygiene attitudes and cholera knowledge, attitude, and practice (KAP) among people living in resettlement sites in Cabo Delgado, the northernmost province of Mozambique. Between January 1 and March 31, 2022, a cross-sectional survey was conducted by administering a face-to-face interview to IDPs and residents in six relocation sites in Cabo Delgado Province. A total of 440 people were enrolled in the study. Overall, 77.8% (N = 342) were female, 61% (N = 268) were younger than 35 years old, and 60.5% (N = 266) reported primary school to be the highest education level. Seventy-five percent (N = 334) of participants lived with children under 5 years old. Thirty-one percent (N = 140) and 11.8% (N = 52) of the respondents reported, respectively, at least one cholera case and at least one diarrheal-related death among their family members in the previous 2 years. In multivariate analysis, being female, being younger than 35 years old, having attained a higher education level, owning a phone, or having soap at home were factors significantly associated with improved cholera KAP. In severely deconstructed social contexts, continuous education and community sensitization are crucial to achieve and maintain positive cholera prevention attitudes.


Assuntos
Cólera , Refugiados , Criança , Humanos , Feminino , Pré-Escolar , Adulto , Masculino , Saneamento , Água , Cólera/epidemiologia , Cólera/prevenção & controle , Moçambique/epidemiologia , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Higiene
10.
S Afr Med J ; 112(8b): 729-736, 2022 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-36458355

RESUMO

BACKGROUND: The incidence of diarrhoeal disease is closely linked to socioeconomic and environmental factors, household practices and access to health services. South African (SA) district health information and national survey data report wide variation in the incidence and prevalence of diarrhoeal episodes in children under 5 years of age. These differentials indicate potential for reducing the disease burden through improvements in provision of water and sanitation services and changes in hygiene behaviour. OBJECTIVES: To estimate the burden of disease attributed to unsafe water, sanitation and hygiene (WASH) by province, sex and age group for SA in 2000, 2006 and 2012. METHODS: Comparative risk assessment methodology was used to estimate the disease burden attributable to an exposure by comparing the observed risk factor distribution with a theoretical lowest possible population distribution. The study adapts the original World Health Organization scenario-based approach for estimating diarrhoeal disease burden from unsafe WASH, by assigning different standards of household water and sanitation-specific geographical classification to capture SA living conditions in rural, urban and informal settlements. RESULTS: SA experienced an improvement in water and sanitation supply in eight of the nine provinces between 2001 and 2011, with the exception of Northern Cape Province. In 2011, 41% of South Africans lived with poor water and sanitation conditions; however, wide provincial inequalities exist. In 2012, it was estimated that 84.1% of all deaths due to diarrhoeal disease were attributable to unsafe WASH; this equates to 13 757 deaths (95% uncertainty interval (UI) 13 015 - 14 300). Of these diarrhoeal disease deaths, 48.2% occurred in children under 5 years of age, accounting for 13.9% of all deaths in this age group (95% UI 13.1 - 14.4). Between 2000 and 2012, the proportion of deaths attributable to diarrhoea reduced from 3.6% to 2.6%. Gauteng and Western Cape provinces experienced much lower WASHattributable death rates than the more rural, poorer provinces. CONCLUSION: Unsafe WASH remains an important risk factor for disease in SA, especially in children. High priority needs to be given to the provision of safe and sustainable sanitation and water facilities and promoting safe hygiene behaviours. The COVID-19 pandemic has reinforced the critical importance of clean water for preventing and containing disease.


Assuntos
COVID-19 , Saneamento , Criança , Humanos , Pré-Escolar , África do Sul/epidemiologia , Água , Pandemias , Higiene , Diarreia/epidemiologia , Diarreia/etiologia , Efeitos Psicossociais da Doença
11.
Geospat Health ; 17(2)2022 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-36468596

RESUMO

We provide a novel approach to understanding the multiple causations of maternal anaemia in a geospatial context, highlighting how genetics, environment and socioeconomic disparities at the micro-geographical level lead to the inequitable distribution of anaemia. All first-trimester pregnant women registered for the antenatal care programme in Anuradhapura District, Sri Lanka from July to September 2019 were invited to the Rajarata Pregnancy Cohort (RaPCo), which assessed the prevalence of anaemia in early pregnancy. The combination of the prevalence of anaemia and minor haemoglobinopathy-related anaemia (MHA) with the poverty headcount index of the 22 health divisions in the district was investigated using GeoDa spatial K-means clustering. Sociodemographic and economic data at the divisional level were compared between identified clusters. Combining the analysis with the geographical and environmental characteristics of the region, further hypotheses regarding anaemia in this community were formulated. The study included data from 3,137 pregnant women in early pregnancy. The anaemia and MHA prevalence varied from 13.6 to 21.7% and from 2.6% to 5%, respectively. We identified four distinct spatial clusters. The cluster with the highest anaemia prevalence also included high poverty and the highest prevalence of MHA. The clusters had significant differences with regard to ethnic distribution, access to water, sanitation and dietary patterns. Areas supplied by major irrigation projects had significantly low levels of anaemia, probably attributable to internal migration and improved livelihood. It was evident that genetic, socioeconomic and environmental risk factors were grouped at the divisional level, and that their complex interactions make controlling anaemia with blanket interventions unsuccessful. Analysis of the distribution of heterogeneous risk factors at the micro-geospatial level helped identify context-specific approaches to tackle anaemia in pregnancy.


Assuntos
Anemia , Deficiências de Ferro , Gravidez , Feminino , Humanos , Sri Lanka/epidemiologia , Anemia/epidemiologia , Saneamento , Pobreza
12.
Front Public Health ; 10: 962108, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36452955

RESUMO

Background: Diarrhea remains one of the leading causes of mortality and morbidity, despite the global progression of eradicating the burden of diarrhea-related morbidity and mortality in the past two decades. In Sub-Saharan African (SSA) countries, there is inadequate supply and sanitation of safe water. However, there is a lack of literature that estimates the impact of drinking water and sanitation service on childhood diarrhea in Kersa Demographic and Health Surveillance. Therefore, the current study aimed to assess the prevalence and effect of water supply and environmental sanitation on diarrhea among under-five children from 2017 to 2021 in Kersa Demographic and Health Surveillance, Eastern Ethiopia. Method: A prospective cohort study design was implemented among 6,261 children from the Kersa Health Demographic Surveillance System (HDSS), Eastern Ethiopia, from 1 January 2016 to 31 December 2021. STATA statistical software was used to extract data from the datasets. The binary logistic regression was used to identify the impact of water supply and environmental sanitation on diarrhea by controlling important confounders. The adjusted odds ratio (AOR) with a 95% confidence interval measures this association. Result: The current study showed that among 6,261 under-five children, 41.75% of them had developed active diarrhea during the follow-up time. The final model depicted that having media exposure of 22% [AOR - 0.78 CI: (0.61, 0.98)], a protected tube well source of drinking water of 50% [AOR - 1.50, CI: (1.32, 1.71)], unprotected tube well source of drinking water of 66% [AOR - 1.66 CI: (1.27, 2.18)], having toilet facility of 13% [AOR - 0.87 CI: (0.78, 0.97)], and accessibility of source of water [AOR - 1.17 CI: (1.05, 1.30)] showed a significant association with diarrhea among under-five children. Conclusion: The prevalence of diarrhea is found to be high in the Kersa District. The main predictors of diarrhea under five were a lack of latrines, an unimproved source of drinking water, and a distance from access to drinking water. The study setting should focus on increasing the adequacy of safe drinking water and sanitation.


Assuntos
Água Potável , Saneamento , Criança , Humanos , Etiópia/epidemiologia , Estudos Prospectivos , Diarreia/epidemiologia , Demografia
13.
PLoS One ; 17(12): e0278184, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36490262

RESUMO

BACKGROUND: Diarrhea is one of the major cause of death and morbidity around the world. OBJECTIVES: This scoping review summarizes existing frameworks that aim to mitigate the risks of waterborne diarrheal diseases and describe the strengths and weaknesses of these frameworks. ELIGIBILITY CRITERIA: Published frameworks designed to mitigate the risks of waterborne diarrheal diseases. Frameworks published in English, from around the world and published since inception to date. SOURCES OF EVIDENCE: PubMed, Scopus, Web of Science, Google Scholar, Google Free Search, organization websites and reference lists of identified sources. CHARTING METHODS: Data were charted using the Joanna Briggs Institute tool. Results were summarized and described narratively. A criterion to score the strengths and weaknesses of the included frameworks was also developed. RESULTS: Five frameworks were identified including: the hygiene improvement framework, community led total sanitation, global action plan for pneumonia and diarrhea, participatory hygiene and sanitation transformation, and sanitation and family education. These frameworks shared several common components, including identification of problems and risk factors, identification and implementation of interventions, and evaluation and monitoring. The frameworks had several interventions including different infrastructure, health promotion and education, enabling environment and clinical treatments. Most of the frameworks included health promotion and education. All the frameworks were strengthened by including strategies for implementing and delivering intervention, human resource aspect, community involvement, monitoring, and evaluation. The main weakness included not having components for collecting, storing, and transferring electronic data and the frameworks not being specifically for mitigating waterborne diarrheal diseases. In addition, the identified frameworks were found to be effective in mitigating the risk of diarrhea diseases among other health effects. CONCLUSIONS: Existing frameworks should be updated specifically for mitigating waterborne diarrheal diseases that includes the strengths and addresses weaknesses of reviewed frameworks.


Assuntos
Higiene , Saneamento , Humanos , Diarreia/epidemiologia , Diarreia/prevenção & controle , Promoção da Saúde , Morbidade
14.
Front Public Health ; 10: 1026714, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36568759

RESUMO

Toilet sanitation is related to public health and environmental protection. In the context of the toilet revolution in rural China, an ordered probit regression analysis was conducted to evaluate the impact of access to sanitary toilets on rural residents' health. Using data from the China Family Panel Study (CFPS) in 2014, we found that access to sanitary toilets in rural households significantly improved residents' health, and this finding remained robust across a series of checks. Meanwhile, results of the mechanism analysis showed that preventing feces from contaminating water sources was an important mechanism behind the positive effects of sanitary toilet use on health. We also found that the impact of access to sanitary toilets was more pronounced among female, middle-aged, and low-income people. Toilet revolution plays an important role in ensuring residents' health and protecting water sources, thereby underscoring the need for governments in developing countries to invest in sanitary toilets. In addition, the existing policies and sanitation programs in China need to be improved to promote public health.


Assuntos
Aparelho Sanitário , Pessoa de Meia-Idade , Humanos , Adulto , Feminino , Toaletes , Saneamento , Saúde Pública , Água
15.
Front Public Health ; 10: 1042880, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36568770

RESUMO

Background: International travelers often experience travelers' diarrhea. However, there is paucity of data on whether self-reported gastrointestinal symptoms influence travelers' perceptions of adequacy of sanitation and hygiene services encountered during travel, and to what degree their travel plans, and overall trip experience are impacted. Methods: A cross-sectional face-to-face survey was conducted amongst international travelers in India. Data collected included socio-demographics, travel characteristics, self-reported occurrence and frequency/severity of gastrointestinal symptoms, perceptions of sanitation and hygiene encountered, and adverse effects of symptoms on travel plans and trip experiences. Chi-square tests and logistic regression were performed to describe differences and associations between categorical variables. Results: Of the 300 international travelers surveyed, 46.3% experienced diarrhea. At least two thirds of travelers perceived the quality of sanitation (67.0%) and hygiene (70.0%) encountered to be inadequate. Perceptions of inadequate sanitation (adjusted OR = 3.0; 95% CI 1.7-5.5) and poor hygiene (adjusted OR = 7.7; 95% CI 4.1-15.5) were higher among travelers who experienced diarrhea. Additionally, both higher likelihood of travel plans being affected (adjusted OR = 10.7; 95% CI 5.1-23.6) and adverse impacts on overall trip experience (adjusted OR = 2.8; 95% CI 1.4-5.8) were reported among those who experienced diarrhea. Conclusions: More than two thirds of travelers surveyed in India experienced inadequate sanitation and hygiene services, with perceptions influenced by occurrence and frequency of diarrhea. Self-reported diarrhea was also associated with adverse effects on travel plans and overall trip experience. While these results may seem intuitive, they have important implications and suggest that improving sanitation and hygiene standards in India could potentially enhance tourism.


Assuntos
Diarreia , Saneamento , Humanos , Diarreia/prevenção & controle , Estudos Transversais , Viagem , Higiene , Índia
16.
Water Sci Technol ; 86(9): 2348-2357, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36378184

RESUMO

Over the recent years, managers of the Algerian National Sanitation Office (ONA) have been worrying about the degraded state of their Urban Drainage Systems (UDS). This infrastructure failure is due essentially to the lack of funding and absence of adequate structured methodology for diagnosis and maintenance. As a result, ONA's managers found it very interesting to get a tool that allows them to assess their management of UDS operation. The aim of this paper is therefore to provide an assessment tool to managers for a good network operation. The adopted approach is participative and takes into account the specific local context. Six performance indicators, grouped into two criteria, have been constructed to achieve this objective. These indicators have been chosen for their effectiveness; they are scaled to get their performance scores according to a scaling constructed here based on standards when available and to the ONA expert's recommendations. The developed tool is applied to the UDS of Bejaia City, in north-eastern Algeria. The assessment and the analysis of the performance evolution of these indicators for the period 2017-2021 are carried out. The results highlighted successes that can be maintained as well as weaknesses that need to be improved.


Assuntos
Saneamento , Argélia , Cidades
17.
PLoS One ; 17(11): e0275491, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36378662

RESUMO

INTRODUCTION: Despite many institutions gaining access to improved water sanitation and hygiene (WASH) services, childcare centres in informal settlements have low access and poor condition of WASH services. It is imperative to understand how existing actors and social networks operate in the WASH sector in childcare centres in Nairobi's informal settlements. OBJECTIVE: To empirically map and understand how different actors within informal settlements influence the provision of adequate and quality water, sanitation and hygiene services within childcare centres in Nairobi's informal settlements. METHODS: This was a qualitative study. We conducted an ethnographic study using governance diaries with 24 participants from Korogocho and Viwandani informal settlements in Nairobi, Kenya. The governance diaries approach involved conducting bi-weekly governance in-depth interviews (IDIs) with study participants for 4 months, complemented with observations, reflections, participant diaries and informal discussions. We used a framework analysis which is partly deductive, informed by the governance framework and stakeholder framework. RESULTS: Social accountability actors were individuals or groups involved in WASH service provision in childcare centres. The actors included both key actors (actors who are primary to meeting the day-to-day WASH service needs of children) and non-key actors (actors operating in the WASH sector but not always present for day-to-day provision in childcare centres). The key actors were unanimously identified as childcare centre owners/teachers and parents/guardians as they had a more direct role in the provision of WASH services in childcare centres. The actors had direct, possible or desired networks, with the direct networks portrayed more by the parents and childcare centre owners, whose roles included acting as a voice and responding to the WASH service needs of children as it relates to access and quality. Centre owners had more power/authority over WASH services for children in childcare centres than the parents. Key actors derived power by their discretion depending on whether a decision was beneficial to children or not. Lastly, the interest of key actors were diverse ranging from income generation, access to WASH services by children, compliance with government regulations, and promotion of child health, to the prevention of the spread of diseases. CONCLUSION: Our study highlights that parents and childcare owners play an important role in WASH service provision. While service providers and other players may be statutorily given primary responsibilities for WASH provision, and more visible in official standing, among study participants they are not seen as primary actors but secondary players with ancillary responsibilities. We conclude that WASH service provision in child care centres may be realised when key actors have a voice and work within networks to demand WASH services from desired networks including the government. We also conclude that developing more direct networks and converting desired and potential networks into direct networks in WASH service provision is critical for the success of WASH service delivery. Lastly, actors in WASH services in childcare centres may need to collaborate in identifying potential avenues for strengthening existing networks that enhance access and quality of WASH services in childcare centres.


Assuntos
Cuidado da Criança , Saneamento , Humanos , Criança , Saúde da Criança , Água , Quênia , Higiene , Responsabilidade Social
18.
PLoS Biol ; 20(11): e3001903, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36383561

RESUMO

Despite high mortality and morbidity, drug-resistant bacterial infections remain the forgotten pandemic. We argue for strengthening of diagnostics, WASH (water, sanitation, and hygiene) and infection prevention and control to reduce drug-resistant infections, as an integral part of sustainable high-quality health services, particularly in low- and middle-income countries.


Assuntos
Infecções Bacterianas , Saneamento , Humanos , Higiene , Pandemias , Água , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/prevenção & controle
19.
Pan Afr Med J ; 42: 279, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36405663

RESUMO

Cholera disproportionately affects the most vulnerable segments of the population, particularly those who have low or no access to basic water, sanitation, and hygiene (WASH). Despite some improvements in WASH conditions, cholera still represents a persistent challenge in Mozambique, where outbreaks occur almost every year, with high case fatality rates, posing a threat to the country's economic development. The Government of Mozambique has started developing a revised National Cholera Plan (NCP), which aligns with "ending cholera-a global roadmap to 2030" launched by the Global Task Force on Cholera Control (GTFCC) in 2017. Ending cholera represents a critical step towards achieving the sustainable development goals and requires effective prevention and control interventions, ensuring that no one is left behind. The NCP must use a multi-sector approach and broad stakeholder collaboration with well-coordinated roles and functions of different partners to address major areas for cholera elimination - water and sanitation, health care services and management, epidemiology and surveillance, and health and hygiene promotion. Every cholera death is preventable. In this review, we reiterate the need for effective coordinated actions to control and eliminate cholera in Mozambique and decrease the cholera burden, enabling a healthy population over the generations.


Assuntos
Cólera , Humanos , Cólera/epidemiologia , Cólera/prevenção & controle , Moçambique/epidemiologia , Saneamento , Surtos de Doenças/prevenção & controle , Água
20.
Sci Rep ; 12(1): 19293, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36369357

RESUMO

Stunting is a public health issue of global concern. Despite, poor sanitation, diarrhea, parasitic infections, and environmental enteric dysfunction (EED) are associated with stunting, their link is poorly understood and has not been investigated in Ethiopia. This study was conducted to assess the associations of stunting with sanitation, enteric infections, and EED among children aged 24-59 months in rural northwest Ethiopia. A community-based cross-sectional study was conducted among 224 randomly selected children aged 24-59 months in rural areas of the east Dembiya district. We collected information on household food insecurity and dietary diversity using pre-tested questionnaires adopted from the food and nutrition technical assistance (FANTA) project. We used height-for-age-z score (HAZ) to define stunting. We also used the data collected to measure the environmental exposures of children to intestinal parasitic infections and fecal biomarkers of EED. A multivariable binary logistic regression model was used to assess the association of stunting with sanitation, enteric infections, and EED. Of the 224 children, 33% (95% CI 27, 39%) were stunted. Stunting in children was significantly associated with poor dietary intake (AOR 3.0, 95% CI 1.2, 7.3), open defecation practice (AOR 3.0, 95% CI 1.2, 7.9), presence of animal excreta in the living environment (AOR 3.4, 95% CI 1.2, 9.9), E. coli contamination of drinking water (AOR 4.2, 95% CI 1.1, 15.3), diarrheal disease incidence (AOR 3.4, 95% CI 1.5, 7.7), intestinal parasites in children (AOR 3.3, 95% CI 1.3, 8.8), and higher EED disease activity scores (AOR 2.9, 95% CI 1.2, 6.7). One-third of the children in the study area were stunted and this high prevalence of stunting was associated with poor dietary intake, poor hygiene and sanitation conditions, enteric infections, and EED. Thus, stunting can be prevented by improving sanitation and hygienic conditions to prevent repeated enteric infections in children and by promoting dietary diversity of children.


Assuntos
Enteropatias Parasitárias , Saneamento , Animais , Estudos Transversais , Etiópia/epidemiologia , Escherichia coli , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Enteropatias Parasitárias/complicações , Prevalência , Diarreia/etiologia , Diarreia/complicações
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