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1.
PLoS Negl Trop Dis ; 14(3): e0008048, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32187188

RESUMO

Investments in water and sanitation systems are believed to have led to the decline in typhoid fever in developed countries, such that most cases now occur in regions lacking adequate clean water and sanitation. Exploring seasonal and long-term patterns in historical typhoid mortality in the United States can offer deeper understanding of disease drivers. We fit modified Time-series Susceptible-Infectious-Recovered models to city-level weekly mortality counts to estimate seasonal and long-term typhoid transmission. We examined seasonal transmission separately by city and aggregated by water source. Typhoid transmission peaked in late summer/early fall. Seasonality varied by water source, with the greatest variation occurring in cities with reservoirs. We then fit hierarchical regression models to measure associations between long-term transmission and annual financial investments in water and sewer systems. Overall historical $1 per capita ($16.13 in 2017) investments in the water supply were associated with approximately 5% (95% confidence interval: 3-6%) decreases in typhoid transmission, while $1 increases in the overall sewer system investments were associated with estimated 6% (95% confidence interval: 4-9%) decreases. Our findings aid in the understanding of typhoid transmission dynamics and potential impacts of water and sanitation improvements, and can inform cost-effectiveness analyses of interventions to reduce the typhoid burden.


Assuntos
Transmissão de Doença Infecciosa/história , Saneamento/métodos , Febre Tifoide/mortalidade , Febre Tifoide/transmissão , Cidades/epidemiologia , História do Século XIX , História do Século XX , Humanos , Saneamento/história , Saneamento/tendências , Estações do Ano , Análise de Sobrevida , Febre Tifoide/história , Estados Unidos/epidemiologia
2.
PLoS One ; 15(2): e0229303, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32074128

RESUMO

INTRODUCTION: Diarrhea is one of the leading causes of child morbidity and mortality in low- and middle-income countries like Ethiopia. The use of safe drinking water and improved sanitation are important practices to prevent diarrhea. However, limited research has been done to link water supply, sanitation and hygiene practices and childhood diarrhea. Therefore, this study aimed at assessing the association between microbial quality of drinking water, sanitation and hygiene practices and childhood diarrhea. METHODS: Community-based matched case-control study design was applied on 198 paired children from June to July 2019 in Kersa and Omo Nada districts of Jimma Zone, Ethiopia. Cases are children < 5 years of age with diarrhea during the two weeks before the survey. The controls are children without diarrhea during the two weeks before the survey. Twenty-five percent matched pair samples of water were taken from households of cases and controls. Data were collected using structured questionnaire by interviewing mothers/caregivers. A sample of water was collected in nonreactive borosilicate glass bottles and analyzed by the membrane filtration method to count fecal indicator bacteria. A conditional logistic regression model was used; variables with p-value less than 0.05 were considered as significantly associated with childhood diarrhea. RESULTS: A total of 396 (each case matched with control) under-five children with their mothers/caregivers were included in this study. In the analysis, variables like presence of under-five child in their home (AOR = 2.76; 95% CI: 1.33-5.71), wealth status (AOR = 5.39; 95% CI: 1.99-14.55), main sources of drinking water (AOR = 4.01; 95% CI: 1.40-11.44), hand washing practice before water collection (AOR = 4.28; 95% CI: 1.46-12.56), treating water at household level (AOR = 1.22; 95% CI: 0.48-3.09), latrine use all the times of the day and night (AOR = 0.22; 95% CI: 0.06-0.78), using pit as method of waste disposal (AOR = 4.91; 95% CI: 1.39-13.29) and use of soap for hand washing (AOR = 2.89; 95% CI: 1.35-6.15) were significantly associated with childhood diarrhea. Moreover, 30% of sampled water from cases and 26% of sampled water from controls families were free from Escherichia coli whereas all sampled water analyzed for Total coliforms were positive. CONCLUSIONS: We conclude that the main sources of drinking water, hand washing before water drawing from a storage container, domestic waste disposal place and use of soap for hand washing were the most important factors for the prevention of childhood diarrhea.


Assuntos
Diarreia/epidemiologia , Diarreia/prevenção & controle , Higiene/normas , Saneamento/métodos , Qualidade da Água/normas , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Diarreia/microbiologia , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
3.
Environ Monit Assess ; 192(2): 96, 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31912299

RESUMO

The objective of this study is to provide a view of the geographic distribution of basic sanitation services offered in Parana, Brazil. Temporal distributions, spatial patterns, and clusters were determined using 2000, 2010, and 2016 data. Tabular data of the percentages of households receiving water supply, waste collection, and sanitary sewage treatments were used as the basic inputs of the study. Time series maps were created using geographic information systems (GIS) for the visualization of the temporal changes in basic sanitation rates. The spatial variation in sanitation services was measured using Moran's Global Index (Moran's I), while the Local Indicators of Spatial Association (LISA) and Getis-Ord Gi*(d) were used to identify the presence of possible clusters and hot spots in the percentage of households with sanitation services. The study showed strong evidence that the service rates for sanitary sewage were significantly lower than those for water supply and waste collection. Waste collection proved to have the highest service rate in the study area. Waste collection was also the service that increased the most in the study period, followed by the water supply service. Identification of the most vulnerable municipalities was performed using LISA and the local Getis-Ord Gi*(d) statistic. Most of the low value clusters and cold spots were detected in the southern and west-central regions, while the high value hot spots and clusters were detected in the northern and northeastern regions of the state of Parana.


Assuntos
Monitoramento Ambiental/métodos , Sistemas de Informação Geográfica , Saneamento/métodos , Purificação da Água/estatística & dados numéricos , Brasil , Cidades , Meio Ambiente , Humanos , Análise Espacial , Abastecimento de Água/normas
4.
PLoS One ; 15(1): e0227273, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31899772

RESUMO

Soil Transmitted Helminth (STH) infections affect over 1.5 billion people worldwide. Although prevalent in all age groups, school aged children are a high-risk groups for STH infections. In Bhutan, epidemiological data on STH were collected from western Bhutan in 2003, which found a prevalence of 16.5%. However, little evidence is available on the prevalence of infection at national level. Therefore, this study was conducted with the aim to assess the prevalence and intensity of STH infections, and identify significant correlates of STH among students. A school-based survey was conducted in three regions of Bhutan. Two-stage cluster sampling was adopted to select a sample of 1500 students from 24 schools, in equal proportion from three regions of the country. A total of 1456 (97%) students were interviewed and their stool sample examined for the presence of parasites. Mini-FLOTAC technique was used to detect the parasite eggs/ova. The prevalence of any STH infection was 1.4%, with 0.8% Ascaris lumbricoides, 0.5% Trichuris trichiura and 0.2% hookworms. The eastern region had the highest prevalence at 2.3%. Except for one student who had moderate intensity of A. lumbricoides, the rest had light infection. Any STH presence was significantly associated with father's occupation, father's education level, type of house and the flooring of the house in which students reported to live. No significant associations were observed between water, sanitation and hygiene (WASH) variables measured and presence of any STH infection. The prevalence of STH was found to be very low with primarily light intensity in this study. Nonetheless, it was also found that the sanitation situation is not ideal in the country, with several students reporting constant or partial open defecation leading to environmental contamination. Based on this prevalence and in line with the WHO guideline, it is recommended that deworming be reduced to once a year in combination with concerted health education on proper hygiene and sanitation practice.


Assuntos
Anti-Helmínticos/administração & dosagem , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Helmintíase/epidemiologia , Solo/parasitologia , Adolescente , Albendazol/administração & dosagem , Animais , Butão/epidemiologia , Criança , Estudos Transversais , Defecação , Água Potável/parasitologia , Fezes/parasitologia , Feminino , Helmintíase/parasitologia , Helmintíase/prevenção & controle , Helmintíase/transmissão , Humanos , Higiene , Masculino , Prevalência , Saneamento/métodos , Saneamento/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adulto Jovem
5.
PLoS One ; 15(1): e0226549, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31914164

RESUMO

INTRODUCTION: Cholera remains a frequent cause of outbreaks globally, particularly in areas with inadequate water, sanitation and hygiene (WASH) services. Cholera is spread through faecal-oral routes, and studies demonstrate that ingestion of Vibrio cholerae occurs from consuming contaminated food and water, contact with cholera cases and transmission from contaminated environmental point sources. WASH guidelines recommending interventions for the prevention and control of cholera are numerous and vary considerably in their recommendations. To date, there has been no review of practice guidelines used in cholera prevention and control programmes. METHODS: We systematically searched international agency websites to identify WASH intervention guidelines used in cholera programmes in endemic and epidemic settings. Recommendations listed in the guidelines were extracted, categorised and analysed. Analysis was based on consistency, concordance and recommendations were classified on the basis of whether the interventions targeted within-household or community-level transmission. RESULTS: Eight international guidelines were included in this review: three by non-governmental organisations (NGOs), one from a non-profit organisation (NPO), three from multilateral organisations and one from a research institution. There were 95 distinct recommendations identified, and concordance among guidelines was poor to fair. All categories of WASH interventions were featured in the guidelines. The majority of recommendations targeted community-level transmission (45%), 35% targeted within-household transmission and 20% both. CONCLUSIONS: Recent evidence suggests that interventions for effective cholera control and response to epidemics should focus on case-centred approaches and within-household transmission. Guidelines did consistently propose interventions targeting transmission within households. However, the majority of recommendations listed in guidelines targeted community-level transmission and tended to be more focused on preventing contamination of the environment by cases or recurrent outbreaks, and the level of service required to interrupt community-level transmission was often not specified. The guidelines in current use were varied and interpretation may be difficult when conflicting recommendations are provided. Future editions of guidelines should reflect on the inclusion of evidence-based approaches, cholera transmission models and resource-efficient strategies.


Assuntos
Cólera/prevenção & controle , Surtos de Doenças/prevenção & controle , Epidemias/prevenção & controle , Características da Família , Guias como Assunto/normas , Saneamento/métodos , Purificação da Água/métodos , Cólera/microbiologia , Cólera/transmissão , Humanos , Agências Internacionais , Microbiologia da Água
6.
Int J Hyg Environ Health ; 223(1): 289-298, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31279687

RESUMO

In Urban Africa, water and sanitation utility companies are facing a huge backlog of sanitation provision in the informal settlement areas. In order to clear this backlog, new investment is required. However, to select appropriate sanitation technologies, lifecycle costs need to be assessed. The aim of this research was to establish lifecycle costs for appropriate sanitation technologies in informal settlement areas. Three sanitation options were compared: simplified sewerage, urine diversion dry toilet (UDDT) and Ventilated Improved Pit (VIP) latrine. Three scenarios for simplified sewerage were considered; gravity flow into existing conventional sewers with treatment; new-build with pumping and treatment; and new-build gravity flow with treatment. The study revealed that simplified sewerage is the cheapest option for Soweto informal settlement, even when the costs of pumping and treatment are included. Gravity simplified sewerage with treatment is cheaper than the UDDT system and VIP latrine at all population densities above 158 and 172 persons/ha, respectively. The total annual cost per household of simplified sewerage and treatment was US$142 compared to US$156 and US$144 for UDDT and VIP latrine respectively. The costs of simplified sewerage could be recovered through a monthly household surcharge and cross-subsidy summing US$5.3 The study concluded that simplified sewerage system was the first choice for Soweto informal settlement areas, given the current population density.


Assuntos
Saneamento/métodos , Aparelho Sanitário , Custos e Análise de Custo , Saneamento/economia , Esgotos , África do Sul , Toaletes
7.
Acta Trop ; 201: 105214, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31600519

RESUMO

Human hookworm, a soil-transmitted helminth (STH) infection caused by either Necator americanus or Anclystoma duodenale, is a major cause of morbidity globally and predominantly affects the world's poorest populations. Transmitted primarily by larval invasion of exposed skin, the adults inhabit the host small intestine, where they consume host blood. The resultant chronic iron deficiency anemia can lead to stunted growth and cognitive deficits in children, reduced work capacity in adults, and a variety of pregnancy complications. Historically, successful STH elimination has only been achieved in regions with concomitant significant economic growth. Since 2001, control of the STHs has been attempted via single-dose mass deworming of at-risk school-aged and preschool-aged children within STH-endemic countries, with the goal of morbidity reduction. Research questioning this strategy has grown in recent years, and current studies are evaluating the effectiveness of novel deworming strategies, including multidrug regimens and expansion of deworming to entire communities. While footwear campaigns may be associated with reduced odds of hookworm infection, the evidence supporting the impact of water, sanitation, and hygiene (WASH) interventions upon hookworm is mixed. Progress towards a human hookworm vaccine continues, with promising results from recent Phase 1 trials and several others ongoing. Integrated STH control programs, which combine mass deworming with WASH interventions, are relatively unstudied but may be a promising advancement. Whether interruption of STH transmission can be achieved apart from significant economic growth remains unanswered, but likely the implementation of intensive, integrated control programs will be necessary to achieve that goal.


Assuntos
Erradicação de Doenças/métodos , Erradicação de Doenças/tendências , Helmintíase/prevenção & controle , Infecções por Uncinaria/prevenção & controle , Saneamento/métodos , Animais , Previsões , Helmintíase/epidemiologia , Infecções por Uncinaria/epidemiologia , Humanos
8.
Artigo em Inglês | MEDLINE | ID: mdl-31861269

RESUMO

Community-level action may be required to achieve the levels of sanitation uptake necessary for health gains. Evidence suggests that collective action is influenced by collective efficacy (CE)-a group's belief in its abilities to organize and execute action to achieve common goals. The extent to which it is necessary to fully contextualize existing CE measurement tools, in order to conduct meaningful assessments of the factors influencing CE perceptions, is not well understood. This study examines the value added of contextualizing an existing CE measurement tool using qualitative formative research. We employed a modified grounded theory approach to develop a contextualized CE framework based on qualitative data from rural Cambodian villages. The resulting framework included sub-constructs that were pertinent for the rural Cambodian context for which an existing, hypothesized framework did not account: perceived risks/benefits, action knowledge, shared needs/benefits, and external accountability. Complex confirmatory factor analyses indicated that contextualized models fit the data better than hypothesized models for women and men. This study demonstrates that inductive, qualitative research allows community-derived factors to enhance existing tools for context-specific CE measurement. Additional research is needed to determine which CE factors transcend contexts and could, thus, form the foundation of a general CE measurement tool.


Assuntos
Participação da Comunidade/estatística & dados numéricos , Higiene , População Rural/estatística & dados numéricos , Saneamento/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Camboja , Feminino , Teoria Fundamentada , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Saneamento/métodos , Adulto Jovem
9.
PLoS One ; 14(12): e0221193, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31841549

RESUMO

Rapid urbanization has led to a growing sanitation crisis in urban areas of Bangladesh and potential exposure to fecal contamination in the urban environment due to inadequate sanitation and poor fecal sludge management. Limited data are available on environmental fecal contamination associated with different exposure pathways in urban Dhaka. We conducted a cross-sectional study to explore the magnitude of fecal contamination in the environment in low-income, high-income, and transient/floating neighborhoods in urban Dhaka. Ten samples were collected from each of 10 environmental compartments in 10 different neighborhoods (4 low-income, 4 high-income and 2 transient/floating neighborhoods). These 1,000 samples were analyzed with the IDEXX-Quanti-Tray technique to determine most-probable-number (MPN) of E. coli. Samples of open drains (6.91 log10 MPN/100 mL), surface water (5.28 log10 MPN/100 mL), floodwater (4.60 log10 MPN/100 mL), produce (3.19 log10 MPN/serving), soil (2.29 log10 MPN/gram), and street food (1.79 log10 MPN/gram) had the highest mean log10 E. coli contamination compared to other samples. The contamination concentrations did not differ between low-income and high-income neighborhoods for shared latrine swabs, open drains, municipal water, produce, and street foodsamples. E. coli contamination levels were significantly higher (p <0.05) in low-income neighborhoods compared to high-income for soil (0.91 log10 MPN/gram, 95% CI, 0.39, 1.43), bathing water (0.98 log10 MPN/100 mL, 95% CI, 0.41, 1.54), non-municipal water (0.64 log10 MPN/100 mL, 95% CI, 0.24, 1.04), surface water (1.92 log10 MPN/100 mL, 95% CI, 1.44, 2.40), and floodwater (0.48 log10 MPN/100 mL, 95% CI, 0.03, 0.92) samples. E. coli contamination were significantly higher (p<0.05) in low-income neighborhoods compared to transient/floating neighborhoods for drain water, bathing water, non-municipal water and surface water. Future studies should examine behavior that brings people into contact with the environment and assess the extent of exposure to fecal contamination in the environment through multiple pathways and associated risks.


Assuntos
Monitoramento Ambiental/métodos , Fezes/microbiologia , Bangladesh , Estudos Transversais , Poluição Ambiental/efeitos adversos , Escherichia coli/patogenicidade , Contaminação de Alimentos , Humanos , Pobreza , Características de Residência , Saneamento/métodos , Solo , Microbiologia do Solo , Urbanização/tendências , Água/análise , Microbiologia da Água
10.
PLoS One ; 14(12): e0226548, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31841540

RESUMO

BACKGROUND: Poor water sanitation and hygiene (WASH) in health care facilities increases hospital-associated infections, and the resulting greater use of second-line antibiotics drives antimicrobial resistance. Recognising the existing gaps, the World Health Organisations' Water and Sanitation for Health Facility Improvement Tool (WASH-FIT) was designed for self-assessment. The tool was designed for small primary care facilities mainly providing outpatient and limited inpatient care and was not designed to compare hospital performance. Together with technical experts, we worked to adapt the tool for use in larger facilities with multiple inpatient units (wards), allowing for comparison between facilities and prompt action at different levels of the health system. METHODS: We adapted the existing facility improvement tool (WASH-FIT) to create a simple numeric scoring approach. This is to illustrate the variation across hospitals and to facilitate monitoring of progress over time and to group indicators that can be used to identify this variation. Working with stakeholders, we identified those responsible for action to improve WASH at different levels of the health system and used piloting, analysis of interview data to establish the feasibility and potential value of the WASH Facility Survey Tool (WASH-FAST) to demonstrate such variability. RESULTS: We present an aggregate percentage score based on 65 indicators at the facility level to summarise hospitals' overall WASH status and how this varies. Thirty-four of the 65 indicators spanning four WASH domains can be assessed at ward level enabling within hospital variations to be highlighted. Three levels of responsibility for WASH service monitoring and improvement were identified with stakeholders: the county/regional level, senior hospital management and hospital infection prevention and control committees. CONCLUSION: We propose WASH-FAST can be used as a survey tool to assess, measure and monitor the progress of WASH in hospitals in resource-limited settings, providing useful data for decision making and tracking improvements over time.


Assuntos
Desinfecção das Mãos/métodos , Desinfecção das Mãos/normas , Higiene das Mãos/normas , Saneamento/normas , Inquéritos e Questionários/normas , Purificação da Água/normas , Organização Mundial da Saúde , Infecção Hospitalar/prevenção & controle , Estudos de Viabilidade , Saúde Global , Implementação de Plano de Saúde/normas , Hospitais , Humanos , Guias de Prática Clínica como Assunto/normas , Melhoria de Qualidade , Saneamento/métodos , Fatores de Tempo , Purificação da Água/métodos , Abastecimento de Água/normas
11.
PLoS Negl Trop Dis ; 13(10): e0007784, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31596851

RESUMO

BACKGROUND: Trachoma is the leading infectious cause of blindness. However, little is known about the behavioural and environmental determinants of transmission of the causative organism, Chlamydia trachomatis. We conducted formative research in a trachoma hyper-endemic area of Ethiopia to explore the behaviours which are likely to contribute to trachoma transmission and map their determinants. METHODOLOGY/PRINCIPAL FINDINGS: Data on water use, hygiene, defecation, and sleeping arrangements were collected from five communities during the dry and rainy seasons in 2016. Data collection involved direct observation in households (n = 20), interviews with caregivers (n = 20) and focus group discussions (n = 11). Although several behaviours that likely contribute to trachoma transmission were identified, no single behaviour stood out as the dominant contributor. Hygiene practices reflected high levels of poverty and water scarcity. Face washing and soap use varied within and between households, and were associated with other factors such as school attendance. Children's faces were rarely wiped to remove nasal or ocular discharge, which was not perceived to be socially undesirable. Bathing and laundry were performed infrequently due to the amount of time and water required. Open defecation was a normative practice, particularly for young children. Latrines, when present, were poorly constructed, maintained and used. Young children and parents slept closely together and shared bedding that was infrequently washed. CONCLUSIONS/SIGNIFICANCE: Existing norms and enabling factors in this context favour the development of interventions to improve facial cleanliness as more feasible than those that reduce unsafe faeces disposal. Interventions to increase the frequency of bathing and laundry may also be infeasible unless water availability within the home is improved.


Assuntos
Higiene , Saneamento/métodos , Tracoma/prevenção & controle , Tracoma/transmissão , Adolescente , Criança , Pré-Escolar , Chlamydia trachomatis , Defecação , Saúde Ambiental , Etiópia , Face/microbiologia , Características da Família , Feminino , Grupos Focais , Comportamentos Relacionados com a Saúde , Humanos , Lactente , Masculino , Fatores de Risco , População Rural , Tracoma/microbiologia
12.
BMC Infect Dis ; 19(1): 886, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651236

RESUMO

BACKGROUND: Trachoma, caused by Chlamydia trachomatis is the leading infectious cause of blindness. It is transmitted via personal contact with infected ocular and nasal secretions by hands, fomites and eye- seeking flies. Active trachoma is more common among children aged 1 to 9 years. The objective of this study was determining the prevalence of active trachoma and associated factors among children aged 1 to 9 years in rural community of Lemo district. METHODS: Community-based cross-sectional study was conducted from March to April, 2018 in rural community of Lemo district. Multistage sampling technique was used to select 589 study participants. Data were collected by using structured pre-tested questionnaire, physical examination and observation. Binocular loupe was used to identify active trachoma cases. The data were entered by using EPi-data version 3.1 and analyzed by SPSS. Binary logistic regression was used to assess factors associated with active trachoma. Variables with p-value < 0.05 in the multivariable analysis were used to declare significance of association. RESULT: Eighty seven (15.2%) children were positive for active trachoma. Absence of solid waste disposal pit (AOR = 2.20, 95% CI (1.12-4.37), do not use latrine as reported by respondent (AOR = 7.53, 95% CI (2.86-19.84), do not use soap for face washing as reported by respondent (AOR =2.3, 95% CI (1.32-4.12), washing face frequency as reported by respondent (AOR = 1.86, 95% CI (1.06-3.26), and family size greater than five (AOR = 1.96, 95% CI (1.06-3.67) were significantly associated with active trachoma. CONCLUSION: Active trachoma among children aged 1 to 9 years is high. Do not use latrine, do not use soap for face washing, and face washing frequency in a day as reported by respondents and family size were associated with active trachoma. Access to adequate water and sanitation can be important components in working towards eliminating trachoma as a public health problem. Therefore, prompt measures must be taken by concerned bodies to increase access to adequate water and sanitation facilities.


Assuntos
Saneamento/métodos , Tracoma/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Etiópia/epidemiologia , Características da Família , Feminino , Água Doce , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Prevalência , Fatores de Risco , População Rural , Sabões
13.
Artigo em Inglês | MEDLINE | ID: mdl-31627456

RESUMO

In many low income developing countries, socioeconomic, environmental and demographic factors have been linked to around half of the disease related deaths that occur each year. The aim of this study is to investigate the sociodemographic factors, mother and child health status, water, sanitation, and hygienic conditions of a Nepalese community residing in a hilly rural village, and to identify factors associated with mother and child health status and the occurrence of diarrheal and febrile disease. A community-based cross-sectional survey was carried out and 315 households from the village of Narjamandap were included in this study. Factors associated with diarrhea, febrile disease, and full maternal and under-five immunizations were assessed using logistic regression. Results showed that higher education level (middle school versus primary education; Odds Ratio (OR): 0.55, p = 0.04; high school versus primary education; OR 0.21, p = 0.001) and having a toilet facility at home were significantly associated with a lower risk of developing diarrhea and febrile disease (OR 0.49, p = 0.01), while, interestingly, the use of improved water supply was associated with higher risk (OR 3.07, p = 0.005). In terms of maternal immunization, the odds of receiving a tetanus toxoid vaccination were higher in women who had regular antenatal checkups (OR 12.9, p < 0.001), and in those who developed complications during pregnancy (OR 4.54, p = 0.04); for under-five immunization, the odds of receiving full vaccination were higher among children from households that reported diarrhea (OR 2.76, p < 0.001). The findings of this study indicated that gaps still exist in the mother and child healthcare being provided, in terms of receiving antenatal checkups and basic immunizations, as evidenced by irregular antenatal checkups, incomplete and zero vaccination cases, and higher under-five deaths. Specific public health interventions to promote maternal health and the health of under-five children are suggested.


Assuntos
Saúde da Criança , Nível de Saúde , Higiene , Mães , Saneamento/métodos , Adulto , Criança , Pré-Escolar , Estudos Transversais , Países em Desenvolvimento , Diarreia/epidemiologia , Feminino , Humanos , Imunização/efeitos adversos , Modelos Logísticos , Nepal/epidemiologia , Razão de Chances , Pobreza , Gravidez , Saúde Pública , População Rural , Toaletes , Água , Abastecimento de Água
14.
Biofouling ; 35(8): 883-899, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31663364

RESUMO

Biofilm growth is a significant source of contamination in the food industry. Enzymes are considered green countermeasures against biofilm formation in the food industry owing to their biodegradability and low toxicity. In this study, the synergistic effect of enzymes was studied against biofilm cleaning from hard surfaces. A mixed-microbial sample was sourced from a meat packaging line and biofilms were grown under high shear conditions on stainless steel and polyethylene surfaces. A model cleaning-in-place (CIP) parallel-plate flow chamber was used for firstly, the enzymatic cleaning and secondly, a disinfection step. The cleaning effectiveness was evaluated in response to different formulations containing non-foaming commercial surfactants among with amylase, protease and lipase at neutral pH. The formulation combining all three enzymes was the most effective, showing a synergy essential for the deformation of biofilm structure and consequently better disinfection of both material surfaces.


Assuntos
Biofilmes/crescimento & desenvolvimento , Detergentes/química , Desinfecção/métodos , Indústria de Processamento de Alimentos/normas , Hidrolases/química , Saneamento/métodos , Incrustação Biológica/prevenção & controle , Modelos Teóricos , Plásticos , Aço Inoxidável , Propriedades de Superfície
15.
PLoS Negl Trop Dis ; 13(9): e0007777, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31536504

RESUMO

BACKGROUND: Helminthiases are a group of disabling neglected tropical diseases that affect billions of people worldwide. Current control methods use preventative chemotherapy but reinfection is common and an inter-sectoral approach is required if elimination is to be achieved. Household and community scale water treatment can be used to provide a safe alternative water supply for contact activities, reducing exposure to WASH (water, sanitation, and hygiene) -related helminths. With the introduction of ultraviolet light emitting diodes (UV-C LEDs), ultraviolet (UV) disinfection could be a realistic option for water treatment in low-income regions in the near future, to provide safe alternative water supplies for drinking and contact activities such as handwashing, bathing, and laundry, but currently there is no guidance for the use of UV or solar disinfection against helminths. METHODOLOGY: A qualitative systematic review of existing literature was carried out to establish which WASH-related helminths are more susceptible to UV disinfection and identify gaps in research to inform future studies. The search included all species that can infect humans and can be transmitted through water or wastewater. Five online databases were searched and results were categorized based on the UV source: sunlight and solar simulators, UV-A and UV-B (long wavelength) sources, and UV-C (germicidal) sources. CONCLUSIONS: There has been very little research into the UV sensitivity of helminths; only 47 studies were included in this review and the majority were carried out before the standard protocol for UV disinfection experiments was published. Only 18 species were studied; however all species could be inactivated by UV light. Fluences required to achieve a 1-log inactivation ranged from 5 mJ/cm2 to over 800 mJ/cm2. Larval forms were generally more sensitive to UV light than species which remain as an egg in the environment. This review confirms that further research is required to produce detailed recommendations for household or community scale UV-C LED or solar disinfection (SODIS) of water for preventing helminthiases.


Assuntos
Desinfecção/métodos , Helmintos/efeitos da radiação , Raios Ultravioleta , Purificação da Água/métodos , Animais , Helmintíase/prevenção & controle , Humanos , Higiene , Saneamento/métodos , Luz Solar , Água/parasitologia
16.
Health Res Policy Syst ; 17(1): 77, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382967

RESUMO

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


Assuntos
Academias e Institutos/organização & administração , Fortalecimento Institucional/organização & administração , Higiene/normas , Pesquisa/organização & administração , Saneamento/métodos , África , Ásia , Países em Desenvolvimento , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Cooperação Internacional , Saneamento/normas , Reino Unido
17.
BMC Res Notes ; 12(1): 478, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375135

RESUMO

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


Assuntos
Higiene/normas , Saúde Pública/normas , População Rural/estatística & dados numéricos , Saneamento/normas , Adulto , Estudos Transversais , Etiópia , Feminino , Desinfecção das Mãos/métodos , Desinfecção das Mãos/normas , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , Saneamento/métodos , Inquéritos e Questionários , Toaletes/normas , Toaletes/estatística & dados numéricos
18.
Bull World Health Organ ; 97(8): 523-533A, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31384071

RESUMO

Objective: To evaluate the long-term impact of a community-led total sanitation campaign in rural India. Methods: Local organizations in Odisha state, India worked with researchers to evaluate a community-led total sanitation campaign, which aimed to increase the demand for household latrines by raising awareness of the social costs of poor sanitation. The intervention ran from February to March 2006 in 20 randomly-selected villages and 20 control villages. Within sampled villages, we surveyed a random subset of households (around 28 households per village) at baseline in 2005 and over the subsequent 10-year period. We analysed changes in latrine ownership, latrine functionality and open defecation among approximately 1000 households. We estimated linear probability models that examined differences between households in intervention and control villages in 2006, 2010 and 2016. Findings: In 2010, 4 years after the intervention, ownership of latrines was significantly higher (29.3 percentage points; 95% confidence interval, CI: 17.5 to 41.2) and open defecation was significantly lower (-6.8 percentage points; 95% CI: -13.1 to -1.0) among households in intervention villages, relative to controls. In 2016, intervention households continued to have higher rates of ever owning a latrine (26.3 percentage points; 95% CI: 20.9 to 31.8). However, latrine functionality and open defecation were no longer different across groups, due to both acquisition of latrines by control households and abandonment and deterioration of latrines in intervention homes. Conclusion: Future research should investigate how to maintain and rehabilitate latrines and how to sustain long-term behaviour change.


Assuntos
Participação da Comunidade/métodos , Promoção da Saúde/métodos , População Rural , Saneamento/métodos , Toaletes/estatística & dados numéricos , Defecação , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Índia , Pobreza , Características de Residência
19.
PLoS Negl Trop Dis ; 13(8): e0007617, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31412023

RESUMO

BACKGROUND: To improve schistosomiasis control programs in Uganda, where intestinal schistosomiasis is a widespread public health problem, a country-wide assessment of the disease prevalence among all age ranges is needed. Few studies have aimed to quantify the relationships between disease prevalence and water and sanitation characteristics across Uganda to understand the potential to interrupt disease transmission with an integrated package of interventions. METHODOLOGY/PRINCIPAL FINDINGS: A nationally representative survey was undertaken that included a household and individual questionnaire followed by disease testing based on detection of worm antigens (circulating cathodic antigen-CCA), diagnosis and treatment. A comprehensive set of questions was asked of randomly sampled individuals, two years of age and above, to understand their water and sanitation infrastructure, open defecation behaviors, exposure to surface water bodies, and knowledge of schistosomiasis. From a set of 170 randomly sampled, geographically diverse enumeration areas, a total of 9,183 study participants were included. After adjustment with sample weights, the national prevalence of schistosomiasis was 25.6% (95% confidence interval (CI): 22.3, 29.0) with children ages two to four most at risk for the disease with 36.1% infected (95% CI: 30.1, 42.2). The defecation behaviors of an individual were more strongly associated with infection status than the household water and sanitation infrastructure, indicating the importance of incorporating behavior change into community-led total sanitation coverage. CONCLUSIONS/SIGNIFICANCE: Our results highlight the importance of incorporating monitoring and evaluation data into control programs in Uganda to understand the geographic distribution of schistosomiasis prevalence outside of communities where endemicity is known to be high. The high prevalence of schistosomiasis among the youngest age group, ineligible to receive drug treatment, shows the imperative to develop a child-appropriate drug protocol that can be safely administered to preschool-aged children. Water and sanitation interventions should be considered an essential investment for elimination alongside drug treatment.


Assuntos
Saneamento/métodos , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Água/parasitologia , Adolescente , Animais , Criança , Pré-Escolar , Estudos Transversais , Meio Ambiente , Características da Família , Humanos , Prevalência , Fatores de Risco , Schistosoma mansoni , Esquistossomose/parasitologia , Esquistossomose mansoni/epidemiologia , Esquistossomose mansoni/parasitologia , Esquistossomose mansoni/prevenção & controle , Inquéritos e Questionários , Uganda/epidemiologia
20.
Sci Total Environ ; 691: 401-406, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31323585

RESUMO

Alternative sanitation options are needed for effective waste management in low-income countries where centralized, large-scale waste treatment is not easily achievable. A newly designed solar concentrator technology utilizes solar thermal energy to treat feces contained in drums. This pilot study assessed the efficacy of the new design to inactivate microbes in 13 treatment drums under field conditions in Kenya. Three-quarters of the drums contained <1000 E. coli/g of total solids following 6 h of solar thermal treatment and inactivation of thermotolerant C. perfringens spores ranged from <1.8 to >5.0 log10. Nearly all (94%) samples collected from treatment drums achieved thermophilic temperatures (>50 °C) during the treatment period, however this alone did not ensure samples met the WHO E. coli guideline; higher, sustained thermophilic temperatures tended to be more effective in reaching this guideline. The newly designed solar concentrator was capable of inactivating thermotolerant, environmentally-stable microorganisms as, or possibly more, efficiently than a previous design. Additional data are needed to better characterize how temperature, time, and other parameters affect the ability of the solar concentrator to inactivate microbes in feces.


Assuntos
Toaletes , Eliminação de Resíduos Líquidos/métodos , Microbiologia da Água , Fezes , Temperatura Alta , Quênia , Projetos Piloto , Pobreza , Saneamento/métodos , Esgotos , Esporos Bacterianos
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