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1.
J Water Health ; 17(6): 896-909, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31850897

RESUMO

Sanitation planners make complex decisions in the delivery of sanitation services to achieve health outcomes. We present findings from a stakeholder engagement workshop held in Kampala, Uganda, to educate, interact with, and solicit feedback from participants on how the relevant scientific literature on pathogens can be made more accessible to practitioners to support decision-making. We targeted Water, Sanitation and Hygiene (WASH) practitioners involved in different levels of service delivery. Practitioners revealed that different sanitation planning tools are used to inform decision-making; however, most of these tools are not user-friendly or adapted to meet their needs. Most stakeholders (68%) expressed familiarity with pathogens, yet less than half (46%) understood that fecal coliforms were bacteria and used as indicators for fecal pollution. A number of stakeholders were unaware that fecal indicator bacteria do not behave and persist the same as helminths, protozoa, or viruses, making fecal indicator bacteria inadequate for assessing pathogen reductions for all pathogen groups. This suggests a need for awareness and capacity development around pathogens found in excreta. The findings underscore the importance to engage stakeholders in the development of support tools for sanitation planning and highlighted broader opportunities to bridge science with practice in the WASH sector.


Assuntos
Tomada de Decisões , Higiene , Saneamento/normas , Microbiologia da Água , Qualidade da Água/normas , Abastecimento de Água/normas , Animais , Conhecimentos, Atitudes e Prática em Saúde , Uganda , Água
2.
Pan Afr Med J ; 33: 244, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692810

RESUMO

Introduction: Access to drinking water and sanitation has been a long-standing issue between many States. However, it represents a daily struggle for hundreds of thousands of city dwellers who live mainly in the developing countries. The government of Cameroon with the assistance of providers of funds have implemented strategies to make sanitation and access to safe drinking water a reality. We have therefore decided to assess sanitation and access to drinking water in Douala V sub division. Method: We conducted a cross-sectional descriptive study from May to June 2018. We used a two-stage random sampling. Data were collected using a questionnaire. The analysis was conducted using Epi Info Version 7.1.3.3. Results: Our study shows that 22.47% of subjects discharged waters into the natural environment after use. Then, 65,55% (493/752) of households consumed borehole water; 53.69% of households rode between 1 to 5 km, 49.25% walked more than 15 minutes to collect water and 85,50% of households did not use a water treatment method. Only 14.49% of subjects used a water treatment method. No household used solar water disinfection (SODIS); 2/752 households (0.26%) had no latrine. Most of the households (54.52%; 410/752) discharged domestic wastes onto the street. Conclusion: The creation of decentralized units: the drillings, waste disposal systems and water treatment education to meet basic needs are essential.


Assuntos
Água Potável/normas , Saneamento/normas , Abastecimento de Água/normas , Camarões , Estudos Transversais , Países em Desenvolvimento , Desinfecção/métodos , Características da Família , Feminino , Humanos , Masculino , Inquéritos e Questionários , Toaletes/estatística & dados numéricos
3.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(5): 525-528, 2019 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-31713385

RESUMO

OBJECTIVE: To investigate the related factors of soil-transmitted nematode infections in Chongqing City, so as to provide the basis for scientific prevention and treatment of the infections. METHODS: From 2011 to 2015, the stool samples of residents of the surveillance sites in Chongqing City were collected every year, and the soil-transmitted nematode eggs were examined by the modified Kato-Katz thick smear method (three smears for a single stool sample). The respondents were surveyed by questionnaires, and the factors affecting soil-transmitted nematode infections were identified. RESULTS: The prevalence of human soil-transmitted nematode infections were 6.44%, 7.30%, 6.85%, 6.93% and 5.56% in Chongqing City from 2011 to 2015, respectively. The more unclean drinking water and the lower frequency of washing hands after using the toilet were the risk factors for Ascaris lumbricoides infection. The more harmless toilets, the higher level of fertilizer application, the lower frequency of drinking raw water, and the lower frequency of food without washing were the protective factors for A. lumbricoides infection. CONCLUSIONS: The local soil-transmitted nematode infections are at a low epidemic level in Chongqing City, and it is necessary to ad-here to the classified guidance, comprehensive prevention and further monitoring on the basis of health education, water and toilet improvement, and environmental sanitation improvement in order to consolidate the prevention and control achievements.


Assuntos
Infecções por Nematoides , Solo , Animais , China/epidemiologia , Humanos , Infecções por Nematoides/epidemiologia , Prevalência , Fatores de Risco , Saneamento/normas , Solo/parasitologia , Inquéritos e Questionários
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(9): 865-870, 2019 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-31474065

RESUMO

According to different epochs and development needs, a series of practices on environmental health and sanitary engineering were carried out, which played significant roles in promoting national economic and social developments and protecting the public health. This paper reviewed the main achievements in the past 70 years infields of patriotic health campaign, water sanitation and toilet improvement in rural areas, surveillance and investigation, health standard system, sanitary engineering equipment, stove improvement etc., and then proposed several prospects in the future.


Assuntos
Saúde Ambiental , População Rural , Engenharia Sanitária , Saneamento , China , Saúde Ambiental/normas , Saúde Ambiental/tendências , Humanos , Saúde Pública/normas , Engenharia Sanitária/tendências , Saneamento/normas , Saneamento/tendências , Toaletes/normas
5.
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
6.
BMC Public Health ; 19(1): 1028, 2019 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366398

RESUMO

BACKGROUND: The Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7) is a handwashing with soap and water treatment intervention program delivered by a health promoter bedside in a health facility and through home visits to diarrhea patients and their household members during the 7 days after admission to a health facility. In a randomized controlled trial among cholera patient households in Bangladesh, the 7-day CHoBI7 program resulted in a significant reduction in cholera among household members of cholera patients and sustained improvements in drinking water quality and handwashing with soap practices 12 months post-intervention. In an effort to take this intervention to scale across Bangladesh in partnership with the Bangladesh Ministry of Health and Family Welfare, this study evaluates the feasibility and acceptability of mobile health (mHealth) programs as a low-cost, scalable approach for CHoBI7 program delivery. METHODS: Formative research for the development of the CHoBI7 mHealth intervention included 40 semi-structured interviews, 4 mHealth workshops, 2 group discussions, and a pilot study of 52 households to assess the feasibility and acceptability of the developed mHealth program. Thematic analysis of the interviews and group discussions was conducted by two individuals separately based on emergent themes, and then themes were compared and discussed. RESULTS: A theory- and evidence-based approach using qualitative research methods was implemented to design the CHoBI7 mHealth program. Semi-structured interviews with government stakeholders identified perceptions and preferences for scaling the CHoBI7 mHealth program. Group discussions and semi-structured interviews with diarrhea patients and their family members identified beneficiary perceptions of mHealth and preferences for CHoBI7 mHealth program delivery. mHealth workshops were conducted as an interactive approach to draft and refine mobile message content based on stakeholder preferences. The pilot findings indicate that the CHoBI7 mHealth program has high user acceptability and is feasible to deliver to diarrhea patients that present at health facilities for treatment in Bangladesh. Both text and voice messages were recommended for program delivery. Dr. Chobi, the sender of mHealth messages, was viewed as a credible source of information that could be shared with others. CONCLUSION: This study presents a theory- and evidence-based approach that can be implemented for the development of future water, sanitation, and hygiene mHealth programs in low-resource settings.


Assuntos
Cólera/prevenção & controle , Diarreia/terapia , Higiene/normas , Desenvolvimento de Programas , Saneamento/normas , Telemedicina/organização & administração , Qualidade da Água/normas , Bangladesh , Características da Família , Estudos de Viabilidade , Feminino , Desinfecção das Mãos , Hospitais , Humanos , Masculino , Projetos Piloto , Pesquisa Qualitativa , Projetos de Pesquisa , Sabões
7.
BMC Public Health ; 19(1): 970, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331313

RESUMO

BACKGROUND: Infant and young children stools are often considered innocuous, and are not disposed of safely despite having a higher pathogen load than adult feces. In Ethiopia, sanitary management of young children's stool is often overlooked and transmission of fecal-oral diseases is still a significant health burden. The study, therefore, describes the prevalence and associated factors of safe and improved child stool disposal. METHODS: Data from the fourth round of the Ethiopian Health and Demographic Survey (EDHS) conducted in 2016 was used for this analysis. Descriptive statistics were computed. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with safe and improved child stool disposal. RESULTS: The prevalence of safe and improved child stool disposal in Ethiopia was 36.9% (95%CI: 33.4-40.5%) and 5.3% (95%CI: 4.3-6.5%) respectively. There was regional variation in the prevalence of safe and improved child stool disposal. The odds of safe stool disposal among households with richest wealth index had 4.54 (AOR: 4.54; 95%CI: 2.89-7.12), richer 3.64 (AOR: 3.64; 95%CI: 2.46-5.38), middle 3.26 (AOR: 2.26; 95%CI: 2.27-4.68), and poorer 1.93 (AOR: 1.93; 95%CI: 1.39-2.68) times higher odds of practicing safe child stool disposal than households with poorest wealth index. Similarly, households found in richest, richer, middle, and poorer wealth index had also (AOR: 20.23; 95%CI: 8.59-47.66), (AOR: 12.53; 95%CI: 5.59-28.10) (AOR: 4.91; 95%CI: 1.92-12.55), and (AOR: 4.50; 95%CI: 2.06-9.84) higher odds of practicing improved child stool disposal than households from poorest wealth index respectively. The odds of safe child stool disposal were higher among households whose children age between 6 and 11 months (AOR: 1.57; 95%CI: 1.17-2.09), 12-17 months (AOR: 1.39; 95%CI: 1.00-1.95), and 18-23 months (AOR: 1.43; 95%CI: 1.03-1.99) than households whose children age between 0 and 5 months. The odds of safe child stool disposal were 1.31 (AOR: 1.31; 95%CI: 1.00-1.72) and 1.44 (AOR: 1.44; 95%CI: 1.04-2.01) times higher among mothers whose age between 25 and 34 and greater than 34 years compared to mothers whose age between 15 and 24 years, respectively. In addition, children's stools are more likely to be disposed of safely in urban households than in rural households (AOR: 3.12; 95%CI: 1.86-5.22). The present study also revealed households with access to improved sanitation facilities fail to use them for disposal of child stool (AOR: 0.99; 95% CI: 0.67-1.45). CONCLUSIONS: The prevalence of safe and improved child stool disposal in Ethiopia was found to be very low. Household socio-demographic and economic determinate were the key factors associated with child stool disposal. Appropriate strategic interventions to ensure safe and improved child stool disposal in Ethiopia is necessary. In addition, integrating child stool management into the existing sanitation interventions programs should be strongly recommended.


Assuntos
Fezes , Segurança/estatística & dados numéricos , Saneamento/normas , Adolescente , Adulto , Demografia , Etiópia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Prevalência , Fatores Socioeconômicos , Adulto Jovem
8.
BMC Res Notes ; 12(1): 399, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31300042

RESUMO

OBJECTIVE: Food borne diseases are predominant in all parts of the world especially in urban areas and are the main source for food borne illness. The aim of this study is to assess sanitation status and its determinants among food establishments in Adwa town, North Ethiopia from March to June 2017. RESULTS: A total of 391 (95.4%) subjects were included in this study. Around 53.3% of food establishments in the study area were in a poor sanitary status. Presence of trained managers on hygiene and sanitation (AOR = 2.6, 95% CI 1.7-4.1); inspection by regulatory personnel (AOR = 1.95, 95% CI 1.36-22.4) and being licensed (AOR = 1.2 95% CI 1.11-2.51) were associated factors which affect sanitary status sanitary of the establishments. The overall sanitary status of the establishments in the study area was found unhygienic. Managers should gain trainings on food hygiene and sanitation to follow and improve the sanitary status of the establishments.


Assuntos
Manipulação de Alimentos/normas , Doenças Transmitidas por Alimentos/diagnóstico , Desinfecção das Mãos/normas , Saneamento/normas , Adulto , Idoso , Estudos Transversais , Etiópia/epidemiologia , Feminino , Alimentos/normas , Alimentos/estatística & dados numéricos , Manipulação de Alimentos/métodos , Manipulação de Alimentos/estatística & dados numéricos , Serviços de Alimentação/legislação & jurisprudência , Serviços de Alimentação/normas , Serviços de Alimentação/estatística & dados numéricos , Doenças Transmitidas por Alimentos/epidemiologia , Desinfecção das Mãos/métodos , Humanos , Higiene/normas , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Saneamento/estatística & dados numéricos , Inquéritos e Questionários , População Urbana/estatística & dados numéricos
9.
BMC Res Notes ; 12(1): 393, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31300055

RESUMO

OBJECTIVE: The study aimed to assess the sanitary condition of services and its implication for intestinal parasitic infections among prison inmates in eastern Tigrai, northern Ethiopia. RESULTS: We have assessed the availability and sanitary condition of services at Adigrat prison. Frequent water cuts and unavailability of soap in the prison have challenged prisoners and food handlers to maintain their hygiene. The living rooms were overcrowded and poorly ventilated besides to unsatisfactory kitchen rooms. The prevalence of intestinal parasites among the participants was 40% (108/270). The dominant parasite was Entamoeba histolytica/dispar (60, 22.2%) followed by Giardia lamblia, 39 (14.4%). The mixed infections of Entamoeba histolytica/dispar and Giardia lamblia were detected among 17 (6.3%) of the participants. In multivariate analysis, participants who were feeding in groups were more likely to harbor intestinal parasites than those who were feeding alone (AOR: 2.1; CI 1.05-4.3). Intestinal parasites are significant health problems to the prisoners of Adigrat prison with poor sanitation of services. Therefore, provision of necessary facilities such as hand washing basins, soaps, disinfectants, disinfestations, and food utensils could significantly reduce the burden of intestinal parasites in the prison.


Assuntos
Enteropatias Parasitárias/diagnóstico , Prisioneiros/estatística & dados numéricos , Prisões , Saneamento/normas , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Fezes/parasitologia , Feminino , Desinfecção das Mãos/métodos , Humanos , Higiene/normas , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-31311186

RESUMO

Nearly 90% of diarrhea-related mortalities are the result of unsafe drinking water, poor sanitation, and insufficient hygiene. Although "Water, Sanitation, and Hygiene" (WASH) interventions may significantly reduce the risk of diarrheal disease, it is currently unclear which interventions are the most effective. In this study, we aim to determine the importance of contextualizing a WASH intervention to the local context and the needs for increasing impact (Clinicaltrials.gov NCT03709368). A total of 1500 households in rural Tanzania will participate in this cluster randomized controlled trial. Households will be randomized into one of three cohorts: (1) a control group receiving a basic intervention and 1 placebo household visit, (2) an intervention group receiving a basic intervention + 9 additional household visits which are contextualized to the setting using the RANAS approach, and (3) an intervention group receiving a basic intervention + 9 additional household visits, which are not contextualized, i.e., a general intervention. Assessments will take place at a baseline, 1 and 2 years after the start of the intervention, and 1 year after the completion of the intervention. Measurements involve questionnaires and spot checks. The primary outcome is hand-washing behavior, secondary objectives include, the impact on latrine use, health, WASH infrastructure, quality of life, and cost-effectiveness.


Assuntos
Desinfecção das Mãos/métodos , Promoção da Saúde/métodos , Serviços de Saúde Rural , Saúde da População Rural , Saneamento/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos Clínicos , Feminino , Seguimentos , Desinfecção das Mãos/normas , Comportamentos Relacionados com a Saúde , Promoção da Saúde/normas , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Projetos de Pesquisa , Serviços de Saúde Rural/normas , Saneamento/normas , Método Simples-Cego , Tanzânia , Adulto Jovem
11.
Ital J Pediatr ; 45(1): 77, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31272479

RESUMO

BACKGROUND: Under nutrition is linked with poor water, sanitation and hygiene (WASH) condition. However, there is conflicting evidence on the effect of WASH on nutritional status of children. This review was, therefore, conducted to estimate the pooled effect of WASH interventions on child under nutrition. METHODS: All published and unpublished cluster-randomized, non-randomized controlled trials, and before and after intervention studies conducted in developing countries were included. Relevant articles were searched from MEDLINE/PubMed, Cochrane Collaboration's database, Web of Science, WHO Global Health Library, Google Scholar, Worldcat and ProQuest electronic databases. The methodological quality of the included studies was assessed using JBI critical appraisal checklist for randomized and non-randomized controlled trials. The risk of bias was assessed using the Cochrane Collaboration's tool for assessing risk of bias in randomized trials. The treatment effect was expressed as standardized mean differences (SMD) with 95% confidence interval (CI). RESULTS: This meta-analysis of 10 studies including 16,473 children (7776 in the intervention and 8687 in the control group) indicated that WASH interventions significantly associated with increased pooled mean height-for-age-z-score (SMD = 0.14, 95% CI = (0.09, 0.19); I2 = 39.3%]. The effect of WASH on HAZ was heterogeneous in age and types of interventions. WASH intervention had more effect on HAZ among under two children [SMD = 0.20, 95% CI = (0.11, 0.29); I2 = 37%]. Children who received combined WASH interventions grew better compared with children who received single interventions [SMD = 0.15, 95% CI = (0.09, 0.20); I2 = 43.8%]. CONCLUSION: WASH interventions were significantly associated with increased mean height-for-age-z score in under 5 years old children. The effect of WASH on linear growth is markedly different with age and types of interventions, either single or combined. Implementing combined WASH interventions has a paramount benefit to improve nutritional status of children.


Assuntos
Desinfecção das Mãos/normas , Higiene/normas , Desnutrição/prevenção & controle , Estado Nutricional , Saneamento/normas , Qualidade da Água/normas , Abastecimento de Água/normas , Criança , Pré-Escolar , Países em Desenvolvimento , Humanos , Lactente , Recém-Nascido
12.
BMC Health Serv Res ; 19(1): 458, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286934

RESUMO

BACKGROUND: The risk of cholera outbreak remains high in Cameroon. This is because of the persistent cholera outbreaks in neighboring countries coupled with the poor hygiene and sanitation conditions in Cameroon. The objective of this study was to assess the readiness of health facilities to respond to cholera outbreak in four cholera-prone districts in Cameroon. METHODOLOGY: A cross-sectional study was conducted targeting all health facilities in four health districts, labeled as cholera hotspots in Cameroon in August 2016. Data collection was done by interview with a questionnaire and by observation regarding the availability of resources and materials for surveillance and case management, access to water, hygiene, and sanitation. Data analysis was descriptive with STATA 11. PRINCIPAL FINDINGS: A total of 134 health facilities were evaluated, most of which (108/134[81%]) were urban facilities. The preparedness regarding surveillance was limited with 13 (50%) health facilities in the Far North and 22(20%) in the Littoral having cholera case definition guide. ORS for Case management was present in 8(31%) health facilities in the Far North and in 94(87%) facilities in the littoral. Less than half of the health facilities had a hand washing protocol and 7(5.1%) did not have any source of drinking water or relied on unimproved sources like lake. A total of 4(3.0%) health facilities, all in the Far North region, did not have a toilet. CONCLUSIONS: The level of preparedness of health facilities in Cameroon for cholera outbreak response presents a lot of weaknesses. These are present in terms of lack of basic surveillance and case management materials and resources, low access to WaSH. If not addressed now, these facilities might not be able to play their role in case there is an outbreak and might even turn to be transmission milieus.


Assuntos
Cólera/epidemiologia , Cólera/prevenção & controle , Surtos de Doenças/prevenção & controle , Instalações de Saúde/normas , Camarões/epidemiologia , Administração de Caso , Estudos Transversais , Desinfecção das Mãos/normas , Pesquisa sobre Serviços de Saúde , Humanos , Higiene/normas , Observação , Saneamento/normas , Inquéritos e Questionários , Abastecimento de Água/normas
13.
J Glob Health ; 9(2): 020402, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31360445

RESUMO

Background: Water, sanitation, and hygiene (WASH) in schools is promoted by development agencies as a modality to improve school attendance by reducing illness. Despite biological plausibility, the few rigorous studies that have assessed the effect of WASH in schools (WinS) interventions on pupil health and school attendance have reported mixed impacts. We evaluated the impact of the Laos Basic Education, Water, Sanitation and Hygiene Programme - a comprehensive WinS project implemented by UNICEF Lao People's Democratic Republic (Lao PDR) in 492 primary schools nationwide between 2013 and 2017 - on pupil education and health. Methods: From 2014-2017, we conducted a cluster-randomized trial among 100 randomly selected primary schools lacking functional WASH facilities in Saravane Province, Lao PDR. Schools were randomly assigned to either the intervention (n = 50) or comparison (n = 50) arm. Intervention schools received a school water supply, sanitation facilities, handwashing facilities, drinking water filters, and behavior change education and promotion. Comparison schools received the intervention after research activities ended. At unannounced visits every six to eight weeks, enumerators recorded pupils' roll-call absence, enrollment, attrition, progression to the next grade, and reported illness (diarrhea, respiratory infection, conjunctivitis), and conducted structured observations to measure intervention fidelity and adherence. Stool samples were collected annually prior to de-worming and analyzed for soil-transmitted helminth (STH) infection. In addition to our primary intention-to-treat analysis, we conducted secondary analyses to quantify the role of intervention fidelity and adherence on project impacts. Results: We found no impact of the WinS intervention on any primary (pupil absence) or secondary (enrollment, dropout, grade progression, diarrhea, respiratory infection, conjunctivitis, STH infection) impacts. Even among schools with the highest levels of fidelity and adherence, impact of the intervention on absence and health was minimal. Conclusions: While WinS may create an important enabling environment, WinS interventions alone and as currently delivered may not be sufficient to independently impact pupil education and health. Our results are consistent with other recent evaluations of WinS projects showing limited or mixed effects of WinS.


Assuntos
Absenteísmo , Diarreia/prevenção & controle , Helmintíase/prevenção & controle , Infecções Respiratórias/prevenção & controle , Serviços de Saúde Escolar , Animais , Criança , Diarreia/epidemiologia , Fezes/parasitologia , Feminino , Helmintíase/epidemiologia , Helmintíase/transmissão , Helmintos/isolamento & purificação , Humanos , Higiene/educação , Higiene/normas , Laos/epidemiologia , Masculino , Avaliação de Programas e Projetos de Saúde , Infecções Respiratórias/epidemiologia , Saneamento/normas , Solo/parasitologia , Abastecimento de Água/normas
14.
Glob Health Action ; 12(1): 1480085, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31154993

RESUMO

Hospital cleaning has been shown to impact on rates of healthcare-associated infections (HCAIs) and good environmental hygiene is critical to quality care, yet those tasked with the role of ensuring a safe and clean environment often go unrecognised as members of the healthcare workforce. Sepsis is a leading cause of maternal and newborn death, a significant proportion of these cases are estimated to be due to HCAIs. Deliveries in health institutions have now reached 75% globally, and in low and middle income countries the corresponding increased pressure on facilities  has impacted both quality of care provided and quality of the birth environment in terms of infection prevention and control (IPC) and HCAIs. The paper discusses the neglected role of health facility cleaners, providing evidence from the literature and from needs assessments conducted by The Soapbox Collaborative and partners in Bangladesh, India, The Gambia and Zanzibar. While not the primary focus of the assessments, common themes emerged consistently pointing to institutional neglect of cleaning and cleaners. The paper argues that low status within facilities, wider societal marginalisation, lack of training, and poor pay and working conditions contribute to the lack of prioritisation placed on health facility environmental hygiene. With increased international attention focused towards health facility water, sanitation and hygiene and a growing focus on IPC, now is the time to address the neglect of this frontline healthcare workforce. We propose that provision of and improved training can enable the recognition of the valuable role cleaning staff play, as well as equipping these staff with the tools required to perform their job to the highest standard. In addition to training, wider systems changes are necessary to establish improvements in environmental hygiene and the role of cleaning staff, including addressing resource availability, supportive supervision, and an increased emphasis on preventative healthcare.


Assuntos
Infecção Hospitalar/prevenção & controle , Maternidades/normas , Serviço Hospitalar de Limpeza/normas , Higiene/normas , Controle de Infecções/normas , Segurança do Paciente/normas , Saneamento/normas , Adulto , Bangladesh , Feminino , Gâmbia , Humanos , Índia , Recém-Nascido , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Gravidez , Tanzânia
15.
BMC Public Health ; 19(1): 801, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31226957

RESUMO

BACKGROUND: Unimproved water, sanitation, and hygiene (WASH) behaviors are key drivers of infectious disease transmission and influencers of mental well-being. While WASH is seen as a critical enabler of health, important knowledge gaps related to the content and delivery of effective, holistic WASH programming exist. Corresponding impacts of WASH on mental well-being are also underexplored. There is a need for more robust implementation research that yields information regarding whether and how community-based, demand-side interventions facilitate progressive and sustained adoption of improved sanitation and hygiene behaviors and downstream health impacts. The purpose of this protocol is to detail the rationale and design of a cluster-randomized trial evaluating the impact of a demand-side sanitation and hygiene intervention on sustained behavior change and mental well-being in rural and peri-urban Amhara, Ethiopia. METHODS: Together with partners, we developed a theoretically-informed, evidence-based behavioral intervention called Andilaye. We randomly selected and assigned 50 sub-districts (kebeles) from three purposively selected districts (woredas); half to receive the Andilaye intervention, and half the standard of care sanitation and hygiene programming (i.e., community-led total sanitation and hygiene [CLTSH]). During baseline, midline, and endline, we will collect data on an array of behavioral factors, potential moderators (e.g., water and sanitation insecurity, collective efficacy), and our primary study outcomes: sanitation and hygiene behaviors and mental well-being. We will perform a process evaluation to assess intervention fidelity and related attributes. DISCUSSION: While CLTSH has fostered sanitation and hygiene improvements in Ethiopia, evidence of behavioral slippage, or regression to unimproved practices in communities previously declared open defecation free exists. Other limitations of CLTSH, such as its focus on disgust, poor triggering, and over-saturation of Health Extension Workers have been documented. We employed rigorous formative research and practically applied social and behavioral theory to develop Andilaye, a scalable intervention designed to address these issues and complement existing service delivery within Ethiopia's Health Extension Program. Evidence from this trial may help address knowledge gaps related to scalable alternatives to CLTSH and inform sanitation and hygiene programming and policy in Ethiopia and beyond. TRIAL REGISTRATION: This trial was registered with clinicaltrials.gov ( NCT03075436 ) on March 9, 2017.


Assuntos
Comportamentos Relacionados com a Saúde , Promoção da Saúde/organização & administração , Higiene/normas , Saúde Mental/estatística & dados numéricos , População Rural , Saneamento/normas , População Suburbana , Adulto , Criança , Pré-Escolar , Etiópia , Feminino , Humanos , Lactente , Masculino , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa , População Rural/estatística & dados numéricos , População Suburbana/estatística & dados numéricos
16.
Environ Sci Pollut Res Int ; 26(19): 19512-19522, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31077047

RESUMO

Availability of clean water and adequate sanitation facilities are the principal measures for limiting various waterborne diseases. These basic amenities are critical for health and sustainable socio-economic development. This study attempted to assess the status of water and sanitation facilities and practices of the people living in rural areas of Chandigarh including awareness about the waterborne diseases. The community-based cross-sectional study design was adopted having 300 households across 12 villages of city Chandigarh. A standardized interview schedule was used to collect information related to water uses, storage, water treatment options, water conservation practices, personal hygiene, knowledge about waterborne diseases, and government schemes. The interview schedule was administered with the head of the family as a study approach during the door-to-door survey. Households in rural Chandigarh have municipal water supply for drinking as well as other domestic purposes. The mean per capita water usage was 67 ± 13.4 l. Most (68.6%) of the study participants reported that they do not treat water before drinking and store it in plastic bottles or bucket (58%). The survey shows that 97% of the household had functional toilets in their premises, remaining reported lack of finances, and space for construction as major barriers. Regarding personal hygiene, 83% of respondents wash hands with soap and rest used only water or ash. Observations made under the study highlighted the need to create awareness regarding the role of water and sanitation practices on health including knowledge about various government schemes to improve water quality, sanitation, and hygiene practices for better health.


Assuntos
Saneamento/normas , Qualidade da Água/normas , Abastecimento de Água/normas , Doenças Transmitidas pela Água/epidemiologia , Adulto , Estudos Transversais , Características da Família , Humanos , Higiene/normas , Índia , Masculino , População Rural , Saneamento/estatística & dados numéricos , Inquéritos e Questionários , Abastecimento de Água/estatística & dados numéricos , Doenças Transmitidas pela Água/prevenção & controle
17.
Parasit Vectors ; 12(1): 273, 2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31138266

RESUMO

The transmission soil transmitted helminths (STH) occurs via ingestion of or contact with infective stages present in soil contaminated with human faeces. It follows therefore that efforts to reduce faecal contamination of the environment should help to reduce risk of parasite exposure and improvements in water, sanitation and hygiene (WASH) are seen as essential for the long-term, sustainable control of STH. However, the link between WASH and STH is not always supported by the available evidence from randomised controlled trials, which report mixed effects of WASH intervention on infection risk. This review critically summarises the available trial evidence and offers an interpretation of the observed heterogeneity in findings. The review also discusses the implications of findings for control programmes and highlights three main issues which merit further consideration: intervention design, exposure assessment, and intervention fidelity assessment.


Assuntos
Helmintíase/prevenção & controle , Higiene , Saneamento/métodos , Solo/parasitologia , Água/parasitologia , Animais , Ensaios Clínicos como Assunto , Controle de Doenças Transmissíveis/estatística & dados numéricos , Controle de Doenças Transmissíveis/tendências , Fezes/parasitologia , Helmintos/fisiologia , Humanos , Saneamento/normas , Instituições Acadêmicas
18.
BMC Public Health ; 19(1): 565, 2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088432

RESUMO

BACKGROUND: Behavior change interventions have been developed by drawing from many different theories using design processes of varying specificity. We describe the development of a behavior change intervention to improve on-site peri-urban sanitation quality in Lusaka, Zambia using the Behavior Centered Design (BCD) framework to explain the results of the process applied to improving the quality of shared peri-urban sanitation and compare them to similar interventions. METHODS: We used the BCD behavioral determinants model to synthesize the data from our literature review and formative research. Then, we partnered with creative professionals using a design process to develop a theory-driven on-site peri-urban sanitation intervention. Particular attention was paid to the implications of using BCD for intervention development on improving its effectiveness, increasing the contributions to knowledge for other behaviors and settings, and advancing the discipline of applied behavioral science. RESULTS: Based on findings from a literature review and formative research, we designed an intervention to encourage landlords to improve their toilets by making them more accessible, desirable, hygienic, and sustainable. The intervention involved landlords meeting in facilitated groups every 2 weeks with individual follow-up after each meeting. The meetings presented surprising "hidden camera"-style videos to reveal tenants' perspectives, used participatory activities to help landlords reevaluate the benefits they would derive from improving sanitation on their plots, and provided practical guidance and mechanisms to facilitate the performance of construction and cleaning behaviors. CONCLUSIONS: Using the BCD framework provided an easy-to-follow intervention design process. The resulting intervention is highly creative and multi-faceted, with each element having a theoretical role in an explicit theory of change. The development of this theory-driven intervention advances applied behavioral science by facilitating evaluation of each of the behavior change techniques and the overall delivery mechanism hypothesized to change the target behaviors. This informs the adaptation of these findings to improving on-site sanitation in other settings and the iterative development of the BCD model, which can be used to more effectively change other behaviors.


Assuntos
Ciências Biocomportamentais , Melhoria de Qualidade , Saneamento/normas , Reforma Urbana/normas , Humanos , Higiene , Reforma Urbana/métodos , Zâmbia
19.
Pan Afr Med J ; 32: 11, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31143316

RESUMO

Introduction: This study aimed to assess the prevalence and associated risk factors of intestinal parasite infections among children less than two years of age in Rutsiro, Rwanda. Methods: A cross-sectional parasitological survey was conducted in Rutsiro in June 2016. Fresh stool samples were collected from 353 children and examined using microscopy to detect parasite. A questionnaire was administered to collect data on hygiene, sanitation, socio-demographic and economic characteristics. Results: Approximately one in two children (44.8%) were found to be infected with at least one intestinal parasite. Ascaris (28.5%) was the most prevalent infection followed by Entamoeba histolytica (25.95%) and Giardia lamblia (19.6%). Infection with more than one pathogen was noted e.g. presence of Ascaris and yeasts (8.9%), and amoeba with Trichocephale (4.4%), respectively. Children from non-farming families were less likely to be at risk of intestinal parasite infections (AOR = 0.41, p = 0.028) compared to children from farming families. Children from households with access to treated drinking water were less likely to contract intestinal parasite infections (AOR = 0.44, p = 0.021) compared with those who used untreated water. Children from families with improved sources of water were twice as likely to be diagnosed with intestinal parasitoses compared to those who did not. We postulate that the majority of families (50.1%) who have access to improved water sources do not treat water before consumption. Conclusion: The high prevalence of intestinal parasitoses in children warrants strict control measures for improved sanitation, while treatment of drinking water should be considered.


Assuntos
Água Potável/normas , Enteropatias Parasitárias/epidemiologia , Microscopia/métodos , População Rural/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Higiene/normas , Lactente , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/parasitologia , Masculino , Prevalência , Fatores de Risco , Ruanda/epidemiologia , Saneamento/normas , Fatores Socioeconômicos , Inquéritos e Questionários
20.
Food Microbiol ; 82: 455-464, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31027805

RESUMO

Listeria monocytogenes causes the foodborne illness listeriosis, which exhibits high fatality among people in risk groups. The incidence of listeriosis has increased in Europe, which raises concerns about L. monocytogenes occurrence in foodstuffs. Ready-to-eat seafood products are considered particularly risky vehicles. Poor hygiene at processing facilities predisposes them to L. monocytogenes contamination, which can be controlled by stringent self-checking system measures. We examined the association of fish-processing plant operational and hygiene practices with the occurrence of L. monocytogenes in vacuum-packaged gravad (cold-salted) and cold-smoked salmon and rainbow trout products. Product sampling of 21 fish-processing plants was carried out, and operational procedures relating to L. monocytogenes control were surveyed using an in-depth risk assessment questionnaire. L. monocytogenes occurred only in sliced and mainly in gravad products of seven fish-processing plants. Shortages in preventive measures were discovered predominantly among the L. monocytogenes positive fish-processing plants. Using generalized linear modeling, we identified the following features associated with L. monocytogenes product contamination: the number of processing machines, deficiencies in the processing environment and machinery sanitation, and staff movement from areas of low toward high hygiene. Furthermore, performing frequent periodic thorough sanitation alongside everyday sanitation practices associated with a decreased risk of product contamination.


Assuntos
Produtos Pesqueiros/microbiologia , Manipulação de Alimentos/métodos , Indústria de Processamento de Alimentos/estatística & dados numéricos , Higiene , Listeria monocytogenes/isolamento & purificação , Saneamento/estatística & dados numéricos , Alimentos Marinhos/microbiologia , Animais , Microbiologia Ambiental , Monitoramento Ambiental , Contaminação de Equipamentos , Contaminação de Alimentos/análise , Contaminação de Alimentos/prevenção & controle , Manipulação de Alimentos/instrumentação , Microbiologia de Alimentos , Indústria de Processamento de Alimentos/normas , Humanos , Higiene/normas , Oncorhynchus mykiss , Salmão , Saneamento/normas , Inquéritos e Questionários , Vácuo
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