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1.
J Environ Manage ; 283: 111992, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33486197

RESUMO

Advancing toilet technologies to address public health and sanitation issues are a concern of governments and organizations. This article mainly studies the assessment methods for the public toilets and some rural toilets considering from design to demolition to assist for the innovation of toilet technologies. The Analytic Hierarchy Process (AHP) and Life Cycle Assessment (LCA) methods were adopted to identify the assessment indicators and rank the weight. The outcome of Toilet Assessment Scheme (TAS), which includes a set of weightings and a classification system for the selected assessment indicators and sub-indicators. The weight calculation result showed that water resources, ecology, and indoor environmental quality are relatively high, which indicates that saving water, protecting the environment and optimizing the toilet environment should be given priority at the current stage. The individual questionnaire experts from the perspective of gender, profession, and generation, have different emphases on the evaluation scheme. This study can improve the comprehensiveness of toilet evaluation under the distinct background conditions, and will play a relevant role in the promotion of new toilet technology. The TAS can accelerate the toilet revolution in areas where toilets are scarce, and thus will improve the sanitary and health conditions of these populations.


Assuntos
Aparelho Sanitário , China , Humanos , Saúde Pública , Saneamento , Toaletes
2.
J Environ Manage ; 281: 111808, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33440324

RESUMO

In Toamasina, the second largest city in Madagascar with 326,286 inhabitants and located at sea level, 97% of households uses latrines. The city produces 14,100 m³ faecal sludge per year and 28,000 latrines need to be emptied annually. Most latrines are emptied manually and sludge used to be buried in the compound, thus contaminating sub surface water that is used for domestic purposes by 60% of the population. This article shows how through an action-research process coordinated by Join For Water emptying, transport and treatment services were improved, these services remain accessible to the lowest social class, and a profitable private service provider, Clean Impact, was created. It further describes the construction of a treatment plant consisting of planted humification beds, and the process towards a sustainable exploitation, today managed by Clean Impact.


Assuntos
Saneamento , Esgotos , Cidades , Madagáscar , Toaletes
3.
J Environ Manage ; 280: 111655, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33309109

RESUMO

Rural toilet retrofitting (RTR) is a complex, dynamic system that is affected by many factors and the positive/negative feedback relationships between subsystems and variables. Traditional technologies and management methods face challenges in fundamentally describing and solving problems in RTR. To bridge this gap, this study utilizes system dynamics and causal loop diagrams to explain such problems based on data collected from the stakeholders of the RTR in Jiaozhou from 2018 to 2019. Specifically, this study examines the RTR system from the perspectives of household users, wastewater treatment plants, local governments, grassroots promoters, operation and maintenance personnel, toilet supplier and construction teams, and fecal sludge end users. The factors and processes involved in RTR are identified, and the feedback and relationships among its major stakeholders are established. Results show that the motivation of farmers to engage in RTR is a key variable that affects their final decisions regarding retrofitting and maintaining toilet functions. Meanwhile, the important variables related to the feedback and relationships among the major stakeholders of RTR are mostly focused on policies, subsidies, technology, satisfaction, and cooperation. A scientific analysis method and the updated RTR plan for toilet revolution are then formulated to promote the implementation of RTR in developing countries.


Assuntos
Aparelho Sanitário , China , Humanos , População Rural , Saneamento , Toaletes
4.
J Environ Manage ; 277: 111474, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33039699

RESUMO

Blantyre, Malawi has approximately one million people who rely on pit latrines for sanitation and yet there is a limited pit-emptying sector to empty, transport and safely discharge the faecal sludge. Over three years, we monitored the volume of sludge that was safely discharged at the authorized Wastewater Treatment Plants (WWTP) and in parallel, estimated the volume of sludge that is currently buried within pit latrines of Blantyre, based on measurements at 321 households. Comparing the volumes of sludge emptied to the volumes of sludge buried, we highlight the fact that a) there is a suspiciously low volume of pit-derived faecal sludge being safely disposed; b) most safely discharged sludge is taken from the small proportion of septic tanks in the city, and not from pit latrines; and c) that the cost of safely discharging does not seem to correlate with the volumes delivered (despite an option to discharge for free). There is a large and growing amount of sludge buried beneath the city which will need to be safely emptied and treated in coming years. The city and the WWTPs must move quickly to ensure that the businesses and infrastructure are prepared for the future faecal sludge management challenges that lay ahead, especially if they are to achieve SDG 6 by 2030.


Assuntos
Bombas (Dispositivos Explosivos) , Esgotos , Cidades , Humanos , Malaui , Saneamento , Toaletes
5.
PLoS One ; 15(12): e0244055, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33338060

RESUMO

Porcine cysticercosis and associated human infections are endemic in Sub-Saharan Africa, Latin America, and Asia. Poor agricultural practices, sanitary practices, and lack of knowledge increase the burden of the diseases in susceptible populations. This study investigates the seroprevalence of Taenia spp. in township pigs in Gauteng, South Africa and describes knowledge and farming practices of pig farmers regarding T. solium infections. Blood samples were collected from 126 pigs in three Gauteng township areas, and analyzed for active Taenia spp. infection using the B158/B60 Ag-ELISA. Farmer questionnaire surveys were conducted in four township areas to investigate the level of knowledge and practices associated with porcine cysticercosis and neurocysticercosis. Logistic regression models were used to assess the relationship between predictor variables and the outcome variable, knowledge of porcine cysticercosis or knowledge of neurocysticercosis. Overall, 7% of the pigs were seropositive for active Taenia spp. infection. 46% of farmers practiced a free-ranging system, while 25% practiced a semi-intensive system. Latrines were absent on all farms; however, 95% of farmers indicated that they have access to latrines at home. Most farmers had no knowledge of porcine cysticercosis (55%) or neurocysticercosis (79%), and this was not associated with any of the factors investigated. The prevalence of active Taenia spp. infection was reasonably low in this study, yet the knowledge level was also low, thus calling for further educational and training programmes to prevent Taenia spp. transmission in these communities.


Assuntos
Cisticercose/epidemiologia , Fazendeiros/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Doenças dos Suínos/epidemiologia , Criação de Animais Domésticos/normas , Animais , Cisticercose/parasitologia , Cisticercose/psicologia , Cisticercose/transmissão , Humanos , Prevalência , Testes Sorológicos/estatística & dados numéricos , África do Sul , Suínos , Doenças dos Suínos/parasitologia , Doenças dos Suínos/transmissão , Taenia solium/classificação , Taenia solium/patogenicidade , Toaletes/estatística & dados numéricos
6.
ANZ J Surg ; 90(11): 2384, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33200516
7.
PLoS One ; 15(10): e0239587, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33006973

RESUMO

Resource-deprived coastal peri-urban settlements in Southern Ghana are characterized by indiscriminate solid waste disposal and open defecation practices. Persons engaged in waste handling in such communities perform their activities with little or no personal protective equipment. They are thus confronted with the risk of faecal pollution of the hands and other bodily parts. A mixed method approach was used to investigate 280 waste handlers performing different activities to estimate recent faecal pollution of their hands and to observe the utilization of personal protective equipment and sanitation/hygiene facilities during work. The log concentration of E. coli on hands of waste handlers after work (8.60 ± 4.20 CFU/hand, mean ± standard deviation) was significantly higher compared with the E. coli log concentration before work (2.95 ± 1.89 CFU/hand, mean ± standard deviation) (p<0.001). The odds of faecal pollution was significantly higher (aOR 4.2; 95% CI: 1.9-9.1) for workers aged 35 years and above compared with those less than 35 years; and for workers at public toilet facilities (aOR 3.0; 95% CI: 1.0-8.4) compared with those who worked for private waste handling companies. Female workers were, however, 60% less likely (aOR 0.4; 95% CI: 0.2-0.8) to experience faecal pollution of their hands compared with males. The workers had limited access to water and sanitation and hygiene facilities, and about one-fifth (n = 59; 21.1%) did not use personal protective equipment during work. Waste handlers should be provided and instructed in proper use of personal protective equipment, have access to sanitation facilities and adopt improved hygiene behaviour to avoid the risk of faecal pollution and associated disease risk.


Assuntos
Fezes , Exposição Ocupacional , Eliminação de Resíduos , Adulto , Carga Bacteriana , Defecação , Poluição Ambiental/prevenção & controle , Escherichia coli/isolamento & purificação , Fezes/microbiologia , Feminino , Gana , Mãos/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/prevenção & controle , Fatores de Risco , Toaletes , População Urbana
8.
J UOEH ; 42(3): 237-249, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32879188

RESUMO

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


Assuntos
Planejamento em Saúde , Pobreza , Saneamento , Classe Social , Toaletes , Saúde da População Urbana , Abastecimento de Água , Humanos , Quênia
9.
J Environ Public Health ; 2020: 2123652, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32879630

RESUMO

Background: Open defecation was largely a rural phenomenon most widely attributed to poor latrine ownership at community level. We aimed at examining latrine ownership and its determinants in rural villages of the Tigray region, Northern Ethiopia. Methods: Community-based cross-sectional study was conducted from June to July 2018. A total of 756 randomly selected households were involved in the study. The multistage cluster sampling technique was used to select study households. Data were checked, coded, and entered into Epi-Info version 7. Besides, it was exported to SPSS version 20 for data analysis. Multivariable logistic regression analysis was involved to estimate the net effect size of factors associated with latrine ownership. Results: The proportion of households owning latrine was 35.7%. The majority (84.4%) of constructed latrines were utilized by household families. Households advocated latrine IEC by Health Extension Workers (HEWs) (AOR = 1.902, 95% CI: 1.269-2.852), living in their private house (AOR = 3.13, 95% CI: 1.528-6.401), and the occupation status of government employees (AOR = 3.54, 95% CI: 0.586-21.397) are more likely to lead to the construction of latrines. The availability of latrine made on slab floor (AOR = 1.790, 95% CI: 0.297-3.102), having a latrine constructed inside the household compound (AOR = 4.463, 95% CI: 1.021-19.516), and delivery of latrine IEC by Women Development Armies (WDAs) (AOR = 2.425, 95% CI: 0.728-8.083) may lead to better latrine utilization at the household level. Conclusion: Households owning latrine at the community level were low. The desired level of latrine ownership will be realized if all sanitation and hygiene components are kept on eye side by side in line with identified predictor factors.


Assuntos
Propriedade/estatística & dados numéricos , População Rural/estatística & dados numéricos , Toaletes/estatística & dados numéricos , Adulto , Idoso , Estudos Transversais , Emprego , Etiópia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto Jovem
10.
Am J Trop Med Hyg ; 103(5): 2012-2018, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32996450

RESUMO

In countries without adequate access to improved sanitation, government-imposed restrictions during the COVID-19 pandemic can impact toilet usage. In India, where millions have recently transitioned to using a toilet, pandemic-related barriers to use might increase open defecation practices. We assessed changes in reported defecation practices in peri-urban communities in Tamil Nadu. Field assistants conducted phone surveys in 26 communities in two districts from May 20, 2020 to May 25, 2020. They asked respondents about their access to a toilet, whether they or a family member left their house to defecate in the past week, and whether specific practices had changed since the lockdown. Among 2,044 respondents, 60% had access to a private toilet, 11% to a public or community toilet, whereas 29% lacked access to any toilet facility. In our study, 92% of the respondents did not change their defecation behaviors in the 2 months following the pandemic-related lockdown. About a third (27%) reported that they or a family member left their house daily to defecate amid lockdown measures. A majority of those with private toilets (91%) or with public toilets (69%) continued using them. Respondents with private toilet access were more likely to report an increased frequency of handwashing with soap (prevalence ratio [PR]: 1.78, 95% CI: 1.04-3.05) since the lockdown. The lack of private toilets contributes to the need to leave the house amid a lockdown. Maintaining shared toilets require disinfection protocols and behavioral precautions to limit the risk of fomite transmission. Robust urban COVID-19 control strategies should include enhanced sanitation facility management and safe usage messaging.


Assuntos
Infecções por Coronavirus/prevenção & controle , Higiene , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saneamento/métodos , Toaletes/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Aparelho Sanitário/provisão & distribução , Betacoronavirus , Estudos Transversais , Defecação , Feminino , Desinfecção das Mãos , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
11.
PLoS One ; 15(9): e0238957, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915880

RESUMO

BACKGROUND: Anemia in women of reproductive age is a major public health challenge for low- and middle-income countries with a long-term negative impact on the health of women, their children, and the economic growth of the society. Even though the world health organization targeted a 50% global reduction of anemia among women of reproductive age by 2025, with the current trend it is unlikely to achieve this goal. OBJECTIVE: This study aimed to assess the prevalence and associated factors of anemia among women of reproductive age in eastern Africa. METHODS: A secondary data analysis, using demographic and health survey (DHS) data of 10 eastern African countries, was conducted. For our study, a total weighted sample of 101524 women of reproductive age was used. We employed a multilevel mixed-effects generalized linear model (using Poisson regression with robust error variance). Both unadjusted and adjusted prevalence ratios with their 95% confidence interval were reported. RESULTS: The prevalence of anemia in eastern Africa was 34.85 (95%CI: 34.56-35.14) ranging from 19.23% in Rwanda to 53.98% in Mozambique. In the multivariable multilevel analysis, being older age, having primary and above education, being from households with second to highest wealth quantiles, being currently working, not perceiving distance as a big problem, use of modern contraceptive methods, and rural residence was associated with a lower prevalence of anemia. While, being married and divorced/separated/widowed, women from female-headed households, women from households with unimproved toilet facility and unimproved water source, ever had of a terminated pregnancy, having high parity, and being from large household size was associated with a higher prevalence of anemia. CONCLUSION: The prevalence of anemia in eastern Africa was relatively high. Both individual level and community level factors were associated with the prevalence of anemia in women of reproductive age. Therefore, giving special attention to those women who are at a higher prevalence of anemia such as younger women, those who are from households with low socioeconomic status, unimproved toilet facility, and source of drinking water, as well as pregnant women could decrease anemia in women of reproductive age.


Assuntos
Anemia/epidemiologia , Adolescente , Adulto , África Oriental/epidemiologia , Fatores Etários , Água Potável , Feminino , Humanos , Modelos Lineares , Estado Civil , Casamento , Pessoa de Meia-Idade , Análise Multinível , Paridade , Gravidez , Prevalência , Fatores de Risco , Classe Social , Toaletes , Mulheres Trabalhadoras , Adulto Jovem
12.
PLoS One ; 15(9): e0238003, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32881905

RESUMO

Improving sanitation conditions in low-income communities is a major challenge for rapidly growing cities of the developing world. The expenses and logistical difficulties of extending sewerage infrastructure have focused increasing attention on the requirements for safe and cost-effective fecal sludge management services. These services, which are primarily provided by the private sector, include the collection and treatment of fecal waste from latrine pits and septic tanks. To determine the degree to which market forces can promote safe fecal sludge removal in low-income neighborhoods of Kisumu, Kenya, we compared household willingness-to-pay for formal pit emptying with the prices charged by service providers. Through surveys of 942 households and a real-money voucher trial with 646 households, we found that stated and revealed demand for formal emptying services were both low, with less than 20% of households willing to pay full market prices. Our results suggest that improving fecal sludge management in these neighborhoods via the private sector will require large subsides, ranging from 55.1-81.4 million KES (551,000-814,000 USD) annually, to address the gap between willingness-to-pay and market prices. Raising and administering subsidies of this scale will require the development of a city-wide sanitation master plan that includes investment, management, and regulatory procedures for fecal sludge management. In the absence of government investment and coordination, it is unlikely that the private sector will address safe sanitation needs in low-income areas of Kisumu.


Assuntos
Toaletes/economia , Adulto , Feminino , Humanos , Quênia , Masculino , Pessoa de Meia-Idade , Áreas de Pobreza , Inquéritos e Questionários , Toaletes/estatística & dados numéricos
13.
PLoS Negl Trop Dis ; 14(8): e0008661, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32866145

RESUMO

Household spraying is a commonly implemented, yet an under-researched, cholera response intervention where a response team sprays surfaces in cholera patients' houses with chlorine. We conducted mixed-methods evaluations of three household spraying programs in the Democratic Republic of Congo and Haiti, including 18 key informant interviews, 14 household surveys and observations, and 418 surface samples collected before spraying, 30 minutes and 24 hours after spraying. The surfaces consistently most contaminated with Vibrio cholerae were food preparation areas, near the patient's bed and the latrine. Effectiveness varied between programs, with statistically significant reductions in V. cholerae concentrations 30 minutes after spraying in two programs. Surface contamination after 24 hours was variable between households and programs. Program challenges included difficulty locating households, transportation and funding limitations, and reaching households quickly after case presentation (disinfection occurred 2-6 days after reported cholera onset). Program advantages included the concurrent deployment of hygiene promotion activities. Further research is indicated on perception, recontamination, cost-effectiveness, viable but nonculturable V. cholerae, and epidemiological coverage. We recommend that, if spraying is implemented, spraying agents should: disinfect surfaces systematically until wet using 0.2/2.0% chlorine solution, including kitchen spaces, patients' beds, and latrines; arrive at households quickly; and, concurrently deploy hygiene promotion activities.


Assuntos
Cólera/epidemiologia , Cólera/prevenção & controle , Desinfecção/métodos , Características da Família , Cloro , Congo/epidemiologia , Surtos de Doenças/prevenção & controle , Feminino , Haiti/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Inquéritos e Questionários , Toaletes , Vibrio cholerae
14.
PLoS One ; 15(7): e0236924, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735608

RESUMO

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


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

RESUMO

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


Assuntos
Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Farmacorresistência Bacteriana Múltipla , Toaletes , Local de Trabalho , Bactérias/genética , Farmacorresistência Bacteriana Múltipla/genética , Microbiologia Ambiental , Feminino , Humanos , Higiene , Masculino , Exposição Ocupacional , Paquistão , Filogenia , Plasmídeos , Prevalência , Fatores R , RNA Ribossômico 16S/genética , Saneamento
16.
Am J Trop Med Hyg ; 103(4): 1735-1741, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32830641

RESUMO

We conducted a comparative cross-sectional study to examine the potential effects of a community-led total sanitation (CLTS) intervention on sanitation and hygiene in Pallisa district in Uganda. Quantitative data were collected from households using a semi-structured questionnaire and an observation checklist, entered and analyzed using univariate, bivariate, and multivariate analyses. Overall, knowledge on sanitation and hygiene was significantly higher (64.5%; 129/200) among households in the CLTS intervention than among those in the nonintervention subcounties (54.0%; 108/200) (P = 0.033). Latrine quality was rated as fair in a majority (73.3%; 143/195) of the CLTS intervention households compared with 50.8% (93/183) in the non-CLTS households (P < 0.001). Latrine cleanliness was rated as good in more than a half (51.3%; 100/195) of households in the intervention area, whereas only 13.7% (25/183) for the nonintervention area (P < 0.001). In this study, 35.0% (70/200) of the households in the intervention subcounty had attained open defecation-free (ODF) status compared with only 6.0% (12/200) in the nonintervention subcounty (P < 0.001). Level of knowledge on hygiene and sanitation (adjusted odd ratio [AOR]: 2.23; 95% CI: 1.24-4.03) and CLTS status (AOR: 8.89; 95% CI: 4.26-18.56) were significantly associated with achievement of ODF status in the multivariate analysis. The mean cases of diarrhea were significantly lower in CLTS implementing (subcounty (0.42 [SD ± 1.03]) than in the non-CLTS implementing subcounty (0.98 [SD ± 1.39]; t = -4.6; P < 0.001). Sanitation and hygiene outcomes were better in the CLTS intervention subcounty than in the non-CLTS intervention subcounty, suggesting that scaling up CLTS could reduce ODF and the burden of diarrheal diseases.


Assuntos
Diarreia/epidemiologia , Higiene , Saneamento , Adolescente , Adulto , Pré-Escolar , Estudos Transversais , Características da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Toaletes , Uganda/epidemiologia , Adulto Jovem
17.
PLoS Negl Trop Dis ; 14(8): e0008600, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32853225

RESUMO

Helminth infections are among the World Health Organization's top neglected diseases with significant impact in many Less Economically Developed Countries. Despite no longer being endemic in Europe, the widespread presence of helminth eggs in archaeological deposits indicates that helminths represented a considerable burden in past European populations. Prevalence of infection is a key epidemiological feature that would influence the elimination of endemic intestinal helminths, for example, low prevalence rates may have made it easier to eliminate these infections in Europe without the use of modern anthelminthic drugs. To determine historical prevalence rates we analysed 589 grave samples from 7 European sites dated between 680 and 1700 CE, identifying two soil transmitted nematodes (Ascaris spp. and Trichuris trichiura) at all locations, and two food derived cestodes (Diphyllobothrium latum and Taenia spp.) at 4 sites. The rates of nematode infection in the medieval populations (1.5 to 25.6% for T. trichiura; 9.3-42.9% for Ascaris spp.) were comparable to those reported within modern endemically infected populations. There was some evidence of higher levels of nematode infection in younger individuals but not at all sites. The genetic diversity of T. trichiura ITS-1 in single graves was variable but much lower than with communal medieval latrine deposits. The prevalence of food derived cestodes was much lower (1.0-9.9%) than the prevalence of nematodes. Interestingly, sites that contained Taenia spp. eggs also contained D. latum which may reflect local culinary practices. These data demonstrate the importance of helminth infections in Medieval Europe and provide a baseline for studies on the epidemiology of infection in historical and modern contexts. Since the prevalence of medieval STH infections mirror those in modern endemic countries the factors affecting STH decline in Europe may also inform modern intervention campaigns.


Assuntos
Helmintíase/epidemiologia , Intestinos/parasitologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Anti-Helmínticos/uso terapêutico , Ascaríase/epidemiologia , Ascaríase/transmissão , Ascaris , Criança , Pré-Escolar , Europa (Continente)/epidemiologia , Feminino , Variação Genética , Helmintíase/tratamento farmacológico , Helmintíase/transmissão , Helmintos/genética , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas/epidemiologia , Nematoides , Prevalência , Solo/parasitologia , Toaletes , Tricuríase/epidemiologia , Tricuríase/transmissão , Trichuris , Adulto Jovem
18.
Am J Trop Med Hyg ; 103(4): 1726-1734, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32815501

RESUMO

Formative research findings from the fast-growing Babati town were used to assess the prevalence of sanitation and hygiene practices among individuals and institutions and associated factors. A cross-sectional study involving household surveys, spot-checks, focus group discussions, in-depth interviews, and structured observations of behaviors showed that 90% of households have sanitation facilities, but 68% have safely managed sanitation services. The most common types of household sanitation facilities were pit latrines with slab (42%) followed by flush/pour flush toilets (32%). Therefore, the management of wastewater depends entirely on onsite sanitation systems. The majority of households (70%) do not practice proper hygiene behaviors. Thirteen percent of the households had handwashing stations with soap and water, handwashing practice being more common to women (38%) than men (18%). The reported handwashing practices during the four critical moments (handwashing with soap before eating and feeding, after defecation, after cleaning child's bottom, and after touching any dirt/dust) differed from the actual/observed practices. Households connected to the town's piped water supply were more likely to practice handwashing than those not directly connected. Sanitation and hygiene behaviors of the people in the study area were seen to be influenced by sociodemographic, cultural, and economic factors. The conditions of sanitation and hygiene facilities in public places were unsatisfactory. There is an urgent need to ensure that the sanitation and hygiene services and behaviors along the value chain (from waste production/source to disposal/end point) are improved both at the household level and in public places through improved sanitation services and the promotion of effective hygiene behavior change programs integrated into ongoing government programs and planning.


Assuntos
Higiene , Saneamento , Adolescente , Adulto , Idoso , Cidades , Estudos Transversais , Características da Família , Feminino , Grupos Focais , Desinfecção das Mãos , Humanos , Masculino , Pessoa de Meia-Idade , Sabões , Tanzânia , Toaletes , Abastecimento de Água , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-32717846

RESUMO

There are considerable challenges to achieving the Sustainable Development Goals' target of universal access to basic sanitation in schools. Schools require safe, clean, and sex-segregated facilities for a large number of students. Robust and affordable solutions are needed to address the economic, spatial, social, institutional, and political factors which contribute to poor sanitary conditions in informal settlements. In 2015, we undertook a randomized controlled trial to assess the feasibility of private sector sanitation delivery (PSSD) in 20 primary schools, in informal settlements of Nairobi, Kenya. Our preliminary evaluation after one year of service delivery suggested that PSSD of urine-diverting dry latrines with routine waste collection and maintenance provided a feasible, lower-cost alternative to the government standard delivery (GSD) of cistern-flush toilets or ventilated improved pit latrines. We conducted a mixed-methods follow-up study to assess sanitation delivery over 3-4 years and investigate prevailing drivers and barriers that may influence the scalability of PSSD. The conditions of newly constructed and rehabilitated GSD facilities diminished quickly, reverting to the conditions of existing facilities, indicating lower sustainability compared to sanitation delivered from the private sector. Barriers in financial aspects related to the ongoing implementation of PSSD emerged, particularly among public schools, and few were able to pay for continued service. Our study demonstrates that the engagement of the private sector may lead to improvements in affordable, safely managed sanitation for schools and their students. Yet, to reach a sustained scale, additional guidance is needed on how to develop these partnerships, streamline procurement and contracting processes, and incorporate appropriate financing mechanisms.


Assuntos
Setor Privado , Saneamento , Seguimentos , Humanos , Quênia , Toaletes
20.
PLoS One ; 15(7): e0235440, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614915

RESUMO

BACKGROUND: Cholera remains a significant public health problem in more than one-third of the countries of the world. Cholera outbreak has become more common in Addis Ababa particularly in the rainy seasons; however, there is a paucity of data on risk factors associated with cholera outbreaks rendering interventions difficult. We investigated the outbreak to identify its etiology, source, risk factors and in order to control the outbreak. METHODS: We compared cases with health center-based unmatched controls (1:2). Cases were patients aged ≥5 years with acute watery diarrhea, with or without vomiting while controls were persons aged ≥5 years without history of acute watery diarrhea. We interviewed our study participants using structured questionnaire to collect demographic and cholera risk factors data. We described the outbreak over time, and then tested our hypotheses using unconditional logistic regression. RESULTS: The outbreak began on 7 September, 2017 reaching its peak on 23 September, 2017 and ended on 01 October, 2017. We identified a total of 25 cases (Median age: 38 years; IQR: 20 years) and recruited 50 controls (Median age: 35 years; IQR: 29 years). All case-patients had acute watery diarrhea and dehydration requiring intravenous fluids. All cases were admitted to cholera treatment center but there were no deaths. Stool and water samples yielded isolates of Vibrio cholerae O1 of serological subtype Ogawa. Consumption of contaminated holy water (AOR: 20.5, 95%CI: 3.50, 119.61) and raw vegetables (AOR: 15.3, 95%CI: 3, 81.51) were independent risk factors whereas washing hands with soap after visiting latrine (AOR: 0.04, 95%CI: 0.01, 0.25) was independent protective factor. CONCLUSION: Our findings demonstrated cholera foodborne transmission via consumption of raw vegetables, and its waterborne transmission via consumption of contaminated holy water. Washing hands with soap after visiting latrine was protective. We recommended cooking of vegetables and promoting hand washing.


Assuntos
Cólera/epidemiologia , Surtos de Doenças , Doenças Transmitidas por Alimentos/epidemiologia , Vibrio cholerae O1/isolamento & purificação , Estudos de Casos e Controles , Diarreia/epidemiologia , Diarreia/microbiologia , Água Potável/microbiologia , Etiópia , Fezes/microbiologia , Microbiologia de Alimentos , Desinfecção das Mãos , Fatores de Risco , Inquéritos e Questionários , Toaletes , Verduras/microbiologia , Verduras/envenenamento , Vômito/epidemiologia , Microbiologia da Água
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