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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46898

RESUMO

Plataforma com dados indicadores sobre a Taxa de mortalidade atribuída a fontes de água inseguras, saneamento inseguro e falta de higiene. Agenda 2030 - objetivo 3 - Saúde e bem estar


Assuntos
Desenvolvimento Sustentável , Saneamento Básico/políticas
2.
Geospat Health ; 14(2)2019 11 06.
Artigo em Inglês | MEDLINE | ID: mdl-31724383

RESUMO

Stunting is recognised as a major public health problem in Rwanda. We therefore aimed to study the demographic, socio-economic and environmental factors determining the spatial pattern of stunting. A cross-sectional study using the data from the 2014- 2015 Rwanda Demographic and Health Survey and environmental data from external geospatial datasets were conducted. The study population was children less than two years old with their mothers. A multivariate linear regression model was used to estimate the effects of demographic, socio-economic and biophysical factors and a proxy measure of aflatoxins exposure on height-for-age. Also, a spatial prediction map of height-for-age to examine the stunting pattern was produced. It was found that age of child, height of mother, secondary education and higher, a child being male and birth weight were associated with height-for-age. After adjusting for demographic and socioeconomic factors, elevation and being served by a rural market were also significantly associated with low height-for-age in children. The spatial prediction map revealed the variability of height-for-age at the cluster-level that was lost when the levels are aggregated at the district level. No associations with height-for-age were found for exclusive breastfeeding, use of deworming tablets, improved water source and improved sanitation in the study population. In addition to the child and mother factors known to determine height-for-age, our study confirms the influence of environmental factors in determining the height-of-age of children in Rwanda. A consideration of the environmental drivers of anthropometric status is crucial to have a holistic approach to reduce stunting.

3.
Sci Total Environ ; 699: 134255, 2019 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-31683215

RESUMO

Citizen science (CS) may be described as research carried out by members of the public with the aim of gathering scientific information for the purpose of aiding in scientific projects. It has many potential advantages, including data collection at a scale not possible by professional scientists alone. The United Nations (UN) has recently recognized citizen science as a potential source of data that may contribute to the UN Sustainable Development Goals (SDGs). The availability of relatively inexpensive water quality monitoring field equipment suitable for CS suggests great potential for increased spatial coverage far beyond that of traditional, laboratory-based monitoring networks for water quality. In support of work towards the achievement of Sustainable Development Goal 6: "Clean Water and Sanitation", this study tested the use of such field equipment by citizen scientists for SDG Indicator 6.3.2: "Proportion of bodies of water with good ambient water quality". Data generated by 26 citizen scientists were compared with the results produced by an accredited laboratory. The results compared well for most parameters, suggesting that citizen science may be able to contribute towards monitoring ambient water quality for the Sustainable Development Goals.

4.
Sci Total Environ ; 701: 134898, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31704399

RESUMO

Worldwide, there is increasing acknowledgement of the dangers of improper human waste management, particularly open defecation, on the environment and human wellbeing. With about 85.7% of Ghana's population without access to decent toilet facilities as of 2017, Ghana ranks highly in the world among countries with poor human waste management practices. Focusing on urban Ghana, the purpose of this article is twofold: first, to analyze the social, economic, institutional and cultural factors inhibiting the provision of household toilet facility in urban Ghana; and second, to assess how urban residents are coping with the absence of in-house toilet facilities, and the urban planning implications. Using Wa municipality as a case study, household survey and key informant interviews were conducted. Findings indicate that provision of in-house toilet facilities is influenced by complex interactions of socio-economic (e.g. income and educational levels) and cultural (community belief system in relation to toilet provision) factors as well as distortions in the urban planning regime (e.g. limited monitoring systems, inadequate logistics and personnel). Findings from a regression analysis between residents' attitudes to provision of toilet facilities and the benefits they receive or derive from the availability and/use of in-house toilet facilities indicated a positive correlation (correlation coefficient 0.750; degrees of freedom 13; p value 0.001), yet residents have resorted to the use of communal toilet facilities, open defecation and 'perching' (i.e. sharing with friends' with in-house toilet facilities). Implications of the findings for environmental planning are discussed.

5.
Infect Dis Poverty ; 8(1): 93, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31744539

RESUMO

BACKGROUND: Determination of infection rates of snail populations is one of the basic tools for epidemiological studies of snail borne diseases. In this study, we opted to determine the trematode infection of freshwater snails in the Omo-Gibe River Basin, southwest Ethiopia. METHODS: We collected snail samples from 130 observation sites in lakes, wetlands, rivers, reservoirs and irrigation canals surveyed during the dry season (March to May) in 2016. The snail samples were examined for trematode infections by cercarial shedding immediately after collection. Habitat conditions, water quality, human water contact practices and other human activities were assessed at each survey site. A redundancy analysis (RDA) was used to examine the relationship between cercarial infection and environmental variables. The statistical significance of eigenvalues and cercariae-environment correlations generated by the RDA were tested using Monte Carlo permutations at 499 permutations. RESULTS: A total of 3107 snails belonging to five species were collected. The most abundant species was Biomphalaria pfeifferi, representing 66% of the total collection. Overall, 109 (3.6%) of the snails were found infected with trematodes (cercariae). Biomphalaria pfeifferi was found to be the most highly infected, accounting 85% of all infected snails. A total of eight morphologically different types of cercariae were recorded, which included: Echinostoma cercariae, brevifurcate apharyngeate distome cercariae, amphistome cercariae, brevifurcate apharyngeate monostome cercariae, xiphidiocercariae, longifurcate pharyngeate distome cercariae, strigea cercariae and unidentified cercariae. Brevifurcate apharyngeate distome cercariae, and Echinostoma cercariae were the most abundant cercariae, accounting for 36 and 34% of all infection, respectively. The mean concentration of water conductivity and 5 days biological oxygen demand were higher in irrigation canals and lake sampling points. Human activities such as open field defecation, urination, livestock grazing, farming, and swimming were highly correlated with trematode infection. CONCLUSIONS: The abundance, occurrence and infection rates of snail species were largely influenced by water physicochemical quality, sanitation and water contact behaviour of the inhabitants. Human activities, such as open field defecation and urination, livestock grazing, farming, and swimming were important predictors of the abundance of cercariae. Therefore, awareness creation should be implemented for proper containment of excreta (urine and faeces) and reducing human and animal contacts with surface waters to reduce snail-borne disease transmission.

6.
Sci Rep ; 9(1): 17124, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31748573

RESUMO

Campylobacter species infections have been associated with malnutrition and intestinal inflammation among children in low-resource settings. However, it remains unclear whether that association is specific to Campylobacter jejuni/coli. The aim of this study was to assess the association between both all Campylobacter species infections and Campylobacter jejuni/coli infections on growth and enteric inflammation in children aged 1-24 months. We analyzed data from 1715 children followed from birth until 24 months of age in the MAL-ED birth cohort study, including detection of Campylobacter species by enzyme immunoassay and Campylobacter jejuni/coli by quantitative PCR in stool samples. Myeloperoxidase (MPO) concentration in stool, used as a quantitative index of enteric inflammation, was measured. The incidence rate per 100 child-months of infections with Campylobacter jejuni/coli and Campylobacter species during 1-24 month follow up were 17.7 and 29.6 respectively. Female sex of child, shorter duration of exclusive breastfeeding, lower maternal age, mother having less than 3 living children, maternal educational level of <6 years, lack of routine treatment of drinking water, and unimproved sanitation were associated with Campylobacter jejuni/coli infection. The cumulative burden of both Campylobacter jejuni/coli infections and Campylobacter species were associated with poor growth and increased intestinal inflammation.

7.
BMC Med ; 17(1): 214, 2019 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-31767012

RESUMO

BACKGROUND: Moderate-to-severe diarrhea (MSD) in the first 2 years of life can impair linear growth. We sought to determine risk factors for linear growth faltering and to build a clinical prediction tool to identify children most likely to experience growth faltering following an episode of MSD. METHODS: Using data from the Global Enteric Multicenter Study of children 0-23 months old presenting with MSD in Africa and Asia, we performed log-binomial regression to determine clinical and sociodemographic factors associated with severe linear growth faltering (loss of ≥ 0.5 length-for-age z-score [LAZ]). Linear regression was used to estimate associations with ΔLAZ. A clinical prediction tool was developed using backward elimination of potential variables, and Akaike Information Criterion to select the best fit model. RESULTS: Of the 5902 included children, mean age was 10 months and 43.2% were female. Over the 50-90-day follow-up period, 24.2% of children had severe linear growth faltering and the mean ΔLAZ over follow-up was - 0.17 (standard deviation [SD] 0.54). After adjustment for age, baseline LAZ, and site, several factors were associated with decline in LAZ: young age, acute malnutrition, hospitalization at presentation, non-dysenteric diarrhea, unimproved sanitation, lower wealth, fever, co-morbidity, or an IMCI danger sign. Compared to children 12-23 months old, those 0-6 months were more likely to experience severe linear growth faltering (adjusted prevalence ratio [aPR] 1.97 [95% CI 1.70, 2.28]), as were children 6-12 months of age (aPR 1.72 [95% CI 1.51, 1.95]). A prediction model that included age, wasting, stunting, presentation with fever, and presentation with an IMCI danger sign had an area under the ROC (AUC) of 0.67 (95% CI 0.64, 0.69). Risk scores ranged from 0 to 37, and a cut-off of 21 maximized sensitivity (60.7%) and specificity (63.5%). CONCLUSION: Younger age, acute malnutrition, MSD severity, and sociodemographic factors were associated with short-term linear growth deterioration following MSD. Data routinely obtained at MSD may be useful to predict children at risk for growth deterioration who would benefit from interventions.

8.
Environ Sci Technol ; 53(22): 13535-13545, 2019 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-31674173

RESUMO

Diverse and numerous sanitation sustainability assessment frameworks have been created to enhance the ability of systems to provide safe sanitation services, especially in resource-limited contexts. However, many go unused while new frameworks are developed and high sanitation system failure rates persist. To better support the sustainable development goal around global sanitation, there is a need to better understand how sanitation sustainability is defined and measured and the potential advantages and disadvantages of existing assessment frameworks. A subset of existing sanitation sustainability assessment frameworks was reviewed after applying each to evaluate multiple successful and failed community sanitation systems in India. Overall, the evaluated frameworks did not share a sanitation sustainability definition or core set of essential indicators. Many indicators lacked clear definitions and guidance on data collection and analysis. When evaluating framework effectiveness, differentiations between successful and failed cases varied greatly between frameworks. Potential improvements include indicator pilot testing to verify measurement feasibility and that they provide expected results; context-specific weightings; and project-specific framework selection. Clarifying and improving sanitation sustainability assessment frameworks could increase their effectiveness and use, leading to better decision-making and improved public and environmental health, economic viability, and sanitation use and acceptance.

9.
Sci Rep ; 9(1): 15193, 2019 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-31645651

RESUMO

Globally, ~1 billion people, mostly residing in Africa and South Asia (e.g. India), still lack access to clean drinking water and sanitation. Resulting, unsafe disposal of fecal waste from open-defecation to nearby drinking water sources severely endanger public health. Until recently, India had a huge open-defecating population, leading declining public health from water-borne diseases like diarrhoea by ingesting polluted water, mostly sourced to groundwater. However, in recent past, sanitation development to achieve Sustainable Development Goals (SDGs) has been encouraged throughout India, but their effect to groundwater quality and human health conditions are yet-unquantified. Here, for the first time, using long term, high-spatial resolution measurements (>1.7 million) across India and analyses, we quantified that over the years, groundwater fecal coliform concentration (2002-2017, -2.56 ± 0.06%/year) and acute diarrheal cases (1990-2016, -3.05 ± 0.01%/year) have significantly reduced, potentially influenced by sanitation development (1990-2017, 2.63 ± 0.01%/year). Enhanced alleviation of groundwater quality and human health have been observed since 2014, with initiation of acceletated constructions of sanitation infrastructures through Clean India (Swachh Bharat) Mission. However, the goal of completely faecal-pollution free, clean drinking water is yet to be achieved. We also evaluated the suitability of using satellite-derived night-time light (NLan, 1992-2013, 4.26 ± 0.05%/year) as potential predictor for such economic development. We observed that in more than 80% of the study region, night-time light demonstrated to be a strong predictor for observed changes in groundwater quality, sanitation development and water-borne disease cases. While sanitation and economic development can improve public health, poor education level and improper human practices can strongly influence on water-borne diseases loads and thus health in parts of India.

10.
BMJ Open ; 9(9): e029968, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31570408

RESUMO

OBJECTIVE: We sought to test hypotheses regarding the principal correlates of child-health performance among African nations based on previous evidence collected at finer spatial scales. DESIGN: Retrospective, cross-sectional study. SETTING: All countries in Africa, excluding small-island nations. PRIMARY AND SECONDARY OUTCOME MEASURES: We defined a composite child-health indicator for each country comprising the incidence of stunting, deaths from respiratory disease, deaths from diarrhoeal disease, deaths from other infectious disease and deaths from injuries for children aged under 5 years. We also compiled national-level data for Africa to test the effects of country-level water quality, air pollution, food supply, breast feeding, environmental performance, per capita wealth, healthcare investment, population density and governance quality on the child-health indicator. RESULTS: Across nations, child health was lowest when water quality, improved sanitation, air quality and environmental performance were lowest. There was also an important decline in child health as household size (a proxy for population density) increased. The remaining variables had only weak effects, but in the directions we hypothesised. CONCLUSIONS: These results emphasise the importance of continued investment in clean water and sanitation services, measures to improve air quality and efforts to restrict further environmental degradation, to promote the UN's Sustainable Development Goal 3 target to '… end preventable deaths of newborns and children under 5' and Goal 6 to '… ensure access to water and sanitation for all' by 2030.

11.
PLoS One ; 14(10): e0223557, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31603926

RESUMO

BACKGROUND: The critical importance of safe and affordable access to water, sanitation and hygiene (WASH) is highlighted in Goal 6 of the Sustainable Development Goals, which seeks to achieve universal and equitable access for all by 2030. However, people with disabilities-who comprise 15% of the global population-frequently face difficulties meeting their WASH needs. Unmet WASH needs amongst people with disabilities may not be captured through current approaches to tracking progress towards Goal 6, which focus on household- rather than individual-level access. OBJECTIVE: To evaluate access to safe water, sanitation and hygiene (WASH), at the individual- and household-level, amongst people with disabilities in the Tanahun district of Nepal. METHODS: A population-based survey of disability was conducted from August-October 2016 to evaluate access to improved water and sanitation facilities between households with members with disabilities (n = 198) and those without (n = 1,265) in the Tanahun district of Nepal. A nested case-control then compared individual-level access between cases aged 15 and above with disabilities (n = 192) and age-sex-location matched controls without disabilities (n = 189), using the newly developed 21-item "Quality of WASH Access" questionnaire. Multivariate regression was used to compare household- and individual-level indicators between people and households with and without disabilities. In-depth interviews with 18 people with disabilities and their caregivers was conducted to assess the acceptability and appropriateness of the "Quality of WASH Access" questionnaire. FINDINGS: There were no significant differences between households with and without members with disabilities in access to an improved sanitation facility or water source. However, at the individual-level, people with disabilities experienced significantly greater difficulties accessing water, sanitation and hygiene compared to people without disabilities (p<0.001 for all three scores). Amongst people with disabilities, water difficulty scores were associated with having a physical impairment and greater disability severity; sanitation difficulty scores were associated with lower socioeconomic status and physical or self-care limitations; and hygiene difficulty scores were positively associated with self-care limitations and lower socioeconomic status, and inversely associated with hearing impairments. Qualitative research found the "Quality of WASH Access" questionnaire was well understood by participants and captured many of the challenges they faced. Additional challenges not covered by the tool included: (1) time spent on WASH, (2) consistency of access, (3) sufficiency of access, and (4) dignity of access. CONCLUSION: People with disabilities face substantial challenges to meeting their WASH needs, particularly in using services autonomously, consistently, hygienically, with dignity and privacy, and without pain or fear of abuse. These challenges are not captured through household-level data, and so individual-level WASH access are needed to monitor progress towards universal WASH access. The Quality of WASH Access questionnaire may provide a useful data collection tool.

12.
BMC Public Health ; 19(1): 1330, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640635

RESUMO

BACKGROUND: To reduce the under-five mortality (U5M), fine-gained spatial assessment of the effects of health interventions is critical because national averages can obscure important sub-national disparities. In turn, sub-national estimates can guide control programmes for spatial targeting. The purpose of our study is to quantify associations of interventions with U5M rate at national and sub-national scales in Uganda and to identify interventions associated with the largest reductions in U5M rate at the sub-national scale. METHODS: Spatially explicit data on U5M, interventions and sociodemographic indicators were obtained from the 2011 Uganda Demographic and Health Survey (DHS). Climatic data were extracted from remote sensing sources. Bayesian geostatistical Weibull proportional hazards models with spatially varying effects at sub-national scales were utilized to quantify associations between all-cause U5M and interventions at national and regional levels. Bayesian variable selection was employed to select the most important determinants of U5M. RESULTS: At the national level, interventions associated with the highest reduction in U5M were artemisinin-based combination therapy (hazard rate ratio (HRR) = 0.60; 95% Bayesian credible interval (BCI): 0.11, 0.79), initiation of breastfeeding within 1 h of birth (HR = 0.70; 95% BCI: 0.51, 0.86), intermittent preventive treatment (IPTp) (HRR = 0.74; 95% BCI: 0.67, 0.97) and access to insecticide-treated nets (ITN) (HRR = 0.75; 95% BCI: 0.63, 0.84). In Central 2, Mid-Western and South-West, largest reduction in U5M was associated with access to ITNs. In Mid-North and West-Nile, improved source of drinking water explained most of the U5M reduction. In North-East, improved sanitation facilities were associated with the highest decline in U5M. In Kampala and Mid-Eastern, IPTp had the largest associated with U5M. In Central1 and East-Central, oral rehydration solution and postnatal care were associated with highest decreases in U5M respectively. CONCLUSION: Sub-national estimates of the associations between U5M and interventions can guide control programmes for spatial targeting and accelerate progress towards mortality-related Sustainable Development Goals.

13.
Artigo em Inglês | MEDLINE | ID: mdl-31652610

RESUMO

Translational research applies scientific techniques to achieve practical outcomes, connecting pure research and pure practice. Many translational research types have arisen since the mid-1900s, reflecting the need to better integrate scientific advancement with policy and practice. Water, sanitation, and hygiene (WaSH) development efforts have aimed to reduce morbidity and mortality and improve service delivery; thus, associated research has a strong orientation toward applied studies that use diverse methods to support decision-making. Drawing from knowledge that emerged to support other professional fields, such as manufacturing and clinical healthcare, we characterize different types of translational research and clarify nomenclature and principles. We describe study approaches relevant to translational research questions, and offer overarching recommendations, specific examples, and resources for further study as practical advice to professionals who seek to apply translational methods to WaSH problems. To enhance collective outcomes, professionals should mindfully align projects within the translational spectrum. We further recommend overarching good practices such as documenting intervention adaptations, overtly considering contextual factors, and better distinguishing efficacy from effectiveness research by replicating studies in different contexts. By consciously improving the compatibility and linkages between WaSH science and practice, this guide can accelerate urgently needed progress toward global development goals.

14.
Sci Total Environ ; 700: 134408, 2019 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-31627043

RESUMO

Finding effective policy interventions for addressing the Sustainable Development Goals, such as reducing carbon emissions (SDG 13), which can also enhance good health and wellbeing (SDG 3), is urgent. Many promising interactions occur between sustainable cities and communities (SDG 11), clean water and sanitation (SDG 6) and affordable and clean energy (SDG 7), which sit at the centre of integrated urban planning and regeneration. In this paper, we consider the framing and findings of four policies we have evaluated as natural experiments, all of which have important co-benefits, which were not always the focus of the initial policies. These policies are: the installation of cycleways and walkways in existing suburbs; a central government measure to recentralise employment after the 2011 Christchurch earthquakes; the streamlining of housing developments by reducing land-use regulation; and ongoing changes of policy about public housing investment. We show that having a clear understanding of the benefits of increased physical activity for health, for example, could accelerate the reduction of carbon emissions. Also, decisions about infrastructure, housing and job locations can generate health and environmental gains if supported by broader public transport investments. Cycling and walking are also more likely to substitute for short habitual car trips. Similarly, measuring the co-benefits of differential residential models, relating to land-use and renewable energy, provides a framework that can facilitate learning from policy interventions, enabling wider and potentially more rapid generalisation of policies, including those for climate change mitigation.

15.
Artigo em Inglês | MEDLINE | ID: mdl-31509974

RESUMO

Sustainable Development Goal (SDG) 6.2 sets an ambitious target of leaving no-one without adequate and equitable sanitation by 2030. The key concern is the lack of local human and financial capital to fund the collection of reliable information to monitor progress towards the goal. As a result, national and local records may be telling a different story of the proportion of safely managed sanitation that counts towards achieving the SDG. This paper unveils such inconsistency in sanitation data generated by urban authorities and proposes a simple approach for collecting reliable and verifiable information on access to safely managed sanitation. The paper is based on a study conducted in Babati Town Council in Tanzania. Using a smartphone-based survey tool, city health officers were trained to map 17,383 housing units in the town. A housing unit may comprise of two or more households. The findings show that 5% practice open defecation, while 82% of the housing units have some form of sanitation. Despite the extensive coverage, only 31% of the fecal sludge generated is safely contained, while 64% is not. This study demonstrates the possibility of using simple survey tools to collect reliable data for monitoring progress towards safely managed sanitation in the towns of global South.

16.
BMJ Open ; 9(9): e030152, 2019 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-31558454

RESUMO

OBJECTIVES: To investigate differences in reported open defecation between a question about latrine use or open defecation for every household member and a household-level question. SETTING: Rural India is home to most of the world's open defecation. India's Demographic and Health Survey (DHS) 2015-2016 estimates that 54% of households in rural India defecate in the open. This measure is based on a question asking about the behaviour of all household members in one question. Yet, studies in rural India find substantial open defecation among individuals living in households with latrines, suggesting that household-level questions underestimate true open defecation. PARTICIPANTS: In 2018, we randomly assigned latrine-owning households in rural parts of four Indian states to receive one of two survey modules measuring sanitation behaviour. 1215 households were asked about latrine use or open defecation individually for every household member. 1216 households were asked the household-level question used in India's DHS: what type of facility do members of the household usually use? RESULTS: We compare reported open defecation between households asked the individual-level questions and those asked the household-level question. Using two methods for comparing open defecation by question type, the individual-level question found 20-21 (95% CI 16 to 25 for both estimates) percentage points more open defecation than the household-level question, among all households, and 28-29 (95% CI 22 to 35 for both estimates) percentage points more open defecation among households that received assistance to construct their latrines. CONCLUSIONS: We provide the first evidence that individual-level questions find more open defecation than household-level questions. Because reducing open defecation in India is essential to meeting the Sustainable Development Goals, and exposure to open defecation has consequences for child mortality and development, it is essential to accurately monitor its progress. TRIAL REGISTRATION NUMBER: Registry for International Development Impact Evaluations (5b55458ca54d1).

17.
Risk Anal ; 39(10): 2214-2226, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31529800

RESUMO

Achieving health gains from the U.N. Sustainable Development Goals of universal coverage for water and sanitation will require interventions that can be widely adopted and maintained. Effectiveness-how an intervention performs based on actual use-as opposed to efficacy will therefore be central to evaluations of new and existing interventions. Incomplete compliance-when people do not always use the intervention and are therefore exposed to contamination-is thought to be responsible for the lower-than-expected risk reductions observed from water, sanitation, and hygiene interventions based on their efficacy at removing pathogens. We explicitly incorporated decision theory into a quantitative microbial risk assessment model. Specifically, we assume that the usability of household water treatment (HWT) devices (filters and chlorine) decreases as they become more efficacious due to issues such as taste or flow rates. Simulations were run to examine the tradeoff between device efficacy and usability. For most situations, HWT interventions that trade lower efficacy (i.e., remove less pathogens) for higher compliance (i.e., better usability) contribute substantial reductions in diarrheal disease risk compared to devices meeting current World Health Organization efficacy guidelines. Recommendations that take into account both the behavioral and microbiological properties of treatment devices are likely to be more effective at reducing the burden of diarrheal disease than current standards that only consider efficacy.

18.
Hisp Health Care Int ; : 1540415319874812, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31523991

RESUMO

INTRODUCTION: Previously published community health assessments (CHA) have explored social determinants of health in low-resource, Haitian-majority Dominican communities. The present CHA was conducted in Las Malvinas II, a Dominican-majority low-resource community, and represented a first step for developing a building a healthier community process. METHOD: A binational community-academic partnership adapted the Centers for Disease Control and Prevention's CHANGE (Community Health Assessment and Group Evaluation) guide to conduct a CHA through community-engaged, mixed-methods research. Data were collected on five community selected public health priorities (i.e., education, sanitation, unwanted pregnancies, chronic disease management, and vaccine-preventable diseases) and community assets through focus groups, interviews with key informants, and a household survey using GIS (geographical information systems) technology. RESULTS: Of all five priorities, unwanted pregnancies and sanitation received the lowest average CHANGE tool ratings for both policies and Systems and Environment. However, data gathered on the five public health priorities reflect the perceived needs and assets of Las Malvinas II, and are equally important in improving the community's health and well-being status. Community members identified as important goals the construction of a primary health clinic, as well as a bigger school, that includes pre-school and high school levels. CONCLUSION: A coalition emerged from the CHA to address the identified issues. The coalition used CHA findings to develop a community health improvement plan. The establishment of a primary health care center and a bigger school were identified as primary goals.

19.
Washington, D.C.; OPS; 2019-09-23.
em Espanhol | PAHO-IRIS | ID: phr-51563

RESUMO

[Introducción]. El clima y otros cambios ambientales son algunos de los principales factores que han concurrido para que aparecieran o reaparecieran enfermedades transmitidas por vectores (ETV). Estos factores pueden expandir la distribución geográfica de dichas enfermedades y extender la temporada de transmisión, con lo que influyen en la morbilidad y mortalidad de estas enfermedades. Las enfermedades infecciosas tienen una repercusión importante en la salud pública de la Región de las Américas. Por ejemplo, en 2017 se notificó a la Organización Panamericana de la Salud (OPS) que hubo un total de 483.208 casos de dengue y 253 muertes por esta causa. Ese mismo año también se notificaron más de 180.000 casos de chikunguña, y el número acumulado de casos presuntos o confirmados de zika en el período comprendido entre 1 de enero 2015 y el 4 de enero de 2018 fue de 583.451 y 223.477, respectivamente, con 20 muertes confirmadas y 3.720 casos confirmados de síndrome congénito por el virus de Zika. Considerando estos impactos, será necesario incorporar múltiples enfoques integrales y multisectoriales en las estrategias de vigilancia y control de vectores. En dichos enfoques se deberán tomar en cuenta iniciativas que promuevan entornos saludables, por ejemplo, mediante la mejora de la gestión de los residuos sólidos, la gestión segura del agua y el saneamiento a fin de garantizar la continuidad y la calidad de los servicios, y el manejo adecuado de los residuos químicos que se usan en el control de vectores, entre otros. En esta publicación se presentan algunas orientaciones clave para promover acciones de vigilancia y control de vectores que pongan énfasis en las intervenciones en materia de salud ambiental, utilizando enfoques interprogramáticos e intersectoriales.


Assuntos
Fenômenos Ecológicos e Ambientais , Doença Ambiental , Controle de Vetores , Saúde Ambiental , Saneamento , Higiene , Cidade Saudável , Vigilância Sanitária Ambiental
20.
Sci Total Environ ; 693: 133536, 2019 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-31374498

RESUMO

In the first two decades of the 21st century, 79 global big cities have suffered extensively from drought disaster. Meanwhile, climate change has magnified urban drought in both frequency and severity, putting tremendous pressure on a city's water supply. Therefore, tackling the challenges of urban drought is an integral part of achieving the targets set in at least 5 different Sustainable Development Goals (SDGs). Yet, the current literatures on drought have not placed sufficient emphasis on urban drought challenge in achieving the United Nations' 2030 Agenda for Sustainable Development. This review is intended to fill this knowledge gap by identifying the key concepts behind urban drought, including the definition, occurrence, characteristics, formation, and impacts. Then, four sub-categories of urban drought are proposed, including precipitation-induced, runoff-induced, pollution-induced, and demand-induced urban droughts. These sub-categories can support city stakeholders in taking drought mitigation actions and advancing the following SDGs: SDG 6 "Clean water and sanitation", SDG 11 "Sustainable cities and communities", SDG 12 "Responsible production and consumption", SDG 13 "Climate actions", and SDG 15 "Life on land". To further support cities in taking concrete actions in reaching the listed SDGs, this perspective proposes five actions that city stakeholders can undertake in enhancing drought resilience and preparedness:1) Raising public awareness on water right and water saving; 2) Fostering flexible reliable, and integrated urban water supply; 3) Improving efficiency of urban water management; 4) Investing in sustainability science research for urban drought; and 5) Strengthening resilience efforts via international cooperation. In short, this review contains a wealth of insights on urban drought and highlights the intrinsic connections between drought resilience and the 2030 SDGs. It also proposes five action steps for policymakers and city stakeholders that would support them in taking the first step to combat and mitigate the impacts of urban droughts.

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