Pit latrine fill-up rates: variation determinants and public health implications in informal settlements, Nakuru-Kenya.

BACKGROUND: Pit latrine operational management and sludge accumulation rate, presents a challenging sanitation problem in low-income urban settlements. However, these challenges have been under-researched. This study was carried out between December 2014 and September 2015 in Nakuru, Kenya. Its objectives were to determine pit latrine management activities and content accumulation rates. METHODS: A longitudinal design was used to study 100 households and their respective pit latrines. Sludge accumulation in 73 pit latrines was monitored for 10 months using a digital laser range-finder. Data analysis included normality testing and descriptive statistics. Differences in fill up across and within the study areas were analysed using one-way analysis of variance and the Fisher's Exact Test used to determine areas with significant differences. RESULTS: Sixty-one percent of the pit latrines were used as solid waste disposal points while 45% of the respondents had no hygiene awareness. The annual fill-up rate and individual sludge contribution were 0.87 ± 0.20 m3 and 41.82 l respectively. The sludge accumulation rates across the study areas had statistically significant mean differences (p < 0.05). CONCLUSION: Operational management and design affect the fill-up rates and post fill-up management operations. This study argues for a need to link information and awareness to users, construction artisans, property owners and local authorities on appropriate vault volumes and management practices. Linking the variables would ensure efficient sanitation service delivery and public health protection.

Recommendations for dealing with waste contaminated with Ebola virus: a Hazard Analysis of Critical Control Points approach.

OBJECTIVE: To assess, within communities experiencing Ebola virus outbreaks, the risks associated with the disposal of human waste and to generate recommendations for mitigating such risks. METHODS: A team with expertise in the Hazard Analysis of Critical Control Points framework identified waste products from the care of individuals with Ebola virus disease and constructed, tested and confirmed flow diagrams showing the creation of such products. After listing potential hazards associated with each step in each flow diagram, the team conducted a hazard analysis, determined critical control points and made recommendations to mitigate the transmission risks at each control point. FINDINGS: The collection, transportation, cleaning and shared use of blood-soiled fomites and the shared use of latrines contaminated with blood or bloodied faeces appeared to be associated with particularly high levels of risk of Ebola virus transmission. More moderate levels of risk were associated with the collection and transportation of material contaminated with bodily fluids other than blood, shared use of latrines soiled with such fluids, the cleaning and shared use of fomites soiled with such fluids, and the contamination of the environment during the collection and transportation of blood-contaminated waste. CONCLUSION: The risk of the waste-related transmission of Ebola virus could be reduced by the use of full personal protective equipment, appropriate hand hygiene and an appropriate disinfectant after careful cleaning. Use of the Hazard Analysis of Critical Control Points framework could facilitate rapid responses to outbreaks of emerging infectious disease.

Needs assessment to strengthen capacity in water and sanitation research in Africa: experiences of the African SNOWS consortium.

BACKGROUND: Despite its contribution to global disease burden, diarrhoeal disease is still a relatively neglected area for research funding, especially in low-income country settings. The SNOWS consortium (Scientists Networked for Outcomes from Water and Sanitation) is funded by the Wellcome Trust under an initiative to build the necessary research skills in Africa. This paper focuses on the research training needs of the consortium as identified during the first three years of the project. METHODS: We reviewed the reports of two needs assessments. The first was a detailed needs assessment led by one northern partner, with follow-up visits which included reciprocal representation from the African universities. The second assessment, led by another northern partner, focused primarily on training needs. The reports from both needs assessments were read and stated needs were extracted and summarised. RESULTS: Key common issues identified in both assessments were supervisory skills, applications for external research funding, research management, and writing for publication in the peer-reviewed scientific literature. The bureaucratisation of university processes and inconsistencies through administration processes also caused problems. The lack of specialist laboratory equipment presented difficulties, particularly of inaccessibility through a lack of skilled staff for operation and maintenance, and of a budget provision for repairs and running costs. The lack of taught PhD modules and of research training methods also caused problems. Institutionally, there were often no mechanisms for identifying funding opportunities. On the other hand, grantees were often unable to understand or comply with the funders' financial and reporting requirements and were not supported by their institution. Skills in staff recruitment, retention, and performance were poor, as were performance in proposal and paper writing. The requirements for ethical clearance were often not known and governance issues not understood, particularly those required by funders. CONCLUSIONS: SNOWS believes that working with African universities to develop networks that support African-led research driven by the local context is an effective approach to develop and retain research skills needed to change policy and practice in water, sanitation, and hygiene in Africa.