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PubMedDate not supplied

Attitude and practices regarding diarrhoea in rural community in Chandigarh.

The present study on diarrhoea, its prevalence, practices and awareness of mothers was conducted in 120 randomly selected households in the rural area of Chandigarh during monsoons in 1996. Inspite of access to safe drinking water and latrines in 83% and 74% of the households in the village respectively, the prevalence rate of diarrhoea in 181 under five children was observed to be 23.2%. Majority (88.1%) of children had treatment for diarrhoea whereas only half (54.8%) of children were given oral rehydration solution. 86.7% of the mothers were aware of ORS but only 18.7% could tell the correct method of its preparation. A large number of respondents implicated a variety of food items responsible for diarrhoea and restricted them during the episodes.

Child, Preschool↗
PubMed2004

Food-borne intestinal trematodiases in humans.

Food-borne trematodiases still remain a public health problem world-wide, despite changes in eating habits, alterations in social and agricultural practices, health education, industrialization, environmental alteration, and broad-spectrum anthelmintics. Food-borne trematodiases usually occur focally, are still persistently endemic in some parts of the world, and are most prevalent in remote rural places among school-age children, low-wage earners, and women of child-bearing age. Intestinal fluke diseases are aggravated by socio-economic factors such as poverty, malnutrition, an explosively growing free-food market, a lack of sufficient food inspection and sanitation, other helminthiases, and declining economic conditions. Control programs implemented for food-borne zoonoses and sustained in endemic areas are not fully successful for intestinal food-borne trematodiases because of centuries-old traditions of eating raw or insufficiently cooked food, widespread zoonotic reservoirs, promiscuous defecation, and the use of "night soil" (human excrement collected from latrines) as fertilizer. This review examines food-borne intestinal trematodiases associated with species in families of the Digenea: Brachylaimidae, Diplostomidae, Echinostomatidae, Fasciolidae, Gastrodiscidae, Gymnophallidae, Heterophyidae, Lecithodendriidae, Microphallidae, Nanophyetidae, Paramphistomatidae, Plagiorchiidae, and Strigeidae. Because most of the implicated species are in the Echinostomatidae and Heterophyidae, emphasis in the review is placed on species in these families.

Animals↗
PubMedDate not supplied

Responses of dairy cows to badger urine and faeces on pasture with reference to bovine tuberculosis transmission.

Grazing cattle were observed when they encountered badger urine or faeces which, in all but the first study, came only from badgers which were not infected with bovine tuberculosis. The faeces were very strongly avoided and there was generally a strong avoidance of ingestion of badger urine. There was no evidence that cattle were attracted to badger latrines in an area where some infected badgers were present and cows actively avoided faeces up to 28 days old which was placed on grass turves or on pasture. 99.3% of cows took no bites from small grass plots contaminated with faeces and 88.7% of cows took no bites from urine-treated plots. There was generally avoidance of pasture treated with badger urine up to 14 days old. However, two cows out of 240 were willing to graze close to faeces and seven out of 240 were willing to graze near urine. Contaminated herbage was eaten most when attractive herbage became scarce. Wet weather did not reduce the strength of avoidance of urine. Some cows responded to badger urine, and to a lesser extent to faeces, by more sniffing, particularly when herbage was scarce. The odour of faeces, and sometimes that of urine, often resulted in the ejection of mouth contents. As a consequence of their avoidance of badger faeces and urine, the vast majority of cows are unlikely to contract tuberculosis from infected badgers by ingestion. Most cows totally avoid badger products so they are unlikely to be infected via inhalation. However, the small minority of unselective cows must be more at risk and this finding warrants further investigation.

Animals↗
PubMedDate not supplied

The Imo State (Nigeria) Drinking Water Supply and Sanitation Project, 1. Description of the project, evaluation methods, and impact on intervening variables.

A health impact evaluation was conducted in conjunction with the Imo State Drinking Water Supply and Sanitation Project in Nigeria. The project consisted of a package of water supply, sanitation, and health and hygiene education given by village-based workers. The evaluation was a quasi-experimental study covering pre-, peri- and post-intervention periods. Data were collected from 3 intervention and 2 control villages. Baseline surveys indicated that the intervention and control areas were similar with respect to most socio-demographic variables. Use of the improved water supply was high, although this was influenced by borehole-to-population ratios and household-to-borehole distances. Water collection time was consequently greatly reduced. Data from a small sample of households showed that borehole water became heavily contaminated during collection and storage, and that there was no significant change in consumption of water per person. Adults in 46% of household units in the intervention area were using ventilated improved pit latrines by the end of the study period. Use by young children (2-5 years old), however, was low. Limitations in the success of the health education component of the project were found. Although changes were found in knowledge, attitudes and practices related to water and sanitation, and in management of childhood diarrhoea, this occurred in both the intervention and control areas.

Health Education↗
PubMedDate not supplied

The epidemiology and control of hookworm infection in the Burma Valley area of Zimbabwe.

An integrated hookworm control programme, involving mass chemotherapy and improvements in public health, was conducted in the Burma Valley and Vumba areas of Zimbabwe between 1985 and 1990. Three sequential annual mass chemotherapy programmes were implemented. Infection status was monitored annually throughout. Initial observations indicated asymptotic age prevalence and intensity profiles, with peak infection levels in adults. Mass chemotherapy was shown to have immediate and medium term benefits for community health. Reinfection was slow to develop, and average intensity had not returned to pre-intervention levels 39 months after the cessation of chemotherapy. The results support the existence of age-dependency in reinfection. Despite a marked increase in the number of sanitation units, no relationship was found between latrine availability and reinfection intensity on individual farms. This result is consistent with observations that the effect of sanitation is slow to develop, and indicates that repeated anthelmintic intervention should be maintained until sanitation has an impact on transmission.

Adolescent↗
PubMedDate not supplied

Approaches to vector control: new and trusted. 4. Appropriate technology for vector control: impregnated bed nets, polystyrene beads and fly traps.

There are social, economic and entomological problems with conventional insecticidal spraying methods for vector control. There is therefore interest in alternative technologies, especially the impregnation of bed nets with pyrethroid insecticides against malaria vectors. This method is cheap, socially acceptable and effective where bed nets are already widely used and where malaria transmission is not very intense. In holoendemic areas, and where people consider bed nets unaffordable, there are still unanswered questions. Whether pyrethroid resistance will be selected in anophelines also deserves more attention than it has so far attracted. Where Culex mosquitoes breed in confined sites such as pit latrines, the application of floating layers of polystyrene beads is a long-lasting and effective control method. There is increasing evidence that house flies are important agents in the mechanical transmission of diarrhoea due to Shigella. Simple fly traps can be an effective way of controlling house fly populations and this deserves comprehensive testing in tropical countries.

Animals↗
PubMed1995

Methods to remove inhibitors in sewage and other fecal wastes for enterovirus detection by the polymerase chain reaction.

Typical environmental sample concentration procedures developed to purify virions are not always compatible with reverse transcription-polymerase chain reaction (RT-PCR). The processing steps of polyethylene glycol (PEG) precipitation and ultrafiltration were found to enrich not only virions but also certain RT-PCR inhibitors. Inhibitors were eliminated by a single-step guanidinium isothiocyanate (GIT) extraction to purify and precipitate viral genomic RNAs immediately prior to RT-PCR. The detection sensitivity of GIT extraction--RT-PCR was found to be 0.6-0.003 50% tissue culture infectious doses (TCID50) for 9 enteroviruses in infected cell extracts. When sewage, concentrated up to 385,000-fold and seeded with 1-3 plaque-forming units of poliovirus, was extracted with GIT solution, viruses were detectable in samples originally judged negative by direct RT-PCR without GIT extraction. Eleven waste samples (3 sewage, 5 latrine solids, 2 gauze pads extracts and 1 stool) processed by a series of steps that included PEG precipitation, solvent extractions, and Sephadex G-200 chromatography were examined for enteroviruses by RT-PCR, both with and without GIT extraction. GIT extraction eliminated sample inhibitory substances and increased the proportion of enterovirus positive samples from 3 to 7 of 11. GIT extraction in conjunction with virion concentration improves RT-PCR detection of viruses in sewage and other fecal wastes.

Animals↗
PubMed1988

Critical control points for foods prepared in households whose members had either alleged typhoid fever or diarrhea.

Hazard analysis of food preparation practices were conducted in four households and eleven others were visited to survey both food preparation practices and environmental conditions. Households selected had members who were suffering from either diarrhea of unknown etiology or alleged typhoid fever. Hazard analyses and sanitary surveys included gathering data on time-temperature exposures of foods, collecting samples of food and drinking water, sampling sewage or drains, and obtaining stool specimens from persons with diarrhea and from family controls. Food samples were tested for aerobic mesophilic colony counts and common foodborne pathogens; specimens were tested for Salmonella, Shigella, Campylobacter and Yersinia. Campylobacter was isolated from two persons purported to have diarrhea, but neither Salmonella, Shigella nor Yersinia were recovered from alleged cases or controls. Salmonella agona was recovered from a latrine. Most foods were cooked to internal temperatures to or near to boiling. Those not promptly eaten were held at ambient room or outside temperatures until a subsequent meal, until a family member returned home, or until lunch time when taken to the fields. During these intervals, microorganisms multiplied and mesophilic aerobic organisms increased often reaching 10(8)/g or greater before consumption. None of these foods were reheated before eating. Bacillus cereus was isolated from 4 of 10 samples; one sample of 'moro' (beans and rice) exceeded 10(6)/g, two other samples exceeded 10(3)/g. Staphylococcus aureus was isolated from 7 of 14 samples, one exceeded 10(5)/g. Fecal coliforms were isolated from 8 of 14 food samples, five exceeded 10(5)/g. Neither Salmonella nor Shigella were isolated from any food, the community water supplies or from vessels of water within houses. Fecal coliform counts of water were less than 3/ml, except one sample from a clay vessel (9/ml). Risks associated with cooked foods which were not promptly eaten appeared to be greater than that associated with water.

Adolescent↗
PubMed1986

Old world blowflies in the new world.

Human activity, particularly migration and the export of live animals, can provide vehicles for the dispersal of many parasites and their vectors. These movements, often overlooked until too late, provide potential for epidemic outbreaks and can profoundly alter accepted ideas on the geographic distribution and epidemiological status of particular species. In this review, Brian Laurence discusses the recent rapid spread of blowflies into the americas; these conspicious green flies transport a variety of gastro-intestinal pathogens between their favoured environments of latrines and exposed food, and some species are important parasites of flesh wounds, causing cutaneous myiasis.

Journal Article↗
PubMed1983

Community participation in the control of trachoma in Gazankulu.

Groups of villagers, the care groups, are involved in prevention and treatment of trachoma within their own communities. The effect of the scheme on standards of hygiene and prevalence of trachoma has been evaluated by randomised cluster sampling methods. The number of households who were digging refuse pits, acquired individual face cloths and were aware of the role of good hygiene in the prevention of trachoma exceeded significantly those in (control) villages without a care group, in contrast the acquisition of pit latrines showed an insignificant increase. The prevalence and intensity of active trachoma was found to be significantly reduced as a result of the intervention of the care groups. This scheme has been totally integrated into the primary health care system of the area.

Africa, Southern↗
PubMed1987

Knowledge attitudes and practices in relation to schistosomiasis in a rural community.

A knowledge attitudes and practices survey of sanitation, water supplies and schistosomiasis was carried out in a rural schistosomiasis endemic area of Zimbabwe. Questionnaires were administered to 349 households. No latrines were present in 61% of households and information on use, likes and dislikes was collected. Most drinking water was collected from sources presenting no risk of schistosomiasis whereas most washing activities were carried out at sites presenting such a risk. Schistosomiasis was thought to be a problem in the community by over 50% of households and 79% gave haematuria as a symptom of the disease. There was a correlation between the washing site and the reported presence of schistosomiasis in the family.

Attitude to Health↗
PubMed1988

Maternal education and child survival in developing countries: the search for pathways of influence.

During the past two decades a considerable amount of information has become available from developing countries showing that maternal education has a strong impact on infant and child mortality. On average each one-year increment in mother's education corresponds with a 7-9% decline in under-5s' mortality. Education exercises a stronger influence in early and later childhood than in infancy. The central theme of this paper is to assess the various mechanisms or intervening factors which could explain how mother's education influences the health and survivorship of her children. Two of the possible intervening variables, namely reproductive health patterns and more equitable treatment of sons and daughters, play a relatively minor role in the explanation of the relationship. Economic advantages associated with education (i.e. income, water and latrine facilities, housing quality, etc.) account for about one-half of the overall education-mortality relationship. The influence of use of preventive and curative health services as a group of intervening variables is complex and variable. There are countries whose primary health services are so weak that they have no effect on the health of mothers and children; there are also other countries whose health services may tend to accentuate educational disparities because of differential access. Little is known about the intervening role of health beliefs and domestic practices, but it is hypothesized that they are important in the explanation of the education-mortality relationship. Finally, suggestions for specific studies on mechanisms or intervening factors are made and the relevance of such studies for formulation of health and educational policies is stressed.

Developing Countries↗
PubMed1993

Construction of a socio-economic index to facilitate analysis of health data in developing countries.

In order to plan, implement and monitor health interventions for the most deprived sector of the population, it is necessary to identify socioeconomic groups at risk. Multiple Correspondence Analysis was used to construct a socio-economic index based on data collected from a sample of 2698 households in South-West district of the Ugandan Republic in 1988. This study is a part of the baseline survey done by the Government of Uganda in collaboration with UNICEF. Its aim was to reduce the incidence of death of children below 5 years from diarrhea. Two factorial axes, representing respectively the socio-cultural and the anthropological conditions, explained more than 80% of the total variability. Among the 11 variables employed the most useful in characterizing the socio-economic classification were: father's occupation, parent's literacy, father's professional position and ownership of a radio. A classification in 7 levels was obtained. The first two levels are characterized as professionals and civil servants. The bottom two levels include households where both parents are illiterate and where father's primary activity is agricultural at a subsistence level. The three middle levels represent a transitional situation. In order to classify the family into the different levels, the other related variables, such as father's professional position or ownership of radio or father's religion or presence of latrine proved to be very useful. A flow chart which identifies which level a household belongs to was constructed. A general and valid observation is that families classified into the last two levels (6 and 7) constituted the population at risk for health conditions.

Adult↗
PubMed1992

Epidemiologic observations on porcine cysticercosis in a rural community of Michoacan State, Mexico.

The prevalence of and risk factors for Taenia solium infection (cysticercosis) in pigs were studied in a rural community in Michoacan State, Mexico. Visual inspection of the tongues of 216 pigs revealed cysticerci in 14 (6.5%). The prevalence was slightly higher in male (10/105) than female pigs (4/110) (P = 0.06) and increased with age (P less than 0.05). The most important risk factors for infection in pigs were access to human feces at a public washing area (P = 0.004), the presence of an indoor latrine (P = 0.05) and indiscriminate disposal of human feces around the pig owner's household (P less than 0.1). Effective and long-lasting control of the transmission of T. solium from humans to pigs must include measures to deny pigs access to human feces, a change which is likely to be resisted because of the traditional and functional aspects of established pig-rearing practices.

Age Factors↗
PubMed1988

Etiology and pathogenesis of diverticulosis coli: a new approach.

The paper describes a hypothesis as to the etiology and pathogenesis of diverticulosis coli. Colonic diverticulosis develops as a result of excessive straining at defecation due to habitual bowel emptying in a sitting posture, which is typical of Western man. The magnitude of straining during habitual bowel emptying in a sitting posture is at least three-fold more than in a squatting posture and upon urge. The latter defecation posture is typical of latrine pit users in underdeveloped nations. The bowels of Western man are subjected to lifelong excessive pressures which result in protrusions of mucosa through the bowel wall at points of least resistance. This hypothesis is consistent with recent findings of elastosis of the bowel wall muscles, the distribution of diverticula along the colon, as well as with epidemiological data on the emergence of diverticulosis coli as a medical problem and its geographic prevalence.

Defecation↗
PubMed2005

Human excreta for plant production.

Human excreta are a natural resource which is always available in all societies. Unfortunately, their value is highly underestimated in present agriculture and horticulture including in many tropical developing countries. Especially human urine is rich in nitrogen. This "free" fertiliser should be used as much as possible and needed. In many cases, human urine and composted human faeces could be fortified with wood ash and kitchen and garden waste to meet the potassium and phosphorus needs of plants and to improve soil structure. Avoiding health risks and dosage requirements are also discussed. The ideas presented here can be used even with the cheap pit latrines that are common in the rural and peri-urban areas of developing countries. They do not require electricity and/or tap water. They may also fit conditions in areas of Eastern Europe where piped water and sewerage are absent and/or people lack money for fertilisers and maintenance of wastewater treatment plants.

Agriculture↗
PubMed2006

Etiology and epidemiology of diarrhea in children in Hanoi, Vietnam.

OBJECTIVES: This paper provides a preliminary picture of diarrhea with regards to etiology, clinical symptoms, and some related epidemiologic factors in children less than five years of age living in Hanoi, Vietnam. METHODS: The study population included 587 children with diarrhea and 249 age-matched healthy controls. The identification of pathogens was carried out by the conventional methods in combination with ELISA, immunoseparation, and PCR. The antibiotic susceptibility was determined by MIC following the NCCLS recommendations. RESULTS: Of those with diarrhea, 40.9% were less than one year old and 71.0% were less than two years old. A potential pathogen was identified in 67.3% of children with diarrhea. They were group A rotavirus, diarrheagenic Escherichia coli, Shigella spp, and enterotoxigenic Bacteroides fragilis, with prevalences of 46.7%, 22.5%, 4.7%, and 7.3%, respectively. No Salmonella spp or Vibrio cholerae were isolated. Rotavirus and diarrheagenic E. coli were predominant in children less than two years of age, while Shigella spp, and enterotoxigenic B. fragilis were mostly seen in the older children. Diarrheagenic E. coli and Shigella spp showed high prevalence of resistance to ampicillin, chloramphenicol, and to trimethoprim/sulfamethoxazole. Children attending the hospitals had fever (43.6%), vomiting (53.8%), and dehydration (82.6%). Watery stool was predominant with a prevalence of 66.4%, followed by mucous stool (21.0%). The mean episodes of stools per day was seven, ranging from two to 23 episodes. Before attending hospitals, 162/587 (27.6%) children had been given antibiotics. Overall, more children got diarrhea in (i) poor families; (ii) families where piped water and a latrine were lacking; (iii) families where mothers washed their hands less often before feeding the children; (iv) families where mothers had a low level of education; (v) families where information on health and sanitation less often reached their households. CONCLUSIONS: Group A rotavirus, diarrheagenic Escherichia coli, Shigella spp, and enterotoxigenic Bacteroides fragilis play an important role in causing diarrhea in children in Hanoi, Vietnam. Epidemiological factors such as lack of fresh water supply, unhygienic septic tank, low family income, lack of health information, and low educational level of parents could contribute to the morbidity of diarrhea in children.

Bacteroides Infections↗
PubMed2006

Risk factors for shigellosis in Thailand.

OBJECTIVES: To assess the potential risk factors for shigellosis including housefly density. METHODS: A matched case-control study to investigate potential risk factors for shigellosis was conducted in a semi-urban area, Kaengkhoi District, Saraburi Province, central Thailand. Shigella cases were ascertained from a two-year population-based surveillance study detecting diarrhea and shigellosis in the area. The study evaluated a wide range of exposures, which were assessed by odds ratios (OR) adjusted for proxy markers of socioeconomic status: family income, and type of residence, using conditional logistic regression analysis. RESULTS: Hygiene behaviors such as regular hand washing (p<0.05), a clean environment surrounding the household (p<0.001), and the availability of water to flush the toilet (p=0.08) were associated with a reduced risk for shigellosis in the multivariate model. In contrast factors indicating a lower than average socioeconomic status, such as having to rent instead of owning one's housing (p<0.001) and a low family income (p<0.01) were associated with an increased risk for shigellosis. For children, breastfeeding showed a strong protective effect in reducing the risk of shigellosis (p<0.01). Prior to adjustment for environmental factors, fly density in the kitchen area was associated with an increased risk of shigellosis (p<0.01). CONCLUSIONS: We found a correlation between socioeconomic status and the risk for shigellosis. To reduce shigellosis in this setting, we recommend interventions focused on three aspects: improved water supply and sanitation (especially latrines and garbage disposal) including fly control, health education on hand washing, and the promotion of breastfeeding.

Animals↗