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PubMed2005

A survey of the supply and bacteriologic quality of drinking water and sanitation in Jakarta, Indonesia.

We assessed the water supply, water quality and human waste disposal and their association with diarrheal illness in Jatinegara, East-Jakarta, where part of the area has been involved in the Kampung Improvement Program (KIP). Three hundred seventy-eight households, randomly selected in the study area, were visited and questioned about water source, sanitation and diarrheal illness during the previous 3 months. Microbiological quality of drinking water was assessed. The water sources were boreholes (243; 64%), the water mains (77; 20%), bottled water (45; 12%), and vendors or dug wells (243; 4%). Fecal coliforms were isolated in 56% of the samples [median 23 (IQR 6-240) /100 ml in the contaminated samples]. Only 2 (3%) of the water mains' samples contained >100 fecal coliforms/100 ml, compared to 57 (24%) groundwater samples. Most residents used private toilets with drainage into on-site septic tanks, yet in over one quarter of households human excreta was disposed of into rivers or gutters. KIP areas lagged behind in environmental hygiene. Diarrheal episodes, reported in one third of the households, were significantly associated with water contaminated with >100 fecal coliforms/100 ml [OR 2.4 (95% CI: 1.4-4.2)], but no association with water source or environmental contamination was found. Significantly, all individuals reported boiling water before consumption.

Diarrhea↗
PubMed2005

Critical contribution of sanitation infrastructure and primary medical care to child health status in Japan from 1955 to 2000.

We examined the associations between prefectural health status of children and sanitation infrastructure, medical care services and socioeconomic status in Japan during 1955-2000. Four indicators of child health status: infant mortality rate (IMR), Ascaris lumbricoides prevalence and height and weight of elementary school children, and five prefectural social indicators: water supply, sewerage, number of physicians, income and women's education, were calculated over five-year intervals and examined by correlation and panel data analyses. Associations between paediatric health and five social indicators were significant (p<0.001) until 1970. After adjustment for income or education, water supply diffusion rate showed a significantly negative association with IMR until the 1980s. A significantly positive correlation was observed between the number of physician and paediatric health from 1955-70 after adjustment for income. Water supply development showed a positive association with paediatric health after adjustment for economic or educational impact during the phases of rapid and steady economic growth, while medical care showed a positive correlation with paediatric health after adjustment for income during only the phase of rapid economic growth. Relationships between child health status and social indicators have changed over time with stage of economic development.

Animals↗
PubMedDate not supplied

[Water pipelines conduits and urban sanitation in Cartagena in the beginning of the twentieth century].

Throughout its history, Cartagena de Indias, a seaport in the Colombian Caribbean, has been handicapped for not offering salubrious conditions to its people and visitors. The lack of an aqueduct and a sewerage system was an impairment to progress. For nearly forty years (1890-1930) these problems have caused a myriad of medical discourses formulated by scientists, technicians and politicians. Cartagena's contribution to solve the sanitation problem in cities has consisted in making use of engineers' knowledge. The construction of urban facilities in the beginning of the twentieth century required a more technical knowledge, one which would advance a comprehensive solution to the water problem, ensure sufficient supply and efficient drainage. Thus, in the last turn of the century, the medical doctor is no longer the only authoritative voice when it comes to the management of urban life. The construction works which require an engineer, involving him in public health, have drawn a distinction between "hygiene" and "sanitary science".

City Planning↗
PubMedDate not supplied

[Community participation in health promotion: an experience from hygiene and sanitation committees in the district of Touba (Senegal)].

This qualitative exploratory study carried out in November 2000 describes and analyzes health promotion by community participation in the health district of Touba, in Senegal. The committees were primarily made up of women with an implication of local religious authorities which represented the moral responsible. The promotional activities regularly carried out were: health education, distribution of insecticide treated nets, police in waste management and hygiene, and cleaning. Theses activities were supported through the development of income generating activities. The success of the communities is based on the favorable socio-religious environment, strengthened by the particular commitment of the women. The diversity of activities undertaken by the committees is a proof that the identification of people's needs was not limited to health care questions. The community leadership was stimulated by the district, to enhance the dynamics of participation. The financial autonomy of the majority of communities is a guarantee of their sustainability within the district health system. Extremely encouraging results obtained, two essential recommendations were made to strengthen the experience of sanitation committees in health promotion.

Attitude of Health Personnel↗
PubMed1998

Sanitation characteristics of some food processing industries.

The present investigation was carried out to evaluate the sanitary conditions surrounding the food throughout the production stages in some food plants. Observation of the sanitary measures of the studied plants revealed that only 3 out of the 7 plants (42.9%) have acceptable sanitation that complies with the sanitary requirements specified by WHO. Personal hygiene and storage conditions were the most critical problems found in the studied plants. Laboratory examination of nasal and throat swabs and stool samples of workers was carried out to uncover the chronic carriers. Among the food handlers examined 46.3% were positive for intestinal parasites. Bacteriological examination of stool specimens revealed that 4.3% of carriers of Salmonella paratyphi and none were carriers of Vibreo species. Nasal swabs were also positive for Staph. aureus in 29.8% of all the examined swabs. Analysis of the main products of the studied plants revealed generally that the bacterial load of the products of plants having acceptable sanitary conditions was lower than that of the products of the other plants. The frozen vegetable products had a total aerobic mesophilic plate count ranging from 8.1 x 10(4) cfu/g in okra and 3.7 x 10(5) cfu/g in mixed vegetables. The total aerobic plate count of the ice cream (1 x 10(3) cfu/g) complies with specified Egyptian standards. However, the coliform count (9 x 10(1) MPN) was higher than the recommended limit. Lead and cadmium levels were also investigated in all products. The maximum detected level of lead was that of cream wafer (0.94 ppm) followed by banana wafer (0.82 ppm). The two detected levels were higher than Egyptian standards. The lead level in ice cream (0.19 ppm) was also higher than the specified standards. The relatively high levels of lead in cream wafer and ice cream may be attributed to more than one factor; the added color and the old machinery used in some production steps are the most accursed factors. On the other hand, the observed level of cadmium ranged between 0.046 ppm in raw mil and 0.3 ppm in soft cheese.

Colony Count, Microbial↗
PubMed1990

The anthropometric status of children in Kurunegala district in Sri Lanka: its relation to water supply, sanitation and hygiene practice.

Anthropometric data for 1295 children were collected during cross-sectional surveys conducted in Kurunegala District, Sri Lanka between March 1987 and March 1988. The relationship between anthropometric status and a range of water, sanitation and hygiene-related exposures was examined. After taking account of socioeconomic and other potential confounding factors, some evidence was found that boiling of water was associated with improved height-for-age. It seems unlikely that boiling of water alone could be responsible for the observed increase in height-for-age. Boiling of water may be acting as a "marker" for a range of hygiene and child-care behaviours. No convincing evidence of any other association was found. In particular, water source was not associated with anthropometric status. A concurrent study conducted in the same population found evidence of a substantial reduction in diarrhoea morbidity associated with the use of improved sources. These findings, taken together, lend support to the hypothesis that interventions for the control of diarrhoea may have no detectable impact on anthropometric status.

Anthropometry↗
PubMed1989

Lack of impact of a water and sanitation intervention on the nutritional status of children in rural Bangladesh.

The nutritional impact of a water and sanitation intervention in a rural community of Bangladesh, comprising the provision of handpumps, construction of latrines and hygiene education was assessed. During 3 years, the quarterly anthropometric measures of about 200 children aged 12-35 months from the intervention community were compared with those of a similar number of children from a control area. The interventions reduced the incidence of diarrhoea by 25 per cent among the children less than 5 years of age. There was no significant difference in nutritional status, however, between the two groups of children. Moreover, within the intervention area, indicators of water and latrine use were not significantly related to the children's nutritional status. This suggests that either the obtained reduction of diarrhoea was not large enough to have an impact on nutritional status or that diarrhoea is not an important cause of malnutrition in this community.

Bangladesh↗
PubMed1989

Evaluation of a sanitation programme using eggs of Ascaris lumbricoides in household yard soils as indicators.

Soil samples were analysed for the presence of Ascaris lumbricoides eggs as indicators of environmental pollution in household yards in Maputo, Mozambique, with the objective of evaluating the impact of a programme for the promotion of improved latrine construction. The locations for soil sample collection were defined by a random grid on which household activities were mapped. In addition, parasitological examinations were carried out amongst household residents. No significant difference was found between the type of latrine in use and the presence of Ascaris eggs in the soil or human Ascaris infection. Households with at least one infected person appeared more likely to have Ascaris eggs in the yard. It was notable that egg counts around the latrines were only slightly greater than in other areas of the yard and less than those immediately in front of the dwelling. This is taken to indicate that faecal pollution of the household environment is due more to promiscuous defecation than to poor construction or maintenance of the latrines. The findings highlight the need to complement sanitation 'hardware' with the necessary health education 'software'. Ascaris eggs are useful indicators but robust standardized methods are needed for their extraction from household soils.

Adolescent↗
PubMed1988

The faecal coliform fingertip count: a potential method for evaluating the effectiveness of low cost water supply and sanitation initiatives.

A rapid and simple procedure for the enumeration of faecal coliform bacteria present on the fingertips is described. The distribution of individual faecal coliform fingertip counts within households has been compared with a number of variables related to the availability of water supply and sanitation facilities. This showed a strong association between the fingertip count and the possession of in-house water connections. It is proposed that this test might provide a reliable indication of the effectiveness of certain public health interventions.

Bacteriological Techniques↗
PubMed1979

Physical changes of the environment and health effects with special reference to water pollution and sanitation in Malaysia.

Development of a human community are not without changes in its environment. Such changes result in either beneficial or adverse effects on human health. In Malaysia, in the wake of the New Economic Policy aimed at the redressing of the poor population and income distribution, development of the nation has brought about various changes in the environment. Some of these changes have elevated basic public health problems, while others, particularly new agricultural practices and industrialisation programmes with urbanisation trends, have brought a new set of problems due to water pollution and sanitation. Various measures are being taken to protect and to improve the environment so that progress can be realised with minimum adverse effects. This also calls for assistance from international sources, in terms of expertise, training and funds.

Communicable Diseases↗
PubMed1982

[Principal problems limiting community participation in water supply and sanitation projects].

For community participation to be active and sustained, effective communication is needed between the institutions charged with promoting these activities and the population that is to benefit from the programs in view, particularly economically deprived and rural populations. In this document the author considers the obstacles he observed in Guatemala to the promotion of water supply and sanitation systems, and suggests measures for surmounting them. He also proposes a series of general strategies for making the community an active participant in these activities.

Communication Barriers↗
PubMed1982

Diarrhoeal diseases related to sanitation and water supply.

Three Thai communities using river water and three Thai communities utilizing klong water for their domestic consumption were studied to assess the water quality, sanitation and the incidence of diarrhoea in the communities. The incidence of diarrhoeal diseases during a four-month period in the three communities of Bangrasan was 454 per 1000 population and in the three communities of Klongchik was 85 per 1000 population. The relationship between water quality as measured by the MPN coliform index and the incidence of diarrhoeal cases showed that an increase in diarrhoeal cases were accompanied by an increase in MPN value. In general the quality of water seemed to influence the incidence of diarrhoeal cases.

Child↗
PubMed1980

The urban mosquitoes of Suva, Fiji: seasonal incidence and evaluation of environmental sanitation and ULV spraying for their control.

Larval surveys and oviposition traps were used to monitor urban mosquito populations in two adjacent transects in Suva, Fiji between May 1978 and August 1979. Populations of Aedes aegypti and Ae. pseudoscutellaris fluctuated seasonally with changes in rainfall, the latter species being most prevalent throughout the year. Populations of these two species were highest between December and July and lowest between August and October. Larval populations of Culex quinquefasciatus did not show a seasonal variation and larval populations of Cx. annulirostris were too low for any conclusions to be made. All species were found breeding most often in miscellaneous containers, with tyres, plant containers and flower vases also being important sources for Ae. aegypti breeding. Through environmental sanitation the Breteau Index for all species was reduced by 88%; Premise Index by 72% and the Container Index by 83%, when compared to a control area. ULV applied malathion was effective in temporarily reducing Ae. pseudoscutellaris populations from 50--100%. Effects on Ae. aegypti were inconclusive. It is concluded that through enforcement of the existing laws and strict monthly surveillance during the periods of highest seasonal density, urban Aedes and Culex populations can be maintained at an acceptable level.

Aedes↗
PubMed1994

Women's involvement in a rural Bangladesh water and sanitation project.

Rural women were involved in a water and sanitation project (WSS) in which health impacts were compared between children in two areas: intervention and comparison areas. In intervention area people were provided with handpumps, latrines and hygiene education, whereas, in the comparison area, people did not receive these project inputs. In the intervention area women were directly involved in the site selection of handpumps and latrines, their installation, construction, and maintenance. Observations on women's involvement and their performances in the intervention area are presented. About 89% of the pumps maintained by women (n = 30), and 86% of those maintained by project workers (n = 49) were found to be in good working condition. Women supervised the construction of all 754 latrines, fenced 58% of the projects-supported latrines (n = 268) and emptied the pits of 65% of the 276 filled-up latrines. Socio-cultural factors were not barriers to women's involvement and performance. The findings have policy implications for effective involvement of rural women towards the development of sustainable WSS programs.

Adult↗
PubMed1994

Evaluation of health, sanitation, and nutrition in Forces Command Child Development Centers.

In 1992, Forces Command had 42 Child Development Centers on 22 installations. We evaluated program compliance in the areas of health, sanitation, and nutrition using inspection findings from April 1991 through June 1992. Each program was rated on 20 items, using inspection checklists developed for this evaluation. We also surveyed Haemophilus influenza type b (Hib) vaccination records among enrolled children. Most programs and facilities were fully or partially compliant in most areas. By quantifying the inspection findings, we were able to identify compliance items that needed further attention. The most frequent problem area across all programs was documentation of child immunization and health records. For children between 13 and 60 months of age, 77.7% had records indicating appropriate vaccination against Hib. Comparisons with the prior year's findings indicated a trend toward improvement.

Child↗
PubMed1995

Environmental health indicators and sanitation-related disease in developing countries: limitations to the use of routine data sources.

This article explores conceptual issues in the development and use of environmental health indicators for basic problems related to water and sanitation in developing countries. In this context, faecal contamination is the most important environmental health problem, responsible for the death of approximately 3 million children a year, and the infection of hundreds of millions. Good indicators would be invaluable in assessing the magnitude and source of such problems in different settings.

Adolescent↗
PubMed1996

Sustainability of a water, sanitation and hygiene education project in rural Bangladesh: a 5-year follow-up.

An integrated water supply, sanitation and hygiene (WSH) education intervention project was run by the International Centre for Diarrhoeal Disease Research, Bangladesh, over the period 1983-87. In the intervention area the project provided handpumps, pit latrines, and hygiene education to about 800 households. The control population did not receive any interventions, but had access to the usual government and private WSH facilities. After 1987 no external support was provided to maintain these provisions. A cross-sectional follow-up survey, which was carried out in 1992, involved about 500 randomly selected households from the intervention and control areas. In 1992 about 82% of the pumps were still in good functional condition and of these, 94% had been functioning well in 1987. Fewer latrines were functional in 1992 (64%) than at the end of 1987 (93%). In the former intervention area about 84% of the adults were using sanitary latrines in 1992 compared with only 7% in the control area. Knowledge related to disease transmission, however, was poor and similar in both areas. People claimed that they used the WSH facilities to improve the quality of their lives. The prevalence of diarrhoeal diseases in the 1992 survey among the control population was about twice that among those in the intervention area.

Adolescent↗