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PubMed2003

Impact of sanitation and health education on intestinal parasite infection among primary school aged children of Sherpur, Bangladesh.

This study was carried out in 1999-2000 in the northern part of Bangladesh to determine the impact of sanitary latrine use and of health education on intestinal parasites in school-aged children. The children were between 5 and 13 years of age and stool samples revealed that more than half (53%) of the study sample was still infected with one or more intestinal parasites even after 4 years of intervention. Ascariasis was found to have the highest prevalence rate (36.2%) and hookworm the lowest (10.7%). Intestinal parasite infection was significantly lower (P < 0.05) among those who used a sanitary latrine and received health education. This result is consistent with observations that the effect of sanitation and health education is slow to develop. Concerted primary healthcare activities with community development efforts should be undertaken to improve the overall living condition of the people of this area to control this problem.

Adolescent↗
PubMed2004

Disposal of children's faeces and implications for the control of childhood diarrhoea.

Unhygienic disposal of children's faeces is one of the key factors responsible for the high incidence of childhood diarrhoea in developing countries. The aim of this project was to study household behaviours relating to the disposal of faeces of children under the age of five. The study was conducted in Ife South Local Government Area of Osun State, Nigeria, where 320 households, containing 540 mothers with children under the age of five were randomly selected. Data was collected by observation using a schedule specifically designed for the study. Our findings show that while over 80% of children under the age of seven months defecated on a napkin, the majority of older children (over seven months of age) defecated on either the floor of the household and their surroundings or outside in the household's vicinity. Mothers usually cleaned up the children's faeces which were then thrown into a pit latrine. In some cases dogs were used to clean up the faecal matter on the floor. In either case faecal residue remained on the floor. The authors recommend educational interventions to change the unhygienic practices relating to clean up and disposal of children's faeces. The interventions include encouraging children to defecate in plastic chamber pots, promoting the practice of hand washing with soap and water after cleaning up the children's faeces and the construction of affordable and ventilated latrines by members of the communities.

Adult↗
PubMed1990

Soak-away systems and possible groundwater pollution problems in developing countries.

People in the developing countries do not have adequate sanitation and everyone defaecates somewhere. Those who do not have a toilet or latrine have to resort to indiscriminate defaecation either in the sea shore such as in the Lagos lagoon in Nigeria, or vacant plots and open drains as in Iddo area of Lagos and sides of rural footpaths. Water closets (W.C.s) are the most accepted sanitation system, but the cost of operating and maintaining them is high. As a result sewerage is not appropriate for the majority of people in developing countries whose greater population live in rural areas and small towns. The majority of people in urban areas use septic tanks and very often most of these septic tanks are not properly designed or sometimes located too close to sources of water supply, which then become contaminated. It is generally believed that systems like septic tanks, pit latrines and aqua privies are capable of totally eliminating these pathogens. There are many problems associated with the physical, chemical and biological processes that may result in groundwater pollution from septic tanks. Many experiments have shown that faecal organisms do not travel any significant distance radially as a result of concentration gradient. They are, however, carried with groundwater flow. The task is to prevent pathogens from getting into the aquifer. This paper attempts to highlight the ability of some enteric viruses to survive septic tank wastewater treatment.

Developing Countries↗
PubMed2005

Intestinal parasite analysis in organic sediments collected from a 16th-century Belgian archeological site.

Parasite eggs found in organic remains collected from medieval structures in Raversijde (medieval name: Walraversijde), a village on the northern coast of Belgium, are discussed. The eggs were identified as Ascaris lumbricoides and Trichuris trichiura, both human parasites. Species identification allowed elucidating the origin of the organic sediments and the structures, in this case latrines used by humans. Capillaria sp. and free-living nematode larvae were also found in the latrine. Although neither parasite burden nor prevalence rates could be measured, the abundance of human intestinal parasite eggs indicated a high infection rate in the village residents, reflecting very poor sanitation.

Animals↗
PubMed2000

Sampling gravid Culex quinquefasciatus (Diptera: Culicidae) in Tanzania with traps baited with synthetic oviposition pheromone and grass infusions.

The effectiveness of traps baited with (5R,6S)-6-acetoxy-5-hexadecanolide (the synthetic oviposition pheromone) and grass infusions in sampling a population of gravid Culex quinquefasciatus Say was conducted in Muheza, Northeast Tanzania. A counterflow geometry (CFG) trap baited with pheromone and set outdoors, adjacent to a pit latrine building, collected more gravid Cx. quinquefasciatus than a CDC trap baited with pheromone and operated without light. Inside pit latrine buildings, significantly more gravid Cx. quinquefasciatus were collected in a CFG trap-baited with pheromone or grass infusion than in traps baited with tap water. CFG traps baited with either grass infusion or pheromone and set outdoors, away from known breeding sites, caught significantly more gravid Cx. quinquefasciatus than traps baited with tap water. CFG traps baited with pheromone + grass infusion caught significantly more gravid Cx. quinquefasciatus than CFG traps baited with either grass infusion or pheromone. In both cases, the proportion of gravid mosquitoes increased as traps were moved away from a natural emergence site. More gravid Cx. quinquefasciatus were collected in a pheromone-baited CFG trap than were egg rafts deposited in a jar with pheromone-treated water. It is concluded that CFG traps baited with oviposition attractants can be used effectively to sample gravid Cx. quinquefasciatus.

Animals↗
PubMed2002

Baylisascaris procyonis (Nematoda: Ascarididae) larva migrans in free-ranging wildlife in Orange County, California.

Baylisascaris procyonis is well recognized as a cause of visceral (VLM), ocular, and neural (NLM) larva migrans in birds and mammals, including man. A study of the prevalence of larva migrans in free-ranging wildlife associated with raccoon latrines as well as a retrospective study of wildlife mortalities with neurological disease was conducted in 2000 in Orange County, California. Eighty-seven birds of 18 species and 64 mammals of 8 species were found to have NLM or VLM or both. NLM clinical signs included convulsions, torticollis, opisthotonus, head-tilts, circling, ataxia, paralysis, and visual defects. NLM lesions were characterized by focally disseminated, frequently linear, "tracklike" areas of parenchymal degeneration with varying degrees of astrocytosis in the white matter of the cerebrum, cerebellum, brain stem, and spinal cord. Larvae were rarely found in these lesions but were rather isolated in the brain-spinal cord parenchyma. At least 1 larva was isolated by digestion from each case of NLM and identified as Baylisascaris sp., most likely B. procyonis. VLM lesions consisted of granulomatous reactions surrounding intact or degenerative larvae in the parenchyma of the liver, kidney, diaphragm, and, occasionally, the lymph nodes. This report broadens the range of species of wild birds and mammals that have been found to be susceptible to larva migrans caused by B. procyonis and reaffirms the importance of raccoon latrine sites as contaminative foci for wildlife.

Animals↗
PubMedDate not supplied

[Does birth weight affect nutritional status at the end of first year of life?].

OBJECTIVE: To evaluate the association between low birth weight and nutritional status at the end of the first year of life. METHODS: This was a nested case-control study within a cohort. The study was carried out at maternity hospitals in four cities in the Zona da Mata Meridional in Pernambuco state, Brazil. Newborn infants were recruited during the first 24 hours of life. Their weights were measured at birth and at the end of the first year of life. Household visits were made twice weekly during the first year of life to collect data on breastfeeding and occurrence of diarrhea. In the case-control study, each case (child at nutritional risk) was a child with weight-for-age index < the 10th percentile (n = 117) and each control was a child with weight-for-age index > or = the 10th percentile (n = 411). Hierarchical logistic regression analysis was used to investigate risk factors for nutritional status at 12 months. RESULTS: Low birth weight and living in a household with no latrine were significantly associated with nutritional risk at the end of the first year of life. Children born weighing 1,500 g to 2,499 g had 29 times (95% CI = 9.77-87.49) the chance of being at nutritional risk at 12 months of life than those whose birth weights had been > 3,500 g (p < 0.001). Children living in households without a flush toilet had three times (95% CI = 1.54-6.22) the chance of nutritional risk at 12 months of life in relation to those that had a latrine with a septic tank at home (p = 0.01). CONCLUSION: Low birth weight is an important risk factor of nutritional risk at the end of the first year of life. It is important to adopt strategies for its reduction and prevention.

Birth Weight↗
PubMed1999

Can vector control play a useful supplementary role against bancroftian filariasis?

A single campaign of mass treatment for bancroftian filariasis with diethylcarbamazine (DEC) in Makunduchi, a town in Zanzibar, United Republic of Tanzania, combined with elimination of mosquito breeding in pit latrines with polystyrene beads was followed by a progressive decline over a 5-year period in the microfilarial rate from 49% to 3%. Evidence that vector control had contributed to this long-term decline was obtained by comparison with another town, Moga, where a DEC campaign was used without vector control and where resurgence of microfilariae could be observed 3-6 years after the campaign. In Zanzibar town, treatment of 3844 wet pit latrines and cesspits with polystyrene beads reduced the adult mosquito population in houses by about 65%. Supplementary treatment of open drains and marshes with Bacillus sphaericus produced little or no additional reduction compared to a sector of the town where only pit treatment with polystyrene was carried out. The cost and effort of achieving the 65% reduction in mosquito population could hardly be justified for its impact on filariasis alone, but its noticeable impact on biting nuisance might help to gain community support for an integrated programme.

Animals↗
PubMed1998

Protein-energy malnutrition in urban children: prevalence and determinants.

Between February and April 1995, 669 under-five children living in Jimma town were randomly selected and had their nutritional status assessed. Risk factors for protein-energy malnutrition (PEM) were also studied. About half (48%) of the children were found to be malnourished. The prevalence of underweight, wasting and stunting were 36%, 9% and 36%, respectively. Severe protein-energy malnutrition, i.e., marasmus, kwashiorkor and marasmic-kwashiorkor, was detected in 2%. The prevalence of malnutrition was lowest in infants. While underweight and wasting peaked by the second and third years of life, stunting increased dramatically by the second year and peaked in the fifth year. Poor socio-economic background, poor housing condition, non-availability of latrine, "unprotected" water source, an attack of pertussis, not completing immunization, prolonged breast feeding and nutritionally inadequate diet were found to be risk factors for PEM in the bivariate analyses. Multiple logistic regression analyses showed a strong association between PEM and poor housing condition, non-availability of latrine, prolonged breast feeding and diet lacking in animal food. Intervention measures should take the multifactorial causation of PEM into consideration.

Age Distribution↗
PubMed1999

Effects of environmental factors on child survival in Bangladesh: a case control study.

The need for further studies on relationships between deaths and environmental variables has been reported in the literature. This case-control study was, therefore, carried out to find out the associations between several social and environmental variables and deaths of children due to infectious diseases such as those leading to diarrhoea, acute respiratory infection, measles and other diseases. Six hundred and twenty-five deaths (cases) and an equal number of matched living children (controls) aged 1-59 months, were studied in rural Matlab. An analysis of crude and adjusted odds ratio showed differential associations. Sources of drinking water, amount of stored water, conditions of latrines, number of persons sleeping with the child and the type of cooking site were statistically significantly associated with deaths due to infectious diseases after controlling for breast feeding, immunization, and the family size. Significant associations were also observed between: (i) the sources of drinking water and deaths due to ARI, and (ii) conditions of latrines and deaths due to diarrhoeal diseases, after controlling for the confounding variables. Several other environmental factors also showed associations with these various death groups, but they were not statistically significant. The size of the samples in death groups (small) and the prevalence of more or less homogeneous environmental health conditions probably diminished the magnitude of the effects. The results of the study reconfirm the importance of environmental health intervention in child survival, irrespective of breast-feeding, immunization, and selected social variables.

Bangladesh↗
PubMed1999

Demographic and socio-economic factors with implications for the control of lymphatic filariasis in Kwale District, Kenya.

OBJECTIVE: To examine demographic and socio-economic factors with regard to control of lymphatic filariasis. DESIGN: A cross sectional data collection approach using a questionnaire. SETTING: Three adjacent villages, namely Lutsangani, Dzivani and Gandini in Kwale district. This was the study site for a larger KEMRI-JICA lymphatic filariasis control project. Findings from the larger project showed filariasis prevalence rates of 22.6%, 12.1% and 11.9% in the three villages respectively. SUBJECTS: All 891 household-heads in the three villages. MAIN OUTCOME MEASURES: Relationship between selected factors (age, sex, education, employment status, availability of latrine and permanent roofing for the main dwelling) and current use of protection against mosquito bites. RESULTS: Use of mosquito-bed nets, mosquito repellents and insecticides was found in 13.8% of the households. Education and employment status of the household-heads were positively associated with protection against man-vector contact (p < 0.001). Non-availability of latrines and lack of permanent roofing (tiles or corrugated iron sheets) for the main dwellings in 80% and 95% households, respectively, were additional clear indicators of low socio-economic development. CONCLUSION: Given the inter-village variations in the prevalence of the filariasis, wide scale diagnosis for treatment control approach could be prohibitively expensive. Effective control of filariasis in this and similar communities may be by mass treatment with either diethylcarbamazine (DEC) or ivermectin combined with albendazole.

Adolescent↗
PubMed2000

Prevalence of Trichuris trichiura in relation to socio-economic & behavioural determinants of exposure to infection in rural Assam.

BACKGROUND & OBJECTIVES: Stunting, anaemia, and the poor level of mental development are known to be associated with Trichuris trichiura infections. However, no information is available on the socio-environmental predictors relevant to Trichuris infection in rural communities. Whilst geohelminthic infections per se is an inevitable consequence of poor personal hygiene and household sanitation, the importance of specific factors in the epidemiology of Trichuris infection have not been formally investigated. The objective of this study was to explore, quantify and study different socio-environmental risk factors and find out their possible interaction vis-a-vis T. trichiura infection. METHODS: The study population consisted of 244 children (aged 15 yr and below) and 336 adults selected from 144 randomly selected households belonging to three villages of upper Assam. The prevalence rate ratio (PRR; = relative risk) and 95 per cent confidence interval (CI) were calculated. Univariate, multivariate analysis using Cox's proportional hazards regression assuming constant risk period and a tree-based risk factor analysis, were used. RESULTS: In the overall multivariate model, open field defaecation, large family size, and three or more children in the household were found independently associated with Trichuris infection. Gender specific analysis revealed that in females the age was also independently associated with increased risk of infection whereas in males, earth flooring was the most significant risk factor independently associated with the risk of Trichuris infection. Tree-based risk factor analysis indicated interaction between defaecating habits of people and the source of drinking water. INTERPRETATION & CONCLUSIONS: Installation of pit latrines (if not sanitary latrines) together with provision for safe drinking water and the construction of cement floors would probably reduce community prevalence of T. trichiura effectively.

Adolescent↗
PubMed1998

Cholera reveals helminthiasis problem.

Cholera has now lasted for about 6 months in our hilly region in Mwanza, Tanzania. The heavy rains coupled with the poor sanitary conditions and sewage disposal system have worsened the situation. The pit latrines used by the majority of low-income people are either not adequately and properly used for excreta disposal or they overflow. At our regional referral and consultancy hospital we were, for a period, receiving cholera cases which should have been managed in isolation at other centers. (This situation has now been rectified.) Some of the children with cholera either vomited or passed Ascaris lumbricoides in their rice water-like stools. Previously, these children were not being treated for ascariasis. Practical steps can be taken to reduce the transmission of fecal-borne infections. For more than 30 years we have failed to have a latrine for each family; we should aim for at least one for every 10 households. The provision of clean tap-water and facilities to deworm pre-school children would also be welcomed. In addition, medical officers should actively instruct the community in the science of hygiene.

Africa↗
PubMed2003

Epidemiology of sporadic bloody diarrhea in rural Western Kenya.

We conducted laboratory-based surveillance and a case-control study to characterize the epidemiology of bloody diarrhea in rural Western Kenya. From May 1997 through April 2001, we collected stool from 451 persons with bloody diarrhea presenting to four rural clinics. Cultures of 231 (51%) specimens yielded 247 bacterial pathogens: 198 Shigella (97 S. flexneri, 41 S. dysenteriae type 1, 39 S. dysenteriae type non-1, 13 S. boydii, 8 S. sonnei), 33 Campylobacter, 15 non-typhoidal Salmonella, and 1 Vibrio cholerae O1. More than 90% of the isolates (excluding Campylobacter) were resistant to trimethoprim-sulfamethoxazole and tetracycline, and more than 80% were resistant to ampicillin. Most (74%) ill persons received medication to which their isolate was resistant. Drinking Lake Victoria water and sharing latrines between multiple households increased risk of bloody diarrhea. Washing hands after defecating was protective. Providing safe drinking water and more latrines, and promoting hand washing could reduce the burden of illness from bloody diarrhea while limiting injudicious antimicrobial use.

Adolescent↗
PubMed1992

Household sanitation in Uasin Gishu district in Kenya.

In rural Uasin Gishu District in 1990, 78.2% of the households had pit latrines, 11.3% ventilated improved pit latrines, 0.8% water-borne and 9.7% with no toilet facilities. On inspection, 97% of the toilet facilities were in use. Compost pits were present in 52.3% of the households. Utensil drying racks were found in 56.0% of the households. Compared to previous estimates, these levels represent a tremendous improvement in sanitation service coverage. It is recommended that the impact of water and sanitation programmes on health status needs to be evaluated. There is a need for studies to be done on the value of utensil drying racks in disease control.

Garbage↗
PubMed1992

Bilharzia in a small irrigation community: an assessment of water and toilet usage.

A questionnaire study was conducted in the Mushandike small scale irrigation schemes in Zimbabwe to investigate the following: 1) to establish whether field latrines are used or not; 2) to find out why people visit natural water bodies for bathing and laundry instead of using water from boreholes for these purposes; 3) to assess people's knowledge on the transmission and control of schistosomiasis. Results of the study indicated that the field latrines are utilised and that the borehole water is not preferred for bathing and laundry because of its hardness and oily nature. The results further indicated that the community was aware of schistosomiasis but their knowledge on transmission and control of the disease was limited. Possible reasons for the observations made are discussed in the paper and recommendations emanating from the study are stated.

Agriculture↗
PubMed1992

Risk factors contributing to acute diarrhoeal disease in children below five years.

Data regarding factors contributing to acute diarrhoea in children under five years in urban populations in Sri Lanka is meagre. Studies of diarrhoeal disease have been limited mainly to descriptive epidemiological investigations. A case control study on 200 families in the Galle Municipality was undertaken to identify some of the social, behavioural and environmental factors contributing to childhood diarrhoea. Twelve variables were studied by logistic regression, and the following variables were identified as conferring a significant risk of causing diarrhoeal disease in children below five years in an urban setting in Sri Lanka; (1) unavailability of pipe-borne water in the house (2) lack of water-seal latrine in the household (3) low level of mother's education and her lack of awareness regarding infectious nature and mode of spread of diarrhoea (4) not disposing of children's faeces in a latrine (5) improper disposal of garbage.

Case-Control Studies↗
PubMed2004

[Hygiene practices and contamination risks of surface waters by schistosome eggs: the case of an infested village in Northern Senegal].

The transmission of intestinal schistosomiasis presumes that faecal materials containing viable schistosome eggs reach natural water bodies infested with snail intermediate host. So far there is little knowledge about the contamination dynamics of streams with schistosome eggs. We conducted a pilot study on defecating behaviour and hygienic practices in an Schistosoma mansoni endemic focus in Northern Senegal. Questionnaires were used to obtain quantitative data on hygienic practices and the use of latrines in 59 children. Although the community was well endowed with pit latrines, most of the children declared that they usually defecated somewhere else, in particular near the streams where the vegetation offers hideouts. Observations based on mapping of defecation sites showed that a considerable number of stools were left just a few meters from the riverbank, thus bearing a high risk of being washed off into the water. All these practices can easily lead to contamination of water bodies with schistosomae eggs. In order to improve hygienic practices and reduce fecal pollution of the environment, a health education model respecting local beliefs and customs would be indispensable.

Animals↗