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At least 1,531 records · Page 85Linked to original sources
PubMed1993

Maternal behavioural risk factors for severe childhood diarrhoeal disease in Kinshasa, Zaire.

This study examines the relationship between severe diarrhoeal disease and maternal knowledge and behaviours related to hygiene and sanitation. Some 107 paediatric cases admitted to two hospitals in Kinshasa, Zaire in 1988 were matched on age and nearest-neighbour status to 107 controls. Personal interviews and observational methods were used to assess knowledge and behaviours related to hygiene and sanitation. Cases and controls had equivalent socioeconomic status, demographic profiles and access to water and sanitation facilities. However, cases generally exhibited lower levels of knowledge and less sanguine sanitary practices than did controls. Of particular interest was the finding that very specific behavioural items distinguished cases from controls. The disposal of the child faeces and household garbage and mother's knowledge that poor caretaker cleanliness was a cause of diarrhoea in children showed the strongest associations with risk of diarrhoea. There was an exponential relationship between the number of these items a mother answered incorrectly and the odds of diarrhoeal disease. The risk attributable to these three variables was as high as 70%. These findings provide further support for the view that focused educational interventions may have a substantial impact on the occurrence of severe diarrhoeal disease in low-income countries.

Adult↗
PubMed1992

The complementary effect of latrines and increased water usage on the growth of infants in rural Lesotho.

The effects of water quantity and sanitation, alone and in combination with each other, on infant weight gain and length gain were examined. Data on 119 infants were collected from 20 villages in rural Lesotho between July 1984 and January 1985. The interactions between sanitation and increased water usage for weight gain (p = 0.007) and length gain (p = 0.006) were significant after potential confounding was controlled. The biggest growth effects were dependent on families possessing a latrine and increasing their use of water during the warm, wet season. Infants gained 1.031 kg (95% confidence interval (CI) 0.420 to 1.642) and 2.028 cm (95% CI 0.523 to 3.533) more when both positive factors were present, as compared with only having a latrine. Increasing water usage compared with not increasing water usage resulted in only 0.105 kg (95% CI -0.175 to 0.385) more weight gain and -0.309 cm (95% CI -1.005 to 0.387) more length in the absence of a latrine. Similarly, infants gained 1.106 kg (95% CI 0.484 to 1.728) and 2.076 cm (95% CI 0.559 to 3.593) more if both factors were operating than did infants whose families only increased their water usage. In the nonincreased water group, the difference in growth between having and not having a latrine was 0.180 kg (95% CI -0.093 to 0.453) and -0.261 cm (95% CI -0.951 to 0.429). Water supply programs should emphasize use of more water for personal hygiene, and sanitation programs should install toilet facilities where water usage is high or has been increased because of an educational program.

Bias↗
PubMed2006

Risk factors for childhood diarrhea incidence: dynamic analysis of a longitudinal study.

BACKGROUND: Several longitudinal studies have investigated factors associated with childhood diarrhea in developing countries. However, most studies have neglected important dynamic features of the longitudinal design and hierarchical interrelationships among the potential risk factors. METHODS: We conducted a longitudinal study of 902 children, age 0 to 36 months at baseline, in a large urban center in northeastern Brazil. Diarrhea data were collected by following children from October 2000 until January 2002 with biweekly home visits. We used a dynamic time-to-event analysis to account for several longitudinal features. We applied an effect-decomposition strategy to quantify direct and indirect effects of risk factors grouped in different blocks. RESULTS: Child's age and an autoregressive effect of past diarrhea episodes explained some of the decline of diarrhea incidence observed throughout the study (from more than 14 episodes to 2 episodes per child-year), a phenomenon already observed but not explained in other longitudinal diarrhea studies. We identified the following major diarrhea determinants: low socioeconomic status, poor sanitation conditions, presence of intestinal parasites, and absence of prenatal examination. The effect of socioeconomic status was mediated mostly by living and sanitation conditions. CONCLUSION: Our study shows important advantages of applying a dynamic analysis approach to longitudinal observational studies of diarrhea or other acute diseases and highlights the complex interrelationships of diarrhea determinants. Our results confirm the importance of sanitation as a major determinant of child health in urban settings of developing countries.

Brazil↗
PubMed1994

[Health education in Burundi: peer education in practice].

Because almost half of the patients diagnosed in health centers in Burundi suffered from illnesses related to impure water or inadequate sanitation, the Hygiene Education and Training Programme was created to assure the efficient use of water and sanitation infrastructures by the population of Burundi. A specific organizational unit, linked to the ministry of Public Health was created to implement the programme. With the objective of changing non-hygienic behaviour related to water use and sanitation, hygiene education was carried out by field teams using interpersonal peer communication methods in people's homes during a series of education campaigns that each last three months. The programme was directed primarily to households composed of men, women and children, with particular attention given to women and children, who have the primary responsibility for household hygiene. A participatory approach was employed that used teams of volunteers chosen by and from the population, and who visited households twice during each campaign. Audiovisual materials and messages for each campaign were developed in collaboration with the population. The field teams were motivated by a regular programme of training, an intense support and monitoring system, and the availability of audiovisual materials for hygiene education, as well as a system of prizes that was added recently. After 18 months of experience, it is possible to say that the approach is both feasible and effective. The population reacted positively to the hygiene education that was offered and a degree of behaviour change was observed.

Burundi↗
PubMed1994

Environmental health knowledge and practice survey among secondary schoolchildren in Zaria, Nigeria.

Knowledge of environmental health was assessed in a sample of 192 students at Ja'afaru Secondary School, Zaria, Nigeria, by means of a questionnaire. A follow-up practice survey was also administered to assess the environmental sanitation of the school and the homes of a subsample of the students. Observations were recorded on the sources of water, the methods of refuse and sewage disposal, and the hygienic condition of the toilets in both the school and the homes surveyed. The findings indicated that the students' knowledge of environmental hygiene was high for all classes and that students whose fathers had primary, secondary, or post-secondary education scored slightly higher than those whose fathers were illiterate. Analysis of the observations on environmental sanitation showed that even though the school lacked indoor plumbing on the premises, the pupils were accustomed to pipe-borne and well water in their homes. The main method of refuse disposal for school and homes was open dumping, and the main method of sewage disposal for both school and homes was pit latrines, which were dirty and poorly maintained. Although the pupils had good knowledge of environmental hygiene, inadequate opportunities and lack of sanitation facilities at school and homes did not allow them to practice the health knowledge they had acquired. Recommendations were made to the school authority to direct more effort toward providing a safe and adequate water supply, good drainage systems, additional toilets, and renovating the existing toilets. The school should also emphasize the practice of good environmental hygiene to complement theoretical input.

Adolescent↗
PubMed2004

The epidemiological investigation of Trichinella infection in brown rats (Rattus norvegicus) and domestic pigs in Croatia suggests that rats are not a reservoir at the farm level.

Whether the brown rat (Rattus norvegicus) is a reservoir of Trichinella spp. infection or merely an accidental host, which may be vector of Trichinella spp., continues to be debated. We estimated the prevalence of Trichinella sp. infection in brown rat populations and in domestic pigs in 2 villages in Croatia, where Trichinella sp. infection in pigs has been endemic in the past 10 yr. Trichinella spiralis larvae, identified by a multiplex polymerase chain reaction analyses, were the only species detected in both rats and pigs. In 2001 and 2002, 2,287 rats were collected on 60 farms with different levels of sanitation and with, or without, T. spiralis-infected pigs. The prevalence of infection in rats ranged from 0.2 to 10.7%. Infected rats were detected only on farms with T. spiralis-positive pigs and low sanitation or formerly with low sanitation (P = 0.007, Fisher's exact test), yet no infected rat was detected on farms with T. spiralis-negative pigs. The finding that no infected rat was found on farms with T. spiralis-negative pigs suggests that, in the investigated area, the brown rat is not a reservoir but only a victim of improper pig slaughtering.

Animals↗
PubMed1995

Disinfecting poultry production premises.

Hygiene and sanitation play a major role in any effective disease control programme for poultry production premises. One of the important requirements to facilitate hygiene and sanitation is adoption of the 'all-in/all-out' method (i.e. all the birds within a single establishment should be of the same age group), together with the restriction of each enterprise to a single type or species of bird. Poultry premises and buildings should comply with requirements for isolation from the environment and strict observance of principles of hygiene and disease prevention (e.g. restrictions on movement of staff, equipment and vehicles). A poultry site must be prepared methodically for the entry of each new batch (removal of birds, litter and manure; vector and rodent control; dry and wet cleaning; disinfection; fumigation). Attention should be paid to the terminal sanitation of houses and equipment after depopulation (physical and chemical cleaning, pressure washing, disinfection, fumigation). Particular care should be exercised in the performance of sanitary procedures after a disease outbreak. Immediate disposal of dead and diseased birds is an important and effective tool in preventing the dissemination of any disease. Disposal methods include the use of burial pits, tanks, burial in trenches, burning, rendering and composting. Regular visual inspection, together with routine testing by microbiological monitoring methods, is very effective in checking the efficacy of cleaning and disinfection.

Animal Husbandry↗
PubMed2002

Behavior of Listeria monocytogenes inoculated on cantaloupe surfaces and efficacy of washing treatments to reduce transfer from rind to fresh-cut pieces.

Attachment and survival of Listeria monocytogenes on external surfaces (rind) of inoculated cantaloupe, resistance of the surviving bacteria to chlorine or hydrogen peroxide treatments, transfer of the pathogen from unsanitized and sanitized rinds to fresh-cut tissues during cutting and growth, and survival of L. monocytogenes on fresh-cut pieces of cantaloupe were investigated. Surface treatment with 70% ethanol to reduce the native microflora on treated melon, followed by immersion in a four-strain cocktail of L monocytogenes (10(8) CFU/ml) for 10 min, deposited 4.2 log10 CFU/cm2 and 3.5 log10 CFU/cm2 of L monocytogenes on treated and untreated cantaloupe rinds, respectively. L. monocytogenes survived on the treated or untreated cantaloupe rinds for up to 15 days during storage at 4 and 20 degrees C, but populations declined by approximately 1 to 2 log10 CFU/cm2. Fresh-cut pieces prepared from inoculated whole cantaloupes stored at 4 degrees C for 24 h after inoculation were positive for L. monocytogenes. Washing inoculated whole cantaloupes in solutions containing 1,000 ppm of chlorine or 5% hydrogen peroxide for 2 min at 1 to 15 days of storage at 4 degrees C after inoculation resulted in a 2.0- to 3.5-log reduction in L. monocytogenes on the melon surface. Fresh-cut pieces prepared from the sanitized melons were negative for L. monocytogenes. After direct inoculation onto fresh-cut pieces, L. monocytogenes survived, but did not grow, during 15 days of storage at 4 degrees C. Growth was evident by 4 h of storage at 8 and 20 degrees C. It is concluded that sanitizing with chlorine or hydrogen peroxide has the potential to reduce or eliminate the transfer of L. monocytogenes on melon surfaces to fresh-cut pieces during cutting.

Anti-Infective Agents, Local↗
PubMed2002

Pilot-scale study of an anaerobic baffled reactor for the treatment of domestic wastewater.

Large proportions of South Africans live in areas with inadequate sanitation and a poor infrastructure for waterborne sanitation. Service providers are looking for alternative wastewater treatment options. The anaerobic baffled reactor is being considered as a decentralised sanitation option in these areas. A 3,200 L reactor was built and is currently being evaluated at a wastewater treatment works. The reactor was built based on experiences gained from working with a laboratory reactor (10 L) and predicted flow patterns observed on a computational fluid dynamics model. The design and construction of the reactor will be discussed in this paper. The feed to the reactor consists of screen degritted sewage and the flow to the reactor is maintained by means of a programmable logic controller. The pilot-plant layout is discussed in this paper. Samples are analysed for chemical oxygen demand, pH, alkalinity, ammonia, phosphorus, solids and ash content. Reductions of between 70 and 80% are obtained for COD and the pH values for the effluent samples are within the discharge limits.

Bioreactors↗
PubMed2004

Applying sustainable water management concepts in rural and urban areas: some thoughts about reasons, means and needs.

Serving the world population with adequate drinking water and sanitation is an important prerequisite, not only to hygienic safety, but to prosperity and political stability as well, and will foster the adaptive capacity of the societies in the developing countries and beyond. To avoid hygienic and political disasters impacting the world economy, investment in water supply and sanitation must urgently be made. Whether the classical system of urban water supply and sanitation is appropriate to satisfy the needs of the developing world, however, and whether this system meets the general criteria of sustainability is questionable. The costs and the time needed for installation of sewers and wastewater treatment plants are tremendous. In water shortage areas, the amount of tap water required to transport pollutants to the treatment plant is hardly affordable. Recovery and re-introduction of valuable substances, including water, into the urban cycle of materials is impossible because of mixing and dilution effects inherent in the system. Decentralized water and wastewater management should be seriously taken into account as an alternative. Source separation of specific fractions of domestic and industrial wastewater, separate treatment of these fractions and recovery of water and raw materials including fertilizer and energy are the main characteristics of modern high-tech on-site treatment/reuse systems. Mass production of the key components of the system could reduce the costs of the treatment units to a reasonable level. On-site units could be installed independently of the development stage of the urban sewer system. In conjunction with building new housing complexes a stepwise improvement of the hygienic situation in urban and peri-urban areas could be achieved, therefore. Remote control of the satellite systems using modern telecommunication methods would allow reliable operation, and comfort for the users. Intensive research is required, however, to develop this system and bring it to a standard allowing efficient application worldwide.

Conservation of Natural Resources↗
PubMed2004

Effective subsidies in developing countries.

During the last decades, significant subsidies have been allocated to government-owned water and sewerage enterprises in developing countries. However, water and sewerage coverage is still far from desirable and the poor are particularly affected by the shortage of these services. The truth is that a considerable part of these subsidies have been used up to build huge infrastructure works that would make some construction firms happy, while often decreasing the service costs for the richer. The costs associated of delivering water and sanitation services to the poor are significantly higher, as they often live in slums or irregular urban developments without urban infrastructure. It is possible, and desirable, to improve government's effectiveness through the use of appropriate economic incentives. The Brazilian River Basin Pollution Abatement Program, based on the "output-based aid" concept, is a good example of how this can be achieved. The Program is a success story that shows that the quality of expenditures on sanitation can be considerably improved if governments of developing countries refrain from contracting sanitation infrastructure works and start paying for results, not for promises.

Brazil↗
PubMed2004

Sustainable sludge management in developing countries.

Worldwide, unsanitary conditions are responsible for more than three million deaths annually. One of the reasons is the low level of sanitation in developing countries. Particularly, sludge from these regions has a high parasite concentration and low heavy metal content even though the available information is limited. Different issues needed to achieve a sustainable sludge management in developing nations are analysed. Based on this analysis some conclusions arise: sludge management plays an important role in sanitation programs by helping reduce health problems and associated risks; investments in sanitation should consider sludge management within the overall projects; the main restriction for reusing sludge is the high microbial concentration, which requires a science-based decision on the treatment process, while heavy metals are generally low; adequate sludge management needs the commitment of those sectors involved in the development and enforcement of the regulations as well as those that are directly related to its generation, treatment, reuse or disposal; current regulations have followed different approaches, based mainly on local conditions, but they favour sludge reuse to fight problems like soil degradation, reduced crop production, and the increased use of inorganic fertilizers. This paper summarises an overview of these issues.

Biodegradation, Environmental↗
PubMed2003

Water quality and health in the new millennium: the role of the World Health Organization Guidelines for Drinking-Water Quality.

In this report the role of the WHO Guidelines for Drinking Water Quality in promoting safe drinking water for the world's population is briefly described. The guidelines are being revised in a third edition to emphasize an integrated approach to water quality assessment and management from source to consumer. The forthcoming guidelines will: be risk-based and quantitative, emphasize quality protection and prevention of contamination, be proactive and participatory, and address the needs of those in developing countries who have no access to piped community water supplies. The guidelines emphasize the maintenance of microbial quality to prevent waterborne infectious disease as an essential goal. In addition, they address protection from chemical toxicants and other contaminants of public health concern. The forthcoming 3rd edition of the WHO GDWQ intend to be responsive to the under-served in developing countries by inclusion of non-piped supplies and addressing practical systems for their collection, treatment and storage at household level to provide safe water. Beyond the inclusion of these and possibly additional household water collection, treatment and storage systems, what is needed is to achieve their widespread use is an education and dissemination campaign that promotes and explains them and their benefits. Such a communication and marketing campaign is best done by including as many different sectors and stakeholders as possible in the process. It will be important to acknowledge that safe water is one of essential components or needs for healthy living, along with adequate sanitation and proper nutrition. Together, these are the essential health needs to be met in the developing and the developed world. All three contribute to reduced disease and increased health, and the lack of one can degrade the beneficial impact of the others. The importance of safe water, sanitation and nutrition to human health and well-being can be stated no better than it was by United Nations Secretary General Kofi Annan in his statement on "Freedom from Want" in the Millennium Report, 03/04/00. "How can we call human beings free and equal in dignity when over a billion of them are struggling to survive on less than one dollar a day, without safe drinking water, and when half of all humanity lacks adequate sanitation? Some of us are worrying about whether the stock market will crash, or struggling to master our latest computer, while more than half our fellow men and women have much more basic worries, such as where their children's next meal is coming from."

Consumer Product Safety↗
PubMed2005

Intestinal helminth infection in an ethnic minority commune in southern Vietnam.

A program to control intestinal helminth infections, based on stool surveys, mass treatment of children below 17 years, improvement of sanitation and health education was performed between 1997 and 1999 in Phan Tien, an ethnic minority community in mountainous southern Vietnam. Before intervention, 28.6% of children excreted eggs of at least one parasite, hookworm being the most common (23%), followed by Trichuris trichiura (1.9%), Hymenolepis nana (1.9%), Enterobius vermicularis (0.9%), Ascaris lumbricoides (0.5%), and multiple kinds of helminthes (0.5%). Strongyloides stercoralis was never detected. Poor sanitation and personal hygiene, and walking barefoot were considered the main risk factors for intestinal helminth infections. The success of 400 mg albendazole single dose mass treatment was initially frustrated by the poor quality of the drug formulation used, only containing half of the indicated amount of albendazole. Using another formulation quickly reduced the hookworm infection rate. Praziquantel was used to treat H. nana infections. After three years of intervention, intestinal helminth infections were reduced to 3.3% (p<0.0001). We conclude that interventions combining health education, improvement of sanitation and mass treatment effectively control intestinal helminth infections, but the quality of the drugs used is an important factor.

Adolescent↗
PubMed1990

Epidemiology and transmission of rotavirus infections and diarrhoea in St. Lucia, West Indies.

To determine the epidemiology and risk factors of rotavirus infections in St. Lucia, 229 children in three valleys with varying levels of sanitation were studied for 2 years. A four-fold rise in complement fixation antibody to rotavirus antigen was used in paired samples as evidence of recent infection. Results showed that forty-eight per cent of infants experienced at least one infection during a two-year period, and 17% of children were reinfected. Infections occurred within the first months of life and peaked between 6 and 23 months of age. The peak infection coincided with the dry season in each age group. Children breast-feeding had fewer infections. Although crowding within the home was significantly associated with repeated infection, the incidence of infection was not affected by the degree of sanitation. Other studies in the region, using recently developed techniques, concur with these findings which advance our understanding of the epidemiological importance of rotavirus in St. Lucia. Although these studies provide insights into the risk factors for rotavirus infections, other studies are required to determine whether investments should be focused on improved sanitation or immunization or both.

Breast Feeding↗
PubMed1984

Diarrhoeal diseases in rural Malaysia: risk factors in young children.

A survey was conducted in six selected rural villages to obtain baseline data on socioeconomic status, nutrition, environmental sanitation and behavioural aspects in relation to diarrhoeal diseases, using a standard questionnaire. Subsequent to this, children 0-4 years of age were followed weekly for six months for diarrhoeal disease. Eleven variables representing socioeconomic status, nutritional status, housing condition, environmental sanitation, mother's knowledge and beliefs were investigated using stepwise logistic regression to determine significant predictors of diarrhoeal disease. Children who were below two years of age, living in conditions of poor sanitation and poor quality water supply, whose houses were prone to flooding and who had mothers whose sanitary habits were not influenced by their religious beliefs, were at significantly greater risk of diarrhoeal disease.

Child Nutritional Physiological Phenomena↗
PubMed1982

Women--the underused human resource: education and training of women for community participation.

This article goes beyond the rhetorical issue of women's participation as a key to implementing water supply and sanitation projects and suggests concrete ways in which training and education can make these plans a reality. With the improvements proposed for the International Drinking Water Supply and Sanitation Decade, women could be freed to do other tasks vital to the well being of the family and the community. Women, the "invisible resource" of society, play and essential part in encouraging family members to use technological advances and should be trained to effectively promote their acceptance. The author highlights the influence women have in the field of public health: with adequate training, for example, they can help control the spread of diarrheal disease with proper hygiene and an understanding of the fecal-oral route of infection. Moreover, she says that the central role women play in socializing the young and their permanence within the household make them suitable as trainees and trainers for water and sanitation projects at the community and household levels. Women should be recruited for these roles and should be consulted at every stage of development; while women's bureaus exist in many countries, the author states that planners often hesitate to call on them for assistance. The article describes several innovative training programs and, along with a bibliography, presents separate case studies for Mexico and Panama.

Africa↗
PubMed1993

Nutritional and environmental risk factors for diarrhoeal diseases in Ecuadorian children.

Risk factors associated with diarrhoea, based on the recall of a recent episode were evaluated from a cross-sectional national nutrition and health study in 1,620 Ecuadorian children less than 5 years old. Prevalence of diarrhoea varied with the age of the children; 6- to 23-months-old children showed the highest prevalence. In this age range the prevalence of diarrhoea was significantly associated with hygienic factors (quality of drinking water, sanitation and refuse system), but not with demographic factors (sex, altitude, population density, family size). The nutritional status of the children was determined by anthropometry and blood chemistry. After stratification for sanitation levels, a low weight-for-age Z-score and low serum retinol and zinc concentrations showed a statistically significant (p < or = 0.06) association with diarrhoea prevalence only in children living under better hygienic conditions. Multivariate analysis revealed significant associations between both sanitation levels and nutritional level as defined by anthropometry, but not by blood chemistry, and diarrhoea prevalence.

Age Factors↗