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PubMed2002

An Update on the Geohelminths: Ascaris lumbricoides, Hookworms, Trichuris trichiura, and Strongyloides stercoralis.

Geohelminths remain prevalent throughout the developing world where levels of sanitation, personal hygiene, and maternal education are low. The five species of nematodes responsible for the bulk of disease are Ascaris lumbricoides, the hookworms Ancylostoma duodenale and Necator americanus, Trichuris trichiura, and Strongyloides stercoralis. Geohelminths are acquired through ingestion of fecally contaminated food or water or through contact with infected soil. In developing countries, infection with more than one nematode species and high worm burdens are common. The morbidity is substantial, particularly among children, and deaths occur. Geohelminthic infections are encountered in industrialized countries among immigrants and long-term travelers who have lived in endemic regions where sanitation is poor, and occasionally following autochthonous transmission.

Journal Article↗
PubMed1987

The epidemiology of acute diarrhoea in a rural community in Imo State, Nigeria.

As part of an evaluation of a water supply and sanitation project, a baseline cross-sectional study of diarrhoea, and its putative risk factors, was conducted in 5 villages in Imo State, Nigeria. Data were collected from 4641 and 5920 persons during surveys in the dry and wet seasons, respectively. 8 d period prevalence rates for diarrhoea ranged from 5 to 50%, with the highest rates occurring in the 6 to 23 month age group. Diarrhoea was associated with up to 75% of all illnesses in young children and with about 20% in adults. Risk factors included lower socio-economic status, an unclean domestic environment, use of non-purified water, absence of soap, and feeding methods other than exclusive breast-feeding in the early months of infancy. These results suggest that the education component of water supply and sanitation projects should emphasize personal and domestic hygiene and infant feeding.

Adolescent↗
PubMed1987

Repeated mass treatment of schistosomiasis mansoni: experience in hyperendemic areas of Brazil. I. Parasitological effects and morbidity.

The current project, carried out in Viçosa (state of Alagoas, Brazil), sought to assess the impact of repeated mass treatment campaigns (4 times over a period of 5 years) upon the prevalence, egg counts and morbidity of schistosomiasis mansoni. Results were not impressive. Some control seems to have been achieved in zones of the town better-off in terms of sanitation and socio-economic conditions, while in other areas no effect whatsoever of chemotherapy was detected. Neither resistance to the drug (oxamniquine) nor its deterioration could be held responsible, since a short-term follow-up of a group of children personally treated by the authors showed rapid reinfection, after an excellent initial response. This study, complemented by data from an area in Pernambuco and a hospital survey over the period 1978-84, indicated that morbidity due to schistosomiasis was decreasing, although there was some evidence that other factors may be at least partly responsible for the increasing scarcity of "hepatosplenic" schistosomiasis. Schistosomiasis, a strictly focal problem, thus calls for a targeted approach to control. It is believed that chemotherapy alone will not suffice and that sanitation, vector control and, perhaps, health education are equally essential in areas which remain refractory to mass treatment.

Adolescent↗
PubMed1990

Regulation of food-related carcinogens in Japan.

Use of hazardous environmental substances in Japan is regulated, based on their risk assessment, by laws of various ministries, depending upon the chemicals concerned. Food additives and food contaminants are controlled by the Food Sanitation Law of the Ministry of Health and Welfare. When manufacture or import of new food additives is intended, their physicochemical and biological data are evaluated by the Food Sanitation Investigation Council. When new data become available on the carcinogenicity of food additives that have been approved and are in use, these compounds are reevaluated. Between 1974 and 1986, twelve chemicals were proved to be carcinogenic in Japan by task groups for evaluation of the carcinogenicity of food additives, medical drugs and pesticides, which were organized by the Ministry of Health and Welfare. Of these compounds, 2-(2-furyl)-3-(5-nitro-2-furyl)acrylamide was banned from use, but use of hydrogen peroxide and potassium bromate was permitted, provided that these compounds were decomposed or removed from the final products. The use of butylated hydroxyanisole within fixed limits in some foodstuffs was also permitted. Decisions on the use of these compounds were based on the prevailing opinion on carcinogens at the time. This paper reports these facts with a consideration of future problems on the regulation of food carcinogens.

Animals↗
PubMed1988

Intestinal helminthiases in relation to the socioeconomic environment of Panamanian children.

A cross-sectional investigation was made into ascariasis and nutritional status in Panamanian preschool children from October 1983 to July 1984. Within this framework, an analysis was undertaken of possible relationships between a range of intestinal helminthiases and the socioeconomic status of the participants. Attention was paid to caregiver's education, parental occupation, family earnings, quality of housing and sanitation in the assessment of socioeconomic status. On this basis, strong associations were established between the socioeconomic status of the children and infection with Ascaris lumbricoides, Trichuris trichiura and hookworm. In general, the prevalence of single and multiple helminth infections was significantly higher in children living in housing made of wood or bamboo than in those living in housing made of concrete blocks. The same pattern applied to levels of sanitation. Ascaris lumbricoides occurred more frequently in children of mothers with the least formal education and in children living in relatively crowded conditions. Evidence was also obtained to indicate that the intensity of the intestinal helminth infections was greater in the children from the poorer environment. Since children from poorer socioeconomic conditions might be more exposed to infective stages than those from a better environment, the possible role of socioeconomic factors in contributing to the predisposition of some individuals to harbour large worm burdens of intestinal helminths was briefly discussed.

Ascariasis↗
PubMed1989

Child health and child care in Okelele: an indigenous area of the city of Ilorin, Nigeria.

This paper provides a detailed analysis of the survival rates and health problems of a cohort of children born during a 5-yr period in part of the city of Ilorin, Nigera. The findings are linked to a demographic and environmental study which indicates that the study area was relatively stable in terms of family structure and population turnover. Most people work in the informal sector, in trading, small scale crafts and service industries. At the time the survey began, in 1979, the provision of piped water supplies to the area was unreliable and sanitation provisions rudimentary. Most of the people had little or no formal education and were very poor. The study indicated that health status had improved over the 5-yr period, compared to a baseline study conducted in 1979. Common causes of child mortality and morbidity included diarrhea, acute respiratory infections, measles, and malaria. The infant mortality rate was 41.5/1000. The availability of clinic care at nominal cost, and the attendance of mothers at the clinic for checkups and immunization, resulted in a higher level of health for their children than otherwise would have been possible. Some problems of primary health care in the area are mentioned, in the light of Nigeria's current budgetary problems, and the utilization of existing strong social support networks to improve health care and environmental sanitation and water supply is suggested.

Adolescent↗
PubMed1995

Improving human welfare through appropriate technology: government responsibility, citizen duty or customer choice.

This paper explores recent attempts to improve the effectiveness of environmental health programmes and projects by reference to the International Drinking Water Supply and Sanitation Decade (1980-1990) and beyond. Reference is made to how water and sanitation as technical interventions have drawn upon the natural sciences, notably concepts of race and sex, and the social sciences including culture and gender, for their authority and legitimacy. A new and apparently progressive movement, the Water Decade sought to challenge the powerful and enduring high tech image of development on which much western environmental and social transformations have been based. Beginning as a critique of modernism with a commitment to basic needs as human rights, it was driven by a recognition that sophisticated technology could not satisfy human health needs. Alternative technologies would, by contrast, cater for a more extensive and varied market and would promote participatory approaches to service delivery. The paper demonstrates how, during the course of the Decade, sections of the aid community began to redefine basic needs as commodities involving the efficient marketing and delivery of a product with minimal state intervention. Within a shifting international political and economic context, it examines the changing role of the expert and the links being forged between large donors, non-governmental organisations and the private sector. The significance of this reformulated progressivism for the development debate is then considered, notably in relation to concepts of citizenship, consumer choice and the role of the state.

Community Health Planning↗
PubMed1994

Social and environmental factors and life expectancy, infant mortality, and maternal mortality rates: results of a cross-national comparison.

Using data from United Nations sources we conducted an international comparison study of infant and maternal mortality rates and life expectancy at birth. We examined these three dependent variables in relation to a range of independent variables including dietary factors, medical resource availability, gross national product (GNP/capita), literacy rates, growth in the labor force, and provision of sanitation facilities and safe water. Based on exploratory stepwise regression models, we fitted a series of general linear models for each of the three dependent variables. For the models with the highest explanatory ability, the percent of households without sanitation facilities showed the strongest association with all three dependent variables: life expectancy at birth (R2 = 0.83, B = -0.088, P = 0.0007); infant mortality rate (R2 = 0.87, B = +0.611, P < 0.0001); and maternal mortality rate (R2 = 0.54, B = +8.297, P = 0.002). Additional significant predictors of life expectancy at birth and infant mortality rate included the quantity of animal products consumed, the percent of households without safe water, excess calories consumed as fat, and the total literacy level. Maternal mortality rate was significantly associated with total energy consumption and excess energy consumed as fat. Using residuals from the general linear models we chose three outlying countries: Costa Rica, Sri Lanka and Egypt, on which to do case studies. These country case studies are discussed briefly in regard to characteristics that could account for their differing statistical relationships.

Adult↗
PubMed1996

The significance of children's age in estimating the effect of maternal time use on children's well-being.

The women's initiative launched by the United Nations Decade for Women has sparked unresolved controversy over the consequences of mothers' increased participation in economically productive activities on children's well-being. Clearly, in many developing countries, poor mothers face stringent time constraints requiring trade-offs in time allocated to various activities, including child caregiving. However, the impact of these trade-offs on children's well-being remains unclear. The effect of maternal time use on children's nutrition and health status requires more rigorous examination. In particular, the role of children's age in this relationship is critical. Although children's requirement for maternal care varies with factors such as their age (a proxy for stage of psychobiological and sociocultural development), season of year and family size and structure, children's age has not been highlighted in the debate or in the relevant research. This paper documents children's age as a critical factor in the relationship between maternal patterns of time use and the well-being of children 18-30 months of age in peri-urban Egypt. It describes differences in maternal patterns of daily time use according to children's age and illustrates the differential associations between maternal daily activity patterns and children's well-being by children's age. Quantitative data collected on 161 mother-toddler pairs included information on maternal daily time allocation, children's dietary energy intake and diarrheal morbidity, maternal hemoglobin, and household and individual sociodemographics. Data were stratified by children's age at 24 months and were analyzed cross-sectionally using multiple linear and logistic regression. Results indicated that the age of two is critical in Kalama. At this age, toddlers begin to receive less time-intensive care freeing mothers for economic and self production. With respect to children's well-being prior to age two, frequency of feeding was positively related to their energy intake and more time spent in household sanitation activities reduced children's risk of diarrhea (during the diarrhea season). After two years of age, the maternal behaviors measured did not affect children's energy intake; however, children's diarrheal risk was reduced (during the diarrhea season) when mothers held them more and allocated more time to household sanitation year-round. We recommend that other investigators carefully examine the relationships between children's well-being according to developmentally-defined child age intervals and maternal patterns of time use. Results will help to resolve concern over the effect of maternal participation in economically productive activities on children's well-being.

Child Care↗
PubMed2006

The effect of random voice hand hygiene messages delivered by medical, nursing, and infection control staff on hand hygiene compliance in intensive care.

Hand hygiene (HH) compliance in the intensive care unit has been studied extensively, with short-term, nonsustained compliance often because of lack of ongoing reinforcement. HH messages delivered by health care workers responsible for overseeing staff in the intensive care unit provided continuous reinforcement of HH. Compliance measured through product usage and reported as HH/bed-days increased by 60% for soap and sanitizer combined and 25% for sanitizer usage (P < 001).

Administration, Cutaneous↗
PubMed2004

Infant mortality and child health in Brazil.

Child health is a central issue in the public policy agenda of developing countries. Several policies aimed at improving child health have been implemented over the years, with varying degrees of success. In Brazil, such policies have triggered a significant decline in infant mortality rates over the last 30 years. Despite this improvement, however, mortality rates are still high compared to international standards. Moreover, there is considerable imbalance across Brazilian municipalities suggesting that various policies should be adopted. We investigate the determinants of infant mortality at the municipal level and provide an analysis of the factors affecting child health at the individual level. To analyze the mortality rate, we estimate static and dynamic panel data models using four censuses covering the period from 1970 to 2000. The demand for child health, on the other hand, is addressed through a household decision model, estimated using anthropometric data from the 1996 Standard of Living Survey. The results obtained indicate that a rise in sanitation, education and per capita income contributed to the decline of infant mortality in Brazil, with stronger impacts in the long run than in the short run. The fixed effects associated with county characteristics explain the observed dispersion in child mortality rates. The results from the decision model are confirmed by the findings of the mortality model: education, sanitation and poverty are the most important causes of poor child health in Brazil.

Brazil↗
PubMed2005

Effect of controlled atmosphere storage, modified atmosphere packaging and gaseous ozone treatment on the survival of Salmonella Enteritidis on cherry tomatoes.

In recent years, outbreaks of infections associated with raw and minimally processed fruits and vegetables have been reported. The objective of this study was to analyse the growth/survival of Salmonella Enteritidis at spot-inoculated or stem-injected cherry tomatoes during passive modified atmosphere packaging (MAP), controlled atmosphere (CA) and to compare the results with those of air storage at 7 and 22 degrees C. During MAP, the gas composition equilibrated to 6% O2/4% CO2. CO2 level was maintained as 5% through the term of CA storage at 7 and 22 degrees C. The results demonstrate that S. Enteritidis can survive and/or grow during the storage of tomatoes depending on the location site of the pathogen on fruit, suspension cell density and storage temperature. During MAP, CA and air storage, S. Enteritidis with initial population of 7.0 log10 cfu/tomato survived on tomato surfaces with an approximate decrease of 4.0-5.0 log10 cfu/tomato in population within the storage period; however, in the case of initial population of 3.0 log10 cfu/tomato, cells died completely on day 4 during MAP storage and on day 6 during both CA and air storage. The death rate of S. Enteritidis on the surfaces of tomatoes that were stored in MAP was faster than that of stored in air and in CA. Storage temperature was effective on the survival of S. Enteritidis for the samples stored at ambient atmosphere; cells died completely on day 6 at 7 degrees C and on day 8 at 22 degrees C. Stem scars provided protective environments for Salmonella; an approximate increase of 1.0 log10 cfu/tomato in stem-scar population was observed during MAP, CA and air storage at 22 degrees C within the period of 20 days. Cells survived with no significant change in number at 7 degrees C. During the research, the effect of ozone treatment (5-30 mg/l ozone gas for 0-20 min) was also considered for surface sanitation before storage. Gaseous ozone treatment has bactericidal effect on S. Enteritidis, inoculated on the surface of the tomatoes and can be used for surface sanitation of S. Enteritidis on tomatoes before storage at different conditions. Ten mg/l ozone gas treatment with different time intervals of 5 and 15 min was found to be effective respectively on low and high dose inoculum levels of S. Enteritidis attached for 1 h. Another variable considered during ozone treatment was the 4 h attachment time.

Colony Count, Microbial↗
PubMed2005

Laboratory scale Clean-In-Place (CIP) studies on the effectiveness of different caustic and acid wash steps on the removal of dairy biofilms.

A laboratory scale, bench top flow system was used to partially reproduce dairy plant conditions under which biofilms form and to quantify the effectiveness of caustic and acid wash steps in reducing the number of viable bacteria attached to stainless steel (SS) surfaces. Once bacteria attached to surfaces, a standard clean-in-place (CIP) regime (water rinse, 1% sodium hydroxide at 65 degrees C for 10 min, water rinse, 1.0% nitric acid at 65 degrees C for 10 min, water rinse) did not reproducibly ensure their removal. Standard CIP effectiveness was compared to alternative cleaning chemicals such as: caustic blends (Alkazolv 48, Ultrazolv 700, Concept C20, and Reflex B165); a caustic additive (Eliminator); acid blends (Nitroplus and Nitrobrite); and sanitizer (Perform). The addition of a caustic additive, Eliminator, enhanced biofilm removal compared to the standard CIP regime and further increases in cleaning efficiency occurred when nitric acid was substituted with Nitroplus. The combination of NaOH plus Eliminator and Nitroplus achieved a 3.8 log reduction in the number of cells recovered from the stainless steel surface. The incorporation of a sanitizer step into the CIP did not appear to enhance biofilm removal. This study has shown that the effectiveness of a "standard" CIP can possibly be enhanced through the testing and use of caustic and acid blends. There are many implications of these findings, including: the development of improved cleaning regimes and improved product quality, plant performance, and economic returns.

Analysis of Variance↗
PubMed2005

Fungal survival during anaerobic digestion of organic household waste.

Anaerobic digestion of organic waste yields energy rich biogas and retains nutrients (N, P, K, S, etc.) in a stabilised residue. For the residue to be used as a soil fertiliser, it must be free from pollutants and harmful microorganisms. Fungal survival during sanitation and anaerobic treatment of source-separated organic household waste and during aerobic storage of the residue obtained was investigated. Decimal reduction times were determined for inoculated fungi (Aspergillus flavus and Aspergillus fumigatus, Penicillium roqueforti, Rhizomucor pusillus, Thermoascus crustaceus and Thermomyces lanuginosus). Several different fungal species were found after waste sanitation treatment (70 degrees C, 1 h), with Aspergillus species dominating in non-inoculated waste. Anaerobic waste degradation decreased the diversity of fungal species for processes run at both 37 and 55 degrees C, but not total fungal colony forming units. Fungi surviving the mesophilic anaerobic digestion were mainly thermotolerant Talaromyces and Paecilomyces species. T. crustaceus and T. lanuginosus were the only inoculated fungi to survive the thermophilic anaerobic degradation process. Aerobic storage of both types of anaerobic residues for one month significantly decreased fungal counts.

Anaerobiosis↗
PubMed2003

Increase of human MTH1 and decrease of 8-hydroxydeoxyguanosine in leukocyte DNA by acute and chronic exercise in healthy male subjects.

To investigate the effects of exercise on oxidative DNA damage, we measured the levels of 8-hydroxydeoxyguanosine (8-OH-dG, 7,8,dihydro-8-oxo-deoxyguanosine), and mRNA of its sanitization enzyme, human MutT homologue (hMTH1), after mild acute exercise in healthy male subjects. The basal 8-OH-dG levels of physically active subjects were significantly lower than those of sedentary subjects. After mild exercise for 30min, the 8-OH-dG levels of the sedentary subjects significantly decreased. In correspondence with the change of 8-OH-dG levels, the hMTH1 mRNA levels of the physically active subjects were significantly higher than those of the sedentary subjects. The levels of hMTH1 mRNA of sedentary subjects significantly increased after mild exercise. Furthermore, there was a significant negative correlation between the levels of 8-OH-dG and hMTH1 mRNA. These results suggest that a mild exercise has a beneficial effect on the maintenance of low levels of 8-OH-dG probably by keeping the sanitization system at higher levels.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed2004

Impact of drainage and sewerage on intestinal nematode infections in poor urban areas in Salvador, Brazil.

This cross-sectional study was conducted in 1989 among children aged between 5 and 14 years old living in nine poor urban areas of the city of Salvador (pop. 2.44 million), capital of Bahia State, in Northeast Brazil. Three of these areas had benefited from both drainage and sewerage, 3 from improved drainage only, and 3 from neither. The children studied thus belonged to 3 exposure groups regarding their level of sanitation infrastructure. An extensive questionnaire was applied to collect information on each child and on the conditions of the household, and stool examinations of the children 5-14 years old were performed to measure nematode infection. Comparison of the sewerage group with the drainage-only group and the latter with the control (no sewerage or drainage) group showed that, when the level of community sanitation was better, the prevalence of infection among children was less, but risk factors identified for infection were more numerous and more significant. Intensity of infection with Trichuris, but not with Ascaris or hookworm, was also less. The results suggest that sewerage and drainage can have a significant effect on intestinal nematode infections, by reducing transmission occurring in the public domain.

Adolescent↗
PubMed2000

Field investigations of bacterial contaminants and their effects on extended porcine semen.

Field investigations (n=23) were made over a 3-yr period at North American boar studs and farms in which the primary complaint was sperm agglutination in association with decreased sperm longevity of extended semen, and increased regular returns to estrus and/or vaginal discharges across parity. Microscopic examination of extended semen from these units revealed depressed gross motility (usually <30%), sperm agglutination, and sperm cell death occurring within 2 d of semen collection and processing regardless of the semen extender used. The extended semen exhibited a high number of induced acrosome abnormalities (>20%). Sample pH was acidic (5.7 to 6.4) in 93% of the submitted samples. Aerobic culture yielded a variety of bacteria from different genera. A single bacterial contaminant was obtained from 66% of the submitted samples (n=37 doses); 34% contained 2 or more different bacterial genera. The most frequently isolated contaminant bacteria from porcine extended semen were Alcaligenes xylosoxydans (n=3), Burkholderia cepacia (n=6), Enterobacter cloacae (n=6), Escherichia coli (n=6), Serratia marcescens (n=5), and Stenotrophomonas [Xanthomonas] maltophilia (n=6); these 6 bacteria accounted for 71% of all contaminated samples, and were spermicidal when re-inoculated and incubated in fresh, high quality extended semen. All contaminant bacteria were found to be resistant to the aminoglycoside gentamicin, a common preservative antibiotic used in commercial porcine semen extenders. Eleven genera were spermicidal in conjunction with an acidic environment, while 2 strains (E. coli, S. maltophilia) were spermicidal without this characteristic acidic environment. Bacteria originated from multiple sources at the stud/farm, and were of animal and nonanimal origin. A minimum contamination technique (MCT) protocol was developed to standardize hygiene and sanitation. This protocol focused on MCT's during boar preparation, semen collection, semen processing and laboratory sanitation. Implementation of the MCT, in addition to specific recommendations in stud management, resulted in the control of bacterial contamination in the extended semen.

Alcaligenes↗
PubMed1987

Nutrition and management of the dog.

This article reviews those aspects of canine management relating to sanitation, reproduction, and nutrition. Within an effective system of management, the clinician will be better able to recognize and solve individual health problems and to assess their relationship to the facility as a whole. Integration of sanitation, nutrition, reproduction management, and health procedures and thorough and accurate record-keeping should be the goals of the consulting clinician.

Animal Husbandry↗