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Drinking water, sanitation, and hygiene (WASH) situation in primary schools of Pakistan: the impact of WASH-related interventions and policy on children school performance

Ahmed J, Wong LP, Chua YP, Hydrie MZI, Channa N

Environ Sci Pollut Res Int, 2022 Jan;29(1):1259-1277.
PMID: 34355319 DOI: 10.1007/s11356-021-15681-w

The United Nation's Sustainable Development Goals include the target of ensuring access to water and sanitation and hygiene (WASH) for all; however, very few studies have assessed comprehensive school WASH service in Pakistan. The purpose of this study was to identify WASH services in primary schools of Pakistan, and to assess how recent WASH interventions and policies are associated with the school's academic performance. A representative cross-sectional study was conducted in primary schools in the Sindh province of Pakistan. Structured observations and interviews were done to ascertain the schools' WASH conditions. The primary exposures of interest were the implementation of previous WASH interventions and National WASH policy in the school and the WASH coverage. Outcomes of interest included WASH conditions and school performance. The structural equation modeling (SEM) using a bootstrap resampling procedure was employed to characterize how WASH exposures were associated with WASH conditions and school performance. Data were collected from 425 schools. The Basic WASH facilities coverage in the primary schools of Sindh remains overall low according to WHO WASH service ladder criteria. Also, inconsistency in all three inclusive domains of WASH (availability, accessibility, and functionality) facilities were found. The school performance was significantly associated (P<0.001) with the presence of WASH interventions and/or WASH policy, while WASH policy and/or recent WASH intervention at the school were not associated with overall water quality. Our assessment unveiled several WASH gaps that exist, including high heavy metal and fecal contamination. Adoption of national WASH policy and financing of evidence-based WASH interventions are recommended in primary schools to improve educational outcomes.

Matched MeSH terms: Sanitation
Fulltext A prevalence-based transmission model for the study of the epidemiology and control of soil-transmitted helminthiasis

Chong NS, Hardwick RJ, Smith SR, Truscott JE, Anderson RM

PLoS One, 2022;17(8):e0272600.
PMID: 36006929 DOI: 10.1371/journal.pone.0272600

Much effort has been devoted by the World Health Organization (WHO) to eliminate soil-transmitted helminth (STH) infections by 2030 using mass drug administration targeted at particular risk groups alongside the availability to access water, sanitation and hygiene services. The targets set by the WHO for the control of helminth infections are typically defined in terms of the prevalence of infection, whereas the standard formulation of STH transmission models typically describe dynamic changes in the mean-worm burden. We develop a prevalence-based deterministic model to investigate the transmission dynamics of soil-transmitted helminthiasis in humans, subject to continuous exposure to infection over time. We analytically determine local stability criteria for all equilibria and find bifurcation points. Our model predicts that STH infection will either be eliminated (if the initial prevalence value, y(0), is sufficiently small) or remain endemic (if y(0) is sufficiently large), with the two stable points of endemic infection and parasite eradication separated by a transmission breakpoint. Two special cases of the model are analysed: (1) the distribution of the STH parasites in the host population is highly aggregated following a negative binomial distribution, and (2) no density-dependent effects act on the parasite population. We find that disease extinction is always possible for Case (1), but it is not so for Case (2) if y(0) is sufficiently large. However, by introducing stochastic perturbation into the deterministic model, we discover that chance effects can lead to outcomes not predicted by the deterministic model alone, with outcomes highly dependent on the degree of worm clumping, k. Specifically, we show that if the reproduction number and clumping are sufficiently bounded, then stochasticity will cause the parasite to die out. It follows that control of soil-transmitted helminths will be more difficult if the worm distribution tends towards clumping.

Matched MeSH terms: Sanitation
Fulltext A planetary health model for reducing exposure to faecal contamination in urban informal settlements: Baseline findings from Makassar, Indonesia

French MA, Fiona Barker S, Taruc RR, Ansariadi A, Duffy GA, Saifuddaolah M, et al.

Environ Int, 2021 10;155:106679.
PMID: 34126296 DOI: 10.1016/j.envint.2021.106679

BACKGROUND: The intense interactions between people, animals and environmental systems in urban informal settlements compromise human and environmental health. Inadequate water and sanitation services, compounded by exposure to flooding and climate change risks, expose inhabitants to environmental contamination causing poor health and wellbeing and degrading ecosystems. However, the exact nature and full scope of risks and exposure pathways between human health and the environment in informal settlements are uncertain. Existing models are limited to microbiological linkages related to faecal-oral exposures at the individual level, and do not account for a broader range of human-environmental variables and interactions that affect population health and wellbeing.
METHODS: We undertook a 12-month health and environmental assessment in 12 flood-prone informal settlements in Makassar, Indonesia. We obtained caregiver-reported health data, anthropometric measurements, stool and blood samples from children

Matched MeSH terms: Sanitation
The war using microbes: A sustainable approach for wastewater management

Priya AK, Pachaiappan R, Kumar PS, Jalil AA, Vo DN, Rajendran S

Environ Pollut, 2021 Apr 15;275:116598.
PMID: 33581625 DOI: 10.1016/j.envpol.2021.116598

Anthropogenic activities and population growth have resulted in a reduced availability of drinking water. To ensure consistency in the existence of drinking water, it is inevitable to establish wastewater treatment plants (WWTPs). 70% of India's rural population was found to be without WWTP, waste disposal, and good sanitation. Wastewater has emerged from kitchens, washrooms, etc., with industry activities. This scenario caused severe damage to water resources, leading to degradation of water quality and pathogenic insects. Thus, it is a need of an hour to prompt for better WWTPs for both rural and urban areas. Many parts of the world have started to face severe water shortages in recent years, and wastewater reuse methods need to be updated. Clean water supply is not enough to satisfy the needs of the planet as a whole, and the majority of freshwater in the polar regions takes the form of ice and snow. The increasing population requires clean water for drinks, hygiene, irrigation, and various other applications. Lack of water and contamination of water result from human activities. 90% of wastewater is released to water systems without treatment in developing countries. Studies show that about 730 megatons of waste are annually discharged into water from sewages and other effluents. The sustenance of water resources, applying wastewater treatment technologies, and calling down the percentage of potable water has to be strictly guided by mankind. This review compares the treatment of domestic sewage to its working conditions, energy efficiency, etc. In this review, several treatment methods with different mechanisms involved in waste treatment, industrial effluents, recovery/recycling were discussed. The feasibility of bioaugmentation should eventually be tested through data from field implementation as an important technological challenge, and this analysis identifies many promising areas to be explored in the future.

Matched MeSH terms: Sanitation
Fulltext A holistic approach to promoting early child development: a cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh

Pitchik HO, Tofail F, Rahman M, Akter F, Sultana J, Shoab AK, et al.

BMJ Glob Health, 2021 03;6(3).
PMID: 33727278 DOI: 10.1136/bmjgh-2020-004307

INTRODUCTION: In low- and middle-income countries, children experience multiple risks for delayed development. We evaluated a multicomponent, group-based early child development intervention including behavioural recommendations on responsive stimulation, nutrition, water, sanitation, hygiene, mental health and lead exposure prevention.
METHODS: We conducted a 9-month, parallel, multiarm, cluster-randomised controlled trial in 31 rural villages in Kishoreganj District, Bangladesh. Villages were randomly allocated to: group sessions ('group'); alternating groups and home visits ('combined'); or a passive control arm. Sessions were delivered fortnightly by trained community members. The primary outcome was child stimulation (Family Care Indicators); the secondary outcome was child development (Ages and Stages Questionnaire Inventory, ASQi). Other outcomes included dietary diversity, latrine status, use of a child potty, handwashing infrastructure, caregiver mental health and knowledge of lead. Analyses were intention to treat. Data collectors were independent from implementers.
RESULTS: In July-August 2017, 621 pregnant women and primary caregivers of children<15 months were enrolled (group n=160, combined n=160, control n=301). At endline, immediately following intervention completion (July-August 2018), 574 participants were assessed (group n=144, combined n=149, control n=281). Primary caregivers in both intervention arms participated in more play activities than control caregivers (age-adjusted means: group 4.22, 95% CI 3.97 to 4.47; combined 4.77, 4.60 to 4.96; control 3.24, 3.05 to 3.39), and provided a larger variety of play materials (age-adjusted means: group 3.63, 3.31 to 3.96; combined 3.81, 3.62 to 3.99; control 2.48, 2.34 to 2.59). Compared with the control arm, children in the group arm had higher total ASQi scores (adjusted mean difference in standardised scores: 0.39, 0.15 to 0.64), while in the combined arm scores were not significantly different from the control (0.25, -0.07 to 0.54).
CONCLUSION: Our findings suggest that group-based, multicomponent interventions can be effective at improving child development outcomes in rural Bangladesh, and that they have the potential to be delivered at scale.
TRIAL REGISTRATION NUMBER: The trial is registered in ISRCTN (ISRCTN16001234).

Matched MeSH terms: Sanitation*
Fulltext The Neglected Cestode Infection: Epidemiology of Hymenolepis Nana Infection Among Children in Rural Yemen

Al-Mekhlafi HM

Helminthologia, 2020 Dec;57(4):293-305.
PMID: 33364898 DOI: 10.2478/helm-2020-0038

Hymenolepis nana is the most common cestode reported in humans worldwide. It is prevalent among children in the tropics and subtropics, particularly in rural poor communities where sanitation is inadequate or lacking. This cross-sectional study aims to determine the prevalence and significant risk factors of H. nana infection among children in rural Yemen. Faecal samples were collected from 498 children and screened for intestinal parasites by using wet mount, formalin-ether concentration and Kato-Katz techniques. A pretested questionnaire was used to collect demographic, socioeconomic, housing condition, and personal hygiene information. Overall, 77.5 % (386/498) of the children were found to be infected by at least one intestinal parasite species. The overall prevalence of H. nana was 17.5 % (87/498). Multivariate analysis confirmed that an age of < 6 years (adjusted odds ratio [AOR] = 4.28; 95 % (confidence interval [CI] = 2.04, 8.98), presence of other family members infected with H. nana (AOR = 2.48; 95 % CI = 1.45, 4.24), living in the highlands (AOR = 2.87; 95 % CI = 1.56, 5.26), living in a house without improved toilet facilities (AOR = 2.19; 95 % CI = 1.23, 3.88), not washing vegetables before consumption (AOR = 2.11; 95 % CI = 1.06, 4.19), and not washing hands after defecation (AOR = 1.88; 95 % CI = 1.08, 3.27) were the key factors significantly associated with H. nana infection among the studied children. In conclusion, H. nana is prevalent among children in rural Yemen, particularly among preschool-aged children. Thus, an integrated and effective programme to control intestinal parasitic infections should include preschool-aged children. Such a programme should focus on providing health education on hygienic practices, providing adequate sanitation and improved sources of drinking water, and screening and treating other infected family members.

Matched MeSH terms: Sanitation
Fulltext High incidence of asymptomatic leptospirosis among urban sanitation workers from Kota Kinabalu, Sabah, Malaysian Borneo

Jeffree MS, Mori D, Yusof NA, Atil AB, Lukman KA, Othman R, et al.

Sci Rep, 2020 11 10;10(1):19442.
PMID: 33173153 DOI: 10.1038/s41598-020-76595-0

Leptospirosis is a public health challenge in Sabah State of Malaysian Borneo. Rapid urbanization, rural-to-urban migration, and undocumented immigration in Sabah have increased the pressure on the urban garbage disposal system. Rodents and other small animals thrive under these conditions. We hypothesized that urban sanitation workers would be at risk of developing leptospirosis. In total, 303 urban sanitation workers with a mean age of 42.6 years were enrolled in this study. The serum samples collected from these workers were subjected to the microscopic agglutination test (MAT), PCR and nucleotide sequencing of the amplicons to confirm the presence of Leptospira. The phylogenetic analysis using the neighbor joining method was performed to assess whether they were pathogenic. In this study 43.8% (133/303) of the samples were MAT-seropositive and among them, 29 (21.8%) were positive by PCR. Nucleotide sequencing of the amplicons confirmed the presence of Leptospira. Phylogenetic analysis showed that our strains belonged to the pathogenic group of Leptospira. A high proportion of urban sanitation workers were seropositive for leptospirosis, and a considerable number were PCR positive for Leptospira, thereby indicating asymptomatic infections. Further research is needed to confirm whether this is a transient phenomenon or antibiotic therapy is required.

Matched MeSH terms: Sanitation/statistics & numerical data*
Fulltext Socio-Economic Factors Related to Drinking Water Source and Sanitation in Malaysia

Kong YL, Anis-Syakira J, Fun WH, Balqis-Ali NZ, Shakirah MS, Sararaks S

Int J Environ Res Public Health, 2020 10 29;17(21).
PMID: 33137998 DOI: 10.3390/ijerph17217933

Access to improved water and sanitation is essential. We describe these practices in Malaysia using data from a nationwide community survey and used logistic regression to assess the determinants. Of the 7978 living quarters (LQs), 58.3% were in urban areas. About 2.4%, 0.5% and 27.4% of LQs had non-improved water sources, non-improved toilet types and improper domestic waste disposal, respectively. Open burning was practiced by 26.1%. Water source was a problem for long houses (10.5%), squatters (8.5%) and shared houses (4.0%). Non-improved toilet types were 11.9% for squatters and 4.8% for shared houses. Improper domestic waste disposal practices were higher for occupants of village houses (64.2%), long houses (54.4%), single houses (45.8%) and squatters (35.6%). An increase in education or income level was associated with a decrease in improper domestic waste disposal methods. House type significantly affected water and sanitation after adjusting for the effects of other variables. Lower household income was associated with non-improved toilet types and improper domestic waste disposal. Lower education and rural location influenced domestic waste disposal. The water and toilet facilities in Malaysia were generally good, while domestic waste management practices could be improved. There remain pockets of communities with environmental challenges for the nation.

Matched MeSH terms: Sanitation*
Prevalence and intensity of helminths among inhabitants of the Chi River and Lahanna water reservoir areas of Northeastern Thailand

Rattanapitoon SK, Pechdee P, Boonsuya A, Meererksom T, Wakkhuwatapong P, Leng M, et al.

Trop Biomed, 2020 Sep 01;37(3):730-743.
PMID: 33612786 DOI: 10.47665/tb.37.3.730

Helminth infections (HIs) are an important public health problem in tropical countries, and the associated problems have been neglected in rural areas of Thailand. Therefore, this study reports the prevalence and intensity of HIs among inhabitants of the Khon Sawan district, Chaiyaphum province, and Kaeng Samnam Nang district, Nakhon Ratchasima province, which are located near the Chi River and Lahanna water reservoir, northeastern Thailand. A cross-sectional descriptive study was conducted between July 31, 2018, and June 30, 2019, among rural villagers from 40 rural villages in 4 subdistricts. The participants were selected from the village enrolment list after proportional allocation of the total sample size. Faecal samples from 691 inhabitants were prepared using solvent-free faecal parasite concentrator, and helminths were then detected using a light microscope. Statistical analysis included the Chi-square test with Yates correction, and multivariable logistic regression was performed. A P-value of <0.05 was considered statistically significant. The prevalence of HIs was 2.03%. The most prevalent helminths were Opisthorchis viverrini (1.31%), followed by Strongyloides stercoralis (0.44%), Ascaris lumbricoides (0.29%), hookworm (0.15%), Teania spp. (0.15%) and one minute intestinal fluke (0.15%). Coinfections were identified in 2 cases for S. stercoralis and hookworm and 1 case for O. viverrini and S. stercoralis infection. All infected participants had a light intensity of HI. There was no significant difference between general characteristics for all HIs. The prevalence of HIs was not significantly associated with general characteristics. This study indicates that the infections result mainly from foodborne helminths and skin-penetrating nematodes. Therefore, interventions should concentrate on the personal hygiene of the population and improving sanitation to reduce HIs in this area.

Matched MeSH terms: Sanitation
Fulltext The Power of Multidimensional Poverty in Explaining Life Expectancy: Empirical Evidence from Cross-Sectional Data of 62 Developing Countries

Tafran K, Tumin M, Osman AF

Iran J Public Health, 2020 Sep;49(9):1709-1717.
PMID: 33643946 DOI: 10.18502/ijph.v49i9.4088

Background: We examined whether multidimensional poverty index (MPI) explained variations in life expectancy (LE) better than income poverty; and assessed the relative importance of MPI indicators in influencing LE.
Methods: Cross-sectional data from 62 developing countries were used to run several multivariate linear regressions. R2 was used to compare the powers of MPI with income-poverties (income poverty gaps [IPG] at 1.9 and 3.1 USD) in explaining LE.
Results: Adjusting for controls, both MPI (β =-0.245, P<0.001) and IPG at 3.1 USD (β=-0.135, P=0.044) significantly correlates with LE, but not IPG at 1.9 USD (β=-0.147, P=0.135). MPI explains 12.1% of the variation in LE compared to only 3.2% explained by IPG at 3.1 USD. The effect of MPI on LE is higher on female (β=-0.210, P<0.001) than male (β=-0.177, P<0.001). The relative influence of the deprivation indictors on LE ranks as follows (most to least): Asset ownership, drinking water, cooking fuel, flooring, child school attendance, years of schooling, nutrition, mortality, improved sanitation, and electricity.
Conclusion: Interventions to reduce poverty and improve LE should be guided by MPI, not income poverty indices. Such policies should be female-oriented and prioritized based on the relative influence of the various poverty deprivation indicators on LE.

Matched MeSH terms: Sanitation
The analyze toddler growth and development according to family's economic status in Village Limau Manis, Districts Tanjung Morawa

Pangaribuan IK, Simanullang E, Poddar S

Enferm Clin, 2020 06;30 Suppl 5:92-95.
PMID: 32713594 DOI: 10.1016/j.enfcli.2019.11.029

The toddler stage is a golden period and at the same time a critical period for a child, since he / she will experience rapid brain growth and development so that he/ she need sufficient nutrition intake. Toddler's abnormal growth and development are usually found in low economic community because they cannot afford to provide their need for basic food for their toddler's growth and development. The objective of the research was to analyze toddler's growth and development according to family's economic status. The research used descriptive analytic method with cross-sectional design. It was conducted at Limau Manis Village, Tanjung Morawa Subdistrict, Deli Serdang Regency, from January to June 2016. The population was 1899 toddlers, and 113 of them were used as the samples, taken by using simple random sampling technique. The data were gathered by using questionnaires to find out toddler's growth and development according to family's economic status. The result of univariate analysis showed that 57 toddlers (50.4%) had abnormal growth and development. The result of bivariate analysis with chi-square test showed that there was the correlation of toddler's growth and development with economic status (p value=0.004), women's care pattern (p value=0.028), and environmental sanitation (p value=0.01). Therefore, empowerment of family's economy through the development of family's nutrition portfolio is necessary.

Matched MeSH terms: Sanitation
Sanitation of Ro-Ro vessel at the port of ferry branch Merak Banten - Indonesia

Mukhlasin, Fitri M, Elengoe A

Enferm Clin, 2020 06;30 Suppl 5:213-215.
PMID: 32713573 DOI: 10.1016/j.enfcli.2019.11.057

Ship Sanitation is one of the efforts to overcome several factors of the physical environment that are needed for the main creatures' things that have the damaging effects of physical development, health, and survival. What is done on a transport device that uses a machine or screen that travels nationally or internationally. This type of research uses descriptive methods with a sample of all Ro-Ro vessels at the Merak Ferry Port of 20 ships. Data collection using ship sanitation observation sheets. The results of the study with univariate analysis showed the condition of kitchen sanitation on Ro-Ro vessels which were categorized as not meeting the requirements of 55%, the sanitary conditions of the food raft room category fulfilled the requirements of 85%, the sanitation conditions 80%, the physical conditions of drinking water 100%, the sanitation requirements of the facilities 70% medical, Ro-Ro ship sanitation requirements do not meet the requirements of 53%. Through this research, the authors expect the efforts of related parties to improve the sanitation of Ro-Ro vessels to be safe by increasing sanitation production of clean and healthy Ro-Ro ships.

Matched MeSH terms: Sanitation*
Coevolutionary Governance of Antibiotic and Pesticide Resistance

Søgaard Jørgensen P, Folke C, Henriksson PJG, Malmros K, Troell M, Zorzet A, et al.

Trends Ecol Evol, 2020 Jun;35(6):484-494.
PMID: 32396815 DOI: 10.1016/j.tree.2020.01.011

Development of new biocides has dominated human responses to evolution of antibiotic and pesticide resistance. Increasing and uniform biocide use, the spread of resistance genes, and the lack of new classes of compounds indicate the importance of navigating toward more sustainable coevolutionary dynamics between human culture and species that evolve resistance. To inform this challenge, we introduce the concept of coevolutionary governance and propose three priorities for its implementation: (i) new norms and mental models for lowering use, (ii) diversifying practices to reduce directional selection, and (iii) investment in collective action institutions to govern connectivity. We highlight the availability of solutions that facilitate broader sustainable development, which for antibiotic resistance include improved sanitation and hygiene, strong health systems, and decreased meat consumption.

Matched MeSH terms: Sanitation
Risk factors associated with soil transmitted helminth (STH) infection in two indigenous communities in Malaysia

Nisha M, Aiman M, Asyhira N, Syafiq H, Atiqah N, Kumarasamy V, et al.

Trop Biomed, 2020 Jun 01;37(2):379-388.
PMID: 33612807

Soil-transmitted helminth (STH) could possibly cause mild to severe health effects such as diarrhea, weakness, intestinal blood loss, and impaired cognitive development and growth. In Malaysia, previous studies depicted a high prevalence rate of STH was due to poor hygiene practice and low efficacies of anthelminthic drugs. This study was conducted to investigate hand hygiene practice and WASH criteria's (Water, sanitation and hygiene) related to STH infection among two indigenous tribes in Peninsular Malaysia. A cross-sectional study was carried out to study the relationship among STH infection compared to water quality, sanitation, and hygiene conditions. A total of 190 individuals from two indigenous villages participated in the study, with ages ranging from 5 to 60 years old. In addition, Pearson's Chisquare (X2) test was utilized to test the relationship among STH with demographic socioeconomic and behavioral factors. The confidence interval (CI) of 95% is used to estimate the precision of the odds ratio (OR). Multivariate logistic regression models were also used to identify the risk factors associated with STH infections. The overall findings indicated a prevalence rate of 72% for STH, and distributed mainly among children aged < 12 years. Furthermore, multivariate analyses using logistic regression revealed chronic health problems, incorrect hand washing, and walking bare footed were associated with STH infection. Overall results indicated high prevalence of STH among the indigenous villagers, which aligns with the published literature and proves to be a problem need to be addressed as neglected disease. Interestingly, there was a significant relationship between the presences of chronic diseases and STH infection, which prompted other questions the awareness needs to be educated and the simple and low-cost intervention on the proper way of hand washing may help to reduce STH infection in these indigenous communities.

Matched MeSH terms: Sanitation
Fulltext Devastating urban flooding and dengue outbreak during the COVID-19 pandemic in Pakistan

Junaid Tahir M, Rizwan Siddiqi A, Ullah I, Ahmed A, Dujaili J, Saqlain M

Med J Islam Repub Iran, 2020;34:169.
PMID: 33816368 DOI: 10.47176/mjiri.34.169

Pakistan has recently been overwhelmed by extreme torrential rains, with its most populous city of Karachi experiencing its worst floods in almost a century. Poor flood control and water disposal facilities have led to an immense risk of another dengue outbreak, with multiple cases being reported recently. The enormous accumulation of stagnant water in urban areas is a major source of mosquito breeding and transmission. Historical data has shown the correlation between the number of dengue cases and average rainfall in the region. The monsoon rains have pounded at a time where health authorities are battling to contain the Coronavirus (COVID-19) pandemic. There is a need to implement centralized dengue control strategies to undertake large scale water drainage, sanitation, and disinfection drives in disaster-stricken areas alongside public health awareness programs to combat the after-effects of this natural calamity.

Matched MeSH terms: Sanitation
Fulltext Prevalence and risk factors of geohelminthiasis among the rural village children in Kota Marudu, Sabah, Malaysia

Lim-Leroy A, Chua TH

PLoS One, 2020;15(9):e0239680.
PMID: 32986746 DOI: 10.1371/journal.pone.0239680

Geohelminthiasis is a worldwide problem, especially in low-income countries. Children from rural areas and those living in poverty, lacking basic health amenities and having poor environmental sanitation are likely to be affected. Adverse effects such as anemia, protein malnutrition, colitis are common which can affect both the children's physical and mental growing development. A cross-sectional study on geohelminthiasis was conducted among children from 238 households in 13 villages in Kota Marudu of northern Sabah, East Malaysia. The study involved interviewing villagers using questionnaires to collect demographic and socio-economic data, getting faecal samples from the children, collecting soil samples and identifying parasite eggs with microscopy and molecular methods. A total of 407 children (6 months-17 years old) enrolled in the study. Geohelminthiasis was detected in the faecal samples of children from 54% (7/13) of the villages with mean prevalence of infection per village of 9.0% (0%-34.9%). On a household basis, 18% (43/238) of the households sampled had infected children, with mean prevalence rate per household of 11% (0%-43%). The prevalence was for Ascaris lumbricoides: 9.6% (39/407), Trichuris trichiura: 2.7% (11/407) and hookworms (Necator americanus and Ancylostoma sp.): 2.7% (11/407). The overall mean infection rate of the children examined was 14.3%. Significantly higher prevalence was recorded for the children of mothers who did not have any formal education (p = 0.003); household income of less than USD119 (RM500) (p<0.001); children from homes without proper sanitation facilities (p<0.001); children who usually go about barefoot (p<0.001) and not washing feet before entering the house (p = 0.017). Soil samples were found to have geohelminth eggs or larvae which could be due to unhygienic sanitation practices. This study shows the geohelminthiasis is prevalent in the villages, and the risk factors are lack of maternal education, low income, poor sanitation facilities and irregular deworming practice. Expanding deworming coverage in the study region may help reduce the worm infections in these communities, so that the mental and physical development of the children would not be affected by geohelminthiasis. The data on the prevalence of geohelminthiasis in this study would contribute to better public health monitoring and operation to reduce the infection in rural areas.

Matched MeSH terms: Sanitation
Fulltext Spatial analysis of food poisoning cases and its environmental relations in Sabah, Malaysia

Syed Sharizman Syed Abdul Rahim

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):4-4.
MyJurnal

Introduction: Food poisoning usually occurs with the consumption of contaminated food. Some related factors are unsafe water supply, poor sanitation, unhygienic waste disposal and unhygienic practices or poor personal hygiene by food handlers. The purpose of this study is to describe the spatial epidemiology of food poisoning cases in the four districts of Sabah. Methods: This review consists of all food poisoning cases reported from 2011 to 2014 from Kota Kinabalu, Penampang, Putatan and Papar, Sabah. The coordinates used for locations of cases are based on home addresses. Tools such as SPSS v20, ArcGIS v10 and CrimeStat IV were used for data analysis and mapping. Results: A total of 1,787 cases of food poisoning were reported during this review period. In 2011, only Kota Kinabalu and Pa-par illustrated significant food poisoning clusters. Meanwhile, in the year 2012 to 2014, Kota Kinabalu, Penampang and Putatan had clustering of cases. Analysis of nearest neighbour hierarchical clustering analysis showed 32 food poisoning clusters. There were 4 food poisoning points at 500 meters radius around a market place, 2 food poisoning points near a sewage plant and 1 food poisoning point near a water treatment plant. No cases were near a municipal landfill. For rivers and coastline, there were 37 points of food poisoning cases in the proximity of 500 meters. Con-clusion: Food poisoning usually occurs in clusters with possible associated environmental factors.

Matched MeSH terms: Sanitation
Fulltext Characterisation and correlates of stunting among Malaysian children and adolescents aged 6-19 years

Partap U, Young EH, Allotey P, Sandhu MS, Reidpath DD

Glob Health Epidemiol Genom, 2019;4:e2.
PMID: 30891249 DOI: 10.1017/gheg.2019.1

Background: Despite emerging evidence regarding the reversibility of stunting at older ages, most stunting research continues to focus on children below 5 years of age. We aimed to assess stunting prevalence and examine the sociodemographic distribution of stunting risk among older children and adolescents in a Malaysian population.
Methods: We used cross-sectional data on 6759 children and adolescents aged 6-19 years living in Segamat, Malaysia. We compared prevalence estimates for stunting defined using the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) references, using Cohen's κ coefficient. Associations between sociodemographic indices and stunting risk were examined using mixed-effects Poisson regression with robust standard errors.
Results: The classification of children and adolescents as stunted or normal height differed considerably between the two references (CDC v. WHO; κ for agreement: 0.73), but prevalence of stunting was high regardless of reference (crude prevalence: CDC 29.2%; WHO: 19.1%). Stunting risk was approximately 19% higher among underweight v. normal weight children and adolescents (p = 0.030) and 21% lower among overweight children and adolescents (p = 0.001), and decreased strongly with improved household drinking water sources [risk ratio (RR) for water piped into house: 0.35, 95% confidence interval (95% CI) 0.30-0.41, p < 0.001). Protective effects were also observed for improved sanitation facilities (RR for flush toilet: 0.41, 95% CI 0.19-0.88, p = 0.023). Associations were not materially affected in multiple sensitivity analyses.
Conclusions: Our findings justify a framework for strategies addressing stunting across childhood, and highlight the need for consensus on a single definition of stunting in older children and adolescents to streamline monitoring efforts.

Matched MeSH terms: Sanitation/standards*
Intestinal parasitic infections frequency in referred patients to a large teaching hospital, Khuzestan, Southwest, Iran, 2017

Feiz Haddad MH, Maraghi S, Ali SA, Feiz Haddad R, Nasser Zadeh R

Trop Biomed, 2018 Dec 01;35(4):915-925.
PMID: 33601841

Intestinal parasitic infections (IPIs) are among the most important infectious diseases in Iran. A cross sectional study was designed to determine frequency of intestinal parasites among referrals to a large teaching hospital in Khuzestan, Southwest of Iran, 2017. A total number of 5613 stool samples were examined through direct smear and formalin-ether concentration methods to detect possible parasitic infections. Samples consisted of 2643 (47.09%) male and 2970 (52.91%) female. A total of 1468 (26.15%) samples were positive (13.11% male and 13.4% female) and 4145 (73.85%) were negative. The results also showed that 255 of samples had more than one type of parasite (mix infections). Counting single and mix parasite infections, the total number of positive cases reached to 1723. Helminthes parasites were present in 12 (0.7%) cases, while intestinal protozoan parasites were in 1711 (99.3%) cases. Almost equally, pathogenic and nonpathogenic parasites infected 860 (49.91%) and 863 (50.09%) of patients, respectively. The frequency for helminthes was determined at 0.52% with Hymenolepis nana and Enterobius vermicularis however, Giardia lamblia in 38.54% and Entamoeba histolytica/dispar at 10.68% were concluded as protozoa elements. The IPIs frequency was recorded in female and male patients at 49.16% and 50.14%, respectively. According to the current results the infection rate of intestinal parasites has been significantly reduced especially for helminths infections in this region possibly due to public attention to health issues such as; increased awareness of people, improvement of sanitation, seasonal variations, health education and personal hygiene.

Matched MeSH terms: Sanitation
Diagnostics of intestinal parasites by light microscopy among the population of children between the ages of 4-12 in eastern Turkey

Babat SO, Sirekbasan S, Macin S, Kariptas E, Polat E

Trop Biomed, 2018 Dec 01;35(4):1087-1091.
PMID: 33601855

Intestinal parasitic infections are among important health problems in developing countries. In societies living in low socioeconomic conditions, it has been neglected and mostly affects children. It is important to determine the prevalence and type of intestinal parasites in order to determine the intervention strategies for these infections. Therefore, the aim of this study is to evaluate intestinal parasite prevalence and IgE levels and the factors associated with the region in which the children population live, in Sirnak province, in the eastern of Turkey. A total of 357 symptomatic children aged 4 to 12 years, who were admitted to the Paediatric Polyclinic of Sirnak State Hospital, were examined prospectively. The collected stool samples were examined with direct wet-mount and concentration method under light microscope. In addition, total serum IgE levels were compared among 223 children with parasitic disease and 134 children without parasitic disease. One or more intestinal parasites were detected in 223 out of the 357 children participating in the study. The ratio of single, double, and triple parasitic infections in children was 32.5 %, 22.4 % and 7.6 %, respectively. The most common parasites determined in the study were Taenia spp. (39.9%), Enterobius vermicularis (38.6%) and Giardia intestinalis. (30 %). The difference between IgE levels determined in both groups was not regarded to be statistically significant. This study indicated that that intestinal polyparism is very common in children living in the province of Sirnak, which is located in the east of Turkey, neighbouring Iraq and Syria in the South. For this reason, sustainable control measures are urgently needed to improve personal hygiene and sanitation, to provide a healthy infrastructure and to improve the quality of existing water resources.

Matched MeSH terms: Sanitation

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