Displaying publications 1 - 20 of 343 in total

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  1. Lawson-Wood K, Jaafar M, Felipe-Sotelo M, Ward NI
    Environ Sci Pollut Res Int, 2021 Sep;28(35):48929-48941.
    PMID: 33928502 DOI: 10.1007/s11356-021-13902-w
    Some regions of Argentina are affected by high concentrations of molybdenum, arsenic and vanadium from natural sources in their groundwater. In particular, Mo levels in groundwater from Eduardo Castex (La Pampa, Argentina) typically exceed the guidelines for drinking water formerly established by WHO at 70 μg/L. Therefore, this study investigated the uptake of Mo in plants, using cress (Lepidium sativum L.) as a model using hydroponic experiments with synthetic solutions and groundwater from La Pampa. Cress grown from control experiments (150 μg/L Mo, pH 7) presented an average Mo concentration of 35.2 mg/kg (dry weight, d.w.), higher than the typical total plant range (0.7-2.5 mg/kg d.w.) in the literature. Using pooled groundwater samples (65.0-92.5 μg/L Mo) from wells of La Pampa (Argentina) as growth solutions resulted in significantly lower cress Mo levels (1.89-4.59 mg/kg d.w.) than were obtained for synthetic solutions of equivalent Mo concentration. This may be due to the high levels in these groundwater samples of As, V, Fe and Mn which are known to be associated with volcanic deposits. This research addressed the hitherto scarcity of data about the effect of various physicochemical parameters on the uptake of Mo in plants.
    Matched MeSH terms: Drinking Water*
  2. Guo M, Tan CL, Wu L, Peng J, Ren R, Chiu CH
    PMID: 34682476 DOI: 10.3390/ijerph182010729
    With the development of the network economy, especially the promotion and popularization of mobile networks, traditional offline businesses are further integrated with online businesses, promoting the development of business online strategies. However, with the growth of enterprises' business, their negative externalities on the environment have gradually become prominent, further affecting sustainable consumption. The relationships between businesses, the environment, and consumption have become the focus of attention. China's fast-growing bottled water companies face similar challenges. The pollution that occurs due to bottled water packaging poses great threats to consumers. Hence, this study extended the Theory of Planned Behavior (TPB) by integrating three risk aspects, namely, water pollution risk perception (WPRP), non-degradable package pollution risk perception (NPPRP), and false information risk perception (FIRP), to examine the consumers' perceptions toward these risk aspects before purchasing bottled water online. This study employed a cross-sectional approach to collect data from online consumers via a survey method. A total of 401 valid samples were collected and then analyzed via a structural equation model using the AMOS statistical package. The results showed that attitude (AT), subjective norm (SN), and perceived behavior control (PBC) toward online bottled water purchase had significant and positive effects on the consumers' purchase intentions (PIs). However, under the influence of risk perception, the consumers' attitudes, SNs and PBC became suppressed by WPRP, and SN became suppressed due to the impact of FIRP. Furthermore, the negative impacts of NPPRP and FIRP on PI were partially mediated by AT, SN and PBC. Meanwhile, WPRP imposed the most significant direct effect on PI. The study results will help businesses to develop better online strategies to reduce the risk perception of bottled water and provide theoretical value and practical guidance for realizing sustainable consumption.
    Matched MeSH terms: Drinking Water*
  3. Manimegalai S, Vickram S, Deena SR, Rohini K, Thanigaivel S, Manikandan S, et al.
    Chemosphere, 2023 Jan;312(Pt 1):137319.
    PMID: 36410505 DOI: 10.1016/j.chemosphere.2022.137319
    Water treatment is a worldwide issue. This review aims to present current problems and future challenges in water treatments with the existing methodologies. Carbon nanotube production, characterization, and prospective uses have been the subject of considerable and rigorous research around the world. They have a large number of technical uses because of their distinct physical characteristics. Various catalyst materials are used to make carbon nanotubes. This review's primary focus is on integrated and single-treatment technologies for all kinds of drinking water resources, including ground and surface water. Inorganic non-metallic matter, heavy metals, natural organic matter, endocrine-disrupting chemicals, disinfection by-products and microbiological pollutants are among the contaminants that these treatment systems can remediate in polluted drinking water resources. Significant advances in the antibacterial and adsorption capabilities of carbon-based nanomaterials have opened up new options for excluding organic/inorganic and biological contaminants from drinking water in recent years. The advancements in multifunctional nanocomposites synthesis pave the possibility for their use in enhanced wastewater purification system design. The adsorptive and antibacterial characteristics of six main kinds of carbon nanomaterials are single-walled carbon nanotubes, multi-walled carbon nanotubes, graphene, graphene oxide, fullerene and single-walled carbon nanohorns. This review potentially addressed the essential metallic and polymeric nanocomposites, are described and compared. Barriers to use these nanoparticles in long-term water treatment are also discussed.
    Matched MeSH terms: Drinking Water*
  4. Naderipour A, Nowdeh SA, Babanezhad M, Najmi ES, Kamyab H, Abdul-Malek Z
    Environ Sci Pollut Res Int, 2023 Jun;30(28):71754-71765.
    PMID: 34499303 DOI: 10.1007/s11356-021-16342-8
    In this paper, the technical-economic framework for designing of water pumping system based on photovoltaic clean energy with water tank storage is presented to supply drinking water of customers for remote areas. The objective function is to minimize the net present cost (NPC) (as economic index) including initial investment costs, maintenance, and replacement costs, and reliability constraint is defined as customer's water not supplied probability (CWNSP) as technical index. A meta-heuristic intelligent water drops algorithm (IWDA) is proposed to optimize the solar water pumping system considering NPC and CWNSP with high accuracy and speed of optimization in achieving the global solution. The simulation results show that the proposed method is capable of responding to customer's water demand by optimally sizing components and water storage tank based on IWDA which is inspired based on flowing the water drops in rivers by achieving the lowest cost with optimal reliability. The NPC of the system with CWNSP equal to 3.17 % is obtained 0.24 M$ for 6-m-high water extraction. The results showed that with increasing the water extraction height, the NPC increased, and the reliability also weakened. Moreover, the superiority of the IWDA is confirmed compared with particle swarm optimization (PSO) in designing a water pumping system with the lowest NPC.
    Matched MeSH terms: Drinking Water*
  5. Praveena SM, Aris AZ, Hashim Z, Hashim JH
    J Expo Sci Environ Epidemiol, 2024 Jan;34(1):161-174.
    PMID: 37563210 DOI: 10.1038/s41370-023-00585-3
    BACKGROUND: Like other countries, surface water degradation in Malaysia is linked with common global issues. Although different aspects of drinking water suitability have been examined, the overall understanding of drinking water quality in Malaysia is poor.

    OBJECTIVE: Hence, the present review aims to provide an understanding of drinking water (tap water, groundwater, gravity feed system) quality and its potential implications on policy, human health, and drinking water management law and identification of potential direction of future drinking water research and management needs in Malaysia.

    METHODS: This study utilized a scoping review method. PRISMA Extension for Scoping Reviews was used for search strategy. Relevant studies were screened using the selected keywords and databases.

    RESULTS: A total of 26 drinking water quality studies involving tap water, groundwater, and gravity feed systems have been selected for review. These studies found that the majority of Malaysian Drinking Water and WHO Drinking Water standards have been met. High levels of Cu, Cd, Fe and Pb were attributable to galvanized plumbing and pipe material corrosion. Variation of fluoride in tap water depends on dosage planning and operational processes of the public water supply. Pollutants (nitrate and ammonia) in groundwater and gravity feed system water have been linked to agricultural practices in rural areas. Microbiological quality in tap water is associated with growing biofilms inside the pipelines while in groundwater is caused by shallow surface events. However, only eight studies have reported about the human risks of chemical pollutants in tap water.

    IMPACT STATEMENT: The review discusses the state of drinking water quality in Malaysia and its impact on public health. It suggests that policymakers can use this information to improve the quality of drinking water and enforce restrictions, while also raising public awareness about the importance of safe drinking water. The study can guide future research and initiatives in Malaysia, ultimately contributing to efforts to ensure access to clean and dependable drinking water.

    Matched MeSH terms: Drinking Water*
  6. Hussain A, Maitra J, Saifi A, Ahmed S, Ahmed J, Shrestha NK, et al.
    Environ Res, 2024 Mar 01;244:117952.
    PMID: 38113992 DOI: 10.1016/j.envres.2023.117952
    In developing countries like India, an economically viable and ecologically approachable strategy is required to safeguard the drinking water. Excessive fluoride intake through drinking water can lead to dental fluorosis, skeletal fluorosis, or both. The present study has been under with an objective to investigate the feasibility of using cellulose derived from coconut fiber as an adsorbent under varying pH conditions for fluoride elimination from water. The assessment of equilibrium concentration of metal ions using adsorption isotherms is an integral part of the study. This present finding indicates the considerable effect of variation of adsorbent dosages on the fluoride removal efficiency under constant temperature conditions of 25 ± 2 °C with a contact period of 24 h. It is pertinent to mention that maximum adsorption of 88% has been observed with a pH value of 6 with 6 h time duration with fluoride dosage of 50 mg/L. The equilibrium concentration dwindled to 0.4 mg/L at fluoride concentration of 20 mg/L. The Langmuir model designates the adsorption capacity value of 2.15 mg/L with initial fluoride concentration of 0.21 mg/g with R2 value of 0.660. Similarly, the adsorption capacity using Freundlich isotherms is found to be 0.58 L/g and 0.59 L/g with fluoride concentration of 1.84 mg/L and 2.15 mg/L respectively. The results from the present study confirm that coconut fiber possesses appropriate sorption capabilities of fluoride ion but is a pH dependent phenomenon. The outcomes of the study indicate the possible use of cellulose extracted from waste coconut fiber as a low-cost fluoride adsorbent. The present study can be well implemented on real scale systems as it will be beneficial economically as well as environmentally.
    Matched MeSH terms: Drinking Water*
  7. Yi S, Ngin C, Peltzer K, Pengpid S
    Subst Abuse Treat Prev Policy, 2017 06 26;12(1):32.
    PMID: 28651601 DOI: 10.1186/s13011-017-0117-2
    BACKGROUND: Heavy drinking among university students has been globally recognized as a major public health burden. In the Association of Southeast Asian Nations (ASEAN) region, studies on this issue have been scant, country-specific and in different time frames. The aim of this study was to identify social and behavioral factors associated with binge drinking among university students in nine ASEAN countries.

    METHODS: This cross-sectional study was conducted in 2015 among 8809 undergraduate university students from 13 universities in Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Vietnam using self-administered questionnaire. Multivariate logistic regression analyses were conducted to explore the associated factors.

    RESULTS: More than half (62.3%) of the study sample were female with a mean age of 20.5 (SD = 2.0) years. Of total, 12.8% were infrequent (

    Matched MeSH terms: Alcohol Drinking in College/psychology*; Binge Drinking/epidemiology*; Binge Drinking/psychology*
  8. Wee SY, Haron DEM, Aris AZ, Yusoff FM, Praveena SM
    Environ Geochem Health, 2020 Oct;42(10):3247-3261.
    PMID: 32328897 DOI: 10.1007/s10653-020-00565-8
    Active pharmaceutical ingredients (APIs) are typical endocrine disruptors found in common pharmaceuticals and personal care products, which are frequently detected in aquatic environments, especially surface water treated for drinking. However, current treatment technologies are inefficient for removing emerging endocrine disruptors, leading to the potential contamination of tap water. This study employed an optimized analytical method comprising solid-phase extraction and liquid chromatography-tandem mass spectrometry (SPE-LC-MS/MS) to detect APIs in tap water in Putrajaya, Malaysia. Several therapeutic classes of pharmaceuticals and personal care products, including anti-inflammatory drugs (dexamethasone and diclofenac), antibiotics (sulfamethoxazole and triclosan), antiepileptics (primidone), antibacterial agents (ciprofloxacin), beta-blockers (propranolol), psychoactive stimulants (caffeine), and antiparasitic drugs (diazinon), were detected in the range of 
    Matched MeSH terms: Drinking; Drinking Water/analysis*
  9. Jernigan DH
    J Public Health Policy, 1999;20(1):56-80.
    PMID: 10874398
    As evidence emerges showing alcohol's significant share of the global burden of disease, alcohol sales have flattened in the developed countries, but sales are rising in developing and post-communist countries. A three-year study sought to assess the growing impact of global alcohol transnationals in the developing and post-communist countries. Case studies in three countries--Malaysia, Zimbabwe, and Estonia--provide concrete examples of current global alcohol marketing policies and procedures. Recommendations stress the need for national and local governments, international bodies, non-governmental organizations, and the global alcohol companies to adopt specific measures designed to achieve improved monitoring of alcohol problems, greater public awareness of alcohol's impact, stronger and more effective regulation of the alcohol trade, and greater restraint on the part of the companies. Alcohol problems are too serious and too preventable for the world to be left thirsting for action.
    Matched MeSH terms: Alcohol Drinking*
  10. GUNN DR
    Med J Malaya, 1954 Sep;9(1):84-90.
    PMID: 13213457
    Matched MeSH terms: Drinking Behavior*
  11. Pulikkotil SJ, Nath S, Muthukumaraswamy, Dharamarajan L, Jing KT, Vaithilingam RD
    Community Dent Health, 2020 Feb 27;37(1):12-21.
    PMID: 32031339 DOI: 10.1922/CDH_4569Pulikkotil10
    OBJECTIVE: To determine whether alcohol consumption is associated with the risk of periodontitis.

    BASIC RESEARCH DESIGN: Systematic review and meta-analysis of observational studies performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines.

    METHOD: PubMed and Scopus were searched for eligible articles published in English from inception till November 2018. The quality of studies was assessed by the Newcastle Ottawa Scale. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated for the risk of periodontitis associated with highest versus lowest/non-alcohol in a random effects meta-analysis model. Heterogeneity and sensitivity were investigated in meta regression analysis. A funnel plot was used to assess publication bias.

    RESULTS: Twenty-nine observational studies were included. One study with two separate datasets was considered as two separate studies for analysis. Alcohol consumption was significantly associated with the presence of periodontitis (OR = 1.26, 95% CI= 1.11-1.41). Significant heterogeneity (I2=71%) was present in the overall analysis, primarily attributable to sampling cross-sectional studies (I2=76.6%). A funnel plot and Egger tests (p=0.0001) suggested the presence of publication bias.

    CONCLUSION: Alcohol consumption was associated with increased occurrence of periodontitis and should be considered as a parameter in periodontal risk assessment. Publication bias should be explored in future studies.

    Matched MeSH terms: Alcohol Drinking*
  12. Elfikrie N, Ho YB, Zaidon SZ, Juahir H, Tan ESS
    Sci Total Environ, 2020 Apr 10;712:136540.
    PMID: 32050383 DOI: 10.1016/j.scitotenv.2020.136540
    Agricultural activities have been arising along with the use of pesticides. The use of pesticides can impact not only on vector or other pest but also able to harm human health. Pesticide may leach from the irrigation of plant into the groundwater and in surface water. These waters could be sources of drinking water in a pesticides polluted area. This study aims to determine the occurrence pesticides in surface water and pesticides removal efficiency in a conventional drinking water treatment plant (DWTP) and the potential health risk to consumers. The study was conducted in Tanjung Karang, Selangor, Malaysia. Thirty river water samples and eighteen water samples from DWTP were collected. The water samples were extracted using solid phase extraction (SPE) before injected to the ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS). Five hundreds and ten respondents were interviewed using questionnaires to obtain information for health risk assessments. The results showed that propiconazole had the highest mean concentration (4493.1 ng/L) while pymetrozine had the lowest mean concentration (1.3 ng/L) in river water samples. The pesticides removal efficiencies in the conventional DWTP were 77% (imidacloprid), 86% (propiconazole and buprofezin), 88% (tebuconazole) and 100% (pymetrozine, tricyclazole, chlorantraniliprole, azoxystrobin and trifloxystrobin), respectively. The hazard quotients (HQs) and hazard index (HI) for all target pesticides were <1, indicating there was no significant chronic non-carcinogenic health risk due to consumption of the drinking water. Conventional DWTP was not able to completely remove four pesticide; thus, advanced treatment systems need to be considered to safeguard the health of the community in future.
    Matched MeSH terms: Drinking Water/chemistry*
  13. Ahmed MF, Mokhtar MB
    PMID: 32344678 DOI: 10.3390/ijerph17082966
    Although toxic Cd (cadmium) and Cr (chromium) in the aquatic environment are mainly from natural sources, human activities have increased their concentrations. Several studies have reported higher concentrations of Cd and Cr in the aquatic environment of Malaysia; however, the association between metal ingestion via drinking water and human health risk has not been established. This study collected water samples from four stages of the drinking water supply chain at Langat River Basin, Malaysia in 2015 to analyze the samples by inductivity coupled plasma mass spectrometry. Mean concentrations of Cd and Cr and the time-series river data (2004-2014) of these metals were significantly within the safe limit of drinking water quality standard proposed by the Ministry of Health Malaysia and the World Health Organization. Hazard quotient (HQ) and lifetime cancer risk (LCR) values of Cd and Cr in 2015 and 2020 also indicate no significant human health risk of its ingestion via drinking water. Additionally, management of pollution sources in the Langat Basin from 2004 to 2015 decreased Cr concentration in 2020 on the basis of autoregression moving average. Although Cd and Cr concentrations were found to be within the safe limits at Langat Basin, high concentrations of these metals have been found in household tap water, especially due to the contamination in the water distribution pipeline. Therefore, a two-layer water filtration system should be introduced in the basin to achieve the United Nations Sustainable Development Goals (SDGs) 2030 agenda of a better and more sustainable future for all, especially via SDG 6 of supplying safe drinking water at the household level.
    Matched MeSH terms: Drinking Water*
  14. Kim Y, Kuan G
    PMID: 32545921 DOI: 10.3390/ijerph17124251
    The present study examines the relationship between drinking behaviour and drinking refusal self-efficacy among university students, with a focus on the influential roles of sports type and gender. A total of 354 students from Seoul National University of Science and Technology volunteered and participated in this study. The Korean Alcohol Use Disorders Identification Test (AUDIT-K), the Korean Drinking Refusal Self-Efficacy (DRSE) Questionnaire-Revised, and a questionnaire measuring participation in sports activities were administered to measure students' alcohol drinking behaviours, refusal self-efficacy and sport-related activities, respectively. The data were analysed using descriptive statistics, two-way ANOVAs, correlation analysis, and regression analysis. The subdomains of DRSE had significant influences on binge drinking. Specifically, low DRSE in situations involving social pressure played a key role in predicting increased binge drinking. There was also a significant relationship between sports type and drinking behaviour, but only for male students. Those who participated in individual sports binge drank less than those who participated in team sports. Finally, gender differences were also revealed in drinking behaviour. Male students were more likely to binge drink compared to their female counterparts. This study offers a foundation for practical interventions to help control problematic drinking behaviour among university students.
    Matched MeSH terms: Alcohol Drinking*
  15. Ngui HHL, Kow ASF, Lai S, Tham CL, Ho YC, Lee MT
    Int J Mol Sci, 2022 Nov 29;23(23).
    PMID: 36499240 DOI: 10.3390/ijms232314912
    Recreational use of alcohol is a social norm in many communities worldwide. Alcohol use in moderation brings pleasure and may protect the cardiovascular system. However, excessive alcohol consumption or alcohol abuse are detrimental to one's health. Three million deaths due to excessive alcohol consumption were reported by the World Health Organization. Emerging evidence also revealed the danger of moderate consumption, which includes the increased risk to cancer. Alcohol abuse and periods of withdrawal have been linked to depression and anxiety. Here, we present the effects of alcohol consumption (acute and chronic) on important brain structures-the frontal lobe, the temporal lobe, the limbic system, and the cerebellum. Apart from this, we also present the link between alcohol abuse and withdrawal and mood disorders in this review, thus drawing a link to oxidative stress. In addition, we also discuss the positive impacts of some pharmacotherapies used. Due to the ever-rising demands of life, the cycle between alcohol abuse, withdrawal, and mood disorders may be a never-ending cycle of destruction. Hence, through this review, we hope that we can emphasise the importance and urgency of managing this issue with the appropriate approaches.
    Matched MeSH terms: Alcohol Drinking/adverse effects
  16. Ringgit G, Siddiquee S, Saallah S, Mohamad Lal MT
    Sci Rep, 2022 Nov 03;12(1):18582.
    PMID: 36329094 DOI: 10.1038/s41598-022-21926-6
    An electrochemical method for detecting the presence of zinc (Zn2+) ions in drinking water was developed using functionalized multi-walled carbon nanotubes (f-MWCNTs) and chitosan (CS). Numerous cylinder-shaped graphene molecules make up f-MWCNTs, which have a high mechanical and electrical conductivity. CS benefits from nanomaterials include biocompatibility, biodegradability, and low toxicity, which are excellent in capacity absorption of metal ions. Dangerous levels of metal ions such as zinc are currently present in drinking water as a result of human and natural activity. Zinc toxicity is associated with a variety of disorders, including Alzheimer's, Parkinson's, diabetes, and cancer. This study incorporated f-MWCNTs and CS with Prussian blue (PB) immobilised on a gold electrode (AuE). Several parameters, including as buffers, pH, scan rate, redox indicator, accumulation time, and volume, were optimised using the cyclic voltammetry (CV) method. According to the CV method, the optimal parameters were phosphate buffered saline (0.1 M, pH 2), 5 mM Prussian blue, 200 mVs-1 scan rate, and 5 s accumulation time. Under ideal circumstances, the differential pulse voltammetry (DPV) method was used to determine the Zn2+ ions concentration range of 0.2-7.0 ppm. The limit of detection (LOD) was 2.60 × 10-7 mol L-1 with a correlation coefficient of R2 = 0.9777. The recovery rate of the developed sensor (f-MWCNTs/CS/PB/AuE) ranged from 95.78 to 98.96%. The developed sensor showed a variety of advantages for detecting Zn2+ in drinking water, including a quick setup process, quick detection, high sensitivity, and mobility. This study developed the essential sensor for monitoring Zn2+ levels in drinking water in the future.
    Matched MeSH terms: Drinking Water*
  17. Khairul Hasni NA, Anual ZF, Rashid SA, Syed Abu Thahir S, Veloo Y, Fang KS, et al.
    Environ Pollut, 2023 May 01;324:121095.
    PMID: 36682614 DOI: 10.1016/j.envpol.2023.121095
    Contamination of water systems with endocrine disrupting chemicals (EDCs) is becoming a major public health concern due to their toxicity and ubiquity. The intrusion of EDCs into water sources and drinking water has been associated with various adverse health effects on humans. However, there is no comprehensive overview of the occurrence of EDCs in Malaysia's water systems. This report aims to describe the occurrence of EDCs and their locations. Literature search was conducted electronically in two databases (PubMed and Scopus). A total of 41 peer-reviewed articles published between January 2000 and May 2021 were selected. Most of the articles dealt with pharmaceuticals (16), followed by pesticides (7), hormones (7), mixed compounds (7), and plasticisers (4). Most studies (40/41) were conducted in Peninsular Malaysia, with 60.9% in the central region and almost half (48.8%) in the Selangor State. Only one study was conducted in the northern region and East Malaysia. The Langat River, the Klang River, and the Selangor River were among the most frequently studied EDC-contaminated surface waters, while the Pahang River and the Skudai River had the highest concentrations of some of the listed compounds. Most of the risk assessments resulted in a hazard quotient (HQ) and a risk quotient (RQ)  1 in the Selangor River. An RQ > 1 for combined pharmaceuticals was found in Putrajaya tap water. Overall, this work provides a comprehensive overview of the occurrence of EDCs in Malaysia's water systems. The findings from this review can be used to mitigate risks and strengthen legislation and policies for safer drinking water.
    Matched MeSH terms: Drinking Water*
  18. 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: Drinking Water*
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