Drinking water system treatment and contamination in Shatila refugee camp in Beirut, Lebanon

Drinking water at Shatila Palestinian Refugee Camp in Beirut, Lebanon is of poor quality and unpredictably intermittent quantity. We aimed to characterize drinking water sources and contamination at Shatila and determine how drinking water can be managed to reduce community health burdens. We interviewed the Popular Committee, well owners, water vendors, water shopkeepers and preschool administrators about drinking water sources, treatment methods and the population served. Water samples from the sources and intermediaries were analysed for thermotolerant faecal coliforms [FCs], Giardia lamblia, Cryptosporidium parvum and microsporidia, using immunofluorescent antibody detection for G. lamblia and C. parvum, and chromotrope-2 stain for microsporidia. All drinking water sources were contaminated with FCs and parasites. FC counts [cfu/mL] were as follows: wells [35-300], water vendors [2-178], shops [30-300] and preschools [230-300]. Responsible factors identified included: unskilled operators; improper maintenance of wells and equipment; lack of proper water storage and handling; and misperception of water quality. These factors must be addressed to improve water quality at Shatila and other refugee camps

Trends in infectious disease incidence among children in Afghanistan at a time of public health services expansion

This study reviewed trends in the incidence of common communicable diseases among children under five years in Afghanistan between 2005 and 2013, a period of expansion of public health services. New visits to outpatient clinics constituted the denominator for calculating proportions. In 2013, almost three-quarters of all new visits of children to public health services were for an infectious disease, with respiratory infections the most common. Because of inconsistent data collection for some infections early in the period, the trend for infectious diseases as a whole cannot be estimated. However, there was a statistically significant downward trend in the proportion of new visits that were diagnosed as one of the 11 leading communicable diseases from 74.5% in 2005 to 62.1% in 2013 [P < 0.001]. There was no difference in communicable disease patterns between provinces, but a higher per capita consultation rate was associated with a higher proportion of the leading infections [P = 0.008]. Recent improvements in maternal health, hygiene, and preventive services may have had an impact in reducing the burden of infections