ABSTRACT
Background@#Indigenous peoples (IPs) remain vulnerable to soil-transmitted helminthiasis (STH) due to limited access to sanitary toilets, clean water, quality health education, and services. The World Health Organization recommends periodic mass drug administration (MDA) of anthelminthics, health education, and improvements in water, sanitation, and hygiene (WASH) as control strategies to reduce morbidities caused by STH in target populations such as schoolage children (SAC). This paper complements the published results of the parasitological survey (prevalence and intensity of STH) conducted in selected Aeta and Ata-Manobo communities. @*Objectives@#This study aimed to describe the accessibility of STH control strategies to respond to the needs of SAC in IP communities in Pampanga and Davao del Norte, the Philippines. It likewise intended to describe access of these IP communities to STH control strategies. @*Methods@#Data on accessibility of and access to STH control strategies were collected using key informant interviews (KIIs) and focus group discussions (FGDs). Eleven officials and workers from the departments of health and education, local government units, and two IP leaders were interviewed on the existing STH burden in SAC, implementation of STH control strategies, particularly of MDA, health education campaigns, and improvements in WASH including good practices and challenges in program implementation. Three FGDs with parents, elementary school teachers of IP schools, and rural health midwives were conducted separately. Guide questions focused on accessibility of and access to STH prevention and control strategies for SAC in IP communities. Informed consent to conduct and record KIIs and FGDs were obtained from participants prior to participation. Analysis of a multi-disciplinary team was based on the accessibility framework for IPs accessing indigenous primary health care services by Davy et al. (2016). @*Results@#The characteristics of the STH control strategies and the target populations are interrelated factors that influence accessibility. Challenges in the availability of the MDA program, particularly, inadequate staffing, drug shortages, and delays in delivery affect accessibility of and access to the free STH control strategies. Perceived harm, adverse events, stigma, beliefs, and practices likewise affect access. Lack of information on the similarity of treatment through community- and schoolbased MDA programs also affected engagement of SAC. IP communities are special settings where geographic isolation, peace and order situation as well as water supply need to be considered to help ensure access to STH control strategies, high MDA coverage, and improvements in WASH leading to desired outcomes. @*Conclusions@#Considering the context of IP communities and addressing the challenges in the accessibility of and access to STH control strategies are necessary to ensure successful implementation of an integrated approach in STH prevention and control strategies. Challenges in the accessibility of STH control strategies are inadequate staffing, poor inventory, and delays in the delivery of drugs, as well as poor sanitation and hygiene. Access of SAC is likewise affected by misconceptions on safety and efficacy of anthelminthics, including stigma and cultural practices. The similarity of the MDA programs based in school or community need to be disseminated.
Subject(s)
Indigenous Peoples , Mass Drug AdministrationABSTRACT
Lung function testing is an essential modality of investigation in children as it provides objective evidence of lung disease/ health. With advances in technology, various tests are available that can aid in the diagnosis of lung disease, assess the progression and response to therapy and document the lung development and evolving lung diseases in infants. This narrative review discusses lung function tests in infants and children. Currently, lung function tests can be performed in every age group, from neonates to the elderly. Spirometry and peak expiratory flow rate (PEFR) are the most employed tests in children more than six years of age. Spirometry helps diagnose and monitoring of both obstructive and restrictive diseases. There is a need for expertise to perform and interpret spirometry correctly. The forced oscillation technique (FOT) or impulse oscillometry (IOS) is done with tidal volume breathing and is feasible even in preschool children. Their utility is mainly restricted to asthma in children at present. Lung function tests can be performed in neonates, infants and children using infant pulmonary function test (PFT) equipment, although their availability is limited. Diffusion capacity for carbon monoxide (DLCO) is a valuable tool in restrictive lung diseases. Lung volumes can be assessed by body plethysmography and multiple washout technique. The latter can also assess lung clearance index. It is essential to perform and interpret the lung function test results correctly and correlate them with the clinical condition for optimum treatment and outcome.
ABSTRACT
The objective of the study was to assess the safety and efficacy of Roop Mantra Cucumber Ayurvedic Medicinal Face Wash in subjects with acne, facial scars, pimples, blemishes, dull skin and dry skin. Methods: This was a single-center, open-label, non-randomized post-marketing surveillance study with 120 subjects. Subjects were selected on the basis of inclusion criteria. The study included three scheduled clinical visits on days 0 (screening and baseline visit), 15 (follow-up visit), and 30 (final visit). Following an assessment of baseline data, all subjects were given Roop Mantra Cucumber Ayurvedic Medicinal Face Wash for 30 days. The efficacy of Roop Matra Cucumber Ayurvedic Medicinal Face Wash was determined by measuring changes in parameters such as skin characteristics, skin appearance, and Global Acne Assessment (GAA) score. Product safety was assessed by determining local intolerance and adverse effects of Roop Mantra Cucumber Ayurvedic Medicinal Face Wash. Results: The results of the study showed that applying Roop Mantra Cucumber Ayurvedic Medicinal Face Wash for 30 days significantly improved skin’s characteristic and appearance. Roop Mantra Cucumber Ayurvedic Medicinal Face Wash was also found to be dermatologically well tolerated and had no negative impacts over the course of the study. Conclusion: The polyherbal Roop Mantra Cucumber Ayurvedic Medicinal Face Wash was found to be very safe and effective in reducing acne, pimples, blemishes, and skin dryness with improved skin texture and appearance. Roop Mantra Cucumber Ayurvedic Medicinal Face Wash is therefore a clinically feasible and safe alternative for treating the aforementioned skin conditions.
ABSTRACT
Purpose: To study the incidence of re-surgery after manual small-incision cataract surgery (MSICS) at a tertiary eye-care center in South India and to compare the re-surgery rate between trainees and experts. Methods: A retrospective study was conducted at a tertiary eye-care center in Andhra Pradesh state of South India, which included 19,515 patients who underwent MSICS between 2012 and 2022 with 369 eyes of 369 patients who underwent re-surgery within 1 week of primary surgery. Factors included demographic data, type of re-surgery, that is, wound re-suturing, IOL repositioning, cortical wash, as well as anterior chamber (AC) wash. Results: 19,515 eyes from the year 2012�22 were analyzed. Most of the patients undergoing re-surgery belonged to the age group of 61� years (40.3%). Wound re-suturing was the more frequently performed re-surgery (47.6%). Wound re-suturing rates were comparable between the trainees and experts, whereas IOL repositioning, cortical wash, and AC wash were higher in the cases performed by trainees though statistically not significant. Conclusion: Careful pre-operative assessment, training under supervision, and other measures can be taken to reduce the re-surgery rates. Timely diagnosis and early treatment can give better outcomes and prevent devastating complications like endophthalmitis
ABSTRACT
Objective To explore and extract the elements of educational intervention from sustainable trachoma prevention programs in developing countries particularly in Africa.Methods Literature review was conducted with the search engine, PubMed, with extracting keywords as “Trachoma, intervention, education, SAFE, hygiene, WASH, sustainable, sustainability, and elimination”. After carefully reading the extracted literature and assessing the sustainability of the interventions conducted in Sub-Saharan Africa, using analytical standpoint determined by the JICA evaluation items on sustainability, the elements of educational interventions were categorized.Result Twenty-two articles were extracted and 10 articles that specifically state effectiveness and contents of intervention were selected for analysis. Five categories with elements of educational intervention were classified as follows: [Education in school age and community], [Intangible and tangible support], [Guidance of constructing latrines], [Guidance on how to use equipment and resources], and [Continuation of knowledge and skill transfer activities].Discussion The results of this study suggested the significance of conducting educational intervention, not only the construction but also the management and maintenance of latrines, and the effectiveness of habituation of hygiene behavior to school children by implementing hygiene education at schools which behavior may also diffuse at home. Challenges remained in trachoma prevention effort who are left out of the support, such as unenrolled children who are unable to receive school hygiene education, and/or those who are inaccessible to clean water.Conclusion Elements for educational intervention in sustainable trachoma prevention were examined in this study. It was shown that continuous holistic efforts should be made for the educational interventions as well as for the improvement of accessibility of clean water and hygiene without leaving people and the least developed countries behind.
ABSTRACT
Introduction.Sodium hypochlorite is a crucial element in the water treatment process. We aimed to verify if schools that lack adequate access to water and don't provide hygiene education courses would improve water quality after an intervention program. Methods.Twenty schools from the rural area of Burkina Faso were equipped with electro-chlorinator devices that produce sodium hypochlorite and received training to make water drinkable. Data related to behavioral change was collected. In addition, microbiological analysis of fecal coliforms, total coliforms, and fecal streptococci was performed in the drinking water from water stations or water storage containers. These indicators were measured before and two years after the program in six schools that participated, paired with three control schools from the same region. Results.Before the intervention, no schools practiced treating their water. After intervention, schools did it daily. WASH courses and water treatment training were also observed in intervention schools. Only the samples belonging to the control schools contained microorganisms in the drinking water after the intervention, particularly fecal coliforms and total coliforms. Fecal streptococci were not detected in any of the samples analyzed. Before the intervention, 50% of water samples from the intervention group and 66% from the control group were contaminated with fecal coliforms. Conclusion.Schools became independent of external disinfectant production after receiving electro-chlorinator devices and proper training to comply with WASH measures. Our findings might be useful to public health practitioners trying to implement sustainable programs.
Subject(s)
Sodium Hypochlorite , Waterborne Diseases , Schools , Chlorinators , Public Health , EnvironmentABSTRACT
RESUMO O SARS-CoV-2 é facilmente disseminado por aerossóis e contato direto com pessoas contaminadas. Logo, as condições adversas em áreas rurais podem influenciar a propagação do vírus. Desta forma, estabeleceu-se uma reflexão acerca da disseminação da COVID-19 em função do hábito de lavar as mãos, das condições de saneamento, dos aspectos socioeconômicos e das condições habitacionais em 26 comunidades quilombolas rurais do estado de Goiás. Para isso foram levantadas informações in loco em 533 domicílios e aplicou-se a Analytic Hierarchy Process, utilizando-se critérios selecionados com base na literatura. As comunidades apresentaram uma priorização para a disseminação da COVID-19 variando de 14,9 x 10-3 (pior condição) a 64,3 x 10-3 (melhor condição), na qual a Comunidade José Coleto ocupou a posição mais desfavorável. Buracão mostrou um resultado mais satisfatório, sendo esta menos susceptível à disseminação da COVID-19. A melhoria nas condições de saneamento pode aumentar o hábito da higiene com as mãos, o que reduziria a disseminação da COVID-19 e de outras doenças infecciosas. Assim, a partir dos resultados obtidos, é perceptível a importância do empoderamento quanto aos hábitos de higiene, acesso à informação, saneamento básico e à saúde. Os gestores devem ter uma maior disposição para implantar infraestrutura e melhorar as condições dos critérios apresentados e discutidos neste trabalho.
ABSTRACT SARS-CoV-2 is easily spread by aerosols and direct contact with contaminated people. Therefore, adverse conditions in rural areas can influence the spread of the virus. Thus, a reflection was established about the dissemination of COVID-19 due to the habits of wash hands, sanitation conditions, socioeconomic aspects, and habitability conditions in 26 rural quilombola communities in the state of Goiás. For this, informations were collected in 533 locals households and it was applied the Analytic Hierarchy Process using criteria selected based on the literature. The communities presented a priority for the dissemination of COVID-19 ranging from 14.9 x 10-3 (worst condition) to 64.3 x 10-3 (best condition), and the Community José Coleto has occupied the most unfavorable position. Community Buracão showed a more satisfactory result, being less susceptible to the spread of COVID-19. Improving sanitation conditions can increase hand hygiene habits, which would reduce the spread of COVID-19 and other infectious diseases. Thus, from the results obtained, it is noticeable the importance of empowerment regarding hygiene habits, access to information, basic sanitation and health. The managers should give greater attention to implement infrastructures and improve the conditions of the criteria presented and discussed in this paper.
ABSTRACT
Abstract Introduction: The use of saline irrigation for nasal washes is a well established procedure in the treatment of sinonasal inflammation and infection. In addition to saline solutions, Ringer's lactate is also an efficient option for nasal washes and humidification. Objective: To assess the comfort, humidification and tolerance regarding stinging sensation, provided by sodium chloride nasal gel at the concentrations of 4.5 mg/g and 6.0 mg/g through questionnaires answered by the patients. Methods: A total of 60 patients, 56 females, aged between 22 and 66 years old (mean age of 47) and 4 males, aged between 36 and 66 years (mean age of 49), were included in the study for a period of 17 days (±2 days) treatment. The patients were monitored by a general practitioner throughout the study period. They were instructed to apply each product in both nostrils twice a day during a 7-day period (±2 days). The patients were evaluated prior to the use of the first product at visit 0 (V0), after 7 days of treatment (±2 days) at visit 1 (V1), after 3 days of product discontinuation at visit 2 (V2) and after 7 days (±2 days) of treatment with the second product, in visit 3 (V3). Results: A significant difference (5% significance) was observed regarding comfort and stinging sensation between the two different concentrations; comfort was higher and stinging was lower with the 6.0 mg/g concentration gel. No difference in humidification was observed between the two treatments. Conclusion: Ringer's lactate at the concentration of 6.0 mg/g was superior to that at 4.5 mg/g for parameters comfort and stinging sensation. No statistical difference was observed between the two products regarding nasal humidification.
Resumo Introdução: O uso de soluções salinas para lavagem nasal está consagrado no tratamento de quadros inflamatórios e infecciosos nasossinusais. Além das soluções salinas, o ringer lactato é uma importante opção tanto para lavagem quanto para a hidratação nasal. Objetivo: Avaliar a tolerabilidade (ardência e conforto) e umidificação do produto gel nasal cloreto de sódio 4,5 mg/g em relação ao ringer lactato 6,0 mg/g, por meio de questionários respondidos pelos pacientes. Método: Foram incluídos 60 pacientes, 56 mulheres (22-66 anos; média: 47 anos) e quatro homens (36-66 anos; média: 49 anos) foram incluídos no estudo de 17 dias (± 2 dias) de tratamento. Os pacientes foram supervisionados por um clínico geral durante todo o período do estudo. Os pacientes usaram os produtos com uma borrifada em cada narina duas vezes ao dia, durante sete dias (± 2 dias). As formulações foram avaliadas antes do uso do primeiro produto na visita 0 (V0), após sete dias (± 2 dias) de tratamento na visita 1 (V1), após três dias de interrupção do primeiro tratamento na visita 2 (V2) e após sete dias (± 2 dias) de uso do segundo produto na visita 3 (V3). Resultados: Foi observada diferença significante para o conforto das vias nasais, (significância de 5%), na comparação entre os tratamentos nos atributos de conforto e ardência. O conforto das vias nasais foi superior e a ardência inferior para o gel nasal ringer lactato 6,0 mg/g em comparação ao gel cloreto de sódio 4,5 mg/g. Não foi observada diferença significante para a umidificação entre os tratamentos. Conclusão: O gel ringer lactato 6,0 mg/g foi superior ao produto gel cloreto de sódio 4,5 mg/g nos quesitos conforto e ardência. Não foi observada diferença estatisticamente significante entre os tratamentos em relação à umidificação das vias nasais.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Sodium Chloride/administration & dosage , Nose Diseases/drug therapy , Ringer's Lactate/administration & dosage , Nasal Mucosa/drug effects , Single-Blind Method , Nasal Lavage Fluid , Gels , Humidity , Nasal Mucosa/physiopathologyABSTRACT
Enteric fever is a common but serious disease that affects mostly children and adolescents in the developing countries. Salmonella enterica serovar Typhi remains responsible for most of the disease episodes; however, S. Paratyphi A has also been reported as an emerging infectious agent of concern. The control measures for the disease must encompass early diagnosis, surveillance and vaccine to protect against the disease. Sanitation and hygiene play a major role in reducing the burden of enteric diseases as well. The current status of diagnostics, the surveillance practices in the recent past and the vaccine development efforts have been taken into account for suggesting effective prevention and control measures. However, the challenges in all these aspects persist and cause hindrance in the implementation of the available tools. Hence, an integrative approach and a comprehensive policy framework are required to be in place for the prevention, control and elimination of typhoid fevers.
ABSTRACT
Background: Handwashing is the act of cleaning one's hands for the purpose of removing soil, dirt & microorganisms. Through review of literature it is understood that the most nosocomial infections are thought to be transmitted by the hands of healthcare workers, handwashing is considered the single most important intervention to prevent nosocomial infections. This study was conducted to assess the knowledge, attitude and practices (KAP) on handwashing among the nursing students and to identify the areas of gap in their KAP along with the provisions for handwash.Methods: A descriptive, cross-sectional study was conducted among 192 nursing students at S.V. College of Nursing, Chittoor during October 2018 using pre-validated self-reported questionnaire. Statistical analysis was done with SPSS 20.0 software and Chi-Square test was used with “P” value<0.05 taken as statistically significant.Results: Among all respondents 85% were aware about washing their hands during all common critical times, but practicing was observed in 08% only. 50% felt that alcohol based handrub is effective than handwashing with soap and water, but facilitated 10% only. While the final year students all (100%) were well aware about all critical times of handwashing, whereas 1st and 2nd years 71% and 3rd year students 87% were aware (p=0.002).Conclusions: There is a need of orientation and arrangements for proper handwashing to be improved.
ABSTRACT
Background: Hand wash morale is changing among health workers and, despite many efforts; it is not always possible to achieve lasting improvement. Considering the fact that today’s preschoolers are tomorrow’s health workers, hand washing is one of the habits that should be strictly acquired earlier in life. The purpose of this study is to investigate whether hand washes morale among preschoolers can be improved by introducing a regular educational program. Methods: As a part of the collaboration between the County Hospital and an urban kindergarten, we have developed an interactive educational program that involves both health professionals and kindergarten teachers. The program disseminated information about hand washing and hand hygiene through children’s stories, songs, video films, hand washing puzzles, and board games. Kindergarten teachers held the training sessions twice a week. Before and after the introduction of the program, we examined the children’s hand washing patterns using a UV light kit. Results: Before the introduction of the educational program, only 12.3% of children were able to wash their hands properly. This figure increased to 44.3% after the introduction of the interactive educational program. There were no significant differences between boys and girls, neither in the pre-intervention nor in the post-intervention phase. Conclusions: Hand wash morale for preschool children can be improved through regular interactive educational programs. Through these, children can be induced to compete among themselves to have a cleaner hand. In our opinion, this can be transformed into a multiplier that needs to be further strengthened in the elementary school.
ABSTRACT
Background: Hand hygiene is now regarded as one of the most important element of infection control activities. Medical students in their clinical training phase throng the healthcare facilities and can potentially transmit infections besides being the healthcare providers of future when their pattern of training will reflect on their infection control practices. Therefore, this study was carried out to assess the knowledge of undergraduate medical students regarding hand hygiene practices.Methods: A cross-sectional study was carried out and data was collected by using “WHO hand hygiene knowledge questionnaire for health care workers” among 2nd M.B.B.S medical students at Junagadh. Knowledge was graded as good, moderate or poor based on the total number of correct answers.Results: Total 123 students participated in the study. There were 65 (53%) females and 58 (47%) were males. The mean hand hygiene knowledge score (out of 25) was 15.05 (SD: ±2.37, 95% CI: 14.63-15.48). Majority of the participants (76%) had moderate knowledge of hand hygiene practices.Conclusions: In the present study majority of the students had not received formal training regarding hand hygiene practices. Majority of the students had moderate knowledge of hand hygiene. Incorporation of teaching and training of hand hygiene practice in the undergraduate teaching during the initial study years is the need of the hour to prevent further emergence of antimicrobial resistance and health care associated infections.
ABSTRACT
Resumo A Operação Lava Jato vem ocupando as principais páginas de notícias como a maior operação de combate à corrupção já realizada no Brasil. A importância deste estudo reside na possibilidade de interpretar e compreender a maior investigação de crimes de corrupção no país utilizando conceitos e raciocínios durkheimianos, com vistas a contribuir para a análise do fenômeno no caso concreto e na administração pública como um todo. Verificou-se que a corrupção descoberta pela Operação Lava Jato é um fato social patológico presente na estrutura de diferentes órgãos e instituições que afeta a ordem social, decorrente de um estado de anomia no qual os indivíduos não aderem às normas sociais e morais vigentes.
Resumen En Brasil, la Operación "Lava Jato" viene ocupando las principales páginas de noticias como la mayor operación de combate a la corrupción ya realizada en el país. La importancia del estudio reside en la posibilidad de interpretar y comprender la mayor investigación de crímenes de corrupción ya realizada en Brasil, utilizando conceptos y razonamientos Durkheimianos, en la perspectiva de contribuir a la comprensión del fenómeno en el caso concreto y en toda la administración pública. Se verificó que la corrupción descubierta por la Operación "Lava Jato" es un hecho social patológico presente en la estructura de diferentes órganos e instituciones y que afecta el orden social, proveniente de un estado de anomia, en el cual los individuos no se adhieren a las normas sociales y morales vigentes.
Abstract In Brazil, Operation Car Wash has been occupying the main news pages as the largest anti-corruption operation ever carried out in the country. The importance of the study lies in the possibility of interpreting and understanding the investigations of the operation, using Durkheimian concepts and reasoning, to analyze the phenomenon focusing not only the concrete case but also looking at the whole public administration. The corruption discovered by Operation Car Wash is a pathological social fact present in the structure of different agencies and institutions. It affects the social order and is fruit of a state of anomie, in which individuals do not adhere to social norms and moral values.
Subject(s)
Public Administration , State , CorruptionABSTRACT
Background: The true incidence of male subfertility is unknown due to great variability in the prevalence of subfertility. Artificial insemination with husband’s semen is the most widely used treatment for male infertility, usually presumed because of oligospermia, and for what is called ‘mucus hostility’ when there is failure of sperm penetration of cervical mucus despite normal seminal analysis.Methods: The study was conducted in 438 couples with male factor infertility at the ARTC (artificial reproductive technique centre) of Sri Ramakrishna Hospital, Coimbatore. Results of at least two seminograms (based on WHO norms) were used to primarily classify males into three categories-oligozoospermic, asthenozoo spermic and oligoasthenoteratospermic. The media used were the Earle’s Balanced Salt Solution (EBSS), Ham’s F10 and Medicult. EBSS and Ham’s F10 were obtained as “readymade” solutions from Sigma, USA. Medicult was imported from Denmark. EBSS and Ham’s F10 were supplemented with protein using FCS (Fetal cord Serum) or HEPES (4(2-hydroxyethyil)-1-piperazineethanesulfonic acid). Benzyl pencillin, 60mg per litre and Streptomycin, 50mg per litre were also to the media.Results: By the DMRT analysis of post wash count, the influence of the count below 5 million or above 20 million on the pregnancy rate was significant at all the levels of male factor.Conclusions: Considering the male factor, in cases of oligoasthenoteratospermia, IUI has a positive significant effect on the success rate of pregnancy at all three levels of the post wash sperm count.
ABSTRACT
Background: ‘WASH’ is an acronym that stands for water, sanitation and hygiene and several interrelated public health issues that are of particular interest to international development and is the focus of SDP goal-6. WASH in schools aims to improve the health and learning performance of School-aged children and by extension that of their families, by reducing the incidence of water and sanitation related diseases. The present study was undertaken to assess the knowledge and practices regarding WASH among school children.Methods: A descriptive design was adopted for the study. The study was conducted at Zilla parishath Higher Secondary school with 150 participants selected using purposive sampling technique. Knowledge and practices of WASH were assessed using a structured questionnaire and checklist respectively.Results: The results showed that majority of them 125 (83.33%) had inadequate knowledge and 25 (16.6%) had a moderately adequate knowledge, while 21 (14%) were found to have adequate practices, 81 (54%) had a moderately adequate practices and 48 (32%) were found to have inadequate practices. It was found that there was no significant association between the knowledge and the selected demographic variables and a negative correlation was found between knowledge and practices.Conclusions: The findings revealed that, most of the school children had inadequate knowledge and a moderately adequate practice which indicates a need to impart knowledge and motivate the children regarding WASH to maximize the health and educational outcomes.
ABSTRACT
BACKGROUND@#Soil-transmitted helminthes (STH) infections are among the most common infections worldwide and affect the most deprived communities. Adequate water, sanitation, and hygiene (WASH) prevents environmental contamination, thereby preventing transmission of STH. Cognizant of this, WASH education was implemented in rural Dembiya to reduce intestinal parasitic infections. This study was, therefore, conducted to assess the impacts of the intervention on households' WASH conditions and prevalence of intestinal parasitic infections.@*METHOD@#An uncontrolled before-and-after intervention study was used. Cross-sectional studies were done before and after the intervention. Two hundred twenty-five and 302 under five children were recruited randomly at the baseline and endline, respectively. Data were collected using a structured questionnaire and observational checklists. Direct stool examination and Kato-Katz methods were used to identify parasites in the stool. We used percent point change and prevalence ratio (PR) to see the effects of the intervention on WASH conditions and prevalence of intestinal parasitic infections respectively. Pearson chi-squared and Fisher's exact tests were used to test for statistically significant percentage point changes of WASH conditions. The effect of the intervention on intestinal parasitic infections was statistically tested on the basis of PR with 95% confidence interval (CI).@*RESULTS@#The baseline prevalence of intestinal parasitic infections was 25.8%, and the endline prevalence was 23.8%. The prevalence of intestinal parasitic infections was not significantly decreased at the endline compared with the baseline [PR = 0.92, 95% CI = (0.62, 1.38)]. Ascaris Lumbricoides was the most prevalent parasitic infection both at the baseline and endline. The proportion of children who had good hygienic condition increased from 1.3% at the baseline to 34.4% at the end line (p < 0.05). The percentage of mothers/care givers who washed hands at different pick times was significantly increased from 24.4% at the baseline to 68.2% at the endline (p < 0.001). The proportion of households who practiced home-based water treatment was significantly increased from 7.6% at the baseline to 47% at the endline (p < 0.001). The proportion of households who used sanitary latrine was increased from 32% at the baseline to 49% at the endline (p < 0.05).@*CONCLUSION@#This before-and-after intervention study found that households' WASH performance was significantly improved at the endline compared with the baseline. The endline prevalence of intestinal parasitic infections was slightly lower than the baseline prevalence; however, the reduction was not statistically significant. The local health office needs to strengthen the WASH education program, mobilize the community to construct WASH facilities, and support the community to sustain households' WASH performance.
Subject(s)
Adult , Child, Preschool , Female , Humans , Infant , Male , Cross-Sectional Studies , Drinking Water , Parasitology , Reference Standards , Ethiopia , Epidemiology , Family Characteristics , Feces , Parasitology , Health Behavior , Physiology , Health Education , Health Knowledge, Attitudes, Practice , Helminthiasis , Epidemiology , Hygiene , Education , Intestinal Diseases, Parasitic , Epidemiology , Prevalence , Rural Population , Sanitation , Soil , Parasitology , Surveys and QuestionnairesABSTRACT
Soil-transmitted helminth (STH) infections continue to be a major global cause of morbidity, with a large proportion of the burden of STH infections occurring in India. In addition to direct health impacts of these infections, including anaemia and nutritional deficiencies in children, these infections also significantly impact economic development, as a result of delays in early childhood cognitive development and future income earning potential. The current World Health Organization strategy for STH is focused on morbidity control through the application of mass drug administration to all pre-school-aged and school-aged children. In India, the control of STH-related morbidity requires mobilization of significant human and financial resources, placing additional burdens on limited public resources. Infected adults and untreated children in the community act as a reservoir of infection by which treated children get rapidly reinfected. As a result, deworming programmes will need to be sustained indefinitely in the absence of other strategies to reduce reinfection, including water, hygiene and sanitation interventions (WASH). However, WASH interventions require sustained effort by the government or other agencies to build infrastructure and to promote healthy behavioural modifications, and their effectiveness is often limited by deeply entrenched cultural norms and behaviours. Novel strategies must be explored to provide a lasting solution to the problem of STH infections in India other than the indefinite provision of deworming for morbidity control.
ABSTRACT
Objective: To evaluate the impact of water, sanitation and hygiene (WASH) interventions in children (age <18 y) on growth, non-diarrhealmorbidity and mortality in children.Design: Systematic review of randomized controlled trials, non-randomized controlled trials and controlled before-after studies.Setting: Low- and middle-income countries.Participants: 41 trials with WASH intervention, incorporating data on 113055 children.Intervention: Hygiene promotion and education (15 trials), water intervention (10 trials), sanitation improvement (7 trials), all threecomponents of WASH (4 trials), combined water and sanitation (1 trial), and sanitation and hygiene (1 trial).Outcome Measures: (i) Anthropometry: weight, height, weight-for-height, mid-arm circumference; (ii) Prevalence of malnutrition; (iii)Non-diarrheal morbidity; and (iv) mortality.Results: There may be little or no effect of hygiene intervention on most anthropometric parameters (low- to very-low quality evidence).Hygiene intervention reduced the risk of developing Acute respiratory infections by 24% (RR 0.76; 95% CI 0.59, 0.98; moderate qualityevidence), cough by 10% (RR 0.90; 95% CI 0.83, 0.97; moderate quality evidence), laboratory-confirmed influenza by 50% (RR 0.5; 95%CI 0.41, 0.62; very low quality evidence), fever by 13% (RR 0.87; 95% CI 0.74, 1.02; moderate quality evidence), and conjunctivitis by51% (RR 0.49; 95% CI 0.45, 0.55; low quality evidence). There was low quality evidence to suggest no impact of hygiene intervention onmortality (RR 0.65; 95% CI 0.25, 1.7). Improvement in water supply and quality was associated with slightly higher weight-for-age Z-score(MD 0.03; 95% CI 0, 0.06; low quality evidence), but no significant impact on other anthropometric parameters or infectious morbidity (lowto very low quality evidence). There was very low quality evidence to suggest reduction in mortality (RR 0.45; 95% CI 0.25, 0.81).Improvement in sanitation had a variable effect on the anthropometry and infectious morbidity. Combined water, sanitation and hygieneintervention improved height-for-age Z scores (MD 0.22; 95% CI 0.12, 0.32) and decreased the risk of stunting by 13% (RR 0.87; 95% CI0.81, 0.94) (very low quality of evidence). There was no evidence of significant effect of combined WASH interventions on non-diarrhealmorbidity (fever, respiratory infections, intestinal helminth infection and school absenteeism) (low- to very-low quality of evidence). AnyWASH intervention (considered together) resulted in lower risk of underweight (RR 0.81; 95% CI 0.69, 0.96), stunting (RR 0.77; 95% CI0.68, 0.86) and wasting (RR 0.12, 0.85) (low- to very-low quality of evidence).Conclusion: Available evidence suggests that there may be little or no effect of WASH interventions on the anthropometric indices inchildren from low- and middle-income countries. There is low- to very-low quality of evidence to suggest decrease in prevalence ofwasting, stunting and underweight. WASH interventions (especially hygiene intervention) were associated with lower risk of non-diarrhealmorbidity (very low to moderate quality evidence). There was very low quality evidence to suggest some decrease to no change inmortality. These potential health benefits lend support to the ongoing efforts for provision of safe and adequate water supply, sanitationand hygiene.
ABSTRACT
Abstract@#This study aims to evaluate the effect of Fermented Rice After-wash Water (FRAW) on chilli growth and to isolate microorganism present in three brands of white rice FRAW. The study showed that FRAW treatment was comparable with NPK fertiliser. In addition, a number of plant growth-promoting microbes associated with FRAW were also isolated. Isolated bacteria and fungi were then characterised according to their morphology and biochemical analysis. Thus the positive effect of FRAW on the chilli was likely due to the plant growth promoting microorganism present in FRAW.
ABSTRACT
BACKGROUND@#Intestinal parasites are a common problem in the world. The greater proportion of infections is associated with poor water, sanitation, and hygiene (WASH). This study was conducted to assess intestinal parasites, WASH condition, and their association in rural Dembiya, northwest Ethiopia.@*METHODS@#A cross-sectional study was employed. Two hundred twenty-five children aged 6-59 months were included. Mothers were interviewed using a structured questionnaire, and the living environment was observed using checklists. Kato-Katz technique was used to determine the intensity of parasitic infections. Escherichia coli (E. coli) was used as a biological indicator for drinking water quality. Multivariable binary logistic regression analysis was conducted to identify WASH predictors of parasites on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p < 0.05.@*RESULTS@#The prevalence of intestinal parasites was 25.8% (95% CI = 20.3-32.0%). Ascaris lumbricoides (78%), hookworm (12%), Hymenolepis nana (7%), Enterobius vermicularis (5%), Schistosoma mansoni (3%), Giardia lamblia (3%), and Trichuris trichiuria (2%) were identified infections. Intestinal parasites were associated with poor child hand washing practice [AOR = 3.86, 95% CI = 1.53, 9.75], unprotected water sources [AOR = 7.79, 95% CI = 3.30, 18.40], access to water below 20 l/c/d [AOR = 3.05, 95% CI = 1.28, 7.23], poor food safety[AOR = 4.33, 95% CI = 1.62, 11.58], and poor sanitation [AOR = 5.01, 95% CI = 1.56, 16.16].@*CONCLUSION@#A. lumbricoides, hookworm, H. nana, E. vermicularis, S. mansoni, G. lamblia, and T. trichiuria were identified. Child hand washing practice, service level of water supply, water sources, food safety, and sanitation were associated with intestinal parasites. WASH promotion is needed to prevent infections.