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1.
Article in English | WPRIM | ID: wpr-928824

ABSTRACT

BACKGROUND@#To protect the health and safety of healthcare workers (HCWs), it is essential to ensure the provision of sustainable water, sanitation, and hygiene (WASH) services and standard precautions in healthcare facilities (HCF). The objectives of this short communication were 1) to assess the availability of WASH services and standard precautions in HCFs in seven provinces in Afghanistan before the COVID-19 pandemic, and 2) to elucidate the relevance of these patterns with the number of reported HCW infections from COVID-19 in the mentioned provinces.@*METHODS@#We analyzed secondary data from the 2018-19 Afghanistan Service Provision Assessment survey, which included 142 public and private HCFs in seven major provinces in Afghanistan. Data on COVID-19 cases were obtained from the Afghanistan Ministry of Public Health Data Warehouse. Weighted prevalence of WASH services and standard precautions were calculated using frequencies and percentages. ArcGIS maps were used to visualize the distribution of COVID-19 cases, and scatter plots were created to visualize the relevance of WASH services and standard precautions to COVID-19 cases in provinces.@*RESULTS@#Of the 142 facilities surveyed, about 97% had improved water sources, and over 94% had improved toilet for clients. Overall, HCFs had limited availability of hygiene services and standard precautions, which was lower in private than public facilities. More than half of the facilities had safe final disposal and appropriate storage of sharps and medical waste. Of the seven provinces, Herat province had the highest cumulative COVID-19 case rate among HCWs per 100,000 population and reported lower availability of WASH services and standard precautions in HCFs compared to other provinces.@*CONCLUSION@#Our findings show disparities in the availability of WASH services and standard precautions in public and private facilities. Private facilities had a lower availability of hygiene services and standard precautions than public facilities. Provinces with higher availability of WASH services and standard precautions in HCFs had a lower cumulative COVID-19 case rate among HCWs per 100,000 population. Pre-pandemic preparation of adequate WASH services and standard precautions in HCFs could be potentially important in combating infectious disease emergence.


Subject(s)
Afghanistan/epidemiology , COVID-19/prevention & control , Delivery of Health Care , Humans , Hygiene , Pandemics/prevention & control , Sanitation , Water , Water Supply
2.
San Salvador; MINSAL; dic. 21, 2021. 20 p.
Non-conventional in Spanish | LILACS, BISSAL | ID: biblio-1354115

ABSTRACT

La Dirección de Salud Ambiental (DISAM) a través de la Unidad Ambiental, formula la presente Política Ambiental Institucional, que contiene las estrategias y acciones a implementar con la finalidad de proteger y conservar el ambiente, englobadas en los componentes de saneamiento ambiental, agua y cambio climático. Estrategias que contribuyan a proteger el ambiente a través de acciones del personal que labora en las diferentes dependencias del MINSAL


The Environmental Health Directorate (DISAM) through the Environmental Unit, formulates this Institutional Environmental Policy, which contains the strategies and actions to be implemented in order to protect and conserve the environment, encompassed in the components of environmental sanitation, water and climate change. Strategies that contribute to protecting the environment through actions of the personnel that work in the different dependencies of the MINSAL


Subject(s)
Sanitation , Environmental Health , Environmental Policy , Climate Change , Water
3.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(1): 14-21, maio 5, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1354767

ABSTRACT

Introdução: as parasitoses intestinais constituem-se um importante problema de saúde pública mundial. Estas infecções são mais prevalentes em regiões tropicais impactando na morbimortalidade e aumento nos custos para o sistema de saúde. Objetivo: avaliar a prevalência das enteroparasitoses e sua associação com as condições socioeconômicas, sanitárias, ambientais e hábitos de vida em uma comunidade costeira do Nordeste brasileiro. Metodologia: estudo epidemiológico, descritivo e transversal, realizado de modo não probabilístico entre março a junho de 2017, com 105 moradores da Ilha de Boipeba, localizada no Sul da Bahia. O exame parasitológico de fezes foi realizado pelos métodos de sedimentação espontânea, Baermann-Moraes e FAUST. Um questionário foi aplicado para avaliar o perfil sociodemográfico da população. Resultados: do total de indivíduos avaliados, 52,4% eram do sexo feminino e 57,1% tinham entre 15 a 59 anos. Todos os indivíduos possuíam água encanada, porém não tratada, enquanto 91,4% referiu ingerir vegetais crus e 45,7% não higienizavam as mãos antes as refeições. Sintomas gastrointestinais foram relatados em 82,8% dos indivíduos e infecções enteroparasitárias foram diagnosticadas em 69,6%. Os parasitos mais frequentemente encontrados foram Ancilostomídeo (18,1%) e Entamoeba coli (43,8%). O principal fator de risco potencial para contrair a infecção por ancilostomídeos foi a não existência de poço artesiano na residência (RP=4,35), enquanto para Trichuris trichiura foi não dispor de pia no banheiro (RP=3,82). Conclusão: a comunidade analisada apresentou elevada prevalência de enteroparasitoses. Os hábitos precários de higiene e de acesso à água tratada, associados às condições ambientais e climáticas do local, podem ter contribuído para a elevada transmissão de geohelmintos observada.


Introduction: Intestinal parasitic infections are an important public health problem worldwide. They are more prevalent in tropical regions impacting in morbidity and mortality and costs for the health system. Objective: To evaluate the prevalence of enteroparasitosis and its association with socioeconomic, sanitary and environmental conditions and lifestyle habits in a coastal community in the Northeast Brazil. Methodology: This is an epidemiological, descriptive and cross-sectional study, carried out in a non-probabilistic manner between March and June 2017, with 105 residents of Boipeba Island in the Southern Bahia. The parasitological examination of feces was carried out by the methods of spontaneous sedimentation, Baermann-Moraes and FAUST. A questionnaire was applied to assess the sociodemographic profile of the population. Results: Of the total of individuals evaluated, 52.4% were female and 57.1% were between 15 and 59 years old. All individuals had piped, but untreated water, while 91.4% reported eating raw vegetables and 45.7% did not wash their hands before meals. Gastrointestinal symptoms were observed in 82.8% individuals and 69.6% were diagnosed with enteroparasitic infections. The most frequent parasites were the hookworm (18.1%) and Entamoeba coli (43.8%). The main potential risk factor for hookworm infection was the non-existence of an artesian well in the residence (PR=4.35) and Trichuris trichiura it was not having a sink in the toilet (PR=3.82). Conclusion: The analyzed community has a high prevalence of enteroparasitosis, in addition to environmental and climatic conditions that contribute to the transmission of these infections.


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Parasitic Diseases , Sanitation , Epidemiology , Epidemiologic Studies , Demography , Hygiene , Epidemiology, Descriptive , Sanitary Profiles , Entamoeba
4.
Ciênc. Saúde Colet ; 26(4): 1333-1344, abr. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1285913

ABSTRACT

Resumo Este artigo apresenta uma abordagem integral para atuar em projetos comunitários, baseada nas três ecologias de Guattari e do seu diálogo com teóricos da psicossociologia, por envolver a necessidade de conjugar intervenções tecnológicas com abordagens sociais. Explora-se essas contribuições para apontar a necessidade do diálogo na implementação de ações de saneamento, principalmente na zona rural e em Comunidades Tradicionais, envolvendo o indivíduo, os grupos atendidos e sua cultura territorial. A abordagem apresentada foi implementada em uma pequisa-ação, junto com a Comunidade Caiçara da Praia do Sono e o Fórum de Comunidades Tradicionais de Angra dos Reis, Paraty e Ubatuba (FCT), a partir do projeto Observatório de Territórios Sustentáveis e Saudáveis da Bocaina (OTSS/Fiocruz). Pode-se constatar que a inclusão dos atores na mobilização social para o saneamento pode estabelecer uma participação social efetiva, que gere tanto uma mudança subjetiva na consciência dos diversos atores locais, como ganhos estruturais que promovam saúde e qualidade de vida. O panorama abordado mostra a importância de uma compreensão global do problema, mas também, simultaneamente, uma atuação local, territorializada, adaptada a cada realidade por meio do diálogo genuíno e uma participação horizontal.


Abstract This article presents an integral approach to work in community projects, based on Guattari's three ecologies and its dialogue with psychosocial theorists, since it involves the need to combine technological interventions with social approaches. These contributions are explored to point out the need for dialogue in the implementation of sanitation actions, mainly in the rural area and in traditional communities, involving the individual, the groups served and their territorial culture. The approach presented was implemented in a joint action with the Caiçara Community of Praia do Sono and the Forum of Traditional Communities of Angra dos Reis, Paraty and Ubatuba (FCT), based on the Observatory of Sustainable and Healthy Territories of Bocaina (OTSS / Fiocruz). It could be verified that the inclusion of the actors in the social mobilization for the sanitation can entail an effective social participation that generates both a subjective change in the conscience of the diverse local actors and structural gains that promote health and quality of life. The panorama covered shows the importance of a global understanding of the problem, but also, of a simultaneous local, territorialized action, adapted to each reality through genuine dialogue and horizontal participation.


Subject(s)
Humans , Rural Population , Sanitation , Quality of Life , Agriculture , Health Promotion
5.
Säo Paulo med. j ; 139(1): 72-76, Jan.-Feb. 2021.
Article in English | LILACS | ID: biblio-1156962

ABSTRACT

ABSTRACT Coronavirus is a family of viruses that cause respiratory infections. From cases first recorded in China at the end of 2019, a new type of virus in this family, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was discovered. The disease caused by this virus, COVID-19, was brought into Brazil by people in social classes with greater purchasing power, but groups with larger demographic dimensions have tended to become more affected over time. Poor sanitation can generate risky situations and behavior among people who live in spaces with characteristics that limit their quality of life. Installation of piped water in homes and basic education for the population are fundamental measures for disease control, including in relation to COVID-19. In this updating article, the COVID-19 pandemic was analyzed in the context of iniquities in Brazil (comparing these with the situation in other countries). A bibliographic search of texts relating to basic sanitation, socioeconomic development and transmission of COVID-19 in Brazil and worldwide was conducted.


Subject(s)
Humans , Sanitation , Pandemics , COVID-19/transmission , COVID-19/epidemiology , Quality of Life , Socioeconomic Factors , Brazil/epidemiology
7.
Ciênc. Saúde Colet ; 26(1): 351-357, jan. 2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1153766

ABSTRACT

Resumo Este estudo investigou o desenvolvimento humano de oito municípios cearenses rurais que possuem o Sistema Integrado de Saneamento Rural (SISAR) e 170 que não o possuem. Desenvolveu-se um estudo a partir de Indicadores de Desenvolvimento Humano Municipal (IDHM) que constam na plataforma Atlas do Desenvolvimento Humano, extraindo-se dados dos Censos Demográficos de 1991, 2000 e 2010. Contou-se com o auxílio do software R para realização das análises estatísticas. Os resultados encontrados para o IDHM geral mostraram uma diferença significativa entre as médias dos dois grupos, o que não ocorreu quando analisadas as dimensões renda, longevidade e educação. Em suma, verificou-se que, no geral, a implantação de sistemas de abastecimento de água contribui para o aumento dos níveis de desenvolvimento humano, mas, no que se refere às dimensões mais específicas, essa premissa não foi estatisticamente confirmada.


Abstract This study investigated the human development of eight rural municipalities in the state of Ceará that have the Integrated Rural Sanitation System (SISAR) and 170 that do not. The study was developed based on the Municipal Human Development Indicators (MHDIs), which feature in the Atlas of Human Development, by drawing data from the 1991, 2000 and 2010 Demographic Censuses. The R software was used to carry out the statistical analyses. The results found for the general MHDI showed a significant difference between the means of the two groups, which did not occur when the income, longevity, and education dimensions were analyzed. In sum, it was verified that, in general, implementing water supply systems contributes to increasing human development levels, but as regards the more specific dimensions, this premise was not statistically confirmed.


Subject(s)
Humans , Rural Population , Sanitation , Socioeconomic Factors , Water Supply , Brazil , Cities
8.
Bull. W.H.O. (Online) ; 99(11): 762-772, 2021. Tables, figures
Article in English | AIM | ID: biblio-1343719

ABSTRACT

Objective To investigate vaccine hesitancy leading to underimmunization and a measles outbreak in Rwanda and to develop a conceptual, community-level model of behavioural factors. Methods Local immunization systems in two Rwandan communities (one recently experienced a measles outbreak) were explored using systems thinking, human-centred design and behavioural frameworks. Data were collected between 2018 and 2020 from: discussions with 11 vaccination service providers (i.e. hospital and health centre staff); interviews with 161 children's caregivers at health centres; and nine validation interviews with health centre staff. Factors influencing vaccine hesitancy were categorized using the 3Cs framework: confidence, complacency and convenience. A conceptual model of vaccine hesitancy mechanisms with feedback loops was developed. Findings: A comparison of service providers' and caregivers' perspectives in both rural and peri-urban settings showed that similar factors strengthened vaccine uptake: (i) high trust in vaccines and service providers based on personal relationships with health centre staff; (ii) the connecting role of community health workers; and (iii) a strong sense of community. Factors identified as increasing vaccine hesitancy (e.g. service accessibility and inadequate follow-up) differed between service providers and caregivers and between settings. The conceptual model could be used to explain drivers of the recent measles outbreak and to guide interventions designed to increase vaccine uptake. Conclusion :The application of behavioural frameworks and systems thinking revealed vaccine hesitancy mechanisms in Rwandan communities that demonstrate the interrelationship between immunization services and caregivers' vaccination behaviour. Confidence-building social structures and context-dependent challenges that affect vaccine uptake were also identified.


Objectif Déterminer si une intervention au niveau de l'eau, de l'assainissement et de l'hygiène pourrait avoir une influence sur les comportements en la matière, considérés comme importants dans la lutte contre le trachome. Méthodes Nous avons mené un essai randomisé par grappes dans les régions rurales d'Éthiopie entre le 9 novembre 2015 et le 5 mars 2019. Nous avons réparti aléatoirement 20 échantillons où l'intervention consistait à développer les infrastructures d'assainissement et d'approvisionnement en eau et à promouvoir l'hygiène, et 20 échantillons n'ayant fait l'objet d'aucune intervention. Tous les échantillons du groupe d'intervention ont suivi une formation sur l'hygiène à l'école primaire, disposaient d'un point d'eau communautaire, d'un poste de lavage par ménage, de savon à domicile, et recevaient des visites de la part de travailleurs chargés d'enseigner les bonnes pratiques en matière d'hygiène. Nous avons évalué le niveau d'observance des mesures en effectuant des enquêtes annuelles au sein des foyers. Résultats En l'espace de 3 ans, le nombre de postes de lavage, de savons et de latrines dans les ménages a davantage augmenté dans le groupe d'intervention que dans le groupe de contrôle: la différence de risque s'élevait à 47 points de pourcentage (intervalle de confiance de 95%, IC: 41­53) pour les postes de lavage, à 18 points de pourcentage (IC de 95%: 12­24) pour le savon et à 12 points de pourcentage (IC de 95%: 5­19) pour les latrines. La proportion de gens déclarant se laver le visage au savon était plus grande dans le groupe d'intervention (différence de risque de 21 points de pourcentage; IC de 95%: 15­27 pour les enfants de 0 à 5 ans), tout comme celle mentionnant l'usage de latrines (différence de risque de 9 points de pourcentage; IC de 95%: 2­15 pour les enfants de 6 à 9 ans). Pour de multiples indicateurs, il a fallu attendre minimum un an après l'instauration du programme pour que les variations observées entre les groupes d'intervention et de contrôle deviennent statistiquement significatives; ces variations se sont ensuite maintenues lors des visites ultérieures. Conclusion Intervenir à l'école et au sein de la communauté a permis d'améliorer l'accès à l'hygiène et les comportements en la matière. Néanmoins, cette évolution prend du temps et plusieurs années d'intervention sont nécessaires.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Toilet Facilities , Sanitation , Trachoma , Hygiene , Ethiopia
9.
Article in English | AIM | ID: biblio-1368188

ABSTRACT

In 2020, as COVID-19 spread worldwide, prestigious entities published faulty predictions about the level of dissemination, especially when describing African countries and others with "weak healthcare systems." How could the best fall so short, even when using well-known epidemiological variables to predict the behavior of a hygiene-related malady? It might have been due to insufficient data since COVID-19 was a novelty, still poorly understood. The current study aimed to analyze how two variables ­population density and percentage of people with access to improved sanitation ­affected the number of confirmed COVID-19 cases in Mozambique by February 2021, almost one year since the first case in the country. All data were publicly available: population density in Census 2017, access to sanitation in the Mozambique Public Expenditure Review 2014, and the number of COVID-19 cases in the Ministry of Health's COVID-19 daily bulletin (no. 332). JASP 0.13.1.0 allowed correlating all variables, and MicrosoftExcel™ was chosen to perform fitting analysis to model the algebraic relationship between the number of cases and the other variables. The cases showed a positive correlation (r = 0.663) with density, and their relationship was consistent with a cubic function. Sanitation coverage also showed a positive correlation (r = 0.679), but the most straightforward algebraic representation was a quadratic function. The impact of population density on the number of COVID-19 cases was intuitive, but the logic points towards the highest number of cases where sanitation facilities lacked the most. Thus, the influence of other factors outweighed the effect of sanitation, or people tend to be careless before the sense of security where the sanitation is better. Nevertheless, these findings can support predictions and decision-making, and the population needs to abide by the Government's recommendations.


Subject(s)
Sanitation , Population Density , COVID-19
10.
Cad. Saúde Pública (Online) ; 37(6): e00233119, 2021. tab
Article in English | LILACS | ID: biblio-1278627

ABSTRACT

Abstract: This study aims (1) to test the association between access to basic sanitation/hygiene services in Brazilian households with their householders' socioeconomic and demographic characteristics; (2) to analyze the distribution of urban health-relevant elements in the census tracts according to their income, education and race/color composition. The information come from the 2010 Brazilian Demographic Census, which collected data regarding both household conditions and urban structure of the census tracts. Prevalence ratios were calculated using crude and adjusted Poisson regression models. The proportional distribution of the census-tract urban structure was performed, according to the deciles of the exploratory variables, and the ratios and the absolute differences between the extreme deciles were calculated. Around 4.8% of the households had no piped water, 34.7% had no sewage collection system, 9.8% had no garbage collection and 39% were considered inadequate. Families whose householders were black, indigenous or brown had lower income and educational level, and lived in the North, Northeast, and Central West regions. They were more likely to be considered inappropriate for not having piped water, sewage collection system, and garbage collection. Moreover, sectors where the majority of the population was black, had lower educational levels and lower income had significantly poor paving, street lighting, afforestation, storm drain, sidewalk and wheelchair ramp. This study analyzed national data from 2010 and provides a baseline for future studies and government planning. The relevant social inequalities reported in this study need to be addressed by effective public policies.


Resumo: Os objetivos do estudo foram: (1) testar a associação entre os serviços de saneamento básico/higiene nos domicílios brasileiros e as características socioeconômicas e demográficas dos/das chefes de família e (2) analisar a distribuição dos elementos urbanos relacionados à saúde nos distritos sanitários de acordo com a composição de renda, escolaridade e raça/cor. Os dados foram obtidos do Censo Demográfico de 2010, que coletou informações sobre as condições do domicílio e a infraestrutura urbana dos distritos censitários. Foram calculadas as razões de prevalência, usando modelos de regressão Poisson simples e ajustada. Foi avaliada a distribuição proporcional da infraestrutura urbana nos distritos censitários de acordo com os decis das variáveis exploratórias, e foram calculadas as razões e diferenças absolutas entre os decis extremos. Cerca de 4,8% dos domicílios não dispunham de água encanada, 34,7% faltavam esgotamento sanitário, 9,8% não tinham coleta de lixo e 39% das moradias eram consideradas inadequadas. Os domicílios chefiados por pretos/as, pardos/as ou indígenas apresentavam níveis mais baixos de renda e escolaridade, e aqueles localizados no Norte, Nordeste e Centro-oeste tinham níveis maiores de moradia inadequada e falta de água encanada, esgotamento sanitário e coleta de lixo. Além disso, os distritos com maioria negra e com menores níveis de escolaridade e renda apresentavam menores coberturas de pavimentação, iluminação e arborização de ruas, galerias pluviais, calçadas e rampas para cadeira de rodas. O estudo analisou os dados de 2010 e estabeleceu uma linha de base para estudos futuros e planejamento de políticas de governo. As desigualdades sociais relevantes relatadas no estudo devem ser enfrentadas com políticas públicas efetivas.


Resumen: Los objetivos de este estudio son: (1) probar la asociación entre el acceso a servicios básicos de higiene y saneamiento en los hogares brasileños con sus principales características socioeconómicas y demográficas; (2) analizar la distribución de elementos urbanos relevantes para la salud en secciones censales, según la composición de sus ingresos, educación y raza/color. Los datos provienen del Censo Demográfico de 2010, que recogió datos, tanto respecto a las condiciones de los hogares, como al entorno urbano de las secciones censales. Las ratios de prevalencia se calcularon usando modelos de regresión crudos y ajustados de Poisson. Se realizó una distribución proporcional de las secciones censales relacionadas con el entorno urbano, según deciles de las variables exploratorias y las ratios, y se calcularon las diferencias absolutas entre los deciles extremos. Alrededor de un 4,8% de los hogares no contaban con agua canalizada, 34,7% no tenían un sistema de alcantarillado, un 9,8% no tenían recogida de basuras y un 39% de los hogares fueron considerados inadecuados. Hogares, cuyas cabezas de familia eran negros, indígenas o mulatos/mestizos, tenían bajos ingresos, educación, y vivían en el Norte, Noreste, y Centro-oeste tuvieron más probabilidad de ser considerados inapropiados, no contar con agua canalizada, sistema de alcantarillado y recogida de basuras. Además, los sectores donde la mayoría de la población era negra, con bajos niveles educativos e ingresos más bajos tenían significativamente menos cobertura de pavimentación, iluminación de calles, forestación, alcantarillado pluvial, aceras y rampas de acceso para sillas de ruedas. Este estudio analizó los datos nacionales desde 2010 y proporciona una base de referencia para futuros estudios y planificación gubernamental. Las inequidades relevantes sociales reflejadas en este estudio necesitan que ser tratadas mediante políticas públicas eficientes.


Subject(s)
Humans , Censuses , Housing , Socioeconomic Factors , Urban Population , Brazil , Sanitation
11.
Article in English | WPRIM | ID: wpr-922194

ABSTRACT

Antimicrobial resistance (AMR) is increasingly becoming a threat to global public health, not least in low- and middle-income countries (LMICs) where it is contributing to longer treatment for illnesses, use of higher generation drugs, more expenditure on antimicrobials, and increased deaths attributed to what should be treatable diseases. Some of the known causes of AMR include misuse and overuse of antimicrobials in both humans and animals, unnecessary use of antimicrobials in animals as growth promoters, and lack of awareness among the public on how to protect antimicrobials. As a result, resistant organisms are circulating in the wider environment, and there is a need to consider the One Health approach to minimise the continuing development of AMR. Environmental Health, specifically water, sanitation and hygiene (WASH), waste management, and food hygiene and safety, are key components of One Health needed to prevent the spread of antimicrobial-resistant microorganisms particularly in LMICs and reduce the AMR threat to global public health. The key Environmental Health practices in the prevention of AMR include: (1) adequate WASH through access and consumption of safe water; suitable containment, treatment and disposal of human excreta and other wastewater including from health facilities; good personal hygiene practices such as washing hands with soap at critical times to prevent the spread of resistant microorganisms, and contraction of illnesses which may require antimicrobial treatment; (2) proper disposal of solid waste, including the disposal of unused and expired antimicrobials to prevent their unnecessary exposure to microorganisms in the environment; and (3) ensuring proper food hygiene and safety practices, such as sale and consumption of animal products in which adequate antimicrobial withdrawal periods have been observed, and growing vegetables on unpolluted soil. Environmental Health is therefore crucial in the prevention of infectious diseases that would require antimicrobials, reducing the spread of resistant organisms, and exposure to antimicrobial residues in LMICs. Working with other professionals in One Health, Environmental Health Practitioners have a key role in reducing the spread of AMR including health education and promotion, surveillance, enforcement of legislation, and research.


Subject(s)
Developing Countries , Disease Transmission, Infectious/prevention & control , Drug Resistance, Microbial , Environmental Health/standards , Food Safety , Health Personnel/standards , Humans , Hygiene/standards , Role , Sanitation/standards , Waste Management/standards
12.
Article in English | WPRIM | ID: wpr-880345

ABSTRACT

INTRODUCTION@#Approximately 1000 children die each year due to preventable water and sanitation-related diarrheal diseases. Six in 10 people lacked access to safely managed sanitation facilities in 2015. Numerous community- and school-based approaches have been implemented to eradicate open defecation practices, promote latrine ownership, improve situation sanitation, and reduce waterborne disease.@*OBJECTIVE@#Given that current evidence for sanitation interventions seem promising, the aim of this study was to systematically summarize existing research on the effectiveness of community- and school-based randomized controlled sanitation intervention in improving (1) free open defecation (safe feces disposal), (2) latrine usage, (3) latrine coverage or access, and (4) improved latrine coverage or access.@*METHODS@#Eight electronic databases were searched: PubMed, Scopus, WHO Global Health Library (GHL), Virtual Health Library (VHL), POPLINE, Web of Science, Cochrane, and Google Scholar up to 26 April 2019. Original randomized clinical trials addressing community-based or school-based intervention that reported feces disposal and latrine coverage were deemed eligible. More than two researchers independently contributed to screening of papers, data extraction, and bias assessment. We conducted a meta-analysis by random-effects model. The risk of bias was assessed by the Cochrane risk of bias tool.@*RESULTS@#Eighteen papers that matched all criteria and 16 studies were included in the final meta-analysis. Compared to the control, the sanitation intervention significantly increased safe feces disposal (OR 2.19, 95% CI 1.51-3.19, p < 0.05, I@*CONCLUSION@#Our study showed strong evidence for both community- and school-based sanitation interventions as effective for the safe disposal of human excreta. The finding suggests major implications for health policy and design of future intervention in developing countries.


Subject(s)
Community Participation/statistics & numerical data , Randomized Controlled Trials as Topic , Sanitation/instrumentation , School Health Services/statistics & numerical data , Toilet Facilities/statistics & numerical data
13.
Hist. ciênc. saúde-Manguinhos ; 27(4): 1035-1053, Oct.-Dec. 2020.
Article in Portuguese | LILACS | ID: biblio-1142985

ABSTRACT

Resumo Em 1906, Emílio Ribas reorganizou o Serviço Sanitário e centralizou na capital os serviços de saúde pública do estado de São Paulo. Nesse projeto, a campanha de combate ao tracoma, uma enfermidade oftálmica, foi implantada. Este artigo analisa essa campanha que atendeu os enfermos das propriedades rurais em um processo que antecedeu ao Código Sanitário Rural de 1917. O material empírico foi composto por relatórios governamentais, decretos, periódicos médicos e jornais. Concluímos que Ribas, ao criar uma estrutura que unificou os esforços dos distritos sanitários com as equipes de atendimento das Comissões do Tracoma, buscou formar um complexo aparato para combater as enfermidades presentes tanto nas áreas urbanas quanto na zona rural.


Abstract In 1906, Emílio Ribas reorganized the Sanitation Service and centralized São Paulo state public health services in the state capital. A campaign to combat trachoma, an ophthalmic disease, was implemented as part of this project. This article analyzes this campaign, which provided care for the sick living on rural properties in a process that predated the 1917 Rural Sanitary Code. The empirical data was obtained from government reports, decrees, medical journals and newspapers. We conclude that Ribas, by creating an organization that integrated the efforts of the sanitary districts and the Trachoma Commission medical teams, sought to form a complex apparatus to combat the diseases present in both urban areas and the countryside.


Subject(s)
Humans , History, 19th Century , History, 20th Century , Sanitation/history , Trachoma/history , Rural Health Services/history , Public Health Administration/history , Brazil/epidemiology , Sanitation/legislation & jurisprudence , Trachoma/prevention & control , Trachoma/epidemiology , Communicable Disease Control/history , Communicable Disease Control/organization & administration , Administrative Personnel/history , Health Promotion/history
14.
Ciênc. Saúde Colet ; 25(10): 3753-3763, Out. 2020. tab
Article in English, Portuguese | LILACS, ColecionaSUS, SES-SP | ID: biblio-1133016

ABSTRACT

Resumo Este estudo apresenta uma comparação entre domicílios indígenas e não indígenas no tocante à presença de infraestrutura de saneamento básico em áreas urbanas e rurais do Brasil a partir dos dados dos Censos de 2000 e 2010. As análises se basearam em estatísticas descritivas e modelos de Regressões Logísticas Múltiplas (RLM). Os resultados indicam o aumento da presença dos serviços analisados nos domicílios brasileiros ao longo da década. Não obstante, domicílios indígenas apresentaram piores condições sanitárias em 2010. Esgotamento sanitário foi o serviço mais precário registrado em ambos os Censos, com ocorrência ainda menos pronunciada nos domicílios indígenas. Os modelos de RLM confirmaram os resultados descritivos, no sentido de que os domicílios indígenas apresentaram piores condições quanto à presença de serviços de saneamento básico. Observou-se que, em algumas áreas, como o Norte urbano, Sudeste urbano e Centro-Oeste rural, houve o aumento das desigualdades entre domicílios indígenas e não indígenas de 2000 para 2010. O presente estudo não apenas aponta para condições de saneamento menos adequadas em domicílios indígenas no Brasil, como também evidencia a persistência de expressivas desigualdades associadas à cor ou raça.


Abstract This study compares the availability of basic sanitation infrastructure in indigenous and nonindigenous household located in urban and rural areas using data from the 2000 and 2010 Brazilian National Censuses. The analyses were based on descriptive statistics and modelling with multiple logistic regression. While there was an increase in the availability of basic sanitation in Brazilian households over the decade, indigenous households continued to have worse conditions in 2010. Sewage was the sanitation service with the lowest coverage in both censuses, and indigenous households had a lower rate of sewage services than nonindigenous households did. Logistic regression results confirmed the findings of the descriptive analyses, attesting to the fact that sanitation conditions are worse in indigenous households. In some areas, such as the urban North and Southeast and rural areas of the Central-West region, the gap in basic sanitation infrastructure between indigenous and nonindigenous households increased from 2000 to 2010. This study not only indicates the less-adequate sanitation conditions in indigenous households in Brazil but also attests to the persistence of major inequalities associated with race or color in the country.


Subject(s)
Humans , Sanitation , Censuses , Socioeconomic Factors , Brazil , Family Characteristics , Population Groups
15.
Ciênc. Saúde Colet ; 25(10): 3857-3868, Out. 2020. tab, graf
Article in Portuguese | LILACS, ColecionaSUS, SES-SP | ID: biblio-1132995

ABSTRACT

Resumo Quais as repercussões da urbanização mal planejada na saúde da população? Entender a saúde urbana, os riscos acarretados pelas cidades, as repercussões na saúde e as relações sociais auxiliam no planejamento no qual a prevenção deve ser investida. Assim, com o objetivo de verificar a relação entre urbanização e saúde urbana, em especial as infecções ocasionadas pelo vetor "Aedes aegypti", foi realizado um estudo qualitativo e uma investigação descritiva e analítica através de busca documental e bibliográfica. Os resultados apontam que os impactos ambientais decorrentes da falta de infraestrutura resultante da urbanização podem oferecer riscos à saúde humana, visto que a disposição de resíduos em lixões e aterros podem ocasionar exposição a substâncias químicas perigosas à saúde. Além disso, o saneamento ineficaz pode acarretar em doenças veiculadas pela água e propiciar a reprodução de vetores de outras enfermidades, como é o caso do "Aedes aegypti", responsável pela transmissão das arboviroses (dengue, chikungunya e Zika). Dessa forma, estudar saúde ambiental e urbana proporciona embasamento para a promoção de qualidade de vida das pessoas que residem nessas áreas e permite propor medidas que evitem doenças relacionadas à urbanização.


Abstract What are the repercussions of poorly planned urbanization for population health? Understanding urban health, the risks posed by cities, health repercussions, and urban social relations helps urban planners to decide where to target prevention interventions. We conducted a qualitative descriptive analytical study based on a document analysis and bibliographical review to explore the relationship between urbanization and urban health, focusing on diseases transmitted by the mosquito Aedes aegypti. Our findings show that environmental degradation and inadequate infrastructure pose a serious risk to human health, insofar as the disposal of waste in dumps and landfills can cause exposure to hazardous chemicals. In addition, inadequate urban infrastructure and sanitation is conducive to the transmission of water-borne diseases and the reproduction of vectors of other diseases such as Aedes aegypti, responsible for the transmission of arboviruses (dengue, chikungunya, and Zika). Research on environmental and urban health therefore provides an important foundation for improving the quality of life of people living in cities and developing measures designed to prevent diseases related to unplanned urbanization.


Subject(s)
Humans , Animals , Arboviruses , Aedes , Dengue/prevention & control , Dengue/epidemiology , Zika Virus , Zika Virus Infection , Quality of Life , Sanitation , Urban Health , Cities , Mosquito Vectors
16.
Salud(i)ciencia (Impresa) ; 24(3): 124-130, sept. 2020. tab.
Article in Spanish | LILACS, BINACIS | ID: biblio-1146404

ABSTRACT

Introduction: The decreasing prevalence of parasitosis from north to south in Argentina has led the scientific community to focus the epidemiological studies on the most vulnerable areas and, consequently, neglect the populations of Patagonia (South Argentina). The objectives of the present study were (i) to determine the prevalence of intestinal parasites in children and youth of Puerto Madryn (Chubut province, Patagonia), and (ii) to evaluate the parasitic infections found concerning socio-environmental factors and hygiene practices of the population. Materials and methods: Serial stool samples were processed using modified Ritchie and FLOTAC dual pellet techniques, and samples of anal swabs were examined by sedimentation. Socio-environmental variables and hygiene practices of the participants were surveyed using a semi-structured questionnaire. Results: Of all examined participants, 39.1% (68/174) were parasitized. A total of 6 parasite species were found and the most prevalent were Blastocystis sp (19.0%), Enterobius vermicularis (17.8%), and Giardia lamblia (6.3%). The risk of parasitosis and infection for Blastocystis sp was greater in participants who lived in houses without piped water (OR = 2.9 and OR = 3.2, respectively). The risk of infection for G. lamblia was positively associated with the lack of public waste collection service (OR = 5.6). Infection for E. vermicularis was higher in participants whose parents had a basic level of education (OR = 5.0). Conclusion: The parasitic infections observed reflect the environmental conditions of Patagonia and the need to focus studies on populations from peripheral areas to urban centers that are exposed to greater socio-economic vulnerability.


Introducción: La prevalencia de parasitosis decreciente de norte a sur en la Argentina, ha llevado a la comunidad científica a enfocar sus estudios epidemiológicos hacia las zonas más vulnerables y desatender a las poblaciones de la Patagonia (sur de Argentina). Los objetivos del presente estudio fueron: determinar la prevalencia de parásitos intestinales en niños y jóvenes de Puerto Madryn (Chubut, Patagonia), y evaluar las infecciones parasitarias en relación con los factores socioambientales y las prácticas de higiene de la población. Materiales y métodos: Se procesaron muestras seriadas de materia fecal mediante las técnicas Ritchie modificada y FLOTAC dual pellet, y muestras de escobillado anal por sedimentación. Se relevaron las variables socioambientales y las prácticas de higiene de los participantes mediante cuestionarios semiestructurados. Resultados: El 39.1% (68/174) de la población analizada estuvo parasitado. Se halló un total de 6 especies parásitas, las más prevalentes de las cuales fueron Blastocystis sp (19.0%), Enterobius vermicularis (17.8%) y Giardia lamblia (6.3%). El riesgo de parasitosis y de infección por Blastocystis sp fue mayor en los participantes que no poseían agua de red (odds ratio [OR] = 2.9 y OR = 3.2, respectivamente). La infección por G. lamblia se asoció de manera positiva con la falta de recolección pública de residuos (OR = 5.6). La infección por E. vermicularis fue superior en los participantes con padres que tenían un nivel de estudios primario (OR = 5.0). Conclusión: Las infecciones parasitarias observadas reflejan las condiciones ambientales de la Patagonia y la necesidad de orientar los estudios a poblaciones periféricas de los centros urbanos, las cuales están expuestas a mayor vulnerabilidad socioeconómica


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Parasites , Argentina , Sanitation , Hygiene , Giardia lamblia , Blastocystis , Education , Enterobius , Intestines/parasitology
17.
Hist. ciênc. saúde-Manguinhos ; 27(supl.1): 211-230, Sept. 2020.
Article in English | LILACS | ID: biblio-1134086

ABSTRACT

Abstract Economic development and good health depended on access to clean water and sanitation. Therefore, because economic development and good health depended on access to clean water and sanitation, beginning in the early 1970s the World Bank, the World Health Organization (WHO), and others began a period of sustained interest in developing both for the billions without either. During the 1980s, two massive and wildly ambitious projects showed what was possible. The International Drinking Water Supply and Sanitation Decade and the Blue Nile Health Project aimed for nothing less than the total overhaul of the way water was developed. This was, according to the WHO, "development in the spirit of social justice."


Resumo Crescimento econômico e boa saúde dependem de acesso a saneamento e água limpa. Assim, o Banco Mundial, a Organização Mundial da Saúde (OMS) e outros órgãos, a partir do início da década de 1970, inauguraram um período de contínuo interesse no desenvolvimento de ambos para bilhões de pessoas desprovidas de tais necessidades. Durante a década de 1980, dois projetos monumentais e extremamente ambiciosos demonstraram o que era viável fazer. A International Drinking Water Supply and Sanitation Decade e o Blue Nile Health Project visavam à total reestruturação do modelo de desenvolvimento da água. Tratava-se, segundo a OMS, do "desenvolvimento do espírito de justiça social".


Subject(s)
Humans , History, 20th Century , Water Supply/history , Public Health Practice/history , Sanitation/history , Global Health/history , United Nations/history , World Health Organization/history , Africa
18.
Rev. adm. pública (Online) ; 54(4): 1022-1036, jul.-ago. 2020. graf
Article in Portuguese | LILACS | ID: biblio-1136984

ABSTRACT

Resumo A essencialidade da água à vida talvez tenha ficado ainda mais evidente com a pandemia da COVID-19. Aos prestadores dos serviços de saneamento foi atribuída a responsabilidade de garantir à população a manutenção do abastecimento de água potável, fornecendo meios para que ela pudesse preservar os hábitos de higiene e controlar a propagação do vírus. No entanto, como se poderia garantir que a prestação do serviço não fosse afetada, seja pelo acometimento dos funcionários, seja pela reduzida capacidade de pagamento dos usuários? Este foi o desafio enfrentado pelos prestadores. Diversas foram as medidas adotadas pela Administração Pública para responder no curto prazo a esse desafio, tais como: restrição ao atendimento presencial nas unidades, isenção tarifária aos usuários da tarifa social e suspensão do corte por inadimplência. Contudo todas estas medidas podem desequilibrar as contas dos prestadores de serviço, deixando-os em uma situação de instabilidade que, a princípio, deverá ser sustentada até o fim da pandemia, quando os processos de reequilíbrio econômico-financeiro serão conduzidos pelos reguladores. Estes são e continuarão sendo os principais atores na minimização dos impactos que incidiram sobre os prestadores e na mediação das negociações futuras. Este artigo traz recomendações aos reguladores sobre como tratar os desequilíbrios causados pela pandemia nos futuros processos. Caberá aos reguladores emitir diretrizes claras com relação ao procedimento a ser adotado pelos prestadores, para que possam pleitear o reequilíbrio de suas contas. Deve-se cogitar neste momento a flexibilização das metas contratuais.


Resumen Talvez, la esencialidad del agua para la vida se ha hecho aún más evidente con la pandemia de COVID-19. Los proveedores de servicios de saneamiento tuvieron la responsabilidad de mantener el suministro de agua potable para proporcionarle a la población los medios para mantener sus hábitos de higiene y controlar la propagación del virus. Pero, ¿cómo podría garantizarse que la prestación del servicio no se vería afectada, sea por la disminución de empleados o la capacidad de pago reducida de los usuarios? Este fue el desafío planteado a los proveedores. La Administración Pública tomó varias medidas para responder rápidamente a este desafío. Las iniciativas más adoptadas fueron la restricción del servicio presencial, la exención de tarifas para los usuarios vulnerables socioeconómicamente y la suspensión del corte por incumplimiento. El hecho es que todas las medidas pueden desequilibrar las cuentas de los proveedores de servicios, dejándolos en una situación de inestabilidad que, en principio, debería mantenerse hasta el final de la pandemia, cuando los reguladores llevarán a cabo los procesos de reequilibrio económico y financiero. Los reguladores son y serán los principales actores para minimizar los impactos en los proveedores y mediar en las negociaciones futuras. Este artículo proporciona recomendaciones a los reguladores sobre cómo abordar los desequilibrios causados por la pandemia en procesos futuros. Competirá a los reguladores emitir pautas claras con respecto al procedimiento que adoptarán los proveedores para que puedan reclamar el reequilibrio de sus cuentas. En este momento, se debe considerar la flexibilización de los objetivos contractuales.


Abstract The COVID-19 pandemic has evidenced the essentiality of water more prominently. Service providers were responsible for maintaining drinking water supply to the population to maintain good hygiene habits and control the spread of the virus. However, the challenge for providers was guaranteeing the service would not be affected, either by employees falling ill or by users unable to pay for the service provision. Public administration adopted several measures to respond in the short term to this challenge. The actions most frequently observed were the restriction of in-person services, payment exemption for vulnerable users, and suspension of procedures against non-payment. The measures may have unbalanced the accounts of the service providers, leaving them in a situation of instability that, in principle, should be sustained until the end of the pandemic, when the regulators will conduct the process to re-establishing the financial balance. The regulators are and will be the main actors in minimizing the impacts on providers and in mediating future negotiations. This article provides recommendations to regulators on how to address the imbalances caused by the pandemic in future processes. Regulators will have to issue clear guidelines regarding the procedures that providers will adopt to rebalance their accounts. Consideration should be given at this time to making contractual targets more flexible.


Subject(s)
Humans , Male , Female , Water Supply , Financial Support , Sanitation , Hygiene , Coronavirus Infections , Economics
19.
Rev. adm. pública (Online) ; 54(4): 1111-1122, jul.-ago. 2020. tab, graf
Article in English | LILACS | ID: biblio-1136979

ABSTRACT

Abstract Populations living in favelas are facing even more vulnerabilities with the sudden escalation of the COVID-19 pandemic, as social distancing is challenging in such settings. Furthermore, these populations typically lack proper sanitation and hygiene conditions, which are requirements to adequately control the outbreak. This paper proposes the use of System Dynamics modeling to support the public policy-making process in order to avert negative effects of the pandemic in the Brazilian favelas based on measures elicited from the social movement named "Favelas Contra o Corona." The simulation model assessed the effectiveness of strategies and policy bundles encompassing temporary transfer of the favela population, supply of hygiene products, emergency sanitation structures, and expansion of Intensive Care Units. Results indicate that a suitable combination of strategies can bring significant effects to the number of avoidable deaths and the availability of Intensive Care Units for the population.


Resumen Las poblaciones que viven en barrios de bajos recursos enfrentan aún más vulnerabilidades con el surgimiento de la pandemia de COVID-19, ya que para ellos el aislamiento social es una tarea difícil. Además, carecen de condiciones adecuadas de saneamiento e higiene, que son requisitos para controlar la pandemia. Este estudio propone el uso de la Dinámica de Sistemas para apoyar las decisiones de políticas públicas que leen las medidas que se tomarán para aliviar los efectos negativos de la propagación del virus basado en medidas obtenidas del trabajo del movimiento social "Favelas Contra o Corona". Se desarrolla un modelo considerando estrategias y conjunto de políticas basado en: transferencia temporal de la población de barrios de bajos recurso, suministro de productos de higiene, estructuras de saneamiento de emergencia y expansión de la Unidade de Cuidados Intensivos. Se concluye que la solamente por la combinación de políticas efectos significativos serán alcanzados en el número de muertes evitadas y en el logro de la disponibilidad de Unidade de Cuidados Intensivos en el sistema de salud.


Resumo Populações vivendo em favelas no Brasil enfrentam ainda mais vulnerabilidade com o advento da COVID-19, já que para elas o isolamento social é uma tarefa difícil. Além disso, esses locais carecem de saneamento e condições de higiene, que são requisitos importantes para controlar a pandemia. Este artigo propõe o uso de Dinâmica de Sistemas para apoiar decisões de políticas públicas relativas a medidas para aliviar os efeitos negativos da disseminação do vírus baseado em medidas definidas a partir do trabalho do movimento social "Favelas Contra o Corona". O modelo proposto avalia a efetividade de estratégias e conjuntos de políticas que envolvem: transferência temporária da população da favela, suprimento de produtos de higiene, estruturas emergenciais de saneamento e expansão de Unidades de Terapia Intensiva. Os resultados apresentam o impacto de cada uma das estratégias. Entretanto, somente a combinação adequada de medida traz resultados significativos sobre o número de mortes evitadas e à disponibilidade de leitos de Unidades de Terapia Intensiva para a população.


Subject(s)
Humans , Male , Female , Public Policy , Poverty Areas , Sanitation , Health , Coronavirus Infections , Vulnerable Populations
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