Effectiveness of community and school-based sanitation interventions in improving latrine coverage: a systematic review and meta-analysis of randomized controlled interventions

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.

Principais mensagens sobre água, Saneamento e higiene e COVID-19 Instituições responsáveis pelos serviços de água e saneamento (esgoto) / Recomendaciones clave de agua, saneamiento e higiene: COVID-19. Instituciones responsables de agua y saneamiento / Main messages on water, sanitation and hygiene and COVID-19 Institutions responsible for water and sanitation (sewage) services

Os responsáveis pelos serviços de água e saneamento têm um papel relevante na prevenção e controle do vírus causador da doença COVID-19, e é importante que o abastecimento de água, saneamento e higiene sejam gerenciados com segurança, garantindo o cumprimento das regulamentações nacionais. Recomenda-se ativar os mecanismos de coordenação entre os diferentes setores relacionados à água e saneamento, tais como: saúde, educação, habitação, meio ambiente, municípios, instituições governamentais e reguladoras, para facilitar ações conjuntas, oportunas e de maior impacto.

Los responsables de agua y saneamiento tienen un rol relevante en la prevención y control de COVID-19, por lo que es importante que los servicios de agua, saneamiento e higiene sean gestionados de forma segura, garantizando el cumplimiento de las normativas nacionales.

Recomendações importantes sobre água, saneamento e higiene COVID-19 na comunidade / Recomendaciones clave de agua, saneamiento e higiene: COVID-19 en la comunidad / Important recommendations on water, sanitation and hygiene COVID-19 in the community

Boas práticas com água, saneamento e higiene, em particular lavagem de mãos com sabão e água limpa, devem ser estritamente aplicadas e mantidas, pois são importantes barreiras adicionais para a transmissão do o vírus causador da doença COVID-19 e outras doenças infecciosas em geral (OMS, 2002).

Las mejores prácticas de agua, saneamiento e higiene, en particular el lavado de manos con jabón y agua limpia, deben aplicarse y mantenerse estrictamente, ya que constituyen una barrera adicional importante para la transmisión de COVID-19 y para la transmisión de enfermedades infecciosas en general (OMS, 2002).

Recomendações importantes sobre água, saneamento e higiene COVID-19. Estabelecimentos de saúde / Recomendaciones clave de agua, saneamiento e higiene: COVID-19. Establecimientos de salud / Important recommendations on water, sanitation and hygiene COVID - 19. Health facilities

As recomendações existentes sobre água, saneamento e higiene nos estabelecimentos de saúde são importantes para garantir o atendimento adequado ao paciente e proteger tanto pacientes quanto funcionários. Estas incluem: fornecimento suficiente de água potável segura para funcionários, cuidadores e pacientes, higiene pessoal, lavanderia e limpeza; banheiros adequados e acessíveis; gerenciamento seguro de dejetos, incluindo a manutenção das fezes e urina separados do contato humano, seu tratamento e descarte seguros no ambiente; higiene frequente das mãos usando a técnica adequada; limpeza e desinfecção periódica; e gerenciamento seguro de resíduos de saúde.

Las medidas recomendadas existentes de agua, saneamiento e higiene en entornos de atención médica son importantes para proporcionar una atención adecuada a los pacientes y proteger a los pacientes y al personal considerando: la provisión suficiente de agua potable segura para el personal, los cuidadores y los pacientes; la higiene personal; la lavandería y la limpieza.

Assessment of sanitary measures of ras cheese in manufacturing dairy plant in Alexandria governorate

The assessment of sanitary measures of Ras cheese was undertaken through microbiological evaluation of cheese and its processing environments in traditional manufacturing dairy plant in Alexandria Governorate. A total of 215 representative samples include received raw milk [25], cheese curd [25], fresh Ras cheese [25], three months aged Ras cheese [25], and six months aged Ras cheese [25]. As well as swabs from cheese vat [15], stainless-steel cylindrical forms [15], stainless-steel tables [15] and hand workers [15] were taken. Also [15] samples of rennet and [15] samples of annatto [coloring agent] were collected. The trials were repeated 3 times from 3 different patches within 6 months to ensure the most contaminated points. Raw milk was heavily contaminated as the mean values of total bacterial count, Coliforms count, S. aureus count and total Yeast and Mould count were 1.11 x 10[7] +/- 2.45 x 10[6] cfu/ml, 8.24 x 10[4] +/- 1.68 x 10[4] cfu/ml, 7.77 x 10[2] +/- 4.33 x 10[2] cfu/ml and 4.10 x 10[2] +/- 2.0 x 10[2] cfu/ml, respectively. Meanwhile Slight decline of all these counts was observed in curd samples. Then the counts increases again in fresh cheese samples specially Coliforms and S. aureus counts as folow 1.88 x 10[3] +/- 8.13 x 10 cfu/gm and 1.64 x 10[3] +/- 3.66 x 10[2] cfu/gm, respectively. Three aged cheese samples revealed slight reduction in Coliforms and S. aureus counts as follow 1.44 x 10[2] +/- 2.14 x 10 cfu/gm and 8.41 x 10 +/- 1.80 x 10 cfu/gm, respectively. Meanwhile, 6 months aged cheese samples shows great reduction of Coliforms and S. aureus counts as follow 0.2 x 10 +/- 0 cfu/gm and 2.66 x 10 +/- 8.43 x 10 cfu/gm, respectively indicating the fact that the prolonged aging of Ras cheese increase the safety of the product. Samples of rennet, Cheese vat, stainless-steel cylindrical forms and stainless-steel tables showed high contamination with TBC and Coliforms while hand workers swabs were harbored high S. aureus and Coliforms counts. Results pose that the most reliable sources of contamination along Ras cheese manufacturing line were received raw milk, rennet, vats, forms, tables as well as hand workers. Preventive measures and GMP these could be applied to improve the hygienic quality of Ras cheese were fully discussed

Equipamentos de saneamento e desigualdades no espaço metropolitano do Rio de Janeiro / Basic sanitary systems and social inequalities in the Rio de Janeiro metropolitan area

Trata da distirbuiçäo de investimentos em equipamentos de saneamento básico na regiäo metropolitana do Rio de Janeiro no período 1975-91. Distribuímos as inversöes realizadas pela concessionária estadual, a CEDAE, em uma base espacial produzida especialmente para a realizaçäo da presente pesquisa. Esta base foi construída utilizando como indicadores sociais informaçöes do censo demográfico de 1980, único realizado no decorrer do período estudado. As transformaçöes recentes observadas säo explicadas a partir das conjunturas sócio-espaciais e políticas da metrópole e do país, assim como da própria forma de organizaçäo dos serviços. Acrescenta importantes argumentos aos debates sobre a reestruturaçäo dos espaços metropolitanos e as políticas públicas urbanas. A distribuiçäo espacial e social dos investimentos observada no período diferiu do padräo vigente até entäo, mas, embora tenha ocorrido uma substancial democratizaçäo na alocaçäo dos recursos públicos, o padräo näo foi subvertido.

Informe del Ministerio de Salud sobre la epidemia del cólera a la comunidad internacional / Report of Ministry of Health to international community about cholera epidemy

Informe presentado en una reunión con los organismos internacionales y embajadas en el Perú. Contiene cuadros estadísticos y gráficos sobre los casos reportados al 20 de febrero de 1991 y lineamientos básicos sobre la canalización de la cooperación externa mediante el MINSA. Finalmente hace un listado presupuestado por rubros, con lo que se necesita para combatir la epidemia

Plan maestro para el desarrollo del servicio de agua potable y alcantarillado de la región Amazonas: ficha de solicitud de cooperación internacional

El PLan Maestro se desarrolla en el ámbito geográfico de la Región Amazonas, el mismo que coincide con el departamento de Loreto, ubicado en la región nor-oriental del Perú, con una extensión territorial de 379,025 km* (casi el 30% de su superficie territorial). Abarcará a todas las provincias y distritos del departamento de Loreto, que involucran una población actual de 640,454 habs. y estimada de 886,538 habs. para el año 2000