Impact of a School Trachoma Program Emphasizing Facial Cleanliness and Environmental Improvement in Amhara, Ethiopia.

The SAFE (Surgery, Antibiotics, Facial cleanliness, Environmental improvement) strategy is the WHO's endorsed approach for eliminating trachoma as a public health problem; however, not all components have been treated equally. Historically, the F and E components have not been prioritized owing to their perceived complexity. With school enrollment increasing in Ethiopia, development of a national school health program that is focused on the F and E components represents an opportunity to strengthen the SAFE strategy in the country. In 2016, the Trachoma Control Program in Amhara, Ethiopia, along with its partners, developed a School Trachoma Program (STP) that offers grade-specific lessons to improve sanitation and hygiene knowledge and practices among primary school-aged children. To assess its impact, schools were sampled before implementation and then up to 1 year after STP rollout. The aim of this report is to detail STP outcomes and the associations between outcomes and school-level variables. By 2018, adoption of an STP was strong within Amhara, with 85% of the 137 surveyed schools completing their quarterly reports and nearly 80% having at least one teacher trained in the STP. By the end of the third quarter, nearly all schools (86%) had access to a latrine, and 89% of students had a clean face. A schoolwide orientation was associated with increased STP lessons and activities (P = 0.01). Development of an STP, with buy-in from principals and teachers, represents a promising approach for the adoption of a new F- and E-specific curriculum and may help advance efforts to eliminate trachoma.

Simulating internal watershed processes using multiple SWAT models.

The need for effective water quality models to help guide management and policy, and extend monitoring information, is at the forefront of recent discussions related to watershed management. These models are often calibrated and validated at the basin outlet, which ensures that models are capable of evaluating basin scale hydrology and water quality. However, there is a need to understand where these models succeed or fail with respect to internal process representation, as these watershed-scale models are used to inform management practices and mitigation strategies upstream. We evaluated an ensemble of models-each calibrated to in-stream observations at the basin outlet-against discharge and nutrient observations at the farm field scale to determine the extent to which these models capture field-scale dynamics. While all models performed well at the watershed outlet, upstream performance varied. Models tended to over-predict discharge through surface runoff and subsurface drainage, while under-predicting phosphorus loading through subsurface drainage and nitrogen loading through surface runoff. Our study suggests that while models may be applied to predict impacts of management at the basin scale, care should be taken in applying the models to evaluate field-scale management and processes in the absence of data that can be incorporated at that scale, even with the use of multiple models.

Source contribution to phosphorus loads from the Maumee River watershed to Lake Erie.

Coastal eutrophication is a leading cause of degraded water quality around the world. Identifying the sources and their relative contributions to impaired downstream water quality is an important step in developing management plans to address water quality concerns. Recent mass-balance studies of Total Phosphorus (TP) loads of the Maumee River watershed highlight the considerable phosphorus contributions of non-point sources, including agricultural sources, degrading regional downstream water quality. This analysis builds upon these mass-balance studies by using the Soil and Water Assessment Tool to simulate the movement of phosphorus from manure, inorganic fertilizer, point sources, and soil sources, and respective loads of TP and Dissolved Reactive Phosphorus (DRP). This yields a more explicit estimation of source contribution from the watershed. Model simulations indicate that inorganic fertilizers contribute a greater proportion of TP (45% compared to 8%) and DRP (58% compared to 12%) discharged from the watershed than manure sources in the March-July period, the season driving harmful algal blooms. Although inorganic fertilizers contributed a greater mass of TP and DRP than manure sources, the two sources had similar average delivery fractions of TP (2.7% for inorganic fertilizers vs. 3.0% for manure sources) as well as DRP (0.7% for inorganic fertilizers vs. 1.2% for manure sources). Point sources contributed similar proportions of TP (5%) and DRP (12%) discharged in March-July as manure sources. Soil sources of phosphorus contributed over 40% of the March-July TP load and 20% of the March-July DRP load from the watershed to Lake Erie. Reductions of manures and inorganic fertilizers corresponded to a greater proportion of phosphorus delivered from soil sources of phosphorus, indicating that legacy phosphorus in soils may need to be a focus of management efforts to reach nutrient load reduction goals. In agricultural watersheds aground the world, including the Maumee River watershed, upstream nutrient management should not focus solely on an individual nutrient source; rather a comprehensive approach involving numerous sources should be undertaken.

Evaluating management options to reduce Lake Erie algal blooms using an ensemble of watershed models.

Reducing harmful algal blooms in Lake Erie, situated between the United States and Canada, requires implementing best management practices to decrease nutrient loading from upstream sources. Bi-national water quality targets have been set for total and dissolved phosphorus loads, with the ultimate goal of reaching these targets in 9-out-of-10 years. Row crop agriculture dominates the land use in the Western Lake Erie Basin thus requiring efforts to mitigate nutrient loads from agricultural systems. To determine the types and extent of agricultural management practices needed to reach the water quality goals, we used five independently developed Soil and Water Assessment Tool models to evaluate the effects of 18 management scenarios over a 10-year period on nutrient export. Guidance from a stakeholder group was provided throughout the project, and resulted in improved data, development of realistic scenarios, and expanded outreach. Subsurface placement of phosphorus fertilizers, cover crops, riparian buffers, and wetlands were among the most effective management options. But, only in one realistic scenario did a majority (3/5) of the models predict that the total phosphorus loading target would be met in 9-out-of-10 years. Further, the dissolved phosphorus loading target was predicted to meet the 9-out-of-10-year goal by only one model and only in three scenarios. In all scenarios evaluated, the 9-out-of-10-year goal was not met based on the average of model predictions. Ensemble modeling revealed general agreement about the effects of several practices although some scenarios resulted in a wide range of uncertainty. Overall, our results demonstrate that there are multiple pathways to approach the established water quality goals, but greater adoption rates of practices than those tested here will likely be needed to attain the management targets.

Uncertainty in critical source area predictions from watershed-scale hydrologic models.

Watershed-scale hydrologic models are frequently used to inform conservation and restoration efforts by identifying critical source areas (CSAs; alternatively 'hotspots'), defined as areas that export relatively greater quantities of nutrients and sediment. The CSAs can then be prioritized or 'targeted' for conservation and restoration to ensure efficient use of limited resources. However, CSA simulations from watershed-scale hydrologic models may be uncertain and it is critical that the extent and implications of this uncertainty be conveyed to stakeholders and decision makers. We used an ensemble of four independently developed Soil and Water Assessment Tool (SWAT) models and a SPAtially Referenced Regression On Watershed attributes (SPARROW) model to simulate CSA locations for flow, phosphorus, nitrogen, and sediment within the ~17,000-km2 Maumee River watershed at the HUC-12 scale. We then assessed uncertainty in CSA simulations determined as the variation in CSA locations across the models. Our application of an ensemble of models - differing with respect to inputs, structure, and parameterization - facilitated an improved accounting of CSA prediction uncertainty. We found that the models agreed on the location of a subset of CSAs, and that these locations may be targeted with relative confidence. However, models more often disagreed on CSA locations. On average, only 16%-46% of HUC-12 subwatersheds simulated as a CSA by one model were also simulated as a CSA by a different model. Our work shows that simulated CSA locations are highly uncertain and may vary substantially across models. Hence, while models may be useful in informing conservation and restoration planning, their application to identify CSA locations would benefit from comprehensive uncertainty analyses to avoid inefficient use of limited resources.

The hydrologic model as a source of nutrient loading uncertainty in a future climate.

Hydrologic models are applied increasingly with climate projections to provide insights into future hydrologic conditions. However, both hydrologic models and climate models can produce a wide range of predictions based on model inputs, assumptions, and structure. To characterize a range of future predictions, it is common to use multiple climate models to drive hydrologic models, yet it is less common to also use a suite of hydrologic models. It is also common for hydrologic models to report riverine discharge and assume that nutrient loading will follow similar patterns, but this may not be the case. In this study, we characterized uncertainty from both climate models and hydrologic models in predicting riverine discharge and nutrient loading. Six climate models drawn from the Coupled Model Intercomparison Project Phase 5 ensemble were used to drive five independently developed and calibrated Soil and Water Assessment Tool models to assess hydrology and nutrient loadings for mid-century (2046-2065) in the Maumee River Watershed,the largest watershedsdraining to the Laurentian Great Lakes. Under those conditions, there was no clear agreement on the direction of change in future nutrient loadings or discharge. Analysis of variance demonstrated that variation among climate models was the dominant source of uncertainty in predicting future total discharge, tile discharge (i.e. subsurface drainage), evapotranspiration, and total nitrogen loading, while hydrologic models were the main source of uncertainty in predicted surface runoff and phosphorus loadings. This innovative study quantifies the importance of hydrologic model in the prediction of riverine nutrient loadings under a future climate.