Frameworks for mitigating the risk of waterborne diarrheal diseases: A scoping review.

BACKGROUND: Diarrhea is one of the major cause of death and morbidity around the world. OBJECTIVES: This scoping review summarizes existing frameworks that aim to mitigate the risks of waterborne diarrheal diseases and describe the strengths and weaknesses of these frameworks. ELIGIBILITY CRITERIA: Published frameworks designed to mitigate the risks of waterborne diarrheal diseases. Frameworks published in English, from around the world and published since inception to date. SOURCES OF EVIDENCE: PubMed, Scopus, Web of Science, Google Scholar, Google Free Search, organization websites and reference lists of identified sources. CHARTING METHODS: Data were charted using the Joanna Briggs Institute tool. Results were summarized and described narratively. A criterion to score the strengths and weaknesses of the included frameworks was also developed. RESULTS: Five frameworks were identified including: the hygiene improvement framework, community led total sanitation, global action plan for pneumonia and diarrhea, participatory hygiene and sanitation transformation, and sanitation and family education. These frameworks shared several common components, including identification of problems and risk factors, identification and implementation of interventions, and evaluation and monitoring. The frameworks had several interventions including different infrastructure, health promotion and education, enabling environment and clinical treatments. Most of the frameworks included health promotion and education. All the frameworks were strengthened by including strategies for implementing and delivering intervention, human resource aspect, community involvement, monitoring, and evaluation. The main weakness included not having components for collecting, storing, and transferring electronic data and the frameworks not being specifically for mitigating waterborne diarrheal diseases. In addition, the identified frameworks were found to be effective in mitigating the risk of diarrhea diseases among other health effects. CONCLUSIONS: Existing frameworks should be updated specifically for mitigating waterborne diarrheal diseases that includes the strengths and addresses weaknesses of reviewed frameworks.

Community-level interventions for mitigating the risk of waterborne diarrheal diseases: a systematic review.

BACKGROUND: Waterborne diarrhea diseases are among the leading causes of morbidity and mortality globally. These diseases can be mitigated by implementing various interventions. We reviewed the literature to identify available interventions to mitigate the risk of waterborne diarrheal diseases. METHODS: We conducted a systematic database review of CINAHL (Cumulative Index to Nursing and Allied Health Literature), PubMed, Web of Science Core Collection, Cochrane library, Scopus, African Index Medicus (AIM), and LILACS (Latin American and Caribbean Health Sciences Literature). Our search was limited to articles published between 2009 and 2020. We conducted the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement checklist. The identified studies were qualitatively synthesized. RESULTS: Our initial search returned 28 773 articles of which 56 studies met the inclusion criteria. The included studies reported interventions, including vaccines for rotavirus disease (monovalent, pentavalent, and Lanzhou lamb vaccine); enhanced water filtration for preventing cryptosporidiosis, Vi polysaccharide for typhoid; cholera 2-dose vaccines, water supply, water treatment and safe storage, household disinfection, and hygiene promotion for controlling cholera outbreaks. CONCLUSION: We retrieved few studies on interventions against waterborne diarrheal diseases in low-income countries. Interventions must be specific to each type of waterborne diarrheal disease to be effective. Stakeholders must ensure collaboration in providing and implementing multiple interventions for the best outcomes. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020190411 .

Poor Provision of Sanitary Facilities in Markets of Lusaka District Zambia.

Background: Although provision of sanitary facilities in workplaces is an important issue, very few studies have been undertaken in this regard. Objective: This study assessed the provision of sanitary facilities for market traders and their perceptions of the provided facilities in Lusaka district Zambia. Methods: A cross-sectional study of workplace observations in 12 randomly selected markets and interviews with 386 traders, conducted in Lusaka district. Findings: The study revealed that eleven of the twelve markets provided toilets, hand-washing and drying facilities, water, urinals, soap, and toilet paper. However, most of the markets did not comply with the Zambian laws in terms of the adequacy and privacy of facilities. One market did not have any of the listed facilities. Most traders perceived facilities to be unsatisfactory and used them only because of the lack of alternatives. Poor provision of sanitary facilities was observed at markets thus predisposing its workforce and trading population to multiple public health hazards. Conclusions: The findings of this study call for urgent investments in sanitary structures and surveillance systems to guarantee the safety of the population and to promote the health of market traders as well as the community at large.

Bacteriological Quality and Heavy Metal Analysis of Packaged Water Produced in Lusaka, Zambia and Associated Quality Control Measures.

Many people in the world lack safe basic drinking water sources and rely on untreated water source. Packaged water can be considered as an alternative to other water sources if measures are put in place to ensure its safety for consumption. This study aimed to assess the bacteriological quality and heavy metal analysis of packaged water produced in Lusaka, Zambia and associated quality control measures. A cross-sectional study was conducted in May 2019 where 18 brands of packaged water were analyzed for total and fecal coliforms as well as concentrations of Lead, Chromium, and Cadmium. The study found that 33.5% of the packaged water produced in Lusaka did not comply with the standard for drinking water on bacteriological quality. We also found that the concentrations for Lead were <0.01 mg/l in all the 17 samples, thus compliant to WHO/ZABS standards. Concentrations of Chromium were between 0.002 and 0.62 mg/l and compliance to the standard was 11.8%. Concentrations for Cadmium were between 0.009 and 0.2 mg/l against the acceptable concentration of <0.003 mg/l. Most brands of the packaged water did not conform to the standards for drinking water.