A scoping review of the links between early childhood caries and clean water and sanitation: the Sustainable Development Goal 6.

INTRODUCTION: The United Nation's Sustainable Development Goal (SDG) 6 calls for universal access to clean water, sanitation and hygiene (WASH), which are crucial elements of health and well-being and fundamental for a life in dignity. Early childhood caries (ECC) is a preventable disease affecting health and quality of life of millions of young children worldwide. This scoping review aims to explore the connection between ECC and access to clean water and sanitation. METHODS: This scoping review, registered on the Open Science Framework and following PRISMA-ScR guidelines, conducted a thorough search in databases (PubMed, Web of Science, Embase, Google Scholar, SciELO) and websites (via Google) in November 2023. The search, without date limitations, targeted studies in English and Spanish linking ECC to SDG6. Exclusions were made for studies solely focusing on ECC without a direct connection to clean water and sanitation. Descriptive statistics summarized the retrieved papers. RESULTS: The initial search yielded 303 articles. After removing duplicates, 264 articles remained for title and abstract screening after which 244 were excluded and one report was added through citation searching. The 21 remaining articles underwent full text review. There were no studies on a direct association between access to clean water and sanitation and the prevalence of ECC. There were nine studies that showed indirect associations between ECC and access to clean water and sanitation through the links of: water and sanitation access as a marker for poverty (n = 1), water consumption as a feeding practice (n = 4), and the effectiveness of water fluoridation (n = 4). These were used to develop a conceptual model. CONCLUSIONS: While it is conceivable that a direct link exists between ECC and access to clean water and sanitation, the available body of research only offers evidence of indirect associations. The exploration of potential pathways connecting water access to ECC warrants further investigation in future research.

Discovery of interspecific alloparental care of silver-eared mesia nestlings by a mountain bulbul.

Although brood parasitism has been well documented among bird species, interspecific alloparenting, which is parenting behavior of adult individuals of one species toward the progeny of another species, is increasingly being reported. However, compared with the many reports of interspecific alloparenting behavior in North America and Europe, this phenomenon is less well known in China, with only two prior cases of interspecific alloparenting behavior in birds having been recorded. On June 23, 2022, we observed an instance of interspecific alloparental care provided by a mountain bulbul (Ixos mcclellandii) towards silver-eared mesia (Leiothrix argentauris) nestlings in Caihu Village, Jingdong County, Yunnan Province, southwestern China. We recorded 19.5 h of footage during the period in which the mountain bulbul provided care for the nestlings with the aim of documenting detailed observations of interspecific alloparenting to contribute to our overall understanding of this behavior. The alloparenting behavior of the mountain bulbul lasted for at least 5 days. During this period, both silver-eared mesia parents fed their nestlings 157 times and removed their nestlings' fecal sacs 5 times, while the mountain bulbul fed the nestlings 30 times and removed the nestlings' fecal sacs 4 times. In addition, the male silver-eared mesia parent chased the mountain bulbul away during nestling feeding. As there was no life history information for the mountain bulbul at that time, we were unable to directly determine why it exhibited interspecific alloparental care. Regardless of the reason for the mountain bulbul's behavior, these findings provide valuable information for future studies on the reproductive ecology of these two bird species.

Daily Use Water Bottles as a Hub for Microbial Population: A Comparative Study of PET vs. Stainless Steel Water Bottles and Outcome of Washing Strategy Intervention.

Water bottles for everyday usage are a typical addition to people's life and offer a practical way to stay hydrated. Even though safe and clean water is preferred for consumption, the water bottle or container used to drink water was never considered to be cleaned. Here, we examined the adhering microbial populations in water bottles composed of stainless steel (SS) and polyethylene terephthalate (PET). A total of 30 water bottles-15 PET and 15 SS-were gathered from different users. To identify and quantify the adhering microbial populations, microbial swabs from the inside surface of the bottles were collected and later cultivated on certain growth media. Overall the microbial load of PET is significantly higher than the SS water bottles of 68.8 + 19.1 cfu/ml and 35.4 + 8 cfu/ml respectively at initial sampling (P = 0.0027). We also evaluated the efficiency of various cleaning procedures in eliminating adherent bacteria populations. The cleaning strategy significantly reduced the microbial load (P<0.0001). The mean load observed was 11.2 + 2.3 cfu/ml post-wash. This comparison study offers important new information about the adherent microbial populations found in SS and PET water bottles used every day, in the end. This finding emphasizes the necessity of routine cleaning and upkeep of these bottles to reduce the possibility of microbial contamination and the accompanying health risks.

Egestabase - An online evidence platform to discover and explore options to recover plant nutrients from human excreta and domestic wastewater for reuse in agriculture.

Restoring nutrient circularity across scales is important for ecosystem integrity as well as nutrient and food security. As such, research and development of technologies to recover plant nutrients from various organic residues has intensified. Yet, this emerging field is diverse and difficult to navigate, especially for newcomers. As an increasing number of actors search for circular solutions to nutrient management, there is a need to simplify access to the latest knowledge. Since the majority of nutrients entering urban areas end up in human excreta, we have chosen to focus on human excreta and domestic wastewater. Through systematic mapping with stakeholder engagement, we compiled and consolidated available evidence from research and practice. In this paper, we present 'Egestabase' - a carefully curated open-access online evidence platform that presents this evidence base in a systematic and accessible manner. We hope that this online evidence platform helps a variety of actors to navigate evidence on circular nutrient solutions for human excreta and domestic wastewater with ease and keep track of new findings.

Risk Factors of Wasting-Based Malnutrition in the Flood-Affected Areas of Pakistan: A Cross-Sectional Study.

The current study aimed to find the risk factors of wasting in flood-affected areas of Khyber Pakhtunkhwa, Pakistan. Sociodemographic and anthropometric data was collected. Children living in large family are 2.59 times more likely to be wasted (AOR = 2.59, 95% confidence interval (CI): 1.10, 6.10; p value = .029) and children living in medium size family are 2.23 times more likely to be wasted (AOR = 2.23, 95% CI: 1.03, 4.80; p value = .04) as compared to children in small family size. The study underscores the need for targeted interventions to address the identified risk factors and mitigate the impact of flooding on child nutrition.

Overview of transcriptome changes and phenomic profile of sanitized artichoke vis-à-vis non-sanitized plants.

Plant tissue in vitro culture is increasingly used in agriculture to improve crop production, nutritional quality, and commercial value. In plant virology, the technique is used as sanitation protocol to produce virus-free plants. Sanitized (S) artichokes show increased vigour compared to their non-sanitized (NS) counterparts, because viral infections lead to a decline of growth and development. To investigate mechanisms that control the complex traits related to morphology, growth, and yield in S artichokes compared to NS plants, RNAseq analysis and phenotyping by imaging were used. The role of peroxidases (POD) was also investigated to understand their involvement in sanitized plant development. Results showed that virus infection affected regulation of cell cycle, gene expression and signal transduction modulating cellular response to stimulus/stress. Moreover, primary metabolism and photosynthesis were also influenced, contributing to explain the main morphological differences observed between S and NS artichokes. Sanitized artichokes are also characterized by higher POD activity, probably associated with increased plant growth, rather than strengthening of cell walls. Overall, results show that the differences in development of S artichokes may be derived from the in vitro culture stressor, as well as through pathogen elimination, which, in turn, improve qualitative and quantitative artichoke production.

Identification of environmental, socioeconomic, water, sanitation, and hygiene (WaSH) factors associated with COVID-19 incidence in the Philippines: A nationwide modelling study.

Despite the implementation of non-pharmaceutical interventions, the threat of coronavirus disease 2019 (COVID-19) remains significant on a global scale. Identifying external factors contributing to its spread is crucial, especially given the World Health Organization's recommendation emphasizing access to water, sanitation, and hygiene as essential in curbing COVID-19. There is a notable discrepancy in access to sanitation facilities, particularly evident in low- and middle-income countries. However, there is a lack of quantitative assessments regarding these factors. This study examines various environmental, socioeconomic, water, sanitation, and hygiene factors and their associations with COVID-19 incidence. All regions in the Philippines were categorized into clusters based on socioeconomic factors. A conceptual structural equation model (SEM) was developed using domain knowledge. The best-fitting SEM for each cluster was determined, and associations between factors and COVID-19 incidence were estimated. The correlation analysis revealed that rainfall, minimum temperature, and relative humidity were positively correlated with weekly COVID-19 incidence in urban regions. Maximum temperature, mean temperature, wind speed, and wind direction were negatively correlated with weekly COVID-19 incidence in rural regions, with time lags of 0, 3, and 7 weeks. In urban regions (Cluster 1), factors such as urbanization rate (1.00), area (-0.93), and population (0.54) were found to be associated with weekly COVID-19 incidence. Conversely, in rural regions (Cluster 2), factors including area (0.17), basic sanitation (0.84), and wind direction (0.83) showed associations with weekly COVID-19 incidence. These factors were causally associated with a latent variable reflecting the hidden confounders associated with COVID-19 incidence. It is important to note that sanitation factors were associated only in rural regions. Improving access to sanitation facilities in rural regions of the Philippines is imperative to effectively mitigate disease transmission in future pandemics. Identification of the causal effect of unobserved confounders with COVID-19 incidence is recommended for future research.

Key environmental exposure pathways to antimicrobial resistant bacteria in southern Malawi: A SaniPath approach.

Antimicrobial resistance (AMR) poses a severe global health threat, yet the transmission pathways of AMR within communal public environments, where humans and animals interact, remain poorly explored. This study investigated AMR risk pathways, prevalence, and seasonality of extended-spectrum ß-lactamase (ESBL) producing E. coli and K. pneumoniae, and observed practices contributing to environmental contamination within urban, peri-urban, and rural Malawi. Using the SaniPath tool, in August 2020, transect walks across three Malawian study sites identified potential AMR exposure pathways, including drains, standing water, soil, and areas of communal hand contact. Subsequently, from September-2020 to August-2021, 1440 environmental samples were collected at critical points along exposure routes (n = 40/month from each site). These underwent microbiological analysis using chromogenic agar techniques to detect the presence of ESBL E. coli and ESBL K. pneumoniae. Results showed the highest ESBL prevalence in urban environments (68.1 %, 95%CI = 0.64-0.72, p < 0.001) with a higher ESBL presence seen in drains (58.8 %, 95%CI = 055-0.62, p < 0.001) and soil (54.1 %, 95%CI = 0.46-0.62, p < 0.001) compared to other pathways. Environmental contamination was attributed to unavailability and poor condition of sanitation and hygiene infrastructure based on key informant interviews with community leaders (n = 9) and confirmed by independent observation. ESBL prevalence varied between seasons (χ2 (2,N = 1440) = 10.89, p = 0.004), with the highest in the hot-dry period (55.8 % (n = 201)). Prevalence also increased with increased rainfall (for ESBL E.coli). We highlight that community environments are likely to be a crucial component in AMR transmission, evident in the abundance of ESBL bacteria in identified exposure pathways. Additionally, poor sanitation infrastructure and practices coupled with seasonal dynamics further affect the presence of ESBLs in communal environments. Therefore, a context appropriate whole system approach that tackles infrastructure and behavioural factors, supported by effective surveillance is required to impact AMR and a range of aligned development challenges in these settings.

Cholera resurgence in Africa: assessing progress, challenges, and public health response towards the 2030 global elimination target.

Global efforts to combat epidemic cholera outbreaks have witnessed tremendous feats over the decades. However, sporadic outbreaks in regions, particularly across African states, mask these advancements. This regressive trend is frequently fuelled by factors retarding efforts towards optimal environmental sanitation and personal hygiene, which include ingesting infected food, drinking contaminated waters, and engaging in unhealthy environmental practices such as indiscriminate waste and sewage disposal and poor toilet practices. The ongoing efforts to achieve the Global Taskforce on Cholera Control (GTFCC) targets of a 90% reduction in cases and deaths by 2030, even in the wake of continuous outbreaks across various African regions, as reported by the World Health Organization (WHO) face a significant threat. One such effort, among others, is the AFRICHOL project, an enhanced cholera surveillance consortium launched in Africa over a decade ago as part of the GTFCC at WHO to monitor and fast-track the GTFCC's 2030 targets. It is tasked with supporting the implementation of research-based strategies for combating cholera in Africa. The prequalified oral cholera vaccines - Dukoral, Shanchol, and Euvichol - and those with recombinant DNA technology have also emerged as remarkable strides. In the face of this progress, challenges persist. Climate change, including extreme weather events and the lack of safe water, sanitation, and hygiene facilities, acts as a multiplier, amplifying existing challenges and hindering progress. Porous borders with inefficient disease surveillance networks among member states also facilitate the inter-territorial spread of the disease. Despite ongoing challenges, global targets are achievable provided strong institutional infrastructure and additional evidence-based public health initiatives are promulgated and enacted. The Global Roadmap to Ending Cholera Outbreaks by 2030 is a resourceful tool for advancing this fight and eradicating cholera.

Needs and Constraints for Cardiac Rehabilitation Among Patients with Coronary Heart Disease Within a Community-Based Setting: A Study Based on Focus Group Interviews.

Objective: This study aimed to explore the needs and constraints to cardiac rehabilitation (CR) among patients diagnosed with coronary heart disease (CHD) in a community-based setting, and thereby facilitating the implementation of effective CR programs for this population. Methods: Focus group interviews were used as the primary research methodology. A total of 11 community-dwelling individuals diagnosed with CHD were selected from a community hospital to participate in in-depth interviews, aiming to discern and analyze their requirements and constraints experienced concerning medical resources and healthcare agency. The textual data underwent examination using Colaizzi's method of descriptive data analysis. Results: Deficits existed in the perceptions of patients with CHD within a community-based setting about their condition and CR, and in the social support for this disease. Patients expressed expectations for professional guidance during CR, gained an understanding about the beneficial effects of emotional stability on cognitive function. Patients expressed their thoughts and feelings regarding the diversity of physical exercise options. Two main themes and seven sub-themes were identified: (a) "Insufficient CR resources for patients": Lack of awareness about CHD; inadequate knowledge about secondary prevention/CR; insufficient support from family and friends. (b) "Patient CR initiative": Patient self-adjustment; expectation of professional rehabilitation guidance; stable emotions improving cognition; diverse attitudes and awareness of exercise. Conclusion: For more effective CR, community-based medical teams should provide more comprehensive and individualized rehabilitation programs. They should focus on individual variations and preferences of patients, as well as enhance the autonomy of patients and improve their self-care ability through effective empowerment measures.

Schistosoma mansoni infection in residents of a riverside community in Eastern Amazon.

Schistosoma mansoni worms cause a waterborne parasitic disease called schistosomiasis. It commonly affects individuals in lack of sanitation structure. In Brazil, Pará state has Belém as one of the worst sanitation-ranking places in 2023, where schistosomiasis transmission was already documented. This study reports the occurrence of schistosomiasis in residents of Ilha das Onças, an island next to Belém. Stool samples were obtained from participants over 2 years old, all residents from Furo do Rio Grande, one of the rivers on the island. The Kato-Katz technique was performed for parasite investigation in the stool samples. Each participant responded to a sociodemographic and clinical questionnaire. The residences were georeferenced for map designing. Three out of 263 participants were S. mansoni positive, all men, ages ranging from 19 to 41 years old, with low parasitic load. Malacological surveys were carried out, but no Biomphalaria snails were found. Risk factors for schistosomiasis establishment are present on the island, and the lack of sanitation makes it a potential risk area. Malacological surveys are highly encouraged as preventive measures, as well as health surveillance for riverside populations, generating data that will help health authorities in the management and planning of preventive control actions.

Socio-environmental externalities of sewage waste management.

Conventional sewage management is expensive and inefficient, putting the environment and public health at risk, making access to sewage services difficult for everyone. Reusing sewage waste has agricultural and economic potential, but can contain harmful contaminants if not treated properly. This review is based on the hypothesis that the destination of sewage waste generates environmental and social externalities, which have not yet been widely compared. With the aim of identifying, from the literature, the socio-environmental externalities generated by different sewage waste management approaches, a systematic review of the literature was carried out, including 244 documents, with 50 % of these discussing impacts of conventional treatment and 37 % analyzing the reuse of waste. The main impacts and externalities were evaluated in three situations: untreated sewage, treated sewage, and reused waste. The results indicate that sewage waste has an underutilized economic value and can generate revenue, reduce operational costs and electricity expenses. Six negative externalities generated by conventional sewage treatment were identified: health costs; environmental cleaning; carbon offsetting; damage to tourism; damage to fishing and agriculture; and real estate depreciation. In reuse, there is a risk of two negative externalities: health costs and environmental cleaning, but two positive externalities were also identified: the reduction of phosphate rock mining and the neutralization of carbon credits. The complexity of the transition to sustainable sewage treatment practices is highlighted given the lack of consensus on the safe use of sewage waste, the lack of regulatory standardization, implementation costs and differences in regional parameters, highlighting the need for preliminary experimentation in a multidisciplinary and contextualized approach, considering comparative externalities among the available sewage waste management possibilities.

Burden and factors influencing intestinal parasitic infections among food handlers in Gondar City, Northwest Ethiopia.

Background: Intestinal parasitic infections pose significant global health challenges, particularly in developing countries. Asymptomatic infections often present a considerable burden with food handlers serving as potential carriers. In Ethiopia, the prevalence of these parasites varies across regions, and accurate data in the study area is lacking. Therefore, this study aimed to investigate the prevalence of intestinal parasites among food handlers working in hotels and restaurants in Gondar City, Northwest Ethiopia. Methods: A cross-sectional study collected stool samples from food handlers alongside a structured questionnaire gathering socio-demographic and hygiene practice information. Stool specimens were screened for intestinal parasites using direct wet mount and formol-ether concentration techniques. The collected data were checked for completeness, entered into EpiData software version 3.1, and exported to SPSS version 20 for analysis. A multivariable logistic regression analysis was deemed statistically significant if the p-value was less than 0.05. Results: A total of 257 food handlers working in hotels and restaurants in Gondar City participated in the study. Of these, 33.5% (86/257) were found positive for one or more intestinal parasites, with a 95% confidence interval (CI) of 28.0-39.5%. The study identified nine types of intestinal parasites, with E. histolytica/dispar (8.2%, 21/257) and Ascaris lumbricoides (6.6%, 17/257) being the predominant parasites, followed by hookworm (3.5%, 9/257) and S. mansoni (2.3%, 6/257). The prevalence of mixed infections was 9.3% (24/257). A significant association was observed between intestinal parasitic infection and the educational level of food handlers. Conclusion: In this study, a high prevalence of intestinal parasites was detected indicating poor hygiene practices of the food handlers at the study site. Even the prevalence of mixed infections was high. Regular training, strict adherence to personal hygiene and food-handling practices, and routine inspections and medical checkups for food handlers are crucial.

Drinking water, sanitation, hygiene, and health conditions in India: Findings from the national sample survey.

Introduction: Uncertainty exists in the drinking water, sanitation, hygiene, and health conditions due to mosquitoes and flies across India. Therefore, this study aimed to assess the availability of drinking water, sanitation, hygiene, and health in India. Methods: We used secondary analysis data on 95,548 household members from the National Sample Survey, which included 113,822 homes and 555,351 persons across India between June 2017 and 2018. Results: About 36.4% of household members stated that tube wells or boreholes outside the property at a distance of less than 0.2 km were their main source of drinking water. More than 87% of respondents said that the water they drank was free of impurities, and 55.1% said that it had not been treated. About 45.7% of respondents stated that there were no bathrooms in the dwellings. More than 50% of the time, according to the respondents, garbage was not collected. A flea or mosquito problem was reported by about 97% of households. Around 97% of households reported fevers that were caused by a disease. Conclusion: In India, poor access to drinking water, sanitary facilities, good hygiene, and healthcare existed. The results will support the next visionary programs to increase living standards in the country.

Contaminação ambiental de uma agroindústria familiar de queijo colonial no sudoeste paranaense / Environmental contamination of a family colonial cheese agroindustry in the southwest of Parana

As falhas na higienização em um estabelecimento de alimentos podem refletir em problemas causando a contaminação ou deterioração do produto produzido. Esta pesquisa foi motivada por reclamações de consumidores informando que os queijos apresentaram fungos, mesmo estando dentro do prazo de validade e por solicitação do Serviço de Inspeção Municipal. O objetivo desta pesquisa foi avaliar a contaminação ambiental em uma agroindústria da agricultura familiar produtora de queijo colonial no Sudoeste Paranaense. Foram realizadas a contagem para aeróbios mesófilos em equipamentos e superfícies que entram em contato com o alimento e análise microbiológica ambiental de bolores e leveduras na sala de secagem dos queijos. A coleta foi realizada com método de esfregaço de suabe estéril para aeróbios mesófilos e semeadas em placas de Petri com Ágar Padrão de Contagem. Para a coleta ambiental foram expostas placas de Petri com ágar Saboraund durante 15 minutos. Os resultados demonstraram ausência de contaminação nas superfícies, mas foram encontrados bolores e leveduras de forma acentuada na sala de secagem dos queijos, o que pode contribuir para a deterioração do produto, diminuindo sua validade. Para minimizar as perdas por contaminação é necessário que o processo de higienização dos ambientes seja realizado de forma eficiente.

Failures in hygiene in a food establishment can result in problems causing contamination or deterioration of the product produced. This research was motivated by complaints from consumers reporting that the cheeses had mold, even though they were within their expiration date and at the request of the Municipal Inspection Service. This research was to evaluate environmental contamination in an agroindustry in the family farm producing colonial cheese in Southwest Paraná. For the microbiological assessment of environmental contamination, counting for mesophilic aerobes was carried out on equipment and surfaces that come into contact with food and, environmental microbiological analysis of molds and yeast in the cheese drying room. The collection was carried out using the sterile swab smear for mesophilic aerobes and seeded in Petri dishes with Counting Standard Agar. For environmental collection, sheets of Petri with Saboraund agar for 15 minutes. The results demonstrated absence of contamination on surfaces. But the presence of molds and yeasts in the drying room cheeses, which can contribute to the deterioration of the product and thus reduce the validity. To minimize losses due to contamination, it is It is necessary that the process of cleaning and disinfecting environments is carried out efficiently.

Water, Sanitation, and Hygiene (WASH) practices among residents of different slum settlements in a ward of Kolkata: A mixed-methods study.

BACKGROUND: Access to safe water, sanitation, and hygiene (WASH) is the most basic need for mankind. Poor WASH practices are associated with various waterborne diseases, especially in developing countries such as India. The aim of the study was to assess WASH practices among residents of different slum settlements in a ward of Kolkata, identify the factors associated with WASH practice, and explore the barriers faced by the families and municipal staff in providing adequate WASH services to the community. MATERIALS AND METHODS: An observational study, cross-sectional in design with a convergent parallel mixed-methods approach, was conducted in different slum settlements in a ward of Kolkata. Quantitative data were collected by face-to-face interview, spot observation, and measuring the living area, door, and window spaces. Key informant interviews were conducted with the medical officer, ward vector-control coordinator, and municipal waste handlers, in addition to in-depth interviews with respondents who had unsatisfactory WASH practices. SPSS version 25.0 was used to analyze the quantitative data. Qualitative data were analyzed thematically using Atlas.ti 22. RESULTS: The overall WASH practices were considered satisfactory in 58.8% of the households. Education of the respondents up to the secondary level, presence of overcrowding, and inadequate ventilation in the house had statistically significantly higher odds of unsatisfactory practice. Poor living conditions, difficulty in collecting and storing water, waterlogging, blocked sewage drains, common toilets for men and women, and lack of motivation were the primary obstacles identified by the residents. CONCLUSION: Unsatisfactory WASH practices were observed among a high proportion of the slum population. Community engagement and education regarding WASH in communities is strongly recommended along with improvement of infrastructure and capacity building.

Is the persistence of Listeria monocytogenes in food processing facilities and its resistance to pathogen intervention linked to its phylogeny?

The foodborne pathogen Listeria monocytogenes is differentiated into four distinct lineages which differ in their virulence. It remains unknown, however, whether the four lineages also differ with respect to their ability to persist in food processing facilities, their resistance to high pressure, a preservation method that is used commercially for Listeria control on ready-to-eat meats, and their ability to form biofilms. This study aimed to determine differences in the pressure resistance and biofilm formation of 59 isolates of L. monocytogenes representing lineages I and II. Furthermore, the genetic similarity of 9 isolates of L. monocytogenes that were obtained from a meat processing facility over a period of 1 year and of 20 isolates of L. monocytogenes from food processing facilities was analyzed to assess whether the ability of the lineages of L. monocytogenes to persist in these facilities differs. Analysis of 386 genomes with respect to the source of isolation revealed that genomes of lineage II are over-represented in meat isolates when compared with clinical isolates. Of the 38 strains of Lm. monocytogenes that persisted in food processing facilities (this study or published studies), 31 were assigned to lineage II. Isolates of lineage I were more resistant to treatments at 400 to 600 MPa. The thickness of biofilms did not differ between lineages. In conclusion, strains of lineage II are more likely to persist in food processing facilities while strains of lineage I are more resistant to high pressure.IMPORTANCEListeria monocytogenes substantially contributes to the mortality of foodborne disease in developed countries. The virulence of strains of four lineages of L. monocytogenes differs, indicating that risks associated with the presence of L. monocytogenes are lineage specific. Our study extends the current knowledge by documentation that the lineage-level phylogeny of L. monocytogenes plays a role in the source of isolation, in the persistence in food processing facilities, and in the resistance to pathogen intervention technologies. In short, the control of risks associated with the presence of L. monocytogenes in food is also lineage specific. Understanding the route of contamination L. monocytogenes is an important factor to consider when designing improved control measures.

Shared sanitation in informal settlements: A systematic review and meta-analysis of prevalence, preferences, and quality.

Shared sanitation facilities are not considered a type of basic sanitation by the WHO/UNICEF Joint Monitoring Programme (JMP), though they may be the only alternative to open defecation in urban informal settlements. Additionally, JMP indicators for sanitation do not cover aspects related to the quality of shared sanitation, such as those outlined in the Human Right to Water and Sanitation (HRTWS) framework. Data on the prevalence of shared sanitation within informal settlement areas is limited, and there is a need to understand user preferences, experiences, and barriers to the use of shared sanitation to inform effective policy and practice. This systematic review aims to summarize the prevalence and number of households sharing sanitation in informal settlements globally, as well as user experiences and barriers to successful implementation of shared sanitation. We included studies available in English and published after January 1, 2000. We retrieved 4741 articles from seven databases and included a total of 167 relevant publications. Among included studies, 54 reported the prevalence of shared sanitation in informal settlements, and 138 studies reported on user perceptions and experiences related to shared sanitation quality. A meta-analysis of studies reporting the prevalence of shared sanitation in informal settlements globally revealed an estimated overall prevalence of 67% [95% CI: 61%-73%]. Commonly reported user preferences included cleanliness to promote continued use of shared facilities, privacy with a lockable door, facilities for menstrual hygiene management, safety and protection against violence, 24/7 access, proper lighting, and shared responsibility for facility management - which align with the HRTWS framework and represent barriers to shared sanitation use. Based on the findings of this review, we recommend including the number of households or people sharing a sanitation facility in monitoring of shared sanitation quality, locating sanitation facilities within compounds, where applicable, and promoting safety, dignity, and privacy of all users in the development of shared sanitation quality indicators.

Factors associated with hand hygiene adherence among healthcare workers in Guatemala during the COVID-19 pandemic.

BACKGROUND: Healthcare-associated infections are prevalent in low- and middle-income countries and may be reduced through proper hand hygiene (HH) adherence during patient care. AIM: We produced and distributed alcohol-based hand rub (ABHR) to 19 public primary- and secondary-level healthcare facilities in Quetzaltenango, Guatemala, and carried out HH observations to assess healthcare workers' (HCWs) HH adherence, and to identify factors associated with this practice. HH adherence was defined as washing hands with soap and water or using ABHR. METHODS: Observations were conducted before (2021, baseline) and after (2022, follow-up) ABHR distribution to evaluate the evolution of HH practices over time. Bivariate comparisons and mixed-effects logistic regression models were used to explore associations between HH adherence and the following independent variables: healthcare facility level, type of contact performed, timing of HH performance, occupational category of HCW and materials present (e.g., water, soap, ABHR). FINDINGS: We observed 243 and 300 patient interactions among 67 and 82 HCWs at each time point, respectively. HH adherence was low for both observation periods (40% at baseline and 35% at follow-up). HCWs were more likely to adhere to HH during invasive contacts, after patient contact, and if the HCW was a physician. CONCLUSION: HH adherence varied by scenario, which underscores the importance of addressing multiple determinants of behaviour change to improve adherence. This requires interventions implemented with a multi-modal approach that includes both increasing access to HH materials and infrastructure, as well as HH education and training, monitoring and feedback, reminders, and promoting a HH safety culture.

Child feces disposal practices in humanitarian and non-humanitarian settings across 34 low- and middle-income countries.

Globally, safe sanitation has improved significantly in the last two decades, but unsafe child feces disposal remains a growing challenge in many regions, exposing household members and communities to infectious pathogens. The drivers associated with child feces disposal in several contexts including humanitarian settings are not well understood. This study investigated child feces disposal (CFD) practices and associated factors in low- and middle-income countries, including in humanitarian settings. Data from 352,173 women in 34 countries, collected between 2012 and 2021 through Demographic and Health Surveys (DHS), were used. We utilized multivariate logistic regression to assess CFD practices among children under two years old and the factors linked to these practices. We incorporated data from the United Nations High Commissioner for Refugees (UNHCR) regarding refugee camps' locations in the analysis. Time series and local spatial autocorrelation analyses were run to examine changes in safe CFD practices over time and space, respectively. Results showed minimal improvement in safe child feces disposal over the past decade, with 55.6 % of respondents in non-humanitarian settings and 38.1 % in humanitarian settings improperly disposing of feces. Improper CFD significantly correlated with increased odds of diarrhea in non-humanitarian settings (OR 1.09 95 % CI: 1.05-1.13) but not in humanitarian settings (OR 1.14 95 % CI: 0.53-2.49). The most significant factors (p < 0.05) associated with safe CFD included being in the richest wealth quintile (OR 3.27 95 % CI: 3.06-3.49), having basic education (OR 1.28 95 % CI: 1.22-1.33), children eating solid food (OR 1.53 95 % CI: 1.48-1.57), improved sanitation access (OR 1.88 95 % CI: 1.81-1.96), and listening to radio at least weekly (OR 1.40 95 % CI: 135-1.46). Policymakers and development partners must include safe CFD guidelines in national policies and programs, as well as prioritize investments in household-level sanitation and educate caregivers about safe CFD practices.