Shallow Quaternary groundwater in the Lake Chad basin is resilient to climate change but requires sustainable management strategy: Results of isotopic investigation.

Within the Lake Chad Basin, the unconfined Quaternary aquifer offers permanent and easy access to water resources. This transboundary regional aquifer is shared by Chad, Niger, Nigeria and Cameroon and extends over ~500,000 km2. Climatic conditions and repeated droughts as well as the intensification of agriculture in the region have multiple negative impacts on the aquifer such as changes in groundwater level and its quality. Being a strategic water resource for the whole Chadian region, the groundwater potential of the Quaternary aquifer must be better characterized and understood to evaluate its resilience to climate change and anthropogenic impact. Stable isotopes and tritium of the water molecule were used to estimate water origin and residence time at the regional scale and to elucidate the interconnections between the different hydrological and hydrogeological components. Results show active recharge processes to the Quaternary aquifer as well as dynamic connections with surface waters (both river courses and wetlands) but also indicate less dynamic behavior of the Quaternary groundwater resource in some areas of the region. Based on the isotopic investigations, the Quaternary aquifer in the Chad basin was found to be resilient to climate change but its hydrogeological specificities (dependence to surface water from the upstream basins and transboundary nature of its structure) can make it prone to inadequate management strategies.

Success and constraints in the implementation of WHO guidelines for the management of diarrhoea in Albania.

BACKGROUND: The aim of this study is to evaluate the advantages as well as the difficulties resulting from the introduction of WHO guidelines for the treatment of acute diarrhoea in Albania. METHODS: The study was carried out at the Department of Paediatrics, Tirana, Albania. To evaluate the changes in case fatality and duration of hospital stay the clinical course of 226 children admitted for acute diarrhoea during a 1-month period was compared with the course of 235 children admitted for an equivalent period, prior to the introduction of World Health Organisation (WHO) guidelines. A detailed prospective study of 43 children admitted for acute diarrhoea with moderate (28 cases) or severe (15 cases) dehydration, managed according to WHO guidelines, was also carried out to identify problems arising from the new approach. RESULTS: The case fatality ratio was lower (0.44% versus 1.27%) and the mean duration of hospital stay shorter (4.8 versus 5.5 days) after the introduction of WHO guidelines. In 35% (10/28) of cases with moderate dehydration, the oral rehydration therapy failed to improve the hydration status, leading to the need of i.v. treatment. Failures in the Oral Rehydration Solution (ORS) group were always due to the insufficient intake of fluids, in the majority of cases because mothers were not administering it properly. CONCLUSIONS: The introduction of WHO Guidelines for diarrhoea case-management was beneficial. To obtain better compliance in giving ORS to moderately dehydrated children, appropriate training of nursing staff, together with better communication and support to mothers admitted with their child are necessary.