Health-education package to prevent worm infections

June 4, 2013 · 0 comments

Health-education package to prevent worm infections in Chinese schoolchildren. N Engl J Med. 2013 Apr 25;368(17):1603-12. doi: 10.1056/NEJMoa1204885.

Bieri FA, et al. Queensland Institute of Medical Research, Herston, Australia.

BACKGROUND: Soil-transmitted helminths are among the most prevalent sources of human infections globally. We determined the effect of an educational package at rural schools in Linxiang City District, Hunan province, China, where these worms are prevalent. The intervention aimed to increase knowledge about soil-transmitted helminths, induce behavioral change, and reduce the rate of infection.

METHODS: We conducted a single-blind, unmatched, cluster-randomized intervention trial involving 1718 children, 9 to 10 years of age, in 38 schools over the course of 1 school year. Schools were randomly assigned to the health-education package, which included a cartoon video, or to a control package, which involved only the display of a health-education poster. Infection rates, knowledge about soil-transmitted helminths (as assessed with the use of a questionnaire), and hand-washing behavior were assessed before and after the intervention. Albendazole was administered in all the participants at baseline and in all the children who were found to be positive for infection with soil-transmitted helminths at the follow-up assessment at the end of the school year.

RESULTS: At the follow-up assessment, the mean score for the knowledge of helminths, calculated as a percentage of a total of 43 points on a questionnaire, was 90% higher in the intervention group than in the control group (63.3 vs. 33.4, P<0.001), the percentage of children who washed their hands after using the toilet was nearly twice as high in the intervention group (98.9%, vs. 54.2% in the control group; P<0.001), and the incidence of infection with soil-transmitted helminths was 50% lower in the intervention group than in the control group (4.1% vs. 8.4%, P<0.001). No adverse events were observed immediately (within 15 minutes) after albendazole treatment.

CONCLUSIONS: The health-education package increased students’ knowledge about soil-transmitted helminths and led to a change in behavior and a reduced incidence of infection within 1 school year. (Funded by UBS Optimus Foundation, Zurich, Switzerland; Australian New Zealand Clinical Trials Registry number, ACTRN12610000048088.).

Arsenic removal with composite iron matrix filters in Bangladesh

June 4, 2013 · 1 comment

Arsenic removal with composite iron matrix filters in bangladesh: a field and laboratory study. Environ Sci Technol. 2013 May 7;47(9):4544-54.

Neumann A, Kaegi R, Voegelin A, Hussam A, Munir AK, Hug SJ. Eawag , Swiss Federal Institute of Aquatic Science and Technology, Ueberlandstrasse 133, CH-8600 Duebendorf, Switzerland.

The main arsenic mitigation measures in Bangladesh, well-switching and deep tube wells, have reduced As exposure, but water treatment is important where As-free water is not available. Zero-valent iron (ZVI) based SONO household filters, developed in Bangladesh, remove As by corrosion of locally available inexpensive surplus iron and sand filtration in two buckets. We investigated As removal in SONO filters in the field and laboratory, covering a range of typical groundwater concentrations (in mg/L) of As (0.14-0.96), Fe (0-17), P (0-4.4), Ca (45-162), and Mn (0-2.8).

Depending on influent Fe(II) concentrations, 20-80% As was removed in the top sand layer, but As removal to safe levels occurred in the ZVI-layer of the first bucket. Residual As, Fe, and Mn were removed after re-aeration in the sand of the second bucket. New and over 8-year-old filters removed As to <50 μg/L and mostly to <10 μg/L and Mn to <0.2 mg/L. Vertical concentration profiles revealed formation of Fe(II) by corrosion of Fe(0) with O2 and incorporation of As into forming amorphous Fe phases in the composite iron matrix (CIM) of newer filters and predominantly magnetite in older filters.

As mass balances indicated that users filtered less than reported volumes of water, pointing to the need for more educational efforts. All tested SONO filters provided safe drinking water without replacement for up to over 8 years of use.

Risk factors and antimicrobial susceptibility pattern of Campylobacter species

June 4, 2013 · 1 comment

Prevalence, associated risk factors and antimicrobial susceptibility pattern of Campylobacter species among under five diarrheic children at Gondar University Hospital, Northwest Ethiopia. BMC Pediatrics 2013, 13:82.

Ayalew Lengerh, et al.

Background: Recent reports indicate that Campylobacter species are becoming one of the leading causes of bacterial diarrhoeal disease worldwide and most of the isolates are resistant to different antibiotics. This study aimed at determining the prevalence, associated risk factors and susceptibility pattern of Campylobacter species in under-five diarrheic children.

Methods: A cross-sectional study was conducted from October 2011 to March 2012. Samples were collected from under five diarrhoeic children who visited University of Gondar Teaching Hospital and seeking medical services during the study period. Stool specimens were aseptically inoculated using selective media and species isolation was further processed following standard procedures. Antimicrobial susceptibility test for Campylobacter species was performed using the standard agar disc diffusion method. The data was entered and analyzed using SPSS version 16 packages. Odd ratio was used to see their association between variables and then logistic regression was used to measure strengths of association. P-values less than 0.05 were taken as statistically significant.

Result: A total of 285 under five children with diarrhoea were included in this study. Of these144 (50.5%) were males and 141(49.5%) were females with the age range of one month to five years and mean age of 2.26 years (25months). Among 285 stool specimens cultured, 44(15.4%) of them were positive for Campylobacter species. Culture positivity for Campylobacter was higher in children below 12 months of age. Latrine usage, water source, boiling drinking water, bottle feeding, nutritional status and exposure to domestic animals had statistically significant association. Highest drug resistance rate were found in ampicillin (68.2%), tetracycline (56.8%) and trimethoprim- sulfamethoxazole (54.5%).

Conclusion: Isolation rate of Campylobacter species were frequent among under five children. The frequency was higher in those children who were malnourished, drinking of unprotected water and direct contact with infected animals (especially cats, dogs, pigeons, hens and their products). The antimicrobial resistance patterns for some of the commonly prescribed antibiotics were high. Therefore, awareness of hand washing and proper boiling of drinking water are probably important in preventing infection with Campylobacter species and childhood diarrhea should not be underestimated and effectiveness of the drugs should be continuously monitored by doing antimicrobial susceptibility test.

Water, sanitation, and hygiene interventions to improve health among people living with HIV/AIDS: a systematic review

May 30, 2013 · 1 comment

Water, sanitation, and hygiene interventions to improve health among people living with HIV/AIDS: a systematic review. AIDS. 20 May 2013

Peletz, Rachel L.; Mahin, Thomas; Elliot, Mark; Harris, Mamie Sackey; Chan, Ka Seen; Cohen, Myron S.; Bartram, Jamie K.; Clasen, Thomas F.

Abstract – Design: People living with HIV/AIDS (PLHIV) are at increased risk of diarrhoeal disease and enteric infection. This review assesses the effectiveness of water, sanitation, and hygiene (WASH) interventions to prevent disease among PLHIV.

Methods: We searched MEDLINE, EMBASE, Global Health, The Cochrane Library, Web of Science, LILACS, Africa-wide, IMEMR, IMSEAR, WPRIM, CNKI, and WanFang. We also hand searched conference proceedings, contacted researchers and organizations, and checked references from identified studies. Eligible studies were those involving WASH interventions among PLHIV that reported on health outcomes and employed a controlled study design. We extracted data, explored heterogeneity, sub-grouped based on outcomes, calculated pooled effects on diarrhoeal disease using meta-analysis, and assessed studies for methodological quality.

Results: Ten studies met the eligibility criteria and are included in the review, of which nine involved water quality interventions and one involved promotion of handwashing. Among eight studies that reported on diarrhoea, water quality interventions (seven studies, pooled RR = 0[middle dot]57, 95%CI: 0[middle dot]38-0[middle dot]86) and the handwashing intervention (one study, RR = 0[middle dot]42, 95%CI: 0[middle dot]33-0[middle dot]54) were protective against diarrhoea. One study reported that household water treatment combined with insecticide treated bednets slowed the progression of HIV/AIDS. The validity of most studies is potentially compromised by methodological shortcomings.

Conclusions: No studies assessed the impact of improved water supply or sanitation, the most fundamental of WASH interventions. Despite some evidence that water quality interventions and handwashing are protective against diarrhoea, substantial heterogeneity and the potential for bias raises questions about the actual level of protection.

Beyond Distance and Time: Gender and the Burden of Water Collection in Rural Uganda

May 30, 2013 · 1 comment

Beyond Distance and Time: Gender and the Burden of Water Collection in Rural Uganda, 2013.

Richard B. Asaba, G. Honor Fagan, Consolata Kabonesa, and Firminus Mugumya

This study discusses the health and economic impacts on women and children of carrying water in Uganda.

 

Coliform Sources and Mechanisms for Regrowth in Household Drinking Water in Limpopo, South Africa

May 30, 2013 · 2 comments

Coliform Sources and Mechanisms for Regrowth in Household Drinking Water in Limpopo, South Africa. J. Environ. Eng. (Apr. 22, 2013).

Mellor, J., Smith, J., Samie, A., and Dillingham, R.

Resource-limited communities throughout the developing world face significant environmental health problems related to the myriad of coliform sources within those communities. This study comprehensively investigated contamination sources and the biological and chemical mechanisms sustaining them in two adjacent communities in rural Limpopo, South Africa. An eight-month study was conducted of household (n = 14) and source water quality, measurements of biofilm layers on the inside of household water storage containers and water transfer devices, as well as hand-based coliforms and hand-washing effectiveness. A 7-day water container incubation experiment was also performed to determine the biological and chemical changes that occur in a household water storage container independent of human interference.

Results indicate that household drinking water frequently becomes contaminated after collection but before consumption (197 vs 1046 CFU/100 mL, n = 266, p < 0.001). The most important contamination sources include biofilm layers on the inside of storage containers (1.85 ± 1.59 CFU/cm2, n = 44), hands (5097 ± 2125 CFU/hand, n = 48) and coliform regrowth resulting from high assimilable organic carbon (AOC) levels during storage. A maximum specific growth rate, μmax, of 0.072 ± 0.003 h−1 was determined for total coliform bacteria on AOC, and a high correlation between AOC concentrations and the growth potential of total coliform bacteria was observed. These results support the implementation of point-of-use water treatment and other interventions aimed at maintaining the safe water chain and preventing biological regrowth.

Water Hauling and Girls’ School Attendance: Some New Evidence From Ghana

May 23, 2013 · 1 comment

Water Hauling and Girls’ School Attendance: Some New Evidence From Ghana, 2013. World Bank Policy Research Working Paper 6443

Céline Nauges; Jon Strand

In large parts of the world, a lack of home tap water burdens households as the water must be brought to the house from outside, at great expense in terms of effort and time. This paper studies how such costs affect girls’ schooling in Ghana, with an analysis based on four rounds of the Demographic and Health Surveys. Using Global Positioning System coordinates, it builds an artificial panel of clusters, identifying the closest neighbors within each round.

The results indicate a significant negative relation between girls’ school attendance and water hauling activity, as a halving of water fetching time increases girls’ school attendance by 2.4 percentage points on average, with stronger impacts in rural communities. The results seem to be the first definitive documentation of such a relationship in Africa. They document some of the multiple and wide population benefits of increased tap water access, in Africa and elsewhere.

Researchers Discover That The Tulsi Plant Can Be Used To Remove Fluoride From Drinking Water

May 22, 2013 · 0 comments

Researchers Discover That The Tulsi Plant Can Be Used To Remove Fluoride From Drinking Water | Source: From the Trenches World Report, April 2013 |

An exciting and new water treatment breakthrough has been announced that will now make the removal of fluoride from the drinking water supplies of the world’s poorest people more affordable than ever.

Researchers from Rajasthan University in India have discovered that the Tulsi plant, also known as Holy Basil, can be used to significantly reduce the amount of fluoride in drinking water. 

At present, the most reliable methods used to remove excessive fluoride from drinking water are either too expensive or not suitable for the environments where they are needed most.

The method discovered by researchers from Rajasthan University is safe, cheap and readily available, making it an ideal alternative for communities who can’t afford to use the more advanced techniques of removing fluoride that are readily available in the West.

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Risk reduction assessment of waterborne Salmonella and Vibrio by a chlorine contact disinfectant point-of-use device

May 22, 2013 · 0 comments

Int J Hyg Environ Health. 2013 Jun;216(3):355-61.

Risk reduction assessment of waterborne Salmonella and Vibrio by a chlorine contact disinfectant point-of-use device.

Coulliette AD, Enger KS, Weir MH, Rose JB. Michigan State University, Department of Fisheries and Wildlife, East Lansing, MI 48824, USA. ACoulliette@cdc.gov

Unsafe drinking water continues to burden developing countries despite improvements in clean water delivery and sanitation, in response to Millennium Development Goal 7. Salmonella serotype Typhi and Vibrio cholerae bacteria can contaminate drinking water, causing waterborne typhoid fever and cholera, respectively. Household water treatment (HWT) systems are widely promoted to consumers in developing countries but it is difficult to establish their benefits to the population for specific disease reduction.

This research uses a laboratory assessment of halogenated chlorine beads treating contaminated water to inform a quantitative microbial risk assessment (QMRA) of S. Typhi and V. cholerae disease in a developing country community of 1000 people. Laboratory challenges using seeded well water resulted in log10 reductions of 5.44 (± 0.98 standard error (SE)) and 6.07 (± 0.09 SE) for Salmonella serotype Typhimurium and V. cholerae, respectively. In well water with 10% sewage and seeded bacteria, the log10 reductions were 6.06 (± 0.62 SE) and 7.78 (± 0.11 SE) for S. Typhimurium and V. cholerae, respectively.

When one infected individual was contributing to the water contamination through fecal material leaking into the water source, the risk of disease associated with drinking untreated water was high according to a Monte Carlo analysis: a median of 0.20 (interquartile range [IQR] 0.017-0.54) for typhoid fever and a median of 0.11 (IQR 0.039-0.20) for cholera. If water was treated, risk greatly decreased, to a median of 4.1 × 10(-7) (IQR 1.6 × 10(-8) to 1.1 × 10(-5)) for typhoid fever and a median of 3.5 × 10(-9) (IQR 8.0 × 10(-10) to 1.3 × 10(-8)) for cholera. Insights on risk management policies and strategies for public health workers were gained using a simple QMRA scenario informed by laboratory assessment of HWT.

Using Tablets in Rural India to Build Demand for Safe Water

May 22, 2013 · 1 comment

Using Tablets in Rural India to Build Demand for Safe Water: A Hi-Tech Approach to Promoting Good Health | Source: by Safe Water Network, Sacramento Bee, May 20, 2013 |

Safe Water Network announced today the launch of its innovative Tablet-based water and health education campaign designed to build awareness of and demand for safe water in rural communities. In one of the first applications of this technology in such a setting, the campaign uses multiple regional dialects and culturally specific marketing content to educate community members on the benefits of safe water and its link to good health. This work is supported by Merck Foundation and builds upon a long-term partnership with Safe Water Network to accelerate the adoption and usage of safe water for drinking and cooking.

“At Merck, we are interested in understanding how innovation can be used to improve global health,” says Danielle Menture, vice president of Global Safety & the Environment at Merck. “This initiative is an excellent example of a new way to use technology to improve access to clean water.” 

Global health experts have been calling for an increased focus on behavior change for many years. Dr. Aidan Cronin, a Water, Sanitation and Hygiene Specialist at UNICEF India, recently stated, “UNICEF realizes the importance of creating awareness about safe drinking water and its multiple benefits.” Dr. Cronin views the Safe Water Network campaign as an important step forward. “In the midst of technology’s growing reach,” he says, “the Tablet campaign is an innovative program that will make people aware about water safety.”

The Tablet approach delivers standardized content which ensures that important messaging remains consistent across users and regions. According to MARI and ECO-Club, Safe Water Network’s local partners in the field, delivering safe water and hygiene messaging on a Tablet is creating a high level of excitement in rural communities. “The enthusiasm I’m met with in the village when using the Tablet allows me to connect with people quickly and hold their attention longer,” says Vedanta from MARI. “The Tablet symbolizes technology and progress; it creates a connection with their urban cousins.”

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