Professor Sandy Cairncross raises concerns regarding Global Burden of Disease Study 2010

December 19, 2012 · 0 comments

Professor Sandy Cairncross raises concerns regarding Global Burden of Disease Study 2010 | Source: SHARE, Dec 14, 2012

The Global Burden of Disease Study 2010 (GBD 2010) was published in the Lancet on 13th December 2012 and is undeniably “a critical contribution to our understanding of present and future health priorities for countries and the global community“, in the words of Lancet Editor-in-Chief Dr Richard Horton. The GBD 2010 was developed by a Consortium led by the Institute of Health Metrics & Evaluation of the University of Washington. The collaboration of 486 scientists from 302 institutions in 50 countries, including SHARE Research Director Professor Sandy Cairncross, is the largest ever systematic effort to describe the global distribution and causes of a wide array of major diseases, injuries, and health risk factors. GBD 2010 takes the form of seven articles representing different aspects of the studies such as gender or age groups.

The Lancet summarises the key findings of GBD 2010 as follows:

The results show that infectious diseases, maternal and child illness, and malnutrition now cause fewer deaths and less illness than they did twenty years ago. As a result, fewer children are dying every year, but more young and middle-aged adults are dying and suffering from disease and injury, as non-communicable diseases, such as cancer and heart disease, become the dominant causes of death and disability worldwide. Since 1970, men and women worldwide have gained slightly more than ten years of life expectancy overall, but they spend more years living with injury and illness.

Whilst welcoming the new insights afforded by the new GBD 2010 estimates, Professor Sandy Cairncross and Dr Charlotte Watts have raised concerns about aspects of the GBD 2010 methodology in a comment piece in the Lancet. In particular, they flag the lack of rigorous consultation on the study’s strength of evidence and findings, and raise concerns about the GBD 2010 risk factor rankings being used to guide global health policy:

The risk factor rankings should be interpreted with caution. The results are an important starting point, but the process for future global assessments needs to be revisited. Fundamentally, a ranking cannot work if important risk factors for major health burdens are omitted. More broadly, a clearer consensus is needed on the criteria for inclusion of risk factors and health effects, and on strategies to overcome important data gaps.

Long-term Impact of Integration of Household Water Treatment and Hygiene Promotion with Antenatal Services

December 19, 2012 · 0 comments

Am J Trop Med Hyg. 2012 Dec 12.

Long-term Impact of Integration of Household Water Treatment and Hygiene Promotion with Antenatal Services on Maternal Water Treatment and Hygiene Practices in Malawi.

Loharikar A, Russo E, Sheth A, Menon M, Kudzala A, Tauzie B, Masuku HD, Ayers T, Hoekstra RM, Quick R.

Epidemic Intelligence Service, and Division of Foodborne, Bacterial, and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; United Nations Children’s Fund-Malawi, Lilongwe, Malawi; Ministry of Health, Lilongwe, Malawi.

A clinic-based program to integrate antenatal services with distribution of hygiene kits including safe water storage containers, water treatment solution (brand name WaterGuard), soap, and hygiene education, was implemented in Malawi in 2007 and evaluated in 2010. We surveyed 389 participants at baseline in 2007, and found and surveyed 232 (60%) participants to assess water treatment, test stored drinking water for residual chlorine (an objective measure of treatment), and observe handwashing technique at follow-up in 2010.

Program participants were more likely to know correct water treatment procedures (67% versus 36%; P < 0.0001), treat drinking water with WaterGuard (24% versus.2%; P < 0.0001), purchase and use WaterGuard (21% versus 1%; P < 0.001), and demonstrate correct handwashing technique (50% versus 21%; P < 0.001) at the three-year follow-up survey than at baseline. This antenatal-clinic-based program may have contributed to sustained water treatment and proper handwashing technique among program participants.

Josh Kearns – charcoal for water filtration

December 19, 2012 · 1 comment

An ancient filtration material removes pesticides from drinking water | Source: Rob Goodier, Engineering for Change, Dec 13, 2012

Charcoal may have been a part of water treatment for at least 4000 years, but can it remove modern synthetic pesticides from drinking water? Farmers in northern in Thailand, concerned about agricultural runnoff, put the question to Josh Kearns, an environmental engineering doctoral candidate at the University of Colorado in Boulder and the science director at Aqueous Solutions, a non-profit water, sanitation and hygiene development organization.

“Farmers introduced me to the ancient tradition of using charcoal for water filtration and asked me, ‘will it work to remove pesticides?’ I didn’t know the answer, and searching the scientific literature revealed that, in fact, no one knows the answer,” Kearns told E4C.

Josh Kearns works with Thai farmers to build a simple gasifier. Photo courtesy of Josh Kearns

The answer, Kearnes discovered, is that it can. But a lot depends on how you make the char.

Gasifiers and char
Charcoal removes impurities from water by a process called adsorption, meaning that the contaminants adhere to the charcoal’s surface. Because it is porous, however, the water can permeate the charcoal as well, and that permeation is the better-known process of absorption. Dropping the prefixes gives the word “sorption,” which covers both processes.

The Thai communities make their charcoal in traditional kilns that, when burning well, heat the material to 350 to 500 C. In contrast, simple gasifiers burn at 900 C. At that temperature, the wood and agricultural waste that they burn converts more completely into char. The biomass releases gases as it heats, and those are burned as fuel. The release of gases and combustible material leaves behind char that is highly porous with a greatly increased surface area.

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Environmental health and household demographics impacting Biosand Filter maintenance and diarrhea

December 11, 2012 · 0 comments

Environ Sci Technol. 2012 Nov 15.

Environmental health and household demographics impacting Biosand Filter maintenance and diarrhea in Guatemala: an application of structural equation modeling.

Divelbiss D, Boccelli D, Succop P, Oerther D.

In rural health development practice, engineers and scientists must recognize the complex interactions that influence individuals’ contact with disease-causing pathogens and understand how household habits may impact the adoption and long term sustainability of new technology. The goal of this study was to measure the effect of various environmental health factors and household demographics on the operation and maintenance of the Biosand filter (Centre for Affordable Water and Sanitation Technology, Calgary, Alberta, Canada) and diarrhea health burden in the region.

In July and August 2010, randomized household surveys (n = 286) were completed in rural Guatemala detailing water access, sanitation availability, hygiene practice, socio-economic status, education level, filter operation and maintenance, and diarrhea health burden of the home. A hypothesized structural equation model was developed based on a review of published research and tested using the surveyed data.

Model-derived parameter estimates indicated that: a) proper personal hygiene practices significantly promote proper filter operation and maintenance; and b) higher household education level, proper filter operation and maintenance, and improved water supply significantly reduce diarrhea health burden. Additionally, a high level of unexplained variance in diarrhea indicated the filter, though protective of health, is not the only factor influencing diarrhea.

Safe-water shortages, gender perspectives, and related challenges in developing countries

December 11, 2012 · 0 comments

Sci Total Environ. 2012 Nov 22;442C:96-102. doi: 10.1016/j.scitotenv.2012.10.004.

Safe-water shortages, gender perspectives, and related challenges in developing countries: The case of Uganda.

Baguma D, Hashim JH, Aljunid SM, Loiskandl W. United Nations University International Institute for Global Health, UNU-IIGH Building, UKM Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia. Electronic address: david.baguma@unu.edu.

The need for water continues to become more acute with the changing requirements of an expanding world population. Using a logistical analysis of data from 301 respondents from households that harvest rainwater in Uganda, the relationship between dependent variables, such as water management performed as female-dominated practices, and independent variables, such as years of water harvesting, family size, tank operation and maintenance, and the presence of local associations, was investigated. The number of years of water harvesting, family size, tank operation and maintenance, and presence of local associations were statistically significantly related to adequate efficient water management.

The number of years of water harvesting was linked to women’s participation in household chores more than to the participation of men, the way of livelihoods lived for many years. Large families were concurrent with a reduction in water shortages, partially because of the availability of active labour. The findings also reveal important information regarding water-related operations and maintenance at the household level and the presence of local associations that could contribute some of the information necessary to minimise water-related health risks.

Overall, this investigation revealed important observations about the water management carried out by women with respect to underlying safe-water shortages, gender perspectives, and related challenges in Uganda that can be of great importance to developing countries.

Modeling the Complexities of Water, Hygiene, and Health in Limpopo Province, South Africa.

December 11, 2012 · 0 comments

Environ Sci Technol. 2012 Dec 6.

Modeling the Complexities of Water, Hygiene, and Health in Limpopo Province, South Africa.

Mellor JE, Smith JA, Learmonth GP, Netshandama VO, Dillingham RA.

Department of Civil and Environmental Engineering, The University of Virginia.

Researchers have long studied the causes and prevention strategies of poor household water quality and early childhood diarrhea using intervention-control trials. Although the results of such trails can lead to useful information, they do not capture the complexity of this natural/engineered/social system. We report on the development of an agent-based model (ABM) to study such a system in Limpopo, South Africa. The study is based on four years of field data collection to accurately capture essential elements of the communities and their water contamination chain.

An extensive analysis of those elements explored behaviors including water collection and treatment frequency as well as biofilm buildup in water storage containers, source water quality, and water container types. Results indicate that interventions must be optimally implemented in order to see significant reductions in early childhood diarrhea (ECD).

Household boiling frequency, source water quality, water container type, and the biofilm layer contribution were deemed to have significant impacts on ECD. Furthermore, concurrently implemented highly effective interventions were shown to reduce diarrhea rates to very low levels even when other, less important practices were suboptimal. This technique can be used by a variety of stakeholders when designing interventions to reduce ECD incidences in similar settings.

Achieving long-term use of solar water disinfection in Zimbabwe

December 11, 2012 · 0 comments

Public Health, available online 6 December 2012

Achieving long-term use of solar water disinfection in Zimbabwe

H.-J. Mosler, S.M. Kraemerb, , R.B. Johnston,

Eawag, Swiss Federal Institute for Aquatic Science and Technology, Überlandstrasse 133, 8600 Zürich, Switzerland

Objectives – To use a psychological theory of behavioural change to measure and interpret the effectiveness of different promotional strategies for achieving long-term usage of a household water treatment and safe storage (HWTS) system in peri-urban Zimbabwe.

Study design – Solar disinfection (SODIS) was introduced into five peri-urban communities near Harare, Zimbabwe. Six different interventions were developed and were applied in four communities in different combinations, with the fifth remaining as a control area where no interventions were implemented.

Methods – Throughout the 26 months of the study nine longitudinal panel surveys were conducted in which SODIS usage was estimated using three separate metrics: reported, calculated, and observed. A total of 1551 people were interviewed.

Results – The three indicators of SODIS usage broadly agreed with one another. By any measure, the most effective intervention was household visits by trained promoters in combination with persuasion. Households which received household visits maintained SODIS usage rates of 65% or more, even six months after the cessation of all promotional activities. Households receiving other interventions were significantly less effective. Interventions like prompts or public commitment after the application of household visits were effective at maintaining good practices once these were established.

Conclusions – Household promotion in combination with persuasion appears more effective than other approaches, especially when followed with interventions targeting the maintenance of the new behaviour. With this intervention it is possible that around 65% of the households continue to use solar water disinfection (SODIS) more than two years after the initial promotion, and six months after the end of all interventions.

Addressing Inequities in Access to Health Products through the Use of Social Marketing, Community Mobilization, and Local Entrepreneurs in Rural Western Kenya

December 5, 2012 · 0 comments

International Journal of Population Research, Volume 2012 (2012), doi:10.1155/2012/470598

Addressing Inequities in Access to Health Products through the Use of Social Marketing, Community Mobilization, and Local Entrepreneurs in Rural Western Kenya

JR Harris, et al.

While social marketing can increase uptake of health products in developing countries, providing equitable access is challenging. We conducted a 2-year evaluation of uptake of WaterGuard, insecticide-treated bednets (ITNs), and micronutrient Sprinkles in Western Kenya. Sixty villages were randomly assigned to intervention and comparison groups. Following a baseline survey (BL), a multifaceted intervention comprising social marketing of these products, home visits by product vendors from a local women’s group (Safe Water and AIDS Project, or SWAP), product promotions, and modeling of water treatment and safe storage in was implemented in intervention villages.

Comparison villages received only social marketing of WaterGuard and ITNs. We surveyed again at one year (FU1), implemented the intervention in comparison villages, and surveyed again at two years (FU2). At BL, <3% of households had been visited by a SWAP vendor. At FU1, more intervention than comparison households had been visited by a SWAP vendor (39% versus 9%, ), and purchased WaterGuard (14% versus 2%, ), Sprinkles (36% versus 6%, ), or ITNs (3% versus 1%, ) from that vendor. During FU2, 47% and 41% of original intervention and comparison households, respectively, reported ever receiving a SWAP vendor visit (); >90% those reported ever purchasing a product from the vendor. WaterGuard () and ITNs () were purchased less frequently by lower-SES than higher-SES households; Sprinkles, the least expensive product, was purchased equally across all quintiles.

CAWST – New Biosand Filter Website

December 5, 2012 · 0 comments

CAWST has just launched a new website: www.biosandfilters.info

A practitioner’s Knowledge Base on the Biosand Filter, based on CAWST’s experience working with hundreds of organizations implementer Biosand filter programs globally.

You will find:

  • Over 30 Technical Updates
  • Over 30 Implementation Updates including Case Studies and Evaluations
  • Over 100 Frequently Asked Questions
  • Over 40 Research Papers on the BSF
  • BSF Projects profiles
  • this BSF Production Forum embedded in the website

Sign-up to get full access. You can then add your knowledge, experience, case studies, projects and questions. We would love your contributions.

Hands and water as vectors of diarrheal pathogens in Bagamoyo, Tanzania

November 28, 2012 · 1 comment

Environ Sci Technol. 2012 Nov 26.

Hands and water as vectors of diarrheal pathogens in Bagamoyo, Tanzania.

Mattioli MC, Pickering AJ, Gilsdorf R, Davis J, Boehm AB.

Diarrheal disease is a leading cause of under-five childhood mortality worldwide, with at least half of these deaths occurring in sub-Saharan Africa. Transmission of diarrheal pathogens occurs through several exposure routes including drinking water and hands, but the relative importance of each route is not well understood. Using molecular methods, this study examines the relative importance of different exposure routes by measuring enteric bacteria (pathogenic Escherichia coli) and viruses (rotavirus, enterovirus, adenovirus) in hand rinses, stored water, and source waters in Bagamoyo, Tanzania.

Viruses were most frequently found on hands, suggesting that hands are important vectors for viral illness. The occurrence of E. coli virulence genes (ECVG) was equivalent across all sample types, indicating that both water and hands are important for bacterial pathogen transmission. Fecal indicator bacteria and turbidity were good predictors of ECVG, whereas turbidity and human-specific Bacteroidales were good predictors of viruses.

ECVG were more likely found in unimproved water sources, but both ECVG and viral genes were detected in improved water sources. ECVG were more likely found in stored water of households with unimproved sanitation facilities. The results provide insights into the distribution of pathogens in Tanzanian households and offer evidence that hand-washing and improved water management practices could alleviate viral and bacterial diarrhea.

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