Diarrheal Diseases

Water, Sanitation, and Hygiene Interventions to Improve Health among People Living with HIV/AIDS: A Systematic Review

  • Source:
  • Peletz R (2013) Water, Sanitation, and Hygiene Interventions to Improve Health among People Living with HIV/AIDS: A Systematic Review. AIDS 27(16): 2593-2601.

  • Summary:
  • People living with HIV/AIDS (PLHIV) are at increased risk of diarrheal disease and enteric infection. This review assesses the effectiveness of WASH interventions to prevent disease among PLHIV. Ten studies met the eligibility criteria and are included in the review, of which nine involved water quality interventions and one involved promotion of hand washing. Among eight studies that reported on diarrhea, water quality interventions and the hand washing intervention were protective against diarrhea. One study reported that household water treatment combined with insecticide treated bednets slowed the progression of HIV and AIDS. The validity of most studies is potentially compromised by methodological shortcomings. 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 hand washing are protective against diarrhea, substantial heterogeneity and the potential for bias raise questions about the actual level of protection.

  • Keywords:
  • Diarrheal Diseases Evidence Base Handwashing (Hand Washing) Household Water Treatment & Storage People Living with HIV/AIDS (PLHIV)
  • Assessment of Knowledge, Attitude and Practice Regarding Water, Sanitation and Hygiene for People Living with HIV/AIDS

    • Source:
    • Beyene, H & Hailu, D. 2013. Journal of Water, Sanitation and Hygiene for Development Vol 3 No 1, pp 81–85.

    • Summary:
    • A cross-sectional study was conducted to assess the water, sanitation, and hygiene status and the knowledge, attitude and practice of home-based care clients of People Living with HIV/AIDS (PLWHA) regarding water, sanitation and hygiene (WSH). Interviews and observation of WSH facilities were carried out on 331 randomly selected PLWHA in Hawassa City, Southern Ethiopia. Though the latrine coverage was high, 43% use latrines not easily accessible, 31% use contaminated latrines and 73.4% of the latrines lacked hand-washing facilities. Thirty-four per cent did not have a reliable source of water and 196 (59%) of the households stored water at home for more than one day. Women were more likely to practice personal hygiene as compared to their men counterparts. Although a good level of knowledge and favourable attitudes about WSH related health problems were observed, two-thirds of the participants believed that diarrhoeal infection is not preventable. HIV/AIDS and WSH programmes need to be integrated for better intervention activities in Ethiopia.

  • Keywords:
  • Accessing Water Diarrheal Diseases Evidence Base Handwashing (Hand Washing) Home-Based Care Household Water Treatment & Storage People Living with HIV/AIDS (PLHIV) Sanitation/Feces Disposal
  • Prevalence of Intestinal Parasites in HIV-Positive Patients on the Island of Bioko: Its Relation to Sanitary Conditions and Socioeconomic Factors

    • Source:
    • Roka M. 2012. Sci Total Environ, July 2012.

    • Summary:
    • Gender, educational level and low hygiene were associated with intestinal parasitic infection. When comparing the two groups (HIV-positive and HIV-negative), statistical association between HIV co-infection and infection by Giardia and Entamoeba was found. The findings showed high rates of intestinal parasitic infections in HIV-positive people and in the HIV-negative group, suggesting a closer relationship between sanitary status and living conditions than with immune status.

  • Keywords:
  • Diarrheal Diseases Evidence Base Gender Issues Handwashing (Hand Washing) Journal Articles
  • Water, Sanitation, & Hygiene (WASH) and HIV: Current Research and Opportunities

    • Source:
    • Brown, J. 2012. London School of Hygiene and Tropical Medicine.

    • Summary:
    • This is a PowerPoint presentation covering the links between WASH and HIV, as well as summaries of research activities, opportunities, and LSHTM's current work on the topic.

  • Keywords:
  • Diarrheal Diseases Evidence Base Handwashing (Hand Washing) Household Water Treatment & Storage People Living with HIV/AIDS (PLHIV) Sanitation/Feces Disposal
  • Clinical and Social Determinants of Diarrhoeal Disease in a Rural HIV/AIDS Clinic, South Africa: A Case-Control Study

    • Source:
    • Moshabela M. 2012. Int J STD AIDS, May 2012, 23:346—350

    • Summary:
    • Diarrheal diseases are a common cause of morbidity and are associated with mortality in HIV-infected populations. Little is known about the contribution of clinical and socio-environmental factors to the risk of diarrhea in these populations in rural sub-Saharan Africa. The authors conducted a case-control study of people attending a rural HIV clinic with an episode of diarrhea in Bushbuckridge, South Africa. In multivariate analysis, diarrhea remained associated with female gender, limited access to water and pre-ART status. Further intervention research is urgently needed, combining community- and clinic-based approaches, to improve access to water, sanitation and ART for rural areas with high HIV prevalence, along with structural interventions to address gender inequities.

  • Keywords:
  • Diarrheal Diseases Evidence Base Gender Issues Journal Articles
  • Postnatal Depression Symptoms Are Associated with Increased Diarrhea Among Infants of HIV-Positive Ghanaian Mothers

    • Source:
    • Okronipa, H et al. 2012. AIDS Behav, 16: 2216-2225.

    • Summary:
    • HIV infection is linked to increased prevalence of depression which may affect maternal caregiving practices and place infants at increased risk of illness. We examined the incidence and days ill with diarrhea among infants of HIV positive (HIV-P), HIV negative (HIV-N), and unknown HIV status (HIV-U) women, and determined if symptoms of maternal postnatal depression (PND) modulated the risk of diarrhea. Pregnant women (n = 492) were recruited from three antenatal clinics; mothers and infants were followed for 12 months postpartum. Diarrheal incidence was 0.6 episodes/100 days at risk. More HIV-P than HIV-N and HIV-U women tended to report PND symptoms (v 2 = 4.76; P = 0.09). Reporting symptoms was associated with an increased risk of infantile diarrhea only among HIV-P and HIV-U but not HIVN women (interaction term, v 2 = 7.84; P = 0.02). Health care providers should be aware of the increased risk of infantile diarrhea when both maternal HIV and PND symptoms are present and take preventive action.

  • Keywords:
  • Breast Feeding/Infant Feeding Diarrheal Diseases Evidence Base Handwashing (Hand Washing) Journal Articles Maternal and Child Health People Living with HIV/AIDS (PLHIV)
  • Integrated HIV Testing, Malaria, and Diarrhea Prevention Campaign in Kenya: Modeled Health Impact and Cost-Effectiveness

    • Source:
    • Kahn J, Muraguri N, Harris B. 2012. PLoS One, Feb 2012

    • Summary:
    • Efficiently delivered interventions to reduce HIV, malaria, and diarrhea are essential to accelerating global health efforts. A 2008 community-integrated prevention campaign in Western Province, Kenya, reached 47,000 individuals over seven days, providing HIV testing and counseling, water filters, insecticide-treated bed nets, condoms, and for HIV-infected individuals, cotrimoxazole prophylaxis and referral for ongoing care. The program modeled the potential cost-effectiveness of a scaled-up integrated prevention campaign. A mass, rapidly implemented campaign for HIV testing, safe water, and malaria control appears economically attractive.

  • Keywords:
  • Diarrheal Diseases Household Water Treatment & Storage Journal Articles Programming Guidance
  • Water, Sanitation and Hygiene (WASH) Considerations for Accelerated PMTCT Programming

    • Source:
    • USAID & WASHplus. 2012.

    • Summary:
    • Many life-threatening opportunistic infections are caused by exposure to unsafe water, inadequate sanitation and poor hygiene. Diarrhea, a very common symptom that can occur in people living with HIV and AIDS (PLHIV), affects 90 percent of PLHIV and results in significant morbidity and mortality, especially in HIV-positive children. Studies have shown that children 7-14 months of age show an increase in diarrhea after being exclusively breastfed and this is linked to the introduction of complementary feeding. While previously it was thought that unsafe water was the primary cause, recent evidence is also pointing to unsafe food.

  • Keywords:
  • Diarrheal Diseases Handwashing (Hand Washing) Household Water Treatment & Storage Nutrition People Living with HIV/AIDS (PLHIV) PMTCT (Preventing Mother to Child Trans.) Programming Guidance Sanitation/Feces Disposal
  • Cryptosporidium Contamination of Drinking Water for People Living with HIV/AIDS: The Need for Effective Interventions

    • Source:
    • Peletz, R & Mahin, T. London School of Hygiene and Tropical Medicine & Massachusetts Department of Environmental Protection.

    • Summary:
    • The waterborne pathogen Cryptosporidium is currently one of the most frequently identified intestinal pathogens throughout the world and one of the most common waterborne pathogens associated with diarrhoea in people living with HIV/AIDS (PLHIV).

  • Keywords:
  • Diarrheal Diseases Evidence Base Household Water Treatment & Storage People Living with HIV/AIDS (PLHIV)