Evidence Base
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)
Source:
- Nkenfou CN, Nana CT, Payne VK (2013) Intestinal Parasitic Infections in HIV Infected and Non-Infected Patients in a Low HIV Prevalence Region, West-Cameroon. PLoS ONE 8(2): e57914. doi:10.1371/journal.pone.0057914
Summary:
- The magnitude of intestinal parasitic infection in acquired immunodeficiency syndrome patients requires careful consideration in the developing world where poor nutrition is associated with poor hygiene and several tropical diseases. However, there have been very few studies addressing this issue in Cameroon. This study was conducted to determine the prevalence of intestinal parasitosis in HIV/AIDS patients in Dschang -Cameroon. Stool and blood specimens from HIV/AIDS patients and control group were screened respectively for intestinal parasites and for HIV antibodies. Intestinal parasites were identified using direct microscopy, formalin-ether concentration and Ziehl Neelsen methods. Out of 396 participants recruited among patients consulting at hospital, 42 (10.6%) were HIV positive, thirty of them treatment naïve. The overall prevalence of intestinal parasites was 14.64%. Out of 42 HIV/AIDS patients, 59.5% (25/42) were infected with intestinal parasites, while only 9.32% (33/354) of the HIV negative patients were infected with intestinal parasites. The parasites detected in our study population included Crystosporidium parvum (2.53%), Entamoeba histolytica (7.52%), Entamoeba coli (4.04%), Giardia lamblia (0.25%), Trichuris trichura (0.25%), Strongyloides stercoralis (0.25%) and Taenia spp. (0.25%). In the HIV infected group, Crystosporidium parvum (19.04%), Entamoeba histolytica (19.04%), Entamoeba coli (21.42%), Giardia lamblia (2.38%), Strongyloides stercoralis (0.25%) and Taenia spp. (0.25%) were found. Crystosporidium parvum was found to be significantly higher in HIV/AIDS patients than in controls (P<0.05). Multivariate analysis showed that the HIV status and the quality of water were the major risk factors for intestinal parasitosis. Routine examinations of stool samples for parasites would significantly benefit the HIV patients by contributing in reducing morbidity and improving the efficiency of antiretroviral treatment. Even after the introduction of free anti-retroviral drugs, opportunistic intestinal infections are still a threat. HIV patients should be screened routinely for intestinal parasites and treated for their overall well being.
Keywords:
Evidence Base Household Water Treatment & Storage Journal Articles People Living with HIV/AIDS (PLHIV)
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
Source:
- PLoS ONE, Nov 6, 2012
Rachel Peletz, et al.
Summary:
- Assessing Water Filtration and Safe Storage in Households with Young Children of HIV-Positive Mothers: A Randomized, Controlled Trial in Zambia
Background: Unsafe drinking water presents a particular threat to people living with HIV/AIDS (PLHIV) due to the increased risk of opportunistic infections, diarrhea-associated malabsorption of essential nutrients, and increased exposure to untreated water for children of HIV-positive mothers who use replacement feeding to reduce the risk of HIV transmission. This population may particularly benefit from an intervention to improve water quality in the home.
Methods and Findings: We conducted a 12-month randomized, controlled field trial in Zambia among 120 households with children ,2 years (100 with HIV-positive mothers and 20 with HIV-negative mothers to reduce stigma of participation) to assess a high-performance water filter and jerry cans for safe storage. Households were followed up monthly to assess use, drinking water quality (thermotolerant coliforms (TTC), an indicator of fecal contamination) and reported diarrhea (7-day recall) among children ,2 years and all members of the household. Because previous attempts to blind the filter have been unsuccessful, we also assessed weight-for-age Z-scores (WAZ) as an objective measure of diarrhea impact. Filter use was high, with 96% (596/620) of household visits meeting the criteria for users. The quality of water stored in intervention
households was significantly better than in control households (3 vs. 181 TTC/100 mL, respectively, p,0.001). The intervention was associated with reductions in the longitudinal prevalence of reported diarrhea of 53% among children ,2 years (LPR = 0.47, 95% CI: 0.30–0.73, p = 0.001) and 54% among all household members (LPR = 0.46, 95% CI: 0.30–0.70, p,0.001). While reduced WAZ was associated with reported diarrhea (20.26; 95% CI: 20.37 to 20.14, p,0.001), there was no difference in WAZ between intervention and control groups.
Conclusion: In this population living with HIV/AIDS, a water filter combined with safe storage was used correctly and consistently, was highly effective in improving drinking water quality, and was protective against diarrhea.
Keywords:
Evidence Base Household Water Treatment & Storage
Source:
- Potgieter N, Mpofu T, Barnard T. 2012. University of Venda. Water and Health Research Unit. University of Johannesburg
Summary:
- Presently very little data is available on how water, sanitation and hygiene infrastructures are affecting the lives of people living with HIV and AIDS (PLWHA) in Zimbabwe. Literature has identified a series of linkages between water, sanitation and hygiene and HIV and AIDS. According to UNICEF, a hygienic environment, clean water and adequate sanitation are key factors in preventing opportunistic infections associated with HIV and AIDS, and in the quality of life of people living with the disease. PLWHA are more susceptible to water-related diseases than healthy individuals, and they become sicker from these infections than people with healthy immune systems. There is a need for hygiene education at the household level on the importance of household water storage to prevent contamination and appropriate household water treatment systems, such as filters or disinfectants, to ensure that the water is safe for human consumption. The presence of total coliforms in hand swabs is indicative of inadequate hand washing, especially non-use of soap and disinfectants. The aim of this study is to determine the impact of water, sanitation, and hygiene infrastructures and their associated health risks facing PLWHA through detection of pathogenic E. coli in domestic drinking water and on sanitation facilities in and around Bulawayo in Zimbabwe.
Keywords:
Evidence Base Handwashing (Hand Washing) Household Water Treatment & Storage People Living with HIV/AIDS (PLHIV) Sanitation/Feces Disposal
Source:
- C-Change, WASHplus. 2012. USAID
Summary:
- Recognizing the importance of safe water, sanitation, and hygiene promotion in protecting and caring for PLHIV, the trend is to integrate WASH improvement into HIV and AIDS policies and programs. As part of its palliative care approach, PEPFAR has developed a preventive care package that summarizes evidence-based interventions for PLHIV and their families in resource-poor settings. The package identifies three key hygiene improvement practices: safe drinking water, washing hands with soap, and safe handling and disposal of feces, and suggests integrating these into all HIV and AIDS programs. This report also outlines ways to integrate sanitation into existing PEPFAR programs, the rationale for doing so, and examples of how countries have integrated sanitation into their HIV programming. Guidelines and tools are available as annexes.
Keywords:
Best Practices and Lessons Learned Evidence Base Handwashing (Hand Washing) Household Water Treatment & Storage People Living with HIV/AIDS (PLHIV) PEPFAR Programming Guidance Sanitation/Feces Disposal
