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PubMed2005

Acute dysuria among female soldiers.

OBJECTIVE: To assess behavior patterns among active duty female soldiers presenting to military care facilities for acute dysuria. METHODS: A self-administered questionnaire was developed. One hundred twelve female soldiers presenting with acute dysuria and one hundred twenty-six presenting for other reasons were surveyed. RESULTS: During regular duty hours, the dysuria group drank less than the control group (21% and 14%, respectively; p = 0.004). However, field duty appeared to compound this problem, with the dysuria group drinking considerably less than the control group (79% and 19%, respectively; p = 0.002). Both groups stated that they postponed urination during working hours. The dysuria group postponed urination more than did the control group during regular duty (75% and 53%, respectively; p = 0.006) and field duty (79% and 65%, respectively; p = 0.008). CONCLUSIONS: Female soldiers presenting with dysuria were more likely to report fluid restriction and to postpone voiding during duty, behaviors that were reported even more frequently during field duty. Fluid restriction and postponed urination may be significant factors in the development of acute dysuria among female soldiers.

Acute Disease↗
PubMed2000

Volta watertight VIP latrine.

The Danish International Development Agency (DANIDA) is assisting the government of Ghana to provide potable water and improved sanitation facilities to about 50% of the Volta Region's population over a 10-year Community Water and Sanitation Programme (CWSP). Sanitation options include designs for household Ventilated Improved Pit (VIP) latrines. However, areas along the coastal belt of the region have a high water table, between 1-1.5 m (3.3-4.95 ft). In addition, about 80% of the inhabitants in these areas depend on shallow hand-dug wells for domestic purposes and irrigation of vegetable gardens. With the construction of these sanitation options under promotion, pollution of the groundwater is inevitable. Circumventing the problem by the programme led to the modification of the present designs into the "Volta Watertight VIP Latrine (VVIP)". The design considerations and the components that have been incorporated to enable it function effectively are presented in this paper for discussion. Five (5) demonstration units were built, and used for a year. Used pits were covered and pit contents examined after a period of six months. Observations made at the end of this fallow led to the conclusion that the VVIP could be adapted for high water table areas to prevent groundwater pollution, baring any constructional defects and inefficiencies.

Developing Countries↗
PubMed2001

Bacterial contamination associated with electronic faucets: a new risk for healthcare facilities.

OBJECTIVE: To investigate the safety of the hospital water supply following a major flood. DESIGN: Surveillance was conducted of the hospital water supply as it entered the hospital and at randomly selected water faucets throughout the facility. SETTING: A newly constructed surgical critical-care unit in a 265-bed community hospital that had to be evacuated and was out of operation for 6 weeks following a major flood of the city. METHODS: Random water samples throughout the facility were analyzed for heterotrophic plate counts (HPCs), chlorine, and coliforms utilizing standard methods. RESULTS: Water samples entering the hospital met appropriate standards, indicating the city water distribution system was not contaminated. Of 169 faucets tested, 13 (22%) of 59 electronic faucets exceeded the HPC threshold, and 12 (11%) of 110 manual faucets exceeded the HPC threshold (P<.14). A comparison of two brands of electronic faucets with manual faucets and with each other revealed that the HPC threshold was exceeded by 11 (32%) of 34 brand A faucets as compared to 12 (11%) of 110 manual faucets (P<.006). The HPC threshold was exceeded by 2 (8%) of 25 brand B faucets compared to 12 (11%) of 110 manual faucets (P<.94). Contamination rates of brand A and brand B faucets differed significantly (P<.003). Similar testing 2 months after hyperchlorination of the water supply indicated that the HPC threshold was exceeded by 16 (52%) of 31 brand A faucets compared to 10 (9.%) of 110 manual faucets (P<.0000003) and by 2 (18%) of 25 brand B faucets compared to 10 (9%) of 110 manual faucets (P=1.0). CONCLUSIONS: A certain brand of electronic water faucet used in the hospital was associated with unacceptable levels of microbial growth in water and was a continuing source of bacteria potentially hazardous to patients.

Chlorine↗
PubMed1994

Family latrines and paediatric shigellosis in rural Bangladesh: benefit or risk?

BACKGROUND: The potential benefits of installing excreta disposal facilities on the burden of paediatric diarrhoea in less-developed settings remain controversial. We conducted a longitudinal study to evaluate whether family latrines are associated with interruption of the transmission of shigellosis to younger children in rural Bangladesh. METHODS: We prospectively studied 1529 children under 5 years of age exposed to index cases of Shigella dysentery. In all 219 children with culture-proven shigellosis detected during 1 month of follow-up were compared with 1310 control children who did not develop shigellosis or Shigella-negative dysentery. RESULTS: Overall, the presence of a family latrine appeared to be associated with a higher, not a lower, risk of paediatric shigellosis (adjusted odds ratio (ORa) = 1.37, 95% confidence interval (CI): 0.99-1.89). While use of a pit or sanitary latrine revealed no evidence of a protective association (ORa = 0.96, 95% CI: 0.43-2.15), use of a hanging latrine in which faeces were discharged directly onto the ground or into a body of water was associated with a notable increase of risk (ORa = 1.42, 95% CI: 1.02-1.98, P < 0.05). CONCLUSIONS: While cautioning that installation of sanitary latrines may not be sufficient to reduce the burden of paediatric shigellosis in less-developed settings, these data suggest that eliminating unsanitary latrines constitutes a potentially important intervention in its own right in these settings.

Age Factors↗
PubMed1973

Penile trauma.

Explore the source record for details and available documents.

Accidents, Home↗
PubMed2005

Environmental sanitary interventions for preventing active trachoma.

BACKGROUND: Trachoma is the second or third major cause of blindness. It is responsible for about six million blind people worldwide, mostly in the poor communities of developing countries. One of the major strategies advocated for the control of the disease is the application of various environmental sanitary measures to such communities. OBJECTIVES: To assess the evidence for the effectiveness of environmental sanitary measures on the prevalence of active trachoma in endemic areas. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials - CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) on The Cochrane Library (Issue 4, 2004), MEDLINE (1966 to January 2005), EMBASE (1980 to January 2005), LILACS (April 2004), the reference list of trials and the Science Citation Index. We also contacted agencies, experts and researchers in trachoma control. SELECTION CRITERIA: This review included randomised and quasi-randomised controlled trials comparing any form of environmental hygiene measures with no measure. These hygienic measures included fly control, provision of water and health education. Participants in the trials were people normally resident in the trachoma endemic areas. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed the quality of trials. Study authors were contacted for additional information. Three trials met the inclusion criteria but meta-analysis was not conducted due to heterogeneity of the studies. MAIN RESULTS: Two studies that assessed insecticide spray as a fly control measure found that trachoma is reduced by at least 55% to 61% with this measure compared to no intervention. One study found that another fly control measure, latrine provision, reduced trachoma by 29.5% compared to no intervention; this was, however, not statistically significantly different. Another study revealed that health education on personal and household hygiene reduced the incidence of trachoma such that the odds of reducing trachoma in the health education village was about twice that of the no intervention village. However, all the studies have some methodological concerns relating to concealment of allocation and non-consideration of clustering effect in data analysis. AUTHORS' CONCLUSIONS: There is evidence that insecticide spray as a fly control measure reduces trachoma significantly. Latrine provision as a fly control measure has not demonstrated significant trachoma reduction. Health education may be effective in reducing trachoma. There is a dearth of data to determine the effectiveness of all aspects of environmental sanitation in the control of trachoma.

Animals↗
PubMed2005

Analysis of incidence rates in cluster-randomized trials of interventions against recurrent infections, with an application to trachoma.

A method is developed for the Bayesian analysis of rate ratios of repeated events in matched cluster-randomized trials, and applied to the Flies and Eyes trial against trachoma in The Gambia. A non-mechanistic analysis estimates the incidence rate ratio for insecticide spray, relative to no intervention, as 0.59 (95 per cent credible interval 0.37--0.92), and for latrine provision as 0.67 (0.41--1.01). The method also yields incidence and clearance rate ratios for age. In the Flies and Eyes trial, the former rates are estimated to decrease with age, although no clear pattern is seen in the latter. Using clinical active trachoma as a marker of infection, and net catches to measure fly density, a mechanistic model is developed to estimate the proportion of transmission due to flies. However, it was not possible to estimate this proportion accurately, and a lack of association was noted between the magnitudes of reductions in fly density and in trachoma. The lack of knowledge on the relative importance of different transmission routes is a constraint on the current global programme for the elimination of trachoma.

Adolescent↗
PubMed1995

Viral contamination of environmental surfaces on a general paediatric ward and playroom in a major referral centre in Riyadh.

In order to determine the incidence of viral contamination of environmental surfaces in a hospital in Saudi Arabia. A 6-month prospective study was carried out on a general paediatric ward in which both enteric and respiratory viruses were screened. Weekly samples were taken between August 1993-February 1994. A total of 155 samples were taken in which 11 (7%) tested positive for rotavirus. No other viruses were detected. Internal and external temperatures were monitored and an increase in rotavirus incidence was noted with decrease in temperature. Rotavirus was detected on surfaces involving human activity (toilet handles, televisions, toys and vital signs chart). One patient had rotavirus on his hands but no staff were found to carry rotavirus. Further contamination of environmental surfaces (9%) was detected during an increased incidence of rotavirus infection. A proper programme of disinfection and handwashing is essential in order to eliminate this mode of transmission.

Child↗
PubMed2005

Should electronic faucets be used in intensive care and hematology units?

OBJECTIVE: To compare bacterial contamination associated with electronic faucets and manual faucets in wards admitting patients highly susceptible to infection. DESIGN: Water samples from electronic faucets and manual faucets were taken according to the French recommendations on water surveillance in healthcare settings. SETTING: Hematology and intensive care units (ICUs) of a 900-bed university hospital and a 500-bed general hospital. MEASUREMENTS AND RESULTS: Overall 227 water samples were collected, 92 from electronic faucets and 135 from manual faucets. Thirty-six (39%) of the water samples from electronic faucets and 2 (1%) from manual faucets yielded pathogenic bacteria. In hematology wards 17 (30%) samples from electronic faucets and 2 (2%) from manual faucets were contaminated. In ICUs 19 (53%) samples from electronic faucets and none of 48 from manual faucets were contaminated. All samples were contaminated with various strains of Pseudomonas aeruginosa (8 to >100 CFU/100 ml). Despite hyperchlorination the electronic faucets remained contaminated. Replacing the contaminated electronic faucets by manual faucets led to a complete and sustained elimination of bacterial contamination. Contamination was not associated with a particular brand of electronic faucets. CONCLUSIONS: Our findings demonstrate that electronic faucets are significantly more frequently contaminated than manual faucets and could be a major reservoir for P. aeruginosa. Wards admitting patients highly susceptible to infection and using electronic faucets should be aware of this potential threat. Moreover, units already equipped with these devices, should check water quality periodically.

Colony Count, Microbial↗
PubMed1999

Some historical aspects of urinals and urine receptacles.

In the history of mankind the first receptacles for urine were made and employed for diagnostic purposes and developed over centuries to a sophisticated matula. In ancient Greek and Roman history, chamber pots existed and urine was collected to bleach sheets, but it was only in the late medieval and renaissance times that a real urine receptacle or urinal for daily use was developed. We give a short description of the materials used, including clay, pewter, copper, and silver, but more sophisticated receptacles made of china, such as the bourdaloue, and of glass, such as the Kuttrolf, were also developed for use during long church ceremonies. Less known are the wooden "pipes" from Turkestan, used to keep babies dry. In the long history of mankind, urinals sometimes became very original objects.

Europe↗
PubMed2003

Association of inflammatory bowel disease with indicators for childhood antigen and infection exposure.

BACKGROUND AND AIMS: Genetic susceptibility plays an important role in the predisposition to inflammatory bowel disease (IBD), but genetics alone cannot explain the six- to eightfold rise in incidence accompanying postwar socioeconomic changes in developed countries. It is presently unclear how environmental factors either trigger or modify the risk for and course of IBD in the presence of genetic susceptibility. PATIENTS AND METHODS: We evaluated 2,351 consecutive responses from IBD patients and from 3,364 of their unaffected first-degree relatives (parents/siblings) who completed a multi-item questionnaire with their physicians as part of a study of IBD genetics. All single-patient families were excluded from the analysis to avoid ascertainment bias, resulting in 120-133 independent cases for the analysis of environmental factors and 1,685 patients to be included in the analysis of birth rank. RESULTS: No statistically significant association was observed between the presence of IBD and the availability of either (warm) tap water, water toilets, or central heating during childhood. However, higher birth rank (> or =3) was significantly associated with a lower risk of IBD (odds ratio 0.68). CONCLUSION: Lower birth rank as a possible indicator of increased childhood infection exposure was associated with a higher risk for IBD. Future studies need to address the interaction of known genetic variations (e.g., in the NOD2 gene) with environmental factors potentially mediating this effect.

Birth Order↗
PubMed2001

Postoperative fecoflowmetric analysis in patients with anorectal malformation.

Because conventional methods of evaluating anorectal function do not necessarily provide good correlations between investigative results and symptoms in patients who have undergone surgery for an anorectal malformation (ARM), we recently introduced feco-flowmetry (FFM) to simulate natural anorectal evacuation. The purpose of this study was to embody significant parameters to elucidate the dynamics of anorectal activity on FFM. The parameters of FFM were compared with those of manometry and Kelly's clinical score (KCS) in 24 patients who underwent surgery for an ARM. There were three fecoflow patterns, namely, block (B) type, segmental (S) type, and flat (F) type. The B-type or S-type patterns were seen in patients classified as "clinically good." There were close relationships between the fecoflow pattern and both the operative procedure and the KCS (P = 0.01 and 0.001, respectively). Maximum fecal stream flow rate (Fmax) precisely reflected the tolerance rate of intended normal saline solution in the colorectum (TR), the evacuative rate (ER), and KCS. Fmax > 45 ml/s or TR > 70% or ER > 50% was statistically regarded as the borderline of fecal continence. Thus, the fecoflow pattern might reflect the motor activity of the pelvic floor muscle. FFM provided quantiative and qualitative evaluations concerning anorectal motor activity in patients who had undergone surgery for an ARM.

Adolescent↗