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PubMed2000

The effects of water supply and sanitation on childhood mortality in urban Eritrea.

Child mortality differentials according to water supply and sanitation in many urban areas of developing countries suggest that access to piped water and toilet facilities can improve the survival chances of children. The central question in this study is whether access to piped water and a flush toilet affects the survival chance of children under five in urban areas of Eritrea. The study uses data collected by the Demographic and Health Survey (DHS) project in Eritrea in 1995. The results show that while the unadjusted effect of household environment (water supply and toilet facility) is large and statistically significant during the post-neonatal and child periods, it is relatively small and statistically insignificant during the neonatal period. The effect of household environment remains substantial during the post-neonatal and child periods, even when other socioeconomic variables are held constant. However, the household environment effect totally disappears during the neonatal period when the socioeconomic factors are controlled for.

Child, Preschool↗

PubMedDate not supplied

[Epidemiological study of hepatitis A and E viruses in different populations in Uruguay].

The hepatitis A and E virus (HAV and HEV) share the fecal-oral mechanism. Hepatitis A is an endemo-epidemic disease in Uruguay but no data on the epidemiologic pattern of the HEV is available. The aims of this study were to update the epidemiologic behavior of the HAV in Montevideo and demonstrate the circulation of the HEV in Uruguay. Two hundred fourteen patients who consulted in the Policlínica de Nutrición y Digestivo were studied, 185 (86%) of whom were anti HAV (HAVAB, Abbot) positive. 81.8% (117/143) of those residents in Montevideo and 95.7% (68/71) of those who were from the inland were anti-HAV positive. From the Montevideo population 55.8% cases under the age of 40 years were anti-HAV positive and occurred in 97.6% of those older (p < 0.001). Considering the health care conditions of the positive patients in Montevideo, 95.6% (43/45) had septic chambers and 75.5% (74/98) disposed of toilet facilities (p < 0.001). It is concluded that although the global prevalence has been maintained since 1982, there is a change in the epidemiologic pattern with greater risk of infection in patients under the age of 40 years proceeding from areas without toilet facilities. The prevalence of total antibodies for HEV (EIA, Abbot) was 2.8% in this population. An association was observed with HAV in 2.2% (4/185). Moreover, a sample of 252 blood donors from the National Blood Service was analyzed with 5 being found to be anti HEV positive, with only 3 (1.2%) being confirmed in the Center for Disease Control in the United States. Although no definitive conclusions may be drawn from the present study, from an epidemiologic point of view, it has been shown that there is evidence of the circulation of HEV in Uruguay, in both the out patient and in blood donor populations.

Adolescent↗

PubMed2002

Burden of chronic severe anemia in obstetric patients in rural north India.

There were 5124 deliveries during January to December 2000 and of these 386 patients (7.53%) were severely anemic (Hb < 6.0 g/dl). 1083 units of blood were transfused to these patients, a mean of 2.80 units to each patient. There were 2 maternal deaths due to severe anemia. Of the 386 patients, 246 could be interviewed in detail and their demographic details were compared with 100 normal pregnant women with haemoglobin levels of 10 g/dl or more. In the anemic group 81.7% were illiterate, 62.1% had no antenatal check, 78.8% had no access to safe drinking water 90.65% had no toilet facilities and used open fields for defaecation, 63.1% reported having diarrhoea and pain in abdomen off and on. 20.73% reported history of passage of worms in the stools. History of previous menorrhagia was present only in 1.2%. The comparable figures in the non-anaemic group were 34% illiterate, 24% no antenatal checkup, 55% no toilet facilities, 38% unsafe drinking water, 6% diarrhoea, 2% (worms in stools) and 5% menorrhagia. Hence it is concluded that along with prophylaxis with iron and folic acid sufficient consideration should be given to sanitation facilities, safe drinking water, recurrent gastrointestinal infection etc.

Adolescent↗

PubMedDate not supplied

Comparative helminth infections of man in two rural communities of the Niger Delta, Nigeria.

The intestinal parasitic helminth infections of man in Bonny and Isiokpo communities were studied between May 1992 and March 1994. Of the 2008 stool samples examined from Bonny community, 503 (25.0%) were infected. 305 (26.7%) of these infections were males while 198 (22.9%) were females. Ascaris lumbricoides (24.1%) occurred most frequently, followed by Hookworms (18.0%), Trichuris trichiura (17.3%,) Strongyloides stercoralis (10.1%) and Enterobius vermicularis (0.1%). Peak infection (41.7%) was recorded for the males in (10-14) years age bracket. The use of bush as a toilet facility had the highest parasitic infection (38.3%), followed by that of shoreline (35.3%), pit (33.3%), Bucket (27.8%) and of water closet (7.5%). Degree of infection relative to source of drinking water showed that well water was associated with highest infection (43.3%) while the pipe borne water was the lowest (18.0%). From Isiokpo community 2,462 stool samples were examined for intestinal parasites 1,633 (66.3%) people were infected consisting of 862 (64.8%) males and 771 (68.2%) females. Higher parasitic infection of females in this community was attributed to the cultural and occupational factors. Frequency of occurrence of individual helminth was as follows: A-lumbricoides (64.5%), T. trichiura (59.4%), Hookworms (58.8%), S. stercoralis (25.1%), Hymenolepsis nana (2.9%) and E. vermicularis (0.3%). Prevalence of infection was significantly higher in Isiokpo than in Bonny because the climatic and edaphic factors were conducive to larval development and infectivity. On the contrary, the saline soil and surface water of Bonny community constituted harsh environmental conditions inimical to larval development and infectivity. Observations on parasitic infections in relation to toilet facilities and source of drinking water were similar to those made in Bonny. The study therefore demonstrated that the provision of pipe borne water and water closet facilities in rural Niger Delta communities could reduce helminth infections of man.

Adolescent↗

PubMed1983

The incidence of amoebiasis among secondary school students in Calabar, Nigeria.

A study was conducted among 2 500 secondary school students in Calabar, in order to determine the incidence of amoebiasis caused by Entamoeba histolytica. Microscopic examination of faecal sample smears showed higher percentage infections in the males than in the females; 61 out of 1 250 males were infected (4.8%), while 52 of 1 250 females were infected (4.1%). Among infected persons, asymptomatic carriers (64.6%) and symptomatic cases (35.4%) were recorded. Infection was lower among students using water flush toilet facilities than those using pit and bucket latrines. The infection was attributed to poor sanitation and inadequate health facilities.

Adolescent↗

PubMed2000

A study of prevalence of protein energy malnutrition among 0-5 years in rural Benue State, Nigeria.

Three hundred and seventy pre-school children (181 males and 189 females) were studied in order to document the prevalence of protein energy malnutrition and factors that militate it. The prevalence of protein energy malnutrition among the children was revealed to be 41.6% (154). One hundred and fiftyone (40.8%) of them were found to have weight-for-height below -2SD indicating level of stunting among the children. Most malnourished children belonged to mothers who were illiterate 97 (54.8%) when viewed from the mothers' educational perspective. This study also showed the following factors that were statistically significant with PEM: educational status of mothers (p<0.05), marital status (p<0.05) of mothers, occupational status of mothers (p=0.000), parental income per annum (p=0.000), length of breastfeeding (p=0.000), water supply and regularity, type of housing and toilet facilities. Intensification of health education aimed at encouraging beneficial childhood feeding practices in the community is needed together with further study on the subject, which will be directed at actual analysis of the nutritive values of available local foodstuffs as a prerequisite for an effective intervention programme.

Anemia, Iron-Deficiency↗

PubMed1997

Thirst at work--an occupational hazard?

Of 1492 teachers 791 (53%) responded to a survey addressing whether voiding habits at work or behavioral factors influenced by this occupation predisposed women to urinary tract infection. The mean number of voids during the work day was 2.7 +/- 1.4; 24.5% voided infrequently (never or only once) and 26.5% voided four or more times during the work day; 15.8% had had a urinary tract infection in the preceding year. Half of the respondents made a conscious effort to drink less while working, to avoid needing to use the toilet. There was no association between the prevalence of urinary tract infection and the number of voids or infrequent voiding at work. Compared to women who drank the volume they desired at work, those who drank less had a 2.21-fold higher risk (95% CI 1.45-3.38) of urinary tract infection after controlling for being parous, voiding infrequently at work, and urge incontinence. Further study is warranted to determine whether modification of behavioral factors at work can reduce the incidence of urinary tract infections. If this association holds, public policy must be changed to allow workers more adequate access to toilet facilities.

Adult↗

PubMed1992

The complementary effect of latrines and increased water usage on the growth of infants in rural Lesotho.

The effects of water quantity and sanitation, alone and in combination with each other, on infant weight gain and length gain were examined. Data on 119 infants were collected from 20 villages in rural Lesotho between July 1984 and January 1985. The interactions between sanitation and increased water usage for weight gain (p = 0.007) and length gain (p = 0.006) were significant after potential confounding was controlled. The biggest growth effects were dependent on families possessing a latrine and increasing their use of water during the warm, wet season. Infants gained 1.031 kg (95% confidence interval (CI) 0.420 to 1.642) and 2.028 cm (95% CI 0.523 to 3.533) more when both positive factors were present, as compared with only having a latrine. Increasing water usage compared with not increasing water usage resulted in only 0.105 kg (95% CI -0.175 to 0.385) more weight gain and -0.309 cm (95% CI -1.005 to 0.387) more length in the absence of a latrine. Similarly, infants gained 1.106 kg (95% CI 0.484 to 1.728) and 2.076 cm (95% CI 0.559 to 3.593) more if both factors were operating than did infants whose families only increased their water usage. In the nonincreased water group, the difference in growth between having and not having a latrine was 0.180 kg (95% CI -0.093 to 0.453) and -0.261 cm (95% CI -0.951 to 0.429). Water supply programs should emphasize use of more water for personal hygiene, and sanitation programs should install toilet facilities where water usage is high or has been increased because of an educational program.

Bias↗

PubMed1993

Observations on the epidemiology of human taeniasis amongst the Goemai tribe of northern Nigeria.

A study on the epidemiology of human taeniasis amongst the Goemai tribe of Kwande rural community of Qua'an Pan Local Government Area carried out between January and June, 1991 is reported. 115 or 11.5% of the 1,000 persons examined were infected. Of the 614 males and 386 females examined, 77 (12.5%) and 38 (9.9%) respectively had infections. No significant difference in prevalence rates was recorded between the sexes and age groups. Infection was significantly higher (P < 0.05) among farmers than other occupational categories, and in those eating half roasted/cooked meat than in persons eating well-cooked meat. Other epidemiological factors relating to type of toilet facilities used as well as some socio-cultural and traditional beliefs of Goemai people which encourage host-parasite contact and their implications for public health are discussed. Suggestions are made for the control of human taeniasis in the community.

Adolescent↗

PubMed2003

Influence of socio-economic background and antenatal care programmes on maternal mortality in Surabaya, Indonesia.

OBJECTIVE: To determine the risk factors, such as socio-economic background, quality of antenatal care and availability of family planning, responsible for high maternal mortality in Surabaya, Indonesia. METHODS: The study used a case-control design. Descriptive, bivariate and multivariate analyses were carried out, comparing 59 maternal deaths and 177 women survivors in the referral hospital, from 1996 to 1999. RESULTS: The risk factors for maternal mortality were: living outside of Surabaya [odds ratio (OR) = 11.7, 95% confidence interval (CI) = 5.0-29.2], unemployment (OR = 4.4, 95% CI = 1.7-13.8), unavailability of toilet facilities (OR = 2.9, 95% CI = 1.0-7.7), <4 antenatal visits (OR = 2.5, 95% CI = 1.1-5.5) and initial visit to antenatal care facilities after the fourth month of pregnancy (OR = 3.0, 95% CI = 1.3-7.0). There was no significant association between maternal mortality and the availability of family planning. CONCLUSION: Low socio-economic background and the availability of antenatal care have a significant influence on maternal mortality in Surabaya, Indonesia.

Adult↗

PubMed1976

Endemic amebiasis in an Arkansas community.

Parasitologic, serologic, and epidemiologic studies were done during 1967 in Calion, Arkansas (population 544). Infection with Entamoeba histolytica was found to be endemic but was segregated along racial lines. Twenty-two (9.9%) black compared with only one (0.6%) white had E. histolytica demonstrated in one stool examination; only two blacks had symptoms suggestive of amebiasis. No positive amebiasis indirect hemaggulination titers were found in 135 white residents. In contrast, 41 (17.9%) blacks had positive titers. Age, sex, and geographic location were not associated with stool or seropositivity. Within the black population, clustering of stool and seropositivity occurred. Significantly higher rates of stool and seropositivity were seen in households with crowding and poor sanitation as evidenced by lack of indoor toilet facilities. The presence of contaminated water supplies did not correlate with stool or seropositivity. The probable importance of person-to-person transmission is suggested by the observed clustering of infection within households with crowding and unsanitary conditions. The absence of evidence for transmission by food or water further supports this hypothesis.

Adolescent↗

PubMed1999

The impact of an inadequate municipal water system on the residents of Chinhoyi town, Zimbabwe.

OBJECTIVE: To assess the use and impact of the water reticulation system in Chinhoyi on its residents. DESIGN: Cross sectional and case series studies. SETTING: Chinhoyi town. SUBJECTS: 600 Chinhoyi residents. MAIN OUTCOME MEASURES: Practices and perceptions of Chinhoyi residents on the water system, and distribution of water-related diseases per area of residence. RESULTS: Out of 600 respondents, 565 (99.3%) had access to piped water and 558 (98.0%) to flush toilets. Breakdowns of water supply and functioning of toilet facility were reported by 308 (77.0%) and 110 (28.0%) respondents in the previous six months, respectively. Main complaints of Chinhoyi residents were about low water quality (36.2%), inadequate sewage system (31.3%) and environmental pollution (26.5%). Cases of water-related diseases were not associated with natural water bodies. CONCLUSIONS: Chinhoyi residents have good access to the municipal water and an adequate sanitation system. However, low quality of the water, frequent system breakdowns and the degradation and loss of amenity of the environment impair their quality of life.

Attitude to Health↗

PubMed1995

Remote monitoring of health status of the elderly at home. A multidisciplinary project on aging at the University of New South Wales.

This paper discusses the design and implementation of a multidisciplinary research project and associated field trials to test the hypothesis that functional health status amongst the elderly can be accurately determined remotely by continuously monitoring relatively simple parameters that measure the interaction between participants and their environment. In this study we propose that changes in such simple measures as mobility, sleep patterns, and utilisation of cooking, washing and toilet facilities, can identify changes in functional health status. One of the primary end goals of the project will be to automatically prompt appropriate, timely and cost-effective intervention of medical and community based services to help reduce morbidity and maintain an independent high quality of life for the elderly. Targeted intervention will diminish the demand for high cost medical services. This will have large potential economic implications in helping to contain and reduce the increasing cost of providing health care services to the aged.

Activities of Daily Living↗

PubMedDate not supplied

Developing and validating a Chinese instrument to measure lower urinary tract symptoms among employed women in Taiwan.

Lower urinary tract symptoms (LUTS), including urinary incontinence, negatively affect women's quality of life. Employed women are particularly prone to experiencing the negative aspects of LUTS due to their irregular access to toilet facilities. In Taiwan, about 70% of women 25-44 years of age are employed, yet little research on LUTS in the workplace has been conducted. In this article, the development of a Chinese instrument for estimating prevalence of LUTS and identifying factors related to LUTS among employed women is discussed. After instrument-generation and translations, content validity of the instrument was assessed and found to be satisfactory. Following a pilot test, psychometric testing of the instrument (which included test-retest reliability and internal consistency) was conducted. Test-retest reliability for the majority of the items and internal consistency for the construct LUTS were adequate. Based on initial psychometric testing, the authors suggest the instrument is appropriate for use with women in Taiwan. Additional testing is recommended before being used with other populations.

Adaptation, Psychological↗

PubMed1952