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The design of urinal bottles and some suggested improvements.
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A toilet sear for the disabled.
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A modified commode chair.
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Factors associated with intestinal parasitic infection among school children in a rural area of Kathmandu Valley, Nepal.
We studied predisposing factors of enteric parasitic infections in school children [n=340 (Boys: 177 and Girls: 163)] in a rural area in Kathmandu Valley, Nepal. Fecal samples were examined by formal-ether concentration technique. A total of 71.2% children had parasite. Altogether nine types of parasites were recovered; Trichuris trichiura was the commonest one followed by hookworm and others. A structured questionnaire regarding various predisposing factors was used. No significant differences in the infection rate between the sexes, age groups (< or = 10 years, 11-14 years and > or = 15 years) and family sizes (< or = 5 and > or = 6) were observed (P>0.05). The positive rates were significantly low in children with the history of taking antihelminthic drugs in the past six months (P<0.05). A marginally higher positive rate was found among Dalits children compared to Tibeto-Burmans and Indo-Aryans (P>0.05) and children from farming family (P>0.05). No difference in the infection rate was found in children having different types of toilet facility: open-field defecation, pit latrine and modern toilet at their houses (P>0.05). Slightly higher positive rate was associated with drinking water from Kuwa (shallow well) compared to natural spout, piped water and Khola (river) (P>0.05). Children were infected despite of their awareness regarding the safe water and geophagy.
[How important are attitudes towards washroom hygiene and spitting in schools? A telephone survey of school attendants in the Baselstadt canton, April 1998].
The aim of the study was to evaluate the risk spitting poses for students at Basle schools and to document the state of their toilet facilities. A telephone survey with 43 caretakers of the 56 Basle schools revealed, that spitting was considered a problem at 75% of the schools and that at every 4th school it had recently gotten worse. Apart from spitting on the floor (93%), spitting at walls and windows (32%), doors (20%), mirrors (16%), and occasionally at other persons (14%) occurred. Just about every school was equipped with the advised number of toilet units and urinals. On the other hand, 29% of handdrying mechanisms and 36% of soap-type offered as well as 39% of cleaning frequencies of facilities did not correspond to advised norms. 93% of toilet flushing mechanisms, 38% of the urinals and 96% of the washbasins had to be operated manually. This survey shows that spitting was common at practically every Basle school. Spitting at each other which is risky for infection occurred only sporadically. The risk of infection by spitting probably plays a minor role compared to other routes of infection. Despite this we advise a renewed effort in informing parents and students. Toilet hygiene at Basle's schools is still deficient. The facilities should be improved by midterm investments.
Environmental hazards of automobile mechanics in Ibadan, Nigeria.
A cross sectional survey was conducted among automobile mechanics and technicians in Ibadan to determine the socio-demographic characteristics and environmental hazards of these workers. Three hundred workers were interviewed. All respondents were males aged between 13 and 72 years of age. Educational attainment was poor, with only 20% of respondents having completed secondary education. Sanitation facilities were inadequate. Forty percent of workshops provided facilities for refuse disposal. Of the 33 workshops visited, only 1 provided toilet facilities. Most workers used facilities in neighbouring residential premises. Only three workshops (9%) had designated eating areas. Occupational exposure to petrol was common to all trades. Other occupational exposures were to petrochemicals such as engine oil and brake oil. Protective clothing was not used by the majority of workers. Only 25 (8%) respondents were wearing overalls at the time of our visit. This findings illustrate the typical work conditions of workers in small scale industries. There is a need for health education programmes about occupational and non-occupational diseases. This and other health promotion activities can be organized through the unions.
[The prevalence of Enterobius vermicularis in schoolchildren and affecting factors].
This study was carried out in order to determine the factors affecting the presence of Enterobius vermicularis in schoolchildren. This investigation was a cross-sectional and analytic study. The dependent variable was the presence of parasites and the independent variables were the characteristics of the children, families, houses, toilets and drinking water. A stool specimen was taken in the morning using the cellophane tape method, and examined the same day by microscopy. Data were evaluated using the Chi square test and logistic regression analysis and p < 0.05 was accepted as being statistically significant. There were 529 students in the kindergarten and 1-5 classes in the Isikkent and Sait Guzelcan primary schools in the region of the Isikkent Health Center in Izmir. However specimens could only be obtained from 477 (90.2%) students. The mean age of children was 8.6+/-2.0 years. The number of residents in their homes averaged 5.4+/-2.0, the average number of children in the homes was 3.2+/-1.9 and 290 (60.8%) houses were single dwellings. The source for piped water in 404 houses (84.7%) was the city network, and there were modern sanitary facilities (toilets) in 377 (70.6%) houses. Enterobius vermicularis was found in 209 (43.8%) children. According to logistic regression analyses, the rate of Enterobius vermicularis was found to be 3.05 times higher in students from the Sait Guzelcan primary school, if there were more than 6 residents in the home 2.05 times even higher and 2.02 times still higher if there were no sanitary facilities at his/her home. When there was a history of parasites in the family, the risk was significantly decreased. The prevalence of Enterobius vermicularis in schoolchildren was higher in slum areas, in crowded homes and in those that lacked modern sanitary facilities.
[Examination of living environment upon return to home for patients with cervical spinal cord injury--report of a case].
Living environment is a problem for spinal cord injury patients upon their return to the society. There are also many instances of home care problems after hospital discharge. For cervical spinal cord injury patients in particular, appropriate intervention/assistance provided by the authorities in accordance with the level of residual function is essential, but there have been few reports on this issue. Here we report on a municipal facility for cervical spinal cord injury patients where a patient moved into upon hospital discharge that did not provide a suitable environment, and the burden posed on his family increased. The patient was a 55-year-old man with traumatic cervical spinal cord injury who was commuting to our rehabilitation center after hospital discharge. We investigated the environment in the municipal housing facility he had moved into, and examined the relationship between the level of cervical spinal cord injury function and ADL assessment before and after hospital discharge. The main problems were an increase in care provided by his wife due to unsuitable toilet facilities and insufficient public facilities concerning the living environment. In terms of ADL by FIM (functional independence measure), namely, toilet transfer, toilet motion and defecation control which he had performed independently at the time of hospital discharge, all had decreased to a level requiring assistance after he moved into the present apartment. Therefore, approach via welfare equipment compensation were undertaken. As a result, the burden for his wife diminished, but the ADL and FIM scores obtained were low. Thus, the living environment facilities for patients with cervical spinal cord injuries should be in accordance with the level of function and ADL, suggesting the necessity for the authorities to establish a cooperative system for running home facilities.
Viral gastroenteritis aboard a cruise ship.
A 32-nm small round structured virus (SRSV), possibly related to the Snow Mountain agent (SMA), was implicated as the cause of recurrent outbreaks of gastroenteritis on a cruise ship. There was no identifiable relation to food or water consumption, but the risk of gastroenteritis among passengers who had shared toilet facilities was twice that of those who had a private bathroom and the rate of illness was related to the number of passengers sharing a communal restroom (ie, with one or more toilets): contaminated bathrooms may be an important vehicle for person-to-person spread of this enteric agent. In each cabin, index patients who had vomited in their cabins were more likely to have had cabinmates who subsequently became ill than were index patients who had not vomited. These epidemiological findings implicate vomitus in the transmission of viral gastroenteritis and they are consistent with the transmission of viral agents by airborne droplets or person-to-person contact. New strategies for prevention of viral gastroenteritis should include protection against environmental contamination by viruses in airborne droplets or vomitus.
The impact of water supplies and sanitation on growth in Chinese children.
In many developing countries, improvement in water supplies has not been supplemented by improvement in sanitation facilities. Moreover, health education is rarely included in environmental hygiene programmes. Community health workers need to know if water supplies and sanitation have independent or complementary effects on health. This study analysed the weight data of 1,045 Chinese children aged 60 months or below. Regression models with interaction terms were tested against a model with main effects only. There was no evidence of interaction between water supplies and sanitation measures. The results show that water supplies and toilet facilities had independent associations with growth. Improved water source (P = 0.01) and flush-toilet (P = 0.06) were found positively associated with the children's weight. Presence of excreta in the home had a negative, but not statistically significant, association with weight.
Hepatitis A outbreak in Hulu Langat District, Selangor State, Malaysia during April--October 2002.
A Hepatitis A outbreak occurred in Mukim Hulu Langat, Hulu Langat district from April 2002 to October 2002. Of the 51 cases notified, most were among students and the ethnic groups involved were Malays and the Orang Asli (local indigenous community). Epidemiological investigations revealed that the cases were localized along rivers used for recreational activities in this area. River water analysis indicated human faecal contamination and it was believed that the contamination was due to the Orang Asli community living upstream. This occurred due to lack of toilet facilities, water at point of use and the existing traditional practices of the Orang Asli community. Control measures instituted were intense health education to the Orang Asli to avoid using the rivers for defecation, multi agency efforts to provide sanitary toilets and adequate water to the villages affected. Future measures include conducting a sero- prevalence survey to determine the feasibility of Hepatitis A immunization to the susceptible population in this area. The outbreak that began in April 2002 was controlled by October 2002.
Associations between social and environmental factors and perinatal mortality in Jamaica.
Social and environmental factors in Jamaica were compared between 9919 mothers delivering in a 2-month period a singleton who survived the early neonatal period and 1847 mothers who were delivered of a singleton perinatal death in a contiguous 12-month period. Logistic regression showed independent positive statistically significant increased odds of having a perinatal death among mothers who lived in rural parishes, older mothers (aged 30 +), single parents, no other children in the household, large number of adults in the household, mother unemployed, the major wage earner of the household not being in a managerial, professional or skilled non-manual occupation, the household not having sole use of toilet facilities, smaller mothers and those classified as obese or undernourished. Variations were found for different categories of death. Intrapartum asphyxia deaths were not related to union (marital) status, occupation of major wage earner, number of adults nor to the use of the toilet. Antepartum fetal deaths did not vary significantly with occupation of major wage earner or maternal height, but did show a relationship with maternal education, mothers with lowest levels having reduced risk. Deaths from immaturity were significantly related only to occupation of major wage earner, number of children in the household, number of social amenities available (negative relationships) and maternal age (< 17 at highest risk). In conclusion there was little to indicate that social deprivation per se was related to perinatal death, although specific features of the environment showed strong relationships.
[Public and private day-care centers in Pelotas, RS: compliance with the regulations]
OBJECTIVES: Seventy-seven day-care centers were evaluated in Pelotas, RS, Brazil, in 1996, in order to assess compliance with current service regulations. METHODS: Information about physical structure, facilities, equipment, hygiene practices, and day-care staff was collected through a structured questionnaire. RESULTS: The median number of children in public day-care centers was 89 children per center, while in the private centers the median was 29 children per center (p<0.001). A nursery was available in 88% of public day-care centers, and in 36% of the private centers (p<0.001). Concerning the physical structure, the majority of the public centers had exclusive toilet facilities for the children (91%), while this was the case in only 66% of the private centers (p<0.001). Fire extinguishers were found in public centers in a proportion three times higher than in the private centers. Proper bottle washing and refrigeration was done in 95% of the day-care centers studied, while sterilization of the bottles was reported in only 47% of the centers. Despite the fact of 85% of the centers kept records with health information on the children, 93% of the centers did not have the required health license provided by the municipal authority. CONCLUSIONS: There is a good deal of work to do in both private and public day-care centers in order for them to comply with the current service regulations.
Non-attendance at an orthopaedic and trauma specialist outpatient department of a regional hospital.
PURPOSE: To assess the extent of and reasons for non-attendance in the Orthopaedic and Trauma Specialist Outpatient Department. METHOD: The first stage was a retrospective survey and the second stage was a structured face-to-face interview. RESULTS: In stage 1, monthly statistics (12 months) were reviewed. There were no significant statistical differences between the attendance and default counts/rates and the seasons, except the default rate (F = 5.537 (3,8), P = 0.024). The mean default rate ranged from 17.6 to 20.62% over the four seasons. April-June had the lowest mean default rate. In stage 2, 50 subjects were recruited randomly; 25 had attended the clinic and 25 had not. There were no significant differences in the demographic characteristics between the two groups or in the ratings of the attitudes towards the various professional groups. However, those who did not attend the clinic expressed most dissatisfaction with the waiting time, the quality of consultation, and the facilities in the waiting area. DISCUSSION: Although the exact waiting time was not recorded, this did not stop us from evaluating the work process with the aim of shortening waiting time and improving the quality of that time. To develop measures that shorten waiting time, it was necessary to review the functional process of a consultation session. The quality of waiting time can be enhanced by rearranging the waiting areas, providing more chairs, improving the lighting, and ensuring the cleanliness of the toilet facilities. An education programme that adopts a behavioural approach is suggested to help clients appreciate the value of follow-ups.
Prevalence and correlation of urinary incontinence and overactive bladder in Taiwanese women.
AIMS: We randomly sampled a community-based, healthy population to evaluate the prevalence and correlation of urinary incontinence and overactive bladder. We also assessed the influences of these conditions on quality of life and associated risk factors. METHODS: Of the 1,581 women sampled (2.92% of registered female residents aged 20 years and older), 1,253 (79.1%) women were successfully interviewed by using the Bristol Female Urinary Tract Symptoms Questionnaire (r=0.87, P<0.05) and the Questionnaire of Impact index regarding the impact on quality of life (r=0.91, P<0.05). RESULTS: A total of 53.7% of the women sampled suffered from urinary incontinence and related symptoms. The prevalence of stress urinary incontinence, overactive bladder, and mixed incontinence, mutually exclusive of each, was 18.0%, 18.6%, and 17.1%, respectively, from the patients' perceptions. Judging by the criteria of the International Continence Society, the prevalence of the above three conditions was 4.3%, 2.4%, and 1.8%, respectively. Of the women who perceived storage symptoms, 21.1% experienced frequency, 12.6% had urgency, 25.5% had nocturia, and 9.1% had urge incontinence. The occurrence of stress urinary incontinence increased with age up to 65 years old (25% in 50-65-year-old cohort), and the number of overactive bladder conditions significantly increased in the elderly women (over 65 years old, 39.3%). Approximately two thirds of the incontinent women had restricted their social activities (due to worrying about wetting or leakage and no toilet facilities available), and approximately 19% of the incontinent women had an affected sexual life. However, only 27.1% of the women with urinary incontinence and related symptoms in this study had reported seeking medical services to solve these problems. CONCLUSIONS: The prevalence of urinary incontinence and overactive bladder in Taiwanese women is similar to that of Western women.