Home Toilet Research Articles

Epidemiology of Pediatric Astrovirus Gastroenteritis in a Nicaraguan Birth Cohort.

Astrovirus is a leading cause of acute gastroenteritis in children worldwide. However, few prospective studies have analyzed astrovirus in community-dwelling pediatric populations in low- and middle-income countries. We assessed the incidence, risk factors, clinical characteristics, genotypes, viral coinfections, and time distribution of astrovirus gastroenteritis in 443 healthy Nicaraguan children born in 2017 to 2018 who were followed for 36 months. Children were recruited from hospitals and birth records in an economically diverse neighborhood of León city. Astrovirus-positive episodes and genotypes were identified from stool with reverse transcription quantitative polymerase chain reaction and Sanger sequencing. Of 1708 total specimens tested, 80 children (18%) experienced at least 1 astrovirus episode, and 9 experienced repeat episodes, mostly during the rainy season (May-October). Initial astrovirus episodes were not associated with a lowered risk against future episodes. In exploratory analyses, home toilets were associated with a lower risk of future astrovirus episodes (hazard ratio, 0.19; 95% CI, .04-.91). Human astrovirus 5 episodes, representing 15% of all typed episodes, were associated with longer diarrhea and more symptomatic rotavirus coinfections. Astrovirus was a common cause of gastroenteritis in this cohort, and future studies should clarify the role of astrovirus genotype in clinical infection severity.

Household Toilet and Sanitation Insecurity is Associated With Urinary Symptoms, Psychosocial Burden, and Compensatory Bladder Behaviors

ObjectivesTo investigate whether being “at-risk” for toilet and sanitation insecurity in the United States is associated with urinary symptoms, voiding behaviors, and psychosocial burden. Based on census data, nearly 2 million people in the United States do not have access to adequate plumbing. More may have inconsistent access related to cost, inadequate facilities for the number of people in a home, or declining regional infrastructure. The effects of inadequate access in the United States are poorly characterized. MethodsThis is a secondary analysis of a community-based sample of adults electronically recruited to complete questionnaires on clinical and sociodemographic information, living situations, home toilets and plumbing, urinary symptoms, compensatory bladder behaviors, and psychosocial burden. Multivariable logistic regression was used to assess for associations between being at-risk for toilet and sanitation insecurity and urinary and psychosocial symptoms. Linear regression was used to assess for association with adopting compensatory bladder behaviors. ResultsThis sample included 4,218 participants, of whom 17% were identified as being at-risk for toilet and sanitation insecurity. Being at-risk for toilet and sanitation insecurity was associated with worse overall urinary symptoms and greater bother from these symptoms, in addition to worse self-assessed mental and physical health, anxiety, stress, depression, and fewer social supports. Finally, those at-risk for toilet and sanitation insecurity were more likely to adopt burdensome and unhealthy compensatory bladder behaviors. ConclusionsAs with other social determinants of health, toilet and sanitation insecurity may be an under-appreciated contributor to urinary symptoms, unhealthy toileting behaviors, and psychosocial distress.

Navigating Taxpayers Attitude: Exploring Support for Urban Sanitation Surcharge in Kumasi.

Urban sanitation challenges persist in Ghana, prompting Metropolitan, Municipal, and District Assemblies (MMDAs) to explore innovative funding mechanisms such as surcharges to fund sanitation services. This study assesses property owners' attitudes toward the imposition of sanitation surcharge for pro-poor sanitation improvement in the Kumasi Metropolis. An analytical cross-sectional study was conducted among 424 property owners in the Kumasi metropolis. Structured questionnaires were utilized to solicit information from respondents using multi-stage sampling techniques. Findings indicated that 36.1% of respondents were willing to pay the sanitation surcharge, while 63.9% opposed its implementation in the Metropolis. Property ownership and support for a sanitation surcharge were associated with higher odds of willingness to pay. Participants paying property rates had decreased odds of supporting the sanitation surcharge. Factors associated with pro-poor spending support included age (61-80 years) [AOR = 1.81, 95%CI = 1.60-3.82] and willingness to pay sanitation surcharge [AOR = 11.07, 95%CI = 6.63-18.49]. Protective factors against supporting pro-poor spending included residing in medium-class communities [AOR = 0.25, 95%CI = 0.08-0.81], perceiving improvement in sanitation status [AOR = 0.41, 95%CI = 0.21-0.81) and having a home toilet facility (OR = 0.65, 95%CI = 0.36-0.95). The study revealed a nuanced landscape where concerns about fund utilization, perceived tax burdens, and trust in local institutions significantly shape public sentiment. To enhance public acceptance and participation, policymakers should prioritize transparent communication to build trust and convey the effective utilization of funds from the sanitation surcharge.

Determinants of Menstrual Hygiene Among Adolescent School Girls in Indonesia.

The aim of this study was to determine the prevalence of menstrual hygiene management (MHM) and its associated factors among adolescent girls in Tangerang District, Indonesia. This study was a cross-sectional study of 409 female students aged 12-15 years old from 3 junior high schools selected using multistage sampling. The data were collected through a self-reported questionnaire both online and offline that was administered from April to May 2022. Bivariate and multivariable analysis using binary logistic regression were performed to determine the factors and predictors between sociodemographic characteristics, menstruation variables, knowledge, attitude, enabling environment, and the practice on MHM. Our study revealed a prevalence of good MHM practices among 52.3% of students, as well as moderate knowledge (48.9%) and neutral attitudes (70.4%). With regard to water, sanitation, and hygiene (WASH) facilities at school, most girls reported access to hand washing soap, a hook, a mirror, and a covered bin, but at home, the least available facilities were a mirror and a covered bin. Significant predictors of healthy MHM practices were having reached grade 8 (AOR = 1.80, 95% CI = 1.10-2.95), having ever received information about menstruation at school (AOR = 1.95, 95% CI = 1.19-3.18), having a positive attitude (AOR = 4.21, 95% CI = 1.78-9.96), having access to a private home toilet (AOR = 2.71, 95% CI = 1.36-5.42), and having a home toilet with a covered bin (AOR = 2.15, 95% CI = 1.38-3.37). The girls in this study showed a high prevalence of good MHM practices, but access to WASH facilities at school and at home was still a challenge. Positive attitude was the most significant factor associated with good MHM among female students. Therefore, we suggest establishing menstruation-focused education related to attitudes, particularly sociocultural norms, myths, and misconceptions and WASH facilities provided at home.

SOCIOLOGICAL AND ANTHROPOLOGICAL STUDIES OF STUNTING FAMILIES STUNTING IN MALANG REGENCY

Stunting is a failed growth in toddlers as a result of chronic nutritional deficiency occurring during the first 1000 days of life making children too short for their age. Toddlers stunting prevalence nationally in 2013 was 37.2%, increasing from 2010 (35.6%) and 2007 (36.8%). In Malang Regency, toddlers stunting prevalence had an increase in the first three years and a decrease in the last two years of 2012—2016 periods, with highest prevalence 30.6% in 2014 and lowest 22.9% in 2016. The current study aimed to analyze the sociological and anthropological characteristics of families with stunted toddlers in Malang Regency. Applying qualitative research design, 33 participants from 3 stunting locus villages of Ngawonggo, Dilem and Karangsari in Malang Regency were involved to represent the urban, highland and coastal areas. Participants for focused group discussion were 15 authoritative figures from the villages. The majority of 26 (78.7%) pregnant mothers ate 3 times per day, but only 8 mothers (24.2%) had complete variety of food consumption during pregnancy. Some food mothers were restricted to eat during pregnancy prescribed by their old belief system were sea fish, kelotok fish, stink beans, pineapples, durians. The majority of 93% toddlers received breast milk feeding. Regarding toddlers’ energy consumption, 69.7 had excess protein intake, 39.39 had severe deficit fat intake, 87.88 had severe deficit carbohydrate intake. On mothers’ nutritional knowledge, 15.1% participants were in good level, 30.3% adequate, and 45.5% inadequate. Regarding hygiene and sanitation, 81.82% observed households had home toilets, but 18.18% had not. 18.82 households consumed boiled tap water for drinking, and 18.18% bought gallon packaged. Sociological and anthropological factors, namely mothers’ eating habits during pregnancy, dietary restrictions, nutritional knowledge, toddlers eating patterns, home hygiene and sanitation, influenced toddlers stunting incidents.

\u201cA secret club\u201d: focus groups about women\u2019s toileting behaviors

BackgroundUnderstanding reasons for and impact of women’s toileting behaviors on bladder health is important to prevent and manage urinary incontinence (UI) and overactive bladder (OAB).MethodsWomen, regardless of urinary incontinence (UI) and overactive bladder (OAB) status, were recruited in Pennsylvania and North Carolina. Focus groups were conducted by trained female moderators and sessions were audiotaped. Participants completed an anonymous questionnaire containing validated items to determine the presence of UI and OAB. Audiotapes were transcribed and content was analyzed by two investigators to identify themes.ResultsTwenty-four women participated (mean age 68 ± 13.4 years); most had UI (75%) or OAB (87.5%). Many women had difficulty in describing bladder health, and talked about bladder function, diseases or conditions, and control over the bladder. Four themes about toileting emerged: 1) cues/triggers/alerts women used to find and use toilets, 2) toilet cleanliness away from and at home, 3) toileting as a nuisance, and 4) situational awareness. Women described internal (e.g., sensation of heaviness) and external cues/triggers/alerts (e.g., walking by restrooms), and the trade-off between their concerns about public toilet cleanliness and the need to urinate. Some women expressed being irritated or annoyed about having to stop activities to urinate. Most women reported sitting on their home toilets, whereas, many hovered or stood over the toilet in public places.ConclusionsThe information gained from this study will facilitate the development of relevant public health messaging and interventions to raise public awareness about UI, OAB, and bladder health with the aim to encourage women to seek help when symptoms are present.

Determinants of Open Defecation in the Wa Municipality of Ghana: Empirical Findings Highlighting Sociocultural and Economic Dynamics among Households.

This study examined sociocultural and economic factors determining open defecation in the Wa Municipality, Ghana. The study employed a mixed method approach involving questionnaire administration to 367 households systematically selected from 21 communities, observation, and eight key informant interviews. The mixed logit model was used to determine the factors that significantly influence open defecation. The findings revealed that 49.8% of households had no form of toilet facility at home and were either using communal/public toilets or practicing open defecation. Several sociocultural and economic reasons account for this. But for these households, having a toilet facility at home does not seem to be a priority. Six factors (education, household size, occupation, income, traditional norms, and beliefs and ownership of a toilet facility) were positively significant in determining open defecation. Fundamental to many of the significant factors is households' capacity to finance construction of home toilets. In addition to finding new and innovative approaches to public education, the principle of credit financing, that incorporates community-led initiatives, may be considered in assisting households to construct home toilets.

Role of Environmental Factors in Shaping Spatial Distribution of Salmonella enterica Serovar Typhi, Fiji.

Fiji recently experienced a sharp increase in reported typhoid fever cases. To investigate geographic distribution and environmental risk factors associated with Salmonella enterica serovar Typhi infection, we conducted a cross-sectional cluster survey with associated serologic testing for Vi capsular antigen–specific antibodies (a marker for exposure to Salmonella Typhi in Fiji in 2013. Hotspots with high seroprevalence of Vi-specific antibodies were identified in northeastern mainland Fiji. Risk for Vi seropositivity increased with increased annual rainfall (odds ratio [OR] 1.26/quintile increase, 95% CI 1.12–1.42), and decreased with increased distance from major rivers and creeks (OR 0.89/km increase, 95% CI 0.80–0.99) and distance to modeled flood-risk areas (OR 0.80/quintile increase, 95% CI 0.69–0.92) after being adjusted for age, typhoid fever vaccination, and home toilet type. Risk for exposure to Salmonella Typhi and its spatial distribution in Fiji are driven by environmental factors. Our findings can directly affect typhoid fever control efforts in Fiji.

A cross-sectional survey to assess household sanitation practices associated with uptake of “Clean Team” serviced home toilets in Kumasi, Ghana

“Clean Team” provides serviced, free-standing toilets as a sanitation option in low-income areas of Kumasi, Ghana. A cross-sectional survey was carried out to assess sanitation and hygiene practices in 199 Clean Team households and 201 neighbouring, non-Clean Team households. Adults in non-Clean Team households were no more likely to report unsafe defecation (faeces not contained in a latrine) than their Clean Team neighbours, although their reliance on public toilets may lead to occasional unsafe practices. Children in Clean Team households used the household toilet from a younger age than those in non-Clean Team households, and their faeces were thus more often disposed of safely. Soap and water were more frequently found at the latrine in Clean Team households than in latrine-owning non-Clean Team households. Use of Clean Team toilets is likely to reduce faecal contamination of the environment through safer child defecation and stool disposal practices, and may increase the opportunity for post-defecation handwashing with soap.

Investigation on prevalence and risk factors of HIV/AIDS and Schistosoma japonicum, Ascaris lumbricoides and Trichuris trichiura infections in a rural community of southwestern China

To investigate the prevalence and risk factors of helminthic infections including Schistosoma japonicum, Ascaris lumbricoides and Trichuris trichiura and human immunodeficiency virus (HIV), and find out the association among them in a rural community of southwestern China. A community-based cross sectional study was conducted. One town was selected randomly; the infections of S.japonicum, A.lumbricoides and T.trichiura were detected with the modified Kato-Katz thick smear method and HIV infection with the diagnostic Test Kit among all residents. A questionnaire survey was conducted to investigate the related risk factors. Among the participants, the infection rates of HIV, S.japonicum, A.lumbricoides and T.trichiura were 2.33%, 2.05%, 13.47% and 30.59% respectively; 7.08% (31/438) were infected with both A.lumbricoides and T.trichiura; 0.23% (1/438) were co-infected with HIV and A.lumbricoides, and the same with HIV and T.trichiura. The multivariate logistic regression analysis showed that sex (male, OR=3.26, 95% CI：0.97, 10.95) and drug abuse (OR=72.86, 95% CI：18.51, 286.76) were significantly associated with HIV infection. Home toilet was negatively related to A.lumbricoides infection (OR=0.52, 95% CI：0.27, 0.98) and T.trichiura infection (OR=0.48, 95% CI：0.28, 0.80). Compared with the people in Villages Four, the people living in Village One were at a higher risk for A.lumbricoides infection (OR=3.14, 95% CI：1.35, 7.27), and compared with the people living in Village Four, the people living in Village Two and Village Three were more likely to be infected with T.trichiura (OR=3.73, 95% CI：1.92, 7.26; OR=4.53, 95% CI：2.12, 9.68). The people aged between 11 and 20 years had a higher T.trichiura infection risk than the people aged more than 50 years (OR = 3.72, 95% CI：1.59, 8.67). There was a significant association between A.lumbricoides and T.trichiura infections (OR = 3.11, 95% CI：1.63, 5.93). There was no association between S.japonicum infection and related factors above mentioned. The infection rates of HIV, S.japonicum, A.lumbricoides and especially T.trichiura were rather high in this area, and therefore, the prevention and treatment of these diseases should be strengthened. Further studies on the relationship between HIV and the infections of helminths, especially S.japonicum are needed.

Design and production of toilet seat lifting mechanism

Different physiological structure between genders reflects on daily life, in which “going to toilet” is mostly concerned. Going to toilet is an important triviality every day but is closely related to personal health. Since toilet seats directly contact with the skin, the cleanness presents critical influence on physiological health and psychological comfort. It is common to share a set of sanitary equipment in the family, where females reveal several times higher probability on contacting with toilet seats. Aiming at home toilet seats being easily polluted, an improvement program is proposed in this study to reduce gender conflict with a simple mechanism design, which is improved through experiments. Keywords: female population advantage, toilet seat, female right, convenient design of toilet, use efficiency of toilet.

Assessing the risk factors of cholera epidemic in the Buea Health District of Cameroon.

BackgroundCholera is an acute diarrheal disease caused by the bacterium, Vibrio cholerae. A cholera epidemic occurred in Cameroon in 2010. After a cholera-free period at the end of 2010, new cases started appearing in early 2011. The disease affected 23,152 people and killed 843, with the South West Region registering 336 cases and 13 deaths. Hence, we assessed the risk factors of cholera epidemic in the Buea Health District to provide evidence-based cholera guidelines.MethodsWe conducted an unmatched case–control study. Cases were identified from health facility records and controls were neighbours of the cases in the same community. We interviewed 135 participants on socio-economic, household hygiene, food and water exposures practices using a semi-structured questionnaire. Data was analyzed using STATA. Fisher exact test and logistic regression were computed. P < 0.05 was considered to be statistically significant.ResultsThe 135 participants included 34 (25.2 %) cholera cases and 101 (74.8 %) controls. More females [78 (57.8 %)] participated in the study. Ages ranged from 1 year 3 months to 72 years; with a mean of 29.86 (±14.51) years. The cholera attack rate was 0.03 % with no fatality. Most participants [129 (99.2 %)] had heard of cholera. Poor hygienic practices [77 (59.2 %)] and contaminated water sources [54 (41.5 %)] were the main reported transmission routes of cholera. Good hygienic practices [108 (83.1 %)] were the main preventive methods of cholera in both cases [23 (76.6 %)] and controls [85 (85.0 %)]. Logistic regression analysis showed age below 21 years (OR = 1.72, 95 % CI: 0.73–4.06, p = 0.251), eating outside the home (OR = 1.06, CI: 0.46–2.43, p = 1.00) and poor food preservation method (OR = 9.20, CI: 3.67–23.08, p < 0.0001) were independent risk factors of cholera. Also, irregular water supply (OR = 0.66, 95 % CI: 0.30–1.43, p = 0.320), poor kitchen facility (OR = 0.60, CI: 0.16–2.23, p = 0.560), lack of home toilet (OR = 0.69, CI: 0.25–1.86, p = 0.490), and education below tertiary (OR = 0.87, 95 % CI: 0.36–2.11, p = 0.818) were independent protective factors for the occurrence of cholera.ConclusionThere was a good knowledge of cholera among participants. Poor food preservation method was a significant independent risk factor of cholera. Improvement in hygiene and sanitation conditions and water infrastructural development is crucial to combating the epidemic.

A fatal case of post-operative pulmonary thromboembolism with cosmetic liposuction

Pulmonary thromboembolism (PTE) has been regarded as rare in Japan. However, PTE has been increasingly recognised because either of increased incidence, diagnostic progress, or social recognition. Recently, 10 Japanese Medical Associations have submitted preventive guidelines for PTE in post-operative patients and the government decided to fund this, as results of the increase in cases and concern regarding medical negligence. A fatal case of PTE after liposuction is reported. A female patient was in the home toilet after two days of immobilization following day-surgery liposuction. Clinicians must be aware of appropriate methods for the prevention of post operative PTE with cosmetic surgery.

動作解析機器を用いた移乗介助動作と介助空間に関する実験 : 住宅内便所における高齢者の移乗介助空間に関する研究

動作解析機器を用いた移乗介助動作と介助空間に関する実験 : 住宅内便所における高齢者の移乗介助空間に関する研究

Experimental study on the assisting transfer action for the elderly in the home toilet space

Experimental study on the assisting transfer action for the elderly in the home toilet space