Large Towns Research Articles

A One Health approach to pastoral (im)mobility, health, and disease: A qualitative participatory study in Plateau State, Nigeria.

In Plateau State, pastoralism has historically been a cost effective and resilient economic system well-suited to the ecological context. However, changes in land use and conflict have increasingly changed patterns of mobility. Pastoralist movement is now often associated with zoonotic disease transmission, environmental degradation and conflict, increasingly resulting in forced sedentarisation. Rather than a direct outcome of population movement however, animal, human and zoonotic disease drivers are complex and influenced by a range of socio-economic and environmental factors. The interlinkages of (im)mobility and health requires better understanding of underlying vulnerabilities to disease, which we aim to address in this study. Using a multisite case study methodology we investigated pastoralists' animal and human health concerns and priorities in Plateau State, Nigeria. We deployed participatory tools, including open-ended Focus Group Discussions, transect walks, mapping exercises, calendars and matrices. Data were analysed using a One Health conceptual framework. We interviewed 105 participants, from transhumance, migratory and sedentary households, dependent on livestock and small-scale crops. While transhumance was often preferred, participants had become sedentary as a result of insecurity, loss in livestock, and household characteristics. Humans and animals suffered from several endemic diseases, including zoonoses, however veterinary and human health services are only available in larger towns, and people mostly rely on community (animal) health workers and self-medication. Both transhumance and sedentary livestock keepers face challenges around forage grazing, regularly blocked by landowners, sometimes escalating into conflict. While conflict and changes in land use affected animal and human disease patterns, underlying political, social and economic risk factors were important determinants of health. There is a need for more inclusive, transdisciplinary, multilevel approaches to address animal and human disease, based on better contextualization of the challenges, through the participation of affected communities.

A Group Parenting Intervention for Male Postpartum Depression

Male postpartum depression is prevalent across populations; however, there is limited evidence on strategies to address it, particularly in low-income settings. To evaluate the effectiveness of Learning Through Play Plus Dads (LTP + Dads), a nonspecialist-delivered psychosocial intervention, in improving symptoms of male postpartum depression compared to treatment as usual. This cluster randomized clinical trial was conducted in Karachi, Pakistan, between June 2018 and November 2019. Assessors were blind to treatment allocation. Participants were recruited from 2 large towns in the city of Karachi via basic health units. Fathers aged 18 years and older with a DSM-5 diagnosis of major depressive episode and a child younger than 30 months were recruited. Of 1582 fathers approached, 1527 were screened and 357 were randomized in a 1:1 ratio to either the intervention or treatment as usual; 328 were included in the final analysis. Data were analyzed from April to June 2022. LTP + Dads is a manualized intervention combining parenting skills training, play therapy, and cognitive behavior therapy. The intervention was delivered by community health workers via 12 group sessions over 4 months. The primary outcome was change in 17-item Hamilton Depression Rating Scale score at 4 months. Secondary outcomes included anxiety symptoms; parenting stress; intimate partner violence; functioning; quality of life; and child social, emotional, and physical health outcomes. Assessments were completed at baseline and 4 and 6 months postrandomization. Of the 357 fathers included (mean [SD] age, 31.44 [7.24] years), 171 were randomized to the intervention and 186 to treatment as usual. Participants randomized to the intervention demonstrated significantly greater improvements in depression (group difference ratio [GDR], 0.66; 95% CI, 0.47 to 0.91; P < .001), anxiety (GDR, 0.62; 95% CI, 0.48 to 0.81; P < .001), parenting stress (GDR, -12.5; 95% CI, -19.1 to -6.0; P < .001), intimate partner violence (GDR, 0.89; 95% CI, 0.80 to 1.00; P = .05), disability (GDR, 0.77; 95% CI, 0.61 to 0.97; P = .03), and health-related quality of life (GDR, 12.7; 95% CI, 0.17 to 0.34; P < .001) at 4 months. The difference in depression and parenting stress was sustained at 6 months. Children of fathers randomized to the parenting intervention had significantly greater improvements in social-emotional development scores (mean difference, -20.8; 95% CI, -28.8 to -12.9; P < .001) at 6 months. The psychosocial parenting intervention in this study has the potential to improve paternal mental health and child development in Pakistan. Further studies in other populations and with longer follow-up are warranted. ClinicalTrials.gov Identifier: NCT03564847.

Factors associated with colon cancer fragmentation in the Keystone state.

120 Background: Fragmentation of cancer care delivery across multiple providers can impact care quality and patient outcomes. Management of non-metastatic colon cancer often involves adjuvant chemotherapy, which increases the risk of potentially deleterious care dispersion. This study assesses the extent of care fragmentation across different inpatient facilities and examines patient characteristics associated with inpatient care fragmentation. Methods: We adapt the modified Herfindahl-Hirschman market concentration index to construct a Fragmentation Index (FI) capturing the distribution of a patient’s care across inpatient facilities. For patients who underwent oncologic surgery for colon cancer from 2010-2016, we calculate FI for the 15 months post-diagnosis if at least 2 admissions occur during the study period. We use Pennsylvania Cancer Registry data linked to all-payer statewide facility discharge records to estimate the relationship between FI and patient demographics, rurality, area deprivation index (ADI), and payer status using adjusted multivariable linear regression models. Results: For the operative cohort (28.6% Stage I, 34.7% Stage II, 36.7% Stage III, n = 7803), 86% of patients lived in urban areas, 9.5% in large towns and 5% in rural areas. 60% had Medicare, 6.1% Medicaid and 7.1% were uninsured or had unknown payer status. 52% of patients were female and 87% were non-Hispanic White. The overall mean FI was 0.192; 60% (n = 4693) had an FI of 0, indicating all admissions were at the same hospital, and among those with FI&gt; 0 (n = 3110), mean FI was 0.483. The mean FI for patients potentially eligible for adjuvant chemotherapy (Stage II, III) was 0.188: 61% of patients had an FI of 0 and among those with FI &gt; 0 (n = 2173), mean FI was 0.482. Stratification by stage reveals similar proportions of FI &gt; 0.5 (stage I: 24.6%, stage II: 22.3%, stage III: 21.3%). Increased care dispersion was observed in patients from large towns (ΔFI 0.04, CI 0.03—0.06) or rural areas (ΔFI 0.04, CI 0.02—0.08) relative to urban areas, as well as for patients with relatively higher number of hospitalizations (ΔFI 0.04, CI 0.03—0.04). Less care dispersion was seen in patients with stage III disease (relative to stage I ΔFI -0.02, CI -0.03 — -0.01), uninsured status (relative to private insurance ΔFI -0.03, CI -0.05 – -0.01) or residence in the most disadvantaged ADI quartile (relative to Q1 ADI ΔFI -0.02, CI -0.04 — 0.00). Conclusions: Among patients with operatively managed colon cancer, slightly more than half did not experience inpatient care fragmentation. As expected, a higher number of total admissions and non-urban residence were associated with increased inpatient care dispersion. However, our findings of more concentrated care among patients with stage III disease, higher levels of relative economic disadvantage, and uninsured status suggest potentially complex and divergent forces driving hospital selection, to be explored in future work.

Mobile breast screening services in Australia: A qualitative exploration of perceptions and experiences among rural and remote women aged ≥75 years.

This qualitative descriptive study draws on data collected from a sub-sample of 15 women participating in a national study (n = 60) exploring the breast cancer screening motivations and behaviours of women aged ≥75 years. The study aimed to understand why women living in rural and remote areas might continue accessing mobile breast cancer screening despite being outside the targeted age range. Settings ranged from large towns to very remote communities (according to Monash Modified Model (MMM) classification 3-7) where BreastScreen Australia mobile screening services were available. Interview data from 15 women aged ≥75 years living in rural and remote locations who had used mobile screening services was utilised for this study. In-depth individual interviews were conducted via telephone or online platform (Zoom). These were transcribed verbatim and imported into NVivo software to enable thematic analysis to identify key themes. Many women aged ≥75 years in rural and remote areas expressed clear intentions to continue breast cancer screening, despite no longer being invited to do so. They perceived great value in the mobile service and were highly appreciative for it yet acknowledged limited sources of information about the process of ongoing screening. Few women in rural and remote areas had discussed ongoing breast cancer screening with their general practitioner (GP). More information is required to inform women about the risks and benefits of ongoing screening. Without an invitation to attend screening rural women reported difficulty in knowing when the service would be available. Ongoing notification of the availability of mobile services for women aged ≥75 years in rural areas is recommended.

The expansion of an invasive malaria vector: Anopheles stephensi emergence in Arba Minch town in the southern Rift Valley of Ethiopia

Urban areas in malaria-endemic countries in East Africa are experiencing a significant increase in malaria cases, with the establishment of an “exotic” urban malaria vector, Anopheles stephensi, increasing the risk of urban malaria. To this end, the present study aimed to investigate the emergence of this species in Arba Minch, Ethiopia. Following the detection of An. stephensi in other parts of Ethiopia, 76 artificial containers (55 discarded tyres, 18 concrete water storage, and three plastic containers) were sampled in 21 locations in Arba Minch town, for immature Anopheles mosquito stages, using the standard dipping technique. Larvae were reared into adults which were morphologically identified at the species level 2–3 days after emergence. Morphological identification results were confirmed by species-specific polymerase chain reaction. Of the examined containers, 67 (88%) had at least one Anopheles larva. Thirty-two of the adults emerged were morphologically identified as An. stephensi, with 26 (81%) confirmed by molecular analysis. This is the first study to report An. stephensi from Arba Minch, one of South Ethiopia’s largest towns, highlighting the need for increased vigilance. The planned and ongoing study in and around Arba Minch will contribute to understanding the bionomics and role of An. stephensi in malaria parasite transmission, helping develop a strategy to address the impending risk of urban malaria in Ethiopia.

Identifying barriers and facilitators for the effective diagnosis and provision of primary health care for otitis media from the perspective of carers of Aboriginal children.

To identify the barriers and facilitators for timely detection and optimal management of otitis media (OM) in Aboriginal children in a primary care setting from the perspective of carers of Aboriginal children. A qualitative, Aboriginal co-designed, participatory action research study with interviews and focus groups in a large town in the Kimberley, Western Australia. The Consolidated Framework for Implementation Research informed stakeholder group identification and interview framework development. Data underwent thematic analysis using NVivo software. Thirty-two carers of Aboriginal children participated. Key barriers identified for the detection of OM were limited information about OM provided to carers and carers feeling disempowered to express their concerns. Key facilitators identified were the provision of health information through health promotion and the use of culturally secure resources. Having a culturally secure clinical environment was identified as essential, with Aboriginal Health Workers playing a vital role in clinical care. No barriers to management of OM in primary care were reported. Facilitators included health care practitioners (HCPs) emphasising the importance of completing antibiotic course and the clinic providing necessary medications. A culturally secure health promotion strategy with health promotion teams, campaigns and resources is needed to increase community awareness of OM signs and symptoms and facilitate appropriate health seeking. It is essential that the local Aboriginal community co-lead and co-develop these initiatives to ensure the unique wisdom and knowledge of Aboriginal people are captured. HCPs and the clinic effectively facilitate management of OM by providing medications and emphasising completion of antibiotics.

Beaufort-Wes: 'n Oorsig van die geskiedenis van die dorp en distrik

The expansion of the settlement to the north-east in the course of the eighteenth century led to the proclamation of the Beaufort district in 1818. The principal town of the district, the present Beaufort West, was established on the farm Hooyvlakte and was the first municipality in South Africa (1837). From the beginning it was the centre of the educational, church and commercial life of this district, where sheep-farming was the most prominent activity. Today it is the largest town in the central Karoo and is also an important railway centre.

Anthropogenic pressure in Czech protected areas over the last 60 years: A concerning increase

This article focuses on the evolution of anthropogenic pressure across Czech large-scale protected areas (protected landscape areas and national parks, n = 30) over the last 60 years. In four periods (1960s; 1990; 2004; between 2016 and 2020) we analysed the development of artificial structures (built-up areas, recreational areas, roads, dirt roads, and streets) and their impact on landscape fragmentation. These spatial data were derived from topographic maps and aerial imageries and then statistically compared. Principally, built-up and recreational areas have increased; however, intensity varied across protected areas (PAs). Built-up areas have grown more in PAs close to large towns, especially after 1990 as protection did not prevent suburbanization in the PAs. Furthermore, PAs with more built-up areas also have more buildable areas; therefore, further ongoing development is expected. Recreational areas are present the most in some mountainous areas, such as ski resorts, and near large towns and spa towns (e.g. golf courses). The density of roads was more or less stable during the study period. Dirt road density differed within PAs according to the prevalent type of landscape: growth or stagnation in forested areas due to recreation and logging purposes and a decline in agricultural land, mainly as a consequence of collectivization in 1950 s followed by landscape unification and the creation of large patches of agricultural land. To sum up, anthropogenic pressure increased with landscape fragmentation, but these impacts are different across Czechia; in peripheral, attractive or peri-urban areas, which is important from landscape management point of view.

The Rise and Fall of Westmorland’s ‘County’ Racecourse: Kendal Races 1820–1834

Although many towns had race meetings in the past, most survived only a short time. It has been rare that the reasons why so many failed have been explored. Most simply stopped without any local newspaper explanation. This microstudy of a small local northern race meeting is very suggestive about just how complex and precarious the survival of any meeting could be, and aims to encourage further research. Kendal, the largest town in Westmorland, had very occasional low status race meetings in the eighteenth century on its Fell Side. But in 1820 annual races were revived on a new course to the east of the town, and the following year a new improved course was constructed to the west. The new races, the only ones in Westmorland at that time, lasted only fifteen years, from 1820 to 1834. This paper explores their nature, and the complex reasons lying behind the rise and fall of Kendal’s so-called ‘race week’. It starts by exploring its beginnings and describing the varied attractions that the ‘race week’ offered: wagering, heavy drinking, gaming and trickster activities, entertainments, a band, balloon ascent, dramas, social meals, dancing, assemblies, Wombwell’s menagerie, wrestling and cockfighting. It assesses the numbers and nature of the crowds attending. It then examines the complex reasons lying behind its brief growth and rapid decline. A perfect storm of problems came together: political divisions between the powerful landowning Tory Lowthers who held Westmorland and growing Whig and Reform opposition, which affected finances, patronage and elite attendance; middle-class Kendal attitudes, and dissenter religious opposition; funding problems; decline of gentry interest; inferior racehorse entries; low status jockeys; and bad weather.

Nutrition-Related Knowledge and Nutrition-Related Practice among Polish Adolescents-A Cross-Sectional Study.

The aim of this study was to examine the association between nutrition-related knowledge (NRK) and nutrition-related practice (NRP) among 1440 Polish students (aged 10-18 years) and identify the determining factors. Questions about NRK and NRP were thematically similar and referred to the recommendations of the Polish Pyramid of Healthy Nutrition and Lifestyle for Children and Adolescents (4-18 years). A cross-sectional study was conducted using the CAWI method. The respondents obtained an average of 51% of points in the NRK examination and 32% of points in the NRP examination. It was shown that NRP was positively associated with NRK (p < 0.001). The students' NRK was positively determined by the following factors: being female (p < 0.001), older age of students (p < 0.001), living in a larger town (p = 0.012) and a higher level of education of the mother/legal guardian (p < 0.001). NRP was positively associated with greater physical activity of the students (p < 0.001). NRK and NRP were negatively associated with the subjects' BMI (p = 0.029; p = 0.040, respectively). The analysis of NRK shows that the students' knowledge regarding the consumption of milk, milk products and fish should be increased (17-20% correct answers). The analysis of NRP reveals that only 4-14% of students declared appropriate eating habits regarding the consumption of sweet and salty snacks, fish, wholegrain products and milk. This study highlights the need for targeted educational strategies to increase both the understanding and application of dietary guidelines among Polish adolescents for the prevention of diet-related diseases.

THE HISTORICAL TOPOGRAPHY OF THE KHAZOR ZHUSH MONUMENT

when studying the history of a particular area or monument, it is important to pay attention to what it’s natural-geographical and economic-political place in the region is, in addition to focusing on the coverage of the same monument in written sources, its archaeological study. Only then will we be able to properly restore the historical landscape of the monument that we want to explore. Any archaeological site, whether it is an ordinary village or a large city, can take its place in the region on the basis of certain laws. This article examines the historical topography of the Khazor Zhush, a medieval monument located in the northern part of Samarkand, Sogdia. It is known that in the Middle Ages there were dozens of large and small towns, villages and towns in Samarkand Sogdiana. They also served as important regional economic hubs, depending on certain natural, geographical and economic conditions. Local and Arab-Persian written sources have brought us a huge amount of valuable information about the local conditions of Samarkand-Sogdiana, their center, and their economy. Based on the information provided in these sources, it is possible to get an idea of the economic and political role of the cities of Sogdiana, their importance in the Silk Road system. The article highlights the study of the Khazor Zhush monument in the sources, its archaeological description and economic and political significance in Central Sogdia.

Urban-rural inequalities in IV thrombolysis for acute ischemic stroke: A nationwide study.

Rural residency has been associated with lower reperfusion treatment rates for acute ischemic stroke in many countries. We aimed to explore urban-rural differences in IV thrombolysis rates in a small country with universal health care, and short transport times to stroke units. In this nationwide cohort study, adult ischemic stroke patients registered in the Danish Stroke Registry (DSR) between 2015 and 2020 were included. The exposure was defined by residence rurality. Data from the DSR, Statistics Denmark, and the Danish Health Data Authority, were linked on the individual level using the Civil Registration Number. Adjusted treatment rates were calculated by balancing baseline characteristics using inverse probability of treatment weights. Among the included 56,175 patients, prehospital delays were shortest for patients residing in capital municipalities (median 4.7 h), and longest for large town residents (median 7.1 h). Large town residents were predominantly admitted directly to a comprehensive stroke center (98.5%), whereas 30.9% of capital residents were admitted to a hospital with no reperfusion therapy available (non-RT unit). Treatment rates were similar among all non-rural residents (18.5%-18.7%), but slightly lower among rural residents (17.2% [95% CI 16.5-17.8]). After adjusting for age, sex, immigrant status, and educational attainment, rural residents reached treatment rates comparable to capital and large town residents at 18.5% (95% CI 17.7-19.4). While treatment rates varied minimally by urban-rural residency, substantial differences in median prehospital delay and admission to non-RT units underscored marked urban-rural differences in potential obstacles to reperfusion therapies.

The importance of the health motive in undertaking sports and recreational activities by Austrian school students compared to other motives

Sports and recreational activity is an important element of an effective use of their free time by children and school youth. In contrast to competitive sports, which focus on achieving maximum sports results through intense competition, sports and recreational activity should be assessed mainly in terms of its health benefits. Sports and recreational behaviour can be analysed in the context of psychophysical development, personality development, regeneration of vital forces, contact with nature, active rest and relaxation. The literature on the subject distinguishes various motives for undertaking sports and recreational activity, the most important of which include: pleasure, relaxation, health, aesthetic values, physical fitness and social aspects. This work aims to examine what motives guide Austrian school youth when undertaking sports and recreational activity, with particular emphasis on the health motive. The analysis also includes the differences related to gender and environmental conditions. The study included 391 students of general secondary schools in Austria, aged 18. The study group consisted of 96 boys and 103 girls from a large city and 94 boys and 98 girls from a small town. The Sports Activity Motives Questionnaire was used for the analysis. The study results emphasize the significant role played by the health motive in undertaking sports and recreational activities, especially among girls. The social aspect and relaxation also turned out to be important motives for both sexes. Statistical analysis showed significant differences in motives such as physical fitness and risk, which were more important for boys, while aesthetics was much more important for girls. The study did not find any statistically significant differences in the motives for undertaking sports and recreational activities between young people from large and small towns.

고교학점제 관련 학교 요인이 핵심역량 분류에 미치는 영향: 일반고 -직업계고 비교를 중심으로

This study investigates the impact of school factors on students’ categorisation of core competencies&#x0D; in general and vocational high schools, leading up to the full implementation of the high school&#x0D; credit system. The study’s conclusions are summarised based on the main findings. The results of the&#x0D; latent profile classification showed that both general and vocational upper secondary schools could be&#x0D; classified into three types of core competence profiles, namely ‘top core competence’, ‘upper core&#x0D; competence’ and ‘middle core competence’, and that the levels of the four sub-competences in each&#x0D; profile were similar. According to the results of the multinomial logistic regression analysis, the&#x0D; variables that showed statistical significance for the top group in both general and vocational upper&#x0D; secondary schools based on the middle group of core competences were ‘relevance of elective courses&#x0D; to careers’, ‘teaching method (interaction)’, ‘degree of reflection of students’ opinions’ and ‘city and&#x0D; region’, and the most influential variable in both groups was ‘teaching method (interaction)’. For the&#x0D; variables ‘teaching method (individualised)’, ‘no experience with optional courses’, ‘small and&#x0D; medium-sized town’ and ‘private school’, only general secondary schools showed statistically significant&#x0D; effects on group classification, while ‘large town’ showed a statistically significant negative regression&#x0D; value only for vocational schools.

Changes in Town and Country in Late Antiquity and into the Early Medieval Period in Greece and the Aegean Islands

The Greek Aegean in the Late Roman era (5th-mid-7th centuries AD) offers a degree of uniformity, developing further the novel urban and rural patterns that mark the previous Imperial centuries. Characteristically, small towns with fortifications and lavish Christian monuments are surrounded by commercial villa estates, while populations shrink drastically from the mid-6th century. In the 7th-8th centuries fundamental regional divergences appear. Most of mainland Greece is lost to the Eastern Roman (aka Early Byzantine) Empire based at Constantinople, the largest towns and coastal ports excepted, following waves of Slavic settlement. A second model is found on the Aegean Islands, where reduced populations largely survive Arab raids and alien settlement through settlement displacement and negotiation. A third model is represented by the large island of Crete, free from invasion until Arab conquest in the 9th century, ironically when a revived Eastern Roman (Middle Byzantine) Empire regains control of the mainland and remaining Aegean Islands. This paper will present the evidence from archaeology for these scenarios, varying in time and space.

Spatial pattern, and evolution of China’s urban agglomerations

China's urban agglomeration is not only crucial to tackle with the more and more contradiction between population, resources and environment, but also an important spatial actor to increase the global competitiveness and promote the transformation of China's economic development mode. In the national "14th Five-Year Plan" in 2021, it is proposed to "promote the coordinated and development of large, medium-sized and small cities and towns based on urban agglomeration and metropolitan area". Generally, 19 urban agglomerations designated in this Plan are heterogeneous in development level and national functions. To this end, from the nature of urban agglomerations, especially on agglomeration economy and functional urban region hypothesis, the research focuses on the spatial pattern and changes of these 19 areas mainly based on the 6th and 7th national census. The findings show that, China’s UAs are unique in driving forces, and spatial patterns as well. China’s UAs are more state-led, though now the marketing forces more and more crucial. The UAs have been evolved from the early planned economy period to the reform and opening up period, and then to the further development of the Socialist market economy until now. Unlike other typical UAs abroad, most of the developed UAs are more specialized in manufacture, not in producer services, though these regions show a remarkable high-end services oriented shift in 2010–2020.

Let me be fodder: Unravelling human and animal derived plant remains recovered from Roman Mursa, Croatia

Although evidence is sporadic it is becoming clear that haymaking and hay meadow management were likely indispensable elements of practices related to animal husbandry during the Roman period. As large towns begin to emerge, success in breeding large livestock such as cattle and horses would have required good quality fodder. Yet, how we distinguish fodder or other animal associated plant remains in the archaeological record can be problematic for many reasons. This paper explores this issue through the context of Roman Mursa, located in modern day Osijek, Croatia. Two pits dating to c. AD133, contained relatively large quantities of grassland and wet ground species, such as Trifolium/Melilotus sp. Prunella vulgaris and the grasses Poa sp. and Phleum sp., as well as chaff and other remains, such as dung, eggshells, and fish scales. By examining the proportion of species grouped into habitat types, we see that the composition of sample SU391 is indictive of hay meadows and could indicate nearby animal stabling in the centre of the early Roman colony.

Efficacy of Wolbachia-mediated sterility to reduce the incidence of dengue: a synthetic control study in Singapore

Due to the absence of available therapeutics and good vaccines, vector control solutions are needed to mitigate the spread of dengue. Matings between male Aedes aegypti mosquitoes infected with the wAlbB strain of Wolbachia and wildtype females yield non-viable eggs. We evaluated the efficacy of releasing wAlbB-infected Aaegypti male mosquitoes to suppress dengue incidence. In this synthetic control study, we conducted large-scale field trials in Singapore involving release of wAlbB-infected Aaegypti male mosquitoes for dengue control via vector population suppression, from epidemiological week (EW) 27, 2018, to EW 26, 2022. We selected two large towns (Yishun and Tampines) to adopt an expanding release strategy and two smaller towns (Bukit Batok and Choa Chu Kang) to adopt a targeted-release approach. Releases wereconducted two times a week in high-rise public housing estates. All intervention and control locations practised the same baseline dengue control protocol. The main outcome was weekly dengue incidence rate caused by any denguevirus serotype. We used incidence data collected by the Singapore Ministry of Health to assess the efficacy of theinterventions. To compare interventions, we used the synthetic control method to generate appropriate counterfactuals for the intervention towns using a weighted combination of 30 control towns between EW 1, 2014 and EW 26,2022. Our study comprised an at-risk population of 607 872 individuals living in intervention sites and 3 894 544 individuals living in control sites. Interventions demonstrated up to 77·28% (121/156, 95% CI 75·81-78·58) intervention efficacy despite incomplete coverage across all towns until EW 26, 2022. Intervention efficacies increased as release coverage increased across all intervention sites. Releases led to 2242 (95% CI 2092-2391) fewer cases per 100 000 people in intervention sites during the study period. Secondary analysis showed that these intervention effects were replicated across all age groups and both sexes for intervention sites. Our results demonstrated the potential of Wolbachia-mediated incompatible insect technique for strengthening dengue control in tropical cities, where dengue burden is the greatest. Singapore Ministry of Finance, Ministry of Sustainability, and the National Environment Agency, and the Singapore National Robotics Program.

Risk Factors Associated with Soil-Transmitted Helminths in Dog Feces That Contaminate Public Areas of Warsaw, Poland

A constant increase in dog numbers, especially in large towns, has been observed recently. The presence of dogs in urban spaces increases the risk of pollution by dogs’ feces, which may contain growth forms of parasites including canine, soil-transmitted helminths (cSTHs), most of which have a proven zoonotic potential. This study assessed the frequency of occurrence and estimated the potential risk associated with the presence of cSTHs in dogs’ feces left uncollected in urban areas. The study material consisted of 200 fecal samples obtained from city and dog parks situated in selected Warsaw districts. Each fecal sample was processed using the flotation technique. Eggs of cSTHs, including Toxocara canis, Toxascaris leonina, Trichuris vulpis, and hookworms from the Ancylostomatidae family were found in 23 (11.5%) of the examined fecal samples. The most prevalent species were hookworms from the family Ancylostomatidae (8%). The presence of parasites was confirmed in 14 out of 20 studied locations (70%), including eight city parks (72.7%) and six dog parks (66.7%). City and dog parks did not differ significantly in the frequency of parasite occurrence. This study indicated that dogs’ feces, left uncollected, may cause environmental contamination with cSTHs. It also indicated that the presence of dogs’ feces in public areas and the associated presence of parasites is still a problem.

Physicochemical and bacteriological quality of swimming pools water in Kombolcha Town, Northeastern Ethiopia.

The use of swimming pool water for recreation, rehabilitation, and athletics is widespread around the world, especially in large Cities and Towns. However, poorly managed swimming pool water can facilitate the spread of illnesses connected to recreational water. Despite this, there is no evidence on quality of swimming pools water in Kombolcha Town. Therefore, this study was aimed to evaluate the physicochemical and bacteriological quality of swimming pools water in Kombolcha Town. A laboratory-based cross-sectional study was conducted from February to April, 2021 in Kombolcha Town. A total of 90 water samples were collected from the three outdoor swimming pools. The collected data of both physicochemical and bacteriological parameters were entered into Microsoft Excel 2010 and analyzed using SPSS version 25.0. One-way ANOVA was used to test whether there were statistically significant differences between different swimming pools. The level of significance was declared at a p-value of <0.05. In this study, out of all the pool water samples that were examined, 37.8% had pH values between 7.2 and 7.8, 36.7% had temperatures between 21°C and 32°C, and 26.7% had turbidity values that were within the WHO standard. Furthermore, only 16.7% of the pool water samples showed residual chlorine levels of 2-3 mg/L. In addition, only 27.8, 35.6, and 32.2% of the samples, respectively, met the WHO criterion for total coliform, fecal coliform, and heterotrophic plate count. The result indicates that most pool water samples did not fulfill both the physicochemical and bacteriological quality of the WHO standard limit for swimming pools. Thus, it is crucial to clean and regularly check the pool water, apply pool safety requirements, and raise pool user's awareness about the danger of pool water pollution through training.