Latrine Quality Research Articles

The Relationship of Latrine Quality with The Incidence of Worms in The Mekarsari Health Center Area, Lebak District

Family latrines, crucial for sanitation, impact community health. In 2019, Banten had 70.5% latrine use, below the national 72.3%. Poor sanitation causes diseases like helminthiasis, affecting many, especially children. This study aims to determine the relationship between the quality of family latrines and the incidence of helminthiasis in the Mekarsari Health Center area of Lebak Regency. The study used a cross-sectional design. The population included all families with goose-neck latrines in the Mekarsari Health Center area, with a sample size of 88 families. Data analysis was conducted in stages using the chi-square test at an alpha level of 0.05. The results showed that nearly all respondents (93.2%) were male, 96.6% were of productive age, most had low education levels (67%), and nearly all were non-civil servants (97.7%). The majority (73.9%) had a monthly income below the Lebak Regency minimum wage (< Rp 2,944,665). There were still 17% of families with low-quality latrines, and 9.1% of family members suffered from or were infected with helminthiasis (Ancylostoma duodenale). The relationship test results showed a significant relationship between latrine quality and helminthiasis incidence, with a p-value of 0.000 (p<α). The OR value was 63,000, meaning that families with low-quality latrines were 63 times more likely to suffer from or be infected with helminthiasis compared to families with high-quality latrines. The conclusion is that there is a relationship between the quality of latrines and the incidence of helminthiasis in the Mekarsari Health Centre Area, Lebak Regency. Serious efforts are needed to empower families through health education and assistance to encourage them to improve, construct, and maintain quality latrines to prevent helminthiasis infections.

Improved Child Feces Management Mediates Reductions in Childhood Diarrhea from an On-Site Sanitation Intervention: Causal Mediation Analysis of a Cluster-Randomized Trial in Rural Bangladesh

BackgroundThe WASH benefits Bangladesh trial multi-component sanitation intervention reduced diarrheal disease among children < 5 years. Intervention components included latrine upgrades, child feces management tools, and behavioral promotion. It remains unclear which components most impacted diarrhea.MethodsWe conducted mediation analysis within a subset of households (n = 720) from the sanitation and control arms. Potential mediators were categorized into indicators of latrine quality, latrine use practices, and feces management practices. We estimated average causal mediation effects (ACME) as prevalence differences (PD), defined as the intervention’s effect on diarrhea through its effect on the mediator.ResultsThe intervention improved all indicators compared to controls. We found significant mediation through multiple latrine use and feces management practice indicators. The strongest mediators during monsoon seasons were reduced open defecation among children aged < 3 and 3–8 years, and increased disposal of child feces into latrines. The strongest mediators during dry seasons were access to a flush/pour-flush latrine, reduced open defecation among children aged 3–8 years, and increased disposal of child feces into latrines. Individual mediation effects were small (PD = 0.5–2 percentage points) compared to the overall intervention effect but collectively describe significant mediation pathways.DiscussionThe effect of the WASH Benefits Bangladesh sanitation intervention on diarrheal disease was mediated through improved child feces management and reduced child open defecation. Although the intervention significantly improved latrine quality, relatively high latrine quality at baseline may have limited benefits from additional improvements. Targeting safe child feces management may increase the health benefits of rural sanitation interventions.

Quality of latrines and willingness to improve them in rural Ethiopia

Abstract Ethiopia recorded the world's fastest increase in latrine coverage over the past two decades, but it was largely achieved by the adoption of latrines that do not meet basic hygienic standards. Therefore, this study aims to examine the quality of latrines and their upgrading at household level through a case study from the Loka Abaya district, South Ethiopia. Of the initially sampled 549 households, 422 (77%) had private latrines, and a survey was administered among them. The data were characterized descriptively, and correlates of the latrine quality and willingness to improve were analysed. The average latrine quality score in the sample was only 2.8 of the maximum six quality dimensions. Despite the low quality of latrines, 63% of respondents were satisfied with their sanitation situation. Both past improvements and plans to improve latrines were frequently reported. However, these reported changes mostly involved regular maintenance or reconstructions of collapsed latrines. No substantial upgrading of the functionality was identified. We identified inadequate awareness about the means of hygienic sanitation, implying the importance of community education. Demand for as well as supply of hygienic sanitation products are further constrained by the low purchasing power of households implying a need for sanitation subsidies.

Evaluation of an on-site sanitation intervention against childhood diarrhea and acute respiratory infection 1 to 3.5 years after implementation: Extended follow-up of a cluster-randomized controlled trial in rural Bangladesh.

Diarrhea and acute respiratory infection (ARI) are leading causes of death in children. The WASH Benefits Bangladesh trial implemented a multicomponent sanitation intervention that led to a 39% reduction in the prevalence of diarrhea among children and a 25% reduction for ARI, measured 1 to 2 years after intervention implementation. We measured longer-term intervention effects on these outcomes between 1 to 3.5 years after intervention implementation, including periods with differing intensity of behavioral promotion. WASH Benefits Bangladesh was a cluster-randomized controlled trial of water, sanitation, hygiene, and nutrition interventions (NCT01590095). The sanitation intervention included provision of or upgrades to improved latrines, sani-scoops for feces removal, children's potties, and in-person behavioral promotion. Promotion was intensive up to 2 years after intervention initiation, decreased in intensity between years 2 to 3, and stopped after 3 years. Access to and reported use of latrines was high in both arms, and latrine quality was significantly improved by the intervention, while use of child feces management tools was low. We enrolled a random subset of households from the sanitation and control arms into a longitudinal substudy, which measured child health with quarterly visits between 1 to 3.5 years after intervention implementation. The study period therefore included approximately 1 year of high-intensity promotion, 1 year of low-intensity promotion, and 6 months with no promotion. We assessed intervention effects on diarrhea and ARI prevalence among children <5 years through intention-to-treat analysis using generalized linear models with robust standard errors. Masking was not possible during data collection, but data analysis was masked. We enrolled 720 households (360 per arm) from the parent trial and made 9,800 child observations between June 2014 and December 2016. Over the entire study period, diarrheal prevalence was lower among children in the sanitation arm (11.9%) compared to the control arm (14.5%) (prevalence ratio [PR] = 0.81, 95% CI 0.66, 1.00, p = 0.05; prevalence difference [PD] = -0.027, 95% CI -0.053, 0, p = 0.05). ARI prevalence did not differ between sanitation (21.3%) and control (22.7%) arms (PR = 0.93, 95% CI 0.82, 1.05, p = 0.23; PD = -0.016, 95% CI -0.043, 0.010, p = 0.23). There were no significant differences in intervention effects between periods with high-intensity versus low-intensity/no promotion. Study limitations include use of caregiver-reported symptoms to define health outcomes and limited data collected after promotion ceased. The observed effect of the WASH Benefits Bangladesh sanitation intervention on diarrhea in children appeared to be sustained for at least 3.5 years after implementation, including 1.5 years after heavy promotion ceased. Existing latrine access was high in the study setting, suggesting that improving on-site latrine quality can deliver health benefits when latrine use practices are in place. Further work is needed to understand how latrine adoption can be achieved and sustained in settings with low existing access and how sanitation programs can adopt transformative approaches of excreta management, including safe disposal of child and animal feces, to generate a hygienic home environment. ClinicalTrials.gov; NCT01590095; https://clinicaltrials.gov/ct2/show/NCT01590095.

MODELLING OF MITIGATING DIARRHOEA IN THE WETLAND AREA OF BANYUASIN DISTRICT, INDONESIA: A CROSS-SECTIONAL STUDY

Diarrhoea is one of the causes of high morbidity and mortality rates in developing countries that have poor environmental sanitation, inadequate water supply, high poverty rates and low levels of education. The purpose of this study was to examine diarrhoea control models in toddlers of Banyuasin District wetlands. This study used a cross-sectional study design. The study was conducted in the wetland area of Banyuasin District with a sample of 296 respondents. Data analysis was performed in univariate, bivariate and multivariate. The results showed that there was a correlation between chemical indicators (p-value = 0.035), latrine sanitation (p-value = 0.004), latrine quality (p-value = 0.005), income (p-value = 0.023), and hand washing with soap (p-value = 0.035) with the occurrence of diarrhoea in toddlers of Banyuasin District wetlands area. 51.9% of diarrhoea prevention can be explained by the water factor (19.7%), sanitation factor (15.6%), personal hygiene factor (8.2%), toddler factor (4.8%) and mother factor (3.5%) in this study. Improvements of environmental sanitation related to healthy latrines, rubbish bins, sewerage and clean / drinking water sources, as well as intensive education about personal hygiene and breastfeeding toddlers can contribute in reducing the occurrence of diarrhoea in toddlers.

Tingkat Pengetahuan Dan Sikap Masyarakat Tentang Penyakit Kecacingan Berpengaruh Terhadap Kejadian Penyakit Kecacingan

Worm disease is an infectious disease caused by parasites in the form of worms. The cause is soil-transmitted helminthiases (STH), which are intestinal worms that are transmitted to humans through soil contaminated by feces. STH infection can cause people to experience malnutrition. Severe infections can interfere with physical growth and cognitive development of sufferers. The purpose of this study was to determine the correlation between the level of knowledge and people's attitudes about helminthiasis with helminthiasis. This type of research was analytic with the research design using the case control method. The sample in this study was 38 respondents consisting of 19 people with helminthiasis and 19 did not suffer from helminthiasis. Data analysis using chi-square test. Chi-square test results showed the p-value for the correlation of the variable level of knowledge of 0,312&gt; alpha (0,05) and the correlation of the attitude variable of 0,501&gt; alpha (0,05) it can be stated that there is no relationship between the level of knowledge and attitudes of the community about the disease helminthiasis with the incidence of helminthiasis in the working area of cempaka puskesmas. If this research is to be continued, in order to be better, then the research sample should be expanded and other possible factors become one of the causes of STH infection such as clean and healthy life behavior, latrine quality, water quality, soil quality and others.

Effect of a Community-Led Total Sanitation Intervention on Sanitation and Hygiene in Pallisa District, Uganda

We conducted a comparative cross-sectional study to examine the potential effects of a community-led total sanitation (CLTS) intervention on sanitation and hygiene in Pallisa district in Uganda. Quantitative data were collected from households using a semi-structured questionnaire and an observation checklist, entered and analyzed using univariate, bivariate, and multivariate analyses. Overall, knowledge on sanitation and hygiene was significantly higher (64.5%; 129/200) among households in the CLTS intervention than among those in the nonintervention subcounties (54.0%; 108/200) (P = 0.033). Latrine quality was rated as fair in a majority (73.3%; 143/195) of the CLTS intervention households compared with 50.8% (93/183) in the non-CLTS households (P < 0.001). Latrine cleanliness was rated as good in more than a half (51.3%; 100/195) of households in the intervention area, whereas only 13.7% (25/183) for the nonintervention area (P < 0.001). In this study, 35.0% (70/200) of the households in the intervention subcounty had attained open defecation-free (ODF) status compared with only 6.0% (12/200) in the nonintervention subcounty (P < 0.001). Level of knowledge on hygiene and sanitation (adjusted odd ratio [AOR]: 2.23; 95% CI: 1.24-4.03) and CLTS status (AOR: 8.89; 95% CI: 4.26-18.56) were significantly associated with achievement of ODF status in the multivariate analysis. The mean cases of diarrhea were significantly lower in CLTS implementing (subcounty (0.42 [SD ± 1.03]) than in the non-CLTS implementing subcounty (0.98 [SD ± 1.39]; t = -4.6; P < 0.001). Sanitation and hygiene outcomes were better in the CLTS intervention subcounty than in the non-CLTS intervention subcounty, suggesting that scaling up CLTS could reduce ODF and the burden of diarrheal diseases.

FAKTOR RISIKO KEJADIAN DIARE PADA BALITA

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p align="center"&gt;&lt;strong&gt;&lt;em&gt;Abstract&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;Problems with diarrhea are still a relatively large problem. In 2017 the number of diarrhea among toddlers in Indonesia was 40.07% and there were 21 times diarrhea outbreaks in 12 provinces, 17 districts / cities. Jambi Province in 2017 the prevalence of diarrhea in infants is 43.79%. In the city of Jambi the prevalence of diarrhea in children under five was 6.5%. This study aims to look at the risk factors for diarrhea in infants. This research is a quantitative research with case control research design. Case samples were 30 people and control samples were 60 people, the comparison of the number of cases and controls was 1: 2, then the number of samples in the study were 90 toddlers. Data collection was done by filling out questionnaires with univariate and bivariate analysis using the chi square test. The analysis showed that there was a relationship between hand washing with soap and running water (p - value = 0.013 &amp;amp; OR = 3,824), exclusive breastfeeding (p - value = 0,000 &amp;amp; OR = 5,902), nutritional status (p - value = 0,001 &amp;amp; OR = 6,625), Latrine Quality (p - value = 0.001 &amp;amp; OR = 5,035) and source of clean water (p - value = 0,009 &amp;amp; OR = 4,333) on the incidence of diarrhea in children under five. Variables that are at risk for the incidence of diarrhea in infants are hand washing with soap and running water, exclusive breastfeeding, nutritional status, latrine quality and clean water sources&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; &lt;strong&gt;risk factor&lt;/strong&gt;&lt;/em&gt;&lt;strong&gt;&lt;em&gt;s; &lt;/em&gt;&lt;/strong&gt;&lt;strong&gt;&lt;em&gt;diarrhea&lt;/em&gt;&lt;/strong&gt;&lt;strong&gt;&lt;em&gt;; Children&lt;/em&gt;&lt;/strong&gt;&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;

The role of psychological factors in predicting latrine ownership and consistent latrine use in rural Ethiopia: a cross-sectional study

BackgroundInadequate sanitation is one of the leading causes of disease in poor and middle-income countries.ObjectiveThe objective of the study was to identify the psychological factors that predict latrine ownership and consistent latrine use in the rural Becho district of central Ethiopia.MethodA quantitative, cross-sectional, community based study was conducted. A total of 1047 heads of household were interviewed using a structured questionnaire. Ownership of latrine and consistent latrine use constituted the outcome variable of the study. Data were entered using Epi Info version 3.5.4 and were analyzed using SPSS version 20.ResultsOf the 1047 households, 73% owned a traditional pit latrine. Among the psychological factors, attitude (AOR 1.70; 95% CI 1.21–2.37) and injunctive norm (AOR 6.18; 95% CI 4.46–10.44) were positively and significantly associated with latrine ownership. Among the demographic factors, having a family size of more than six (AOR = 1.43; 95% CI 1.01–1.97, having a child attending school (AOR = 1.88; 95% CI 1.17–3.02), and having a high school education (AOR = 1.98; 95% CI 1.34–2.87) were significantly associated with latrine ownership. With respect to exposure to communication about sanitation (the cues to action), households that had a family member who took part in Community Led Total Sanitation and Hygiene (CLTSH) triggering were three times more likely to be latrine owners than those who did not participate in CLTSH triggering (95% CI 1.92–4.78.) Results from adjusted logistic regression analysis of potential predictors of consistent latrine use showed that having a positive attitude (AOR 7.00; 95% CI 4.55–10.55), owning of a latrine that had superstructure (AOR 2.3 95% CI 1.47–3.48), having a clean latrine (AOR 1.69 95% CI 1.00–3.00), and having a latrine with a protected door (AOR 1.94; 95% CI 1.10–3.48) were significantly associated with consistent latrine use.ConclusionThe study findings showed that attitude and injunctive norm are the psychological predictors of latrine ownership, and consistent latrine use was associated with attitude, cleanliness of the latrine, and its privacy. Hence, sanitation intervention needs to focus on changing societal norms, attitudes, and the promotion of latrine quality.

Sustainability of community-led total sanitation outcomes: Evidence from Ethiopia and Ghana.

We conducted a study to evaluate the sustainability of community-led total sanitation (CLTS) outcomes in Ethiopia and Ghana. Plan International, with local actors, implemented four CLTS interventions from 2012 to 2014: health extension worker-facilitated CLTS and teacher-facilitated CLTS in Ethiopia, and NGO-facilitated CLTS with and without training for natural leaders in Ghana. We previously evaluated these interventions using survey data collected immediately after implementation ended, and concluded that in Ethiopia health extension workers were more effective facilitators than teachers, and that in Ghana training natural leaders improved CLTS outcomes. For this study, we resurveyed 3831 households one year after implementation ended, and analyzed latrine use and quality to assess post-intervention changes in sanitation outcomes, to determine if our original conclusions were robust. In one of four interventions evaluated (health extension worker-facilitated CLTS in Ethiopia), there was an 8 percentage point increase in open defecation in the year after implementation ended, challenging our prior conclusion on their effectiveness. For the other three interventions, the initial decreases in open defecation of 8–24 percentage points were sustained, with no significant changes occurring in the year after implementation. On average, latrines in Ethiopia were lower quality than those in Ghana. In the year following implementation, forty-five percent of households in Ethiopia repaired or rebuilt latrines that had become unusable, while only 6% did in Ghana possibly due to higher latrine quality. Across all four interventions and three survey rounds, most latrines remained unimproved. Regardless of the intervention, households in villages higher latrine use were more likely to have sustained latrine use, which together with the high latrine repair rates indicates a potential social norm. There are few studies that revisit villages after an initial evaluation to assess sustainability of sanitation outcomes. This study provides new evidence that CLTS outcomes can be sustained in the presence of training provided to local actors, and strengthens previous recommendations that CLTS is not appropriate in all settings and should be combined with efforts to address barriers households face to building higher quality latrines.

Hubungan Personal Hygiene dan Sanitasi Lingkungan dengan Angka Kejadian Kecacingan (Soil Transmitted Helminth) Pada Petani Sayur di Kelurahan Maharatu Kecamatan Marpoyan Damai Kota Pekanbaru

Abstrak: Personal hygiene and environmental sanitation is an important factor in the health care effort to avoid infection worms. Research has been conducted on vegetable farmers in Sub District of Marpoyan Damai Maharatu Pekanbaru City in March - May 2015 with a total sample of 50 people. The result showed that the majority of workers in the village vegetable worm disease Maharatu positive experience with this type of Ascaris lumbricoides and including minor infections. There is a relationship use of Personal Protective Equipment (PPE), health nails, wash hands, clean water, latrine quality and sewage with the incidence of the disease in Sub Maharatu worms.

Impact of population and latrines on fecal contamination of ponds in rural Bangladesh

A majority of households in Bangladesh rely on pond water for hygiene. Exposure to pond water fecal contamination could therefore still contribute to diarrheal disease despite the installation of numerous tubewells for drinking. The objectives of this study are to determine the predominant sources (human or livestock) of fecal pollution in ponds and examine the association between local population, latrine density, latrine quality and concentrations of fecal bacteria and pathogens in pond water. Forty-three ponds were analyzed for E. coli using culture-based methods and E. coli, Bacteroidales and adenovirus using quantitative PCR. Population and sanitation spatial data were collected and measured against pond fecal contamination. Humans were the dominant source of fecal contamination in 79% of the ponds according to Bacteroidales measurements. Ponds directly receiving latrine effluent had the highest concentrations of fecal indicator bacteria (up to 10 6 Most Probable Number (MPN) of culturable E. coli per 100 mL). Concentrations of fecal indicator bacteria correlated with population surveyed within a distance of 30–70 m (p < 0.05) and total latrines surveyed within 50–70 m (p < 0.05). Unsanitary latrines (visible effluent or open pits) within the pond drainage basin were also significantly correlated to fecal indicator concentrations (p < 0.05). Water in the vast majority of the surveyed ponds contained unsafe levels of fecal contamination attributable primarily to unsanitary latrines, and to lesser extent, to sanitary latrines and cattle. Since the majority of fecal pollution is derived from human waste, continued use of pond water could help explain the persistence of diarrheal disease in rural South Asia.

Assessment of latrine use and quality and association with risk of trachoma in rural Tanzania

The existing evidence regarding latrines and trachoma is inconclusive. Using more precise sanitation measures we examine the association between use and quality of latrines and risk of trachoma. We conducted a case-control study of 678 households (95 cases, 583 controls) in eight villages in Kongwa District, Tanzania. Case households were defined as having a sentinel child with clinical signs of trachoma. A latrine quality score was calculated based on seven indicators and case and control households were compared with respect to use and quality of latrines. Logistic regression analyses controlled for potential confounders. Latrine use was significantly greater in control households than in case households (90.4 vs. 76.8%, P=0.03). The protective effect of latrine use persisted even after controlling for household characteristics significant at P <0.20 (adjusted OR=0.56 [95% CI: 0.32-0.98]). Contrary to expectation, we did not find an inverse association between increasing latrine quality and decreasing odds of trachoma. Although latrine use in the communities was high, latrines, regardless of quality, were significantly associated with decreased risk of trachoma. These findings underscore the importance of achieving 100% latrine use in communities.