Private Latrines Research Articles

Analysis of Individual Aspects in Riverbank Slums on Sustainable Sanitation Development, Case Study: Bima City, NTB, Indonesia

Currently, 24.5% of the population of Bima City lack access to sanitation. The issue is predominantly concentrated in densely populated urban slums along the riverbanks, influenced by the cultural and societal context of Indonesian society. From 2021 to 2022, a comprehensive mixed-method study was conducted in three urban slums, applying the Integrated Framework for Sanitation Services (IFSS) to explore individual aspects within a socio-cultural context. Combining quantitative and qualitative methods, the research involved a household questionnaire survey and in-depth interviews (IDI). The study revealed that individual aspects are shaped by perceptions of the convenience of open defecation and latrine use as well as experiences with shared latrines, driving the adoption of private latrines. Challenges such as financial constraints and limited construction capabilities in urban slum communities often hinder latrine construction, though cultural and traditional values (adat) in the Bima community in urban slums help to alleviate these obstacles. A recommendation is made to enhance the monitoring of sanitation adoption progress, focusing on the sanitation system’s functioning and adherence to the sanitation hierarchy. Despite awareness of the importance of safe disposal, its impact on sanitation behavior in Bima City’s urban slums has been constrained, underscoring the imperative for effective behavior change communication strategies.

Study of defecation places and feces distribution in North Buton Regency

Background: Poor sanitation can likely contaminate drinking water, leading to the development of cholera and other deadly diseases. The number of people who defecate in the open worldwide has fallen by more than two-thirds over the past two decades. Data from the Community Health Development Division of the Southeast Sulawesi Health Office reports that the ODF level in Southeast Sulawesi as of today shows that it is already 59 percent of the total target of 60 percent. So efforts are needed in North Buton Regency to achieve the target of stopping open defecation that has been launched by the Indonesian government. Objective: The aim of this research is to examine defecation habits and places where feces are distributed in North Buton Regency. Methods: This type of research is quantitative descriptive, with a survey approach. The sample in this study was 3,640 houses. Each village/kelurahan is represented by 40 households taken using a simple random sampling technique. Results: The majority of respondents disposed of feces in private latrines, namely 2,769 (76.1%), while the least was defecation in ditches and ditches around people's houses, namely 2 (0.1%), and the majority of houses collected/distributed feces in dug holes. namely 2,369 (65.08%), while the least is accommodated/distributed directly in the river/lake/beach/sea, are15 (0.41%). Conclusion: Most people in North Buton Regency defecate in private latrines, and the resulting feces are channeled/discarded into dug holes in the ground.

Eliminating Trachoma in Africa: The Importance of Environmental Interventions.

Subsequent to the failure of the World Health Organisation (WHO) of achieving their target to eliminatetrachoma by the year 2020, the most effective strategy in eliminating trachoma must be re-examined to accomplish the new target of eradication by the year 2030. Whilst antibiotic therapy is a core foundation of this elimination strategy, another important factor is the state of the environmental conditions in trachoma endemic countries. This manuscript aimed to identify the impact of environmental improvement strategies on the prevalence of trachomaand the significance of environmental improvement alongside the use of antibiotic treatment to achieve trachoma elimination. Two independent literature searches were conducted up until the 5th of July 2021. Two main databases were used to carry out these literature searches, namely, Ovid EMBASE and Ovid MEDLINE. All of the relevant references were found using MeSH and free text terms. Key terms used were 'trachoma', 'water', 'sanitation', 'hygiene'and 'environmental Improvement'. The exclusion criteria included non-African-based studies, review papers, protocols and case reports. A total of 17 studies were included for this review. Living within a close range of a water source was significantly associated with reduced risk of trachoma infection. Water obtained from piped water sources was associated with the lowest rates of active trachoma. Studies on facial cleanliness evidenced a strong association with reduced prevalence of trachoma. Whilst the provision of latrine facilities found was significantly associated with reduced prevalence of trachoma, there was no significant difference between the use of private latrine facilities over communal latrine facilities. The use of repeated scheduled antibiotic treatments over single-use antibiotic distribution had a greater impact both short term and long term on the prevalence rates of trachoma. Nonetheless, prevalence rates increased again following the commencement of treatment. Mass antibiotic treatment has been proven to have a greater impact on lowering the prevalence of trachoma initially, but this impact is not sustainable due to the rise in prevalence rates following the completion of treatment. A holistic approach, therefore, must be implemented with evidence showing that an emphasis on longer-term environmental methods should be implemented to compliment antibiotic distribution. Prioritisation of specific interventional measures should be tailored according to local epidemiology; nonetheless, these measures form the backbone of a trachoma elimination strategy to eliminate trachoma by the year 2030.

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.

PENYULUHAN PERILAKU HIDUP BERSIH DAN SEHAT (PHBS) SERTA PENCEGAHAN STUNTING DI DESA NANGTANG KECAMATAN CIGALONTANG

<span class="ShortAbstract"><span lang="EN-US">Clean and Healthy Living Behavior (PHBS) is a form of effort to provide lessons in the form of experience to each individual, family member, and the general public. The majority of the Nangtang Village community in stilt houses do not have private latrines, so they are accustomed to using public latrines made of bamboo (latrine) while poor sanitation and hygiene levels can increase the risk of stunting in children by 3 times. The purpose of this community service activity is to improve the Nangtang Village community regarding PHBS and stunting prevention. The community service method used is lectures and giving questionnaires in the form of pre-test and post-test. The result of the activity is the influence on the understanding of the material received based on age and level of education</span></span>

Prevalence and risk factors of diarrhea among children less than five years of age in the rural suburbs of Dire Dawa, Eastern Ethiopia; Robust Poisson Regression Analysis.

Diarrhea is the second leading cause of under-five mortality in Ethiopia. Information on the prevalence and the impacting factors of diarrhea in the rural suburbs of Dire Dawa is inadequate. This study was aimed at determining risk factors of diarrhea among children less than five years of age in the rural suburbs of Dire Dawa, eastern Ethiopia. A cross-sectional study was conducted from 02 May 2018, to 31 May 2018. The required 1146 children for this study were selected from the rural suburbs of Dire Dawa using multi-stage sampling. Both bi-variable and multivariable Robust Poisson regressions were used for identifying the risk factors. Explanatory variables with a p-value < 0.05 were considered as independently associated with diarrhea. The prevalence of diarrhea among the children was 23% (95% CI: 20.7 - 25.4). The type of house floor (aPR [adjusted prevalence ratio] = 0.89, 95% CI: 0.84 - 0.95) and sharing latrine with neighbours (aPR = 1.18, 95% CI: 1.09 - 1.26) were the significant factors associated with childhood diarrhea. Earthen house floor and shared use of latrine were the risk factors associated with childhood diarrhea. Hence, improving the house floor condition and construction of private latrine together with health education are recommended.

Barriers to cleaning of shared latrines in slums of Addis Ababa, Ethiopia.

Shared latrines and other shared sanitation facilities are vital for communities that lack private latrines. However, the cleanliness of shared latrines continues to be a problem in sub-Saharan Africa, including slums of Addis Ababa, Ethiopia. Investigating the barriers to cleaning of shared latrines may inform the future strengthening of comprehensive sanitation programs in slums of Addis Ababa, Ethiopia. Thus, a community-based unmatched case-control study was conducted among 100 case and 200 control households that were users of shared latrines from September to November 2017 in a slum district in Addis Ababa. Cases were those who had not cleaned their shared latrines and controls were those who had cleaned their shared latrines at least once during the week prior to data collection. Data were collected using a structured questionnaire and an on-the-spot-observational checklist and analyzed using bivariate (crude odds ratio [COD]) and multivariable (adjusted odds ratio [AOR]) unconditional logistic regression model. Variables having a p-value of less than 0.25 from the bivariate logistic regression analysis were retained into multivariable analysis. From the multivariable analysis, variables with p<0.05 were declared as factors significantly associated with barriers to cleaning of shared latrines. We found that about half 99 (49.5%) of shared latrines used by cases and almost one-third 32 (32.0%) of the shared latrines used by controls had visible cracks and spaces in the floor and slabs. The barriers to cleaning of shared latrines were found to be monthly household income of less than $55.60 USD (AOR = 1.80; 95%CI: 1.2-3.10), users feeling a lack of privacy during latrine use (AOR = 2.95; 95% CI: 1.60-5.43), no locking latch on the latrine door (AOR = 4.60; 95% CI: 2.43-8.79), inadequate ventilation of latrine (AOR: 4.88; 95% CI: 2.44-9.63), lack of regular monitoring of latrine by health extension workers (AOR = 2.86; 95%CI: 1.32-6.21) and a lack of enough water at home for cleaning the latrine (AOR = 4.91; 95% CI: 1.07-9.48). This study found several barriers to cleaning of shared latrines in slums of Addis Ababa. We recommend that stakeholders promote cleaning of shared latrines by designing programs to improve latrine privacy by adding or modifying the superstructure and including a door with locking latch, to make adjustments to the structure for better ventilation, to ensure regular monitoring of latrines by health extension workers and to make enough water consistently available for regular latrine cleaning.

Latrine utilization and associated factors in East Gojjam Zone, North-West Ethiopia: A community-based cross-sectional study.

Objective:This research was aimed at assessing latrine utilization and associated factors in East Gojjam Zone, North West Ethiopia.Methods:A community-based cross-sectional study was conducted on households of East Gojjam Zone, from 1 February to 30 May 2021. Multistage cluster sampling technique was used to select 806 study participants into the study. Data were collected through pretested structured interview questionnaires and direct observation. Collected data were entered and cleaned using EPI info version 7.2 and analysed using SPSS version 23 software package. Bivariable and multivariable logistic regression was employed to assess association of the variables and controlling the effect of confounders, respectively. P value less than 0.05 was taken as statistically significant.Results:The overall latrine utilization in East Gojjam Zone was found to be 45.4% (95% confidence interval = 42.2–49.1). Occupation (adjusted odds ratio = 2.248, 95% confidence interval = 1.037–4.876), participating in model family training (adjusted odds ratio = 2.481, 95% confidence interval = 1.802–3.415), water availability (adjusted odds ratio = 2.456, 95% confidence interval = 1.514–3.983), and type of latrine (adjusted odds ratio = 2.013, 95% confidence interval 1.648–2.972) had statistically significant association with latrine utilization.Conclusion:Latrine utilization in East Gojjam Zone was found to be low relative to other studies and the country’s plan. It is very far apart from the Ethiopian latrine coverage and utilization plan (100%). Occupational status, participated in the model family training, water availability, and type of toilet were significantly associated with toilet utilization. Encouraging private latrine construction with accessibility of water and all households participating in model family training may increase latrine utilization in East Gojjam Zone. Further observational study triangulated with qualitative research should be conducted to provide more strong evidence for further improvement of household latrine utilization status in East Gojjam Zone.

Cost effectiveness of community led total sanitation in Ethiopia and Ghana.

We conducted cost effectiveness analyses of four different CLTS interventions implemented in Ethiopia and Ghana. In each country, a pilot approach in which additional local actors were trained in CLTS facilitation was compared to the conventional approach. Data were collected using bottom-up costing, household surveys, and observations. We assessed variability of cost effectiveness from a societal perspective for latrine ownership and latrine use outcomes in different contexts. Cost effectiveness ranged from $34–$1897 per household ($5.85–$563 per person) gaining access to a private latrine or stopping open defecation, depending on the intervention, context, and outcome considered. For three out of four interventions, CLTS appeared more cost effective at reducing open defecation than at increasing latrine ownership, although sensitivity analysis revealed considerable variation. The pilot approaches were more cost effective at reducing open defecation than conventional approaches in Ethiopia, but not in Ghana. CLTS has been promoted as a low-cost means of improving the ownership and use of sanitation facilities. In our study, the cost of CLTS per household gaining latrine access was slightly higher than in other studies, and the cost of CLTS per household stopping OD was slightly lower than in other studies. Our results show that aggregate measures mask considerable variability in costs and outcomes, and thus the importance of considering and reporting context and uncertainty in economic analysis of sanitation interventions.

Hygienic Practice during Complementary Feeding and Associated Factors among Mothers of Children Aged 6–24 Months in Bahir Dar Zuria District, Northwest Ethiopia, 2019

Introduction. Breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and therefore food is needed. Microbiologically contaminated food is particularly harmful for children &lt;2 years of age. There is scanty of information on hygienic practice and associated factors during complementary feeding among mothers of children aged 6 to 24 months in the country, particularly in the study setting. Objective. The study was aimed to assess hygienic practices and associated factors during complementary feeding among children aged 6 to 24 months in Bahir Dar Zuria District, Northwest Ethiopia. Methods. A community-based cross sectional study was conducted from March 20 to April 20, 2019. A multistage sampling technique was used to select the study participants. Data were collected using the structured interviewer administered questionnaire. Bivariable and multivariable logistic regression analyses were used to identify the factors associated with hygienic practice during complementary feeding. Data were entered by using Epi Data version 3.1, and then it was exported to SPSS version 21 for analysis, and at 95% CI, p value &lt;0.05 was considered statistically significant. Result. Among 604 respondents, 235 (38.9%) of study participants had good hygienic practice during complementary feeding. Access to media (AOR: 8.8, 95% confidence interval (CI): 3.8–20.3), private latrine ownership (AOR: 4.11, 95% CI: 1.90–8.49), presence of hand washing facility at doorstep (AOR: 6.75 95% CI: 3.16–14.41), and residence of the study participants (AOR: 85.42, 95% CI: 1.94–15.2) were significantly associated with good hygienic practice of mothers during complementary feeding. Conclusion. Majority of mothers had poor hygienic practice during complementary feeding. Attitude of mothers, access to media, household private latrine ownership, presence of handwashing facility, and residence of the study participants were significantly associated with hygiene practice of mothers during complementary feeding. The health sector should train mothers on good hygiene practices during complementary feeding.

Design of Sewerage System and Wastewater Treatment Plant in Asemrowo, Surabaya, Indonesia

Asemrowo sub-district is a high-risk area in terms of environmental health. 1113 households in Asemrowo Subdistrict still defecate (BAB) openly. In Asemrowo sub-district 89.6% of the community has a private latrine. This article attempts to design a domestic sewage and wastewater treatment plant in Asemrowo District based on Surabaya City Regulation Number 12 of 2016 concerning Water Quality Management and Wastewater Control. Meanwhile, the effluent quality refers to the Regulation of the Minister of Environment and Forestry of the Republic of Indonesia number 68 of 2016 concerning domestic wastewater quality standards. The processes of the design includes acquiring primary data from field observations, distributing community questionnaires with random sampling of 105 respondents and analyzing the quality of wastewater for references in the wastewater treatment plant (WWTP) design. The domestic wastewater distribution system uses Shallow Sewerage which is divided into 4 blocks. The diameter of the wastewater pipe used in this plan is 114 mm, 140 mm, 216 mm and 267 mm. WWTP used in blocks A, B and C use Aerobic Biofilter and Clarifier. As for WWTP block D, it uses Aerobic Biofilter.

Community-level epidemiology of soil-transmitted helminths in the context of school-based deworming: Baseline results of a cluster randomised trial on the coast of Kenya.

Most epidemiological studies of soil-transmitted helminth (STH) infections focus on school-going children. The majority of large-scale cross-sectional and longitudinal community-based studies have been conducted prior to the implementation of wide-scale mass drug administration (MDA). This study investigates age-related patterns in prevalence and intensity of STH infection, and associated risk factors, in a region of south coastal Kenya that had previously received three consecutive years of school-based deworming (2012–14) and four rounds of community-based MDA for lymphatic filariasis between 2003 and 2014. Between March and May 2015, a cross-sectional survey was conducted in 120 community clusters as a baseline for a cluster randomised trial. Individuals aged two years and above were randomly selected during household surveys and requested to provide stool samples, which were assessed for presence and intensity of STH using the duplicate Kato-Katz thick smear method. Species-specific predictors of presence and intensity were investigated through multilevel logistic regression and zero-inflated negative binomial regression models. Of the 19,684 individuals who provided a stool sample, 21.5% were infected with at least one STH. Hookworm was the predominant species, with an overall prevalence of 19.1%; Trichuris trichiura prevalence was 3.6% and Ascaris lumbricoides was negligible (0.4% prevalence). The vast majority were light intensity infections. Prevalence and intensity of hookworm infection were significantly higher in adults and males, and were associated with environmental conditions, low socio-economic status, household flooring, individual and household water, sanitation and hygiene (WASH) characteristics and behaviours, previous treatment, lack of shoe-wearing and not attending school. In contrast, T. trichiura was more commonly found in school-aged boys and those living in communities close to the coast, with reduced infection in the least poor individuals with private latrine access. Overall, results show that despite several years of school-based deworming, hookworm infection remains common among untreated adults in this population, suggesting that this strategy alone is insufficient to reduce community-wide hookworm infection and in the longer term to eliminate transmission.Trial registrationClinicalTrials.gov NCT02397772

What motivates open defecation? A qualitative study from a rural setting in Nepal.

IntroductionOpen defecation is ongoing in Nepal despite the rise in efforts for increasing latrine coverage and its use. Understanding the reasons for open defecation would complement the ongoing efforts to achieve the ‘open defecation free’ status in Nepal. This study aimed at exploring different motivations of people who practice open defecation in a village in Nepal.MethodsThis study was conducted among the people from the Hattimudha village in Morang district of eastern Nepal, who practiced open defecation. Maximum variation sampling method was used to recruit participants for 20 in-depth interviews and 2 focus group discussions. We adopted a content analysis approach to analyze the data.ResultsWe categorized different reasons for open defecation as motivation by choice and motivation by compulsion. Open defecation by choice as is expressed as a medium for socializing, a habit and an enjoyable outdoor activity that complies with spiritual and religious norms. Open defecation by compulsion include reasons such as not having a latrine at home or having an alternative use for the latrine structures. Despite having a private latrine at home or access to a public latrine, people were compelled to practice open defecation due to constraints of norms restricting latrine use and hygiene issues in general. For women the issues with privacy and issues refraining women to use the same latrine as men compelled women to look for open defecation places.ConclusionOpen defecation is either a voluntary choice or a compulsion. This choice is closely linked with personal preferences, cultural and traditional norms with special concerns for privacy for women and girls in different communities. The ongoing campaigns to promote latrine construction and its use needs to carefully consider these factors in order to reduce the open defecation practices and increase the use of sanitary latrines.

Prevalence of Soil Transmitted Helminthes Infections and its Determinants among Primary School Children in Gena Bossa Tiworeda, Ethiopia: Cross-Sectional Study

Background: Soil-Transmitted Helminths (STH) infection is a major public health problem among school-aged children in developing countries. In Ethiopia, school-aged children have been identified as a high-risk group of population to be infected with Soil Transmitted Helminthes. Effective prevention and control of STH infection require the identification of risk factors among high-risk groups. Therefore, the aim of this study was to assess the prevalence of Soil Transmitted Helminthes infections and its determinants among primary school children in Gena Bossa Woreda, Ethiopia. Methods: Cross-sectional study was conducted in Gena Bossa Woreda, Ethiopia. The data were collected using pre-tested and structured questionnaires. Simple random sampling technique was used. Data analysis was done by SPSS for Windows Version 20.0. Bivariate and Multivariate logistic regressions analyses were conducted. p-value <0.05 was used to declare statistically significant variables. Result: About 303 (97.7%) of the study subjects participated in the study. Above one-third (38.3%) of the study, participants were tested positive for at least one of the STH species. lumbricoides (42.1%) was the predominant parasite followed by Hookworms (37.4%) and T. trichiura (11.2%). Lack of private latrines (AOR=4.12, 95% CI: 1.64 and 3.37), not wearing shoes always (AOR=1.80, 95% CI: 1.01, 3.23), age of children (5 to 10 years) (AOR=2.43, 95%, CI: 1.42 and 4.16) and not knowing causative agents of STH infection (AOR=2.60, 95% CI: 1.37 and 4.93) were found to be determinants of Soil Transmitted Helminthes Infections. Conclusion: Lack of private latrines, not wearing shoes always, age of children (5 to 10 years) and not knowing causative agents of STH infections were found to be major determinants of STH Infections. Therefore; public health policymakers and stakeholders working in the area should focus their intervention against STH infections on integrated control programs including regular health education on children ’ s shoes wearing habits, raising awareness of school children and their families on STH infections and promoting private latrines in every household.

Impact of social capital, harassment of women and girls, and water and sanitation access on premature birth and low infant birth weight in India.

BackgroundGlobally, preterm birth (PTB) and low infant birth weight (LBW) are leading causes of maternal and child morbidity and mortality. Inadequate water and sanitation access (WASH) are risk factors for PTB and LBW in low-income countries. Physical stress from carrying water and psychosocial stress from addressing sanitation needs in the open may be mechanisms underlying these associations. If so, then living in a community with strong social capital should be able to buffer the adverse effects of WASH on birth outcomes. The objective of this study is to assess the relationships between WASH access and social conditions (including harassment and social capital) on PTB and LBW outcomes among Indian women, and to test whether social conditions modified the association between WASH and birth outcomes.Methods and findingsThis cohort study examined the effect of pre-birth WASH and social conditions on self-reported PTB status and LBW status for 7,926 women who gave birth between 2004/2005 and 2011/2012 Waves of the India Human Development Survey. PTB and LBW occurred in 14.9% and 15.5% of women, respectively. After adjusting for maternal biological and socioeconomic conditions, PTB was associated with sharing a building/compound latrine (Odds Ratio (OR) = 1.55; 95% Confidence Interval (CI) = 1.01, 2.38) versus private latrine access, but suggested an effect in the opposite direction for sharing a community/public latrine (OR = 0.67; CI = 0.45, 1.01). Open defecation, type of drinking water source, minutes per day spent fetching water, and one-way time to a drinking water source were not associated with PTB. LBW was associated with spending more than two hours per day fetching water compared to less than two hours (OR = 1.33; CI = 1.05, 1.70) and suggested an association with open defecation (OR = 1.22; CI = 1.00, 1.48), but was not associated with other types of sanitation, type of drinking water source, or time to a drinking water source. Harassment of women and girls in the community was associated with both PTB (OR = 1.33; CI = 1.09, 1.62) and LBW (OR = 1.26; CI = 1.03, 1.54). The data also showed a possible association of local crime with LBW (OR = 1.30; CI = 1.00, 1.68). Statistically significant (p<0.05) evidence of effect modification was only found for collective efficacy on the association between type of sanitation access and PTB. In addition, stratified analyses identified differences in effect size for walking time to the primary drinking water source and PTB by crime, sanitation access and PTB by harassment, and total hours per day fetching water and LBW by collective efficacy. Limitations of this observational study include risk of bias, inability to confirm causality, reliance on self-reported outcomes, and limited sub-group sample sizes for testing effect modification.ConclusionsThe relationship between adverse birth outcomes and sanitation access, domestic water fetching, crime, and gender-based harassment suggests physical and psychosocial stress are possible mechanisms by which WASH access affects PTB and LBW among Indian women. Interventions that reduce domestic responsibilities related to water and sanitation and change social norms related to gender-based harassment may reduce rates of PTB and LBW in India.

Intestinal parasites from public and private latrines and the harbour canal in Roman Period Ephesus, Turkey (1st c. BCE to 6th c. CE)

To improve our knowledge of the parasite species affecting the inhabitants of Roman period Asia Minor, we analysed faecal material from Ephesus, Turkey. Mineralised material from the drain from a private house latrine (3rd c. CE), sediment samples from the sewer drain of a public communal latrine (6th c. CE), and sediment from the harbour canal (ca. 1st c. BCE to ca. 6th c. CE) were studied for the presence of intestinal parasites. Samples were viewed by light microscopy for helminth eggs, and commercial enzyme-linked immunosorbent assay (ELISA) kits were used to test for protozoal parasites that cause dysentery. Eggs of roundworm were found in the public latrine, whipworm in the house latrine, and both whipworm and roundworm in the harbour canal. Sequential sampling of the harbour core suggests that whipworm was by far the most common parasite throughout the Roman period, and there was no clear evidence for change in parasite species over the centuries. Whipworm and roundworm are both spread by the contamination of food and drink by human faeces. Despite the large number of travellers to Ephesus, as the capital of its province and a major port city in the Roman Empire, there was a surprising lack of diversity in parasite species found. This is especially apparent when we consider that ten species of intestinal parasite have been found across the Roman Empire. This is the first Roman site to be directly assessed for differences between infection in individuals using private latrines, public latrines, and mixed town effluent (in the harbour) at the same site.

The associations between water and sanitation and hookworm infection using cross-sectional data from Togo's national deworming program.

BackgroundSustainable control of soil-transmitted helminths requires a combination of chemotherapy treatment and environmental interventions, including access to safe drinking water, sufficient water for hygiene, use of clean sanitation facilities, and handwashing (WASH). We quantified associations between home-, school-, and community-level WASH characteristics and hookworm infection—both prevalence and eggs per gram of stool (intensity)—among Togolese school children in the context of community-based chemotherapy treatments administered in the country from 2010 through 2014.Methodology/Principal findingsWe analyzed data from two surveys conducted by the Togo Ministry of Health: a school-based survey of students aged 6–9 years across Togo conducted in 2009 and a follow-up survey in 2015, after four to five years of preventive chemotherapy. Data were available for 16,473 students attending 1,129 schools in 2009 and for 16,890 students from 1,126 schools in 2015. Between surveys, children in study schools received 0 to 8 rounds of deworming chemotherapy treatments. Few WASH conditions (only unimproved drinking water) were found to be significantly associated with the presence or absence of hookworms in an individual; however, quantitative eggs per gram of feces was associated with availability of unimproved drinking water, availability of improved drinking water either on or off school grounds, having a handwashing station with water available, and access to a sex-separate non-private or private latrine. The association between school WASH conditions and hookworm infection or burden often depended on the 2009 prevalence of infection, as more WASH characteristics were found to be significant predictors of infection among schools with high underlying endemicity of hookworm.Conclusions/SignificanceOur findings emphasize the complex and often inconsistent or unpredictable relationship between WASH and hookworm. Specifically, we found that while preventive chemotherapy appeared to dramatically reduce hookworm infection, WASH was associated with infection intensity.

Analysis of Domestic Waste Water Systems as a Sustainable Development Goals Achievement (SDGs) in Settlements in Bulak District, Surabaya City

Water is an essential substance for life because the body of living things mostlyconsists of water, except for living things in the form of seeds, and spores.Water used by humans undergoes changes in chemical and physical properties.The complex problem that is often overlooked by the government and society is domestic wastewater caused by population growth and building developments in the city of Surabaya. This study used an interview technique (with a questionnaire instrument) and observation interviews. From the results of direct observation and interviews found the number of families who have and use private latrines by 99 respondents and only one respondent who wearspublic toilet. 99.5% of respondents have sewerage and only 0.5% of respondents who do not have.

RELATIONSHIP EDUCATION, INCOME, KNOWLEDGE AND PUBLIC ATTITUDES WITH UTILIZATION OF COMMUNAL MCK

Environment sanitation, public and private communal latrines have been built in densely populated coastal areas with the aim to collect a means of bathing, washing, and toilet. The purpose of this research to determine the relationship of knowledge and attitudes about the use of communal latrines in fishermen settlement Kelurahan Teluk Kabung Selatan of Bungus Teluk Kabung District. Methods research is analytic with cross sectional design and the sample was of 150 people is the head of the family. The Korelasi statistical test indicated was known to have a significant correlation between knowledge society with the use of communal latrines and there is no correlation between people's education, revenue, and attitudes, to the use of Communal toilets. It is necessary to raise awareness to make the most of available Communal Communal MCK by way of extension about its importance to utilize Communal MCK for self health and environmental health.Keywords : Knowledge, Attitude, Utilization, Comunal MCK.

The effect of young children's faeces disposal practices on child growth: evidence from 34 countries.

To characterize the relationship between child faeces disposal and child growth in low- and middle-income countries. We analysed caregiver responses and anthropometric data from Demographic and Health Surveys (2005-2014) for 202614 children under five and 82949 children under two to examine the association between child faeces disposal and child growth. Child faeces disposal in an improved toilet was associated with reduced stunting for children under five [adjusted prevalence ratio (aPR)=0.90, 95% confidence interval (CI) 0.89-0.92] and a 0.12 increase in height-for-age z-score (HAZ; 95% CI: 0.10-0.15) among all households. Among households with improved sanitation access, practicing improved child faeces disposal was still associated with a decrease in stunting (aPR=0.94, 95% CI: 0.91-0.96) and a 0.09 increase in HAZ (95% CI: 0.06-0.13). Improved child faeces disposal was also associated with reductions in underweight and wasting, and an increase in weight-for-age z-score (WAZ), but not an increase in weight-for-height z-score (WHZ). Community coverage level of improved child faeces disposal was also associated with stunting, with 75-100% coverage associated with the greatest reduction in stunting. Child faeces disposal in an unimproved toilet was associated with reductions in underweight and wasting, but not stunting. Improved child faeces disposal practices could achieve greater reductions in child undernutrition than improving toilet access alone. Additionally, the common classification of child faeces disposal as 'safe' regardless of the type of toilet used for disposal may underestimate the benefits of disposal in an improved toilet and overestimate the benefits of disposal in an unimproved toilet.