Hygiene Promotion Research Articles

Relationship between Covid-19 School Reopening Managerial Strategies and Effective Administration of Post Basic Schools in Adamawa State

This study examined the relationship between COVID-19 School Reopening Managerial Strategies and Effective Administration of Post Basic Schools in Adamawa State, Nigeria. Three research questions and three hypotheses guided the study. The population of the study comprised 322 principals and 5734 classroom teachers in Post Basic Schools in Adamawa State, giving a total population of 6056. The sample size is 705 comprising of 130 principals and 575 teachers. This study adopted a correlational research design. Two self-structured instruments were used for data collection for the study. The two two self-structured questionnaires tagged “Covid-19 School Reopening Managerial Strategy Questionnaire (COVID-19 SRMSQ) and “Effective Administration of Post Basic Secondary Schools Questionnaire” (EAPBSQ) were used in collecting data for the study. Cronbach Alpha Statistic was used to ascertain the internal consistency of the items of the instruments. An overall reliability coefficient of 0.86 and 0.83 were obtained for the both instruments. Descriptive statistics of mean and standard deviation were used to answer the research questions using the real limit of numbers. The Pearson Product Moment Correlation Coefficient was used to test the null hypotheses 1 & 2. While, Multiple Regression Analysis was in testing hypothesis 3. The findings of the study revealed that there is significant relationship between wearing of face mask and effective administration of Post Basic Schools in Adamawa State (r – value = 0.304, p <0.05). There is a significant strong correlation between adherence to social distance and the effective administration of post-basic schools in Adamawa State (r = 0.543, p < 0.05). The results revealed that wearing face mask and adherence to social distance are significant predictors of effective administration of Post Basic Schools in Adamawa State, F(5, 703) = 33055.330, p < 0.05. Since the p – value (0.000) is less than 0.05 alpha level, we can conclude that the null hypothesis should be rejected. This means that wearing face mask and adherence to social distance significantly predict effective administration of Post Basic Schools in Adamawa State. Based on the findings of the study, the following recommendations among others were made; government should make provision for free face mask to teachers, students and visitors within the school premises so as to further curtail the spread of the dreaded covid-19 pandemic within schools and its host community. Government should make provision for safety materials (hand sanitizers; also known as hand antiseptic, hand disinfectant, alcohol-based hand sanitizers, hand rub, soap and water) for promotion of better hygiene (hand Sanitization) culture in secondary school in the state for the purpose of removing common pathogens (disease-causing organisms) in order to remove all types of germs from hands.

Facilitating hand hygiene in displacement camps during the COVID-19 pandemic: a qualitative assessment of a novel handwashing stand and hygiene promotion package

BackgroundHandwashing with soap is critical for the prevention of diarrhoeal diseases and outbreak related diseases, including interrupting the transmission of COVID-19. People living in large displacement settings are particularly vulnerable to such outbreaks, however, practicing handwashing is typically challenging in these contexts.MethodsWe conducted a qualitative assessment of the implementation of a combined intervention to facilitate handwashing behaviour in displacement camps and in surrounding communities in Bangladesh, Ethiopia and the Democratic Republic of Congo during the COVID-19 pandemic. The intervention comprised a ‘hardware’ infrastructural component (provision of the Oxfam Handwashing Station) and a ‘software’ hygiene promotion package (Mum’s Magic Hands). We used programmatic logbooks, interviews with implementation staff and focus group discussions with crisis-affected populations to assess the use, feasibility and acceptability of the intervention.ResultsBoth components of the intervention were viewed as novel and appealing by implementing staff and crisis-affected populations across the study sites. The acceptability of the handwashing station could be improved by redesigning the tap and legs, exploring local supply chain options, and by providing a greater number of facilities. The implementation of the hygiene promotion package varied substantially by country making it challenging to evaluate and compare. A greater focus on community engagement could address misconceptions, barriers related to the intuitiveness of the handwashing station design, and willingness to participate in the hygiene promotion component.ConclusionsThe combination of a ‘hardware’ and ‘software’ intervention in these settings appeared to facilitate both access and use of handwashing facilities. The acceptability of the combined intervention was partially because a great deal of effort had been put into their design. However, even when delivering well-designed interventions, there are many contextual aspects that need to be considered, as well as unintended consequences which can affect the acceptability of an intervention.

1192. Containment of Sustained Transmission of Drug-resistant Acinetobacter baumannii by Pulsed-Xenon Ultraviolet Disinfection of the Patient Room in the Intensive Care Unit

Abstract Background No-touch environmental disinfection has been highlighted in the last decade to control transmission of multidrug-resistant Gram-positive organisms including MRSA and VRE, but its effectiveness to control gram-negative bacteria has not been well examined. Also, its effectiveness outside the US healthcare setting is seldom reported. Methods This study was conducted in the intensive care unit (ICU) of Yamagata University Hospital, a 637-bed tertiary referral hospital. Sporadic acquisition of two drug-resistant Acinetobacter baumannii (2DRA) began in late 2013. Despite various infection control practices including hand hygiene promotion and intensified manual terminal cleaning, transmission of this pathogen continued. In February 2018, pulsed-xenon ultraviolet (PX-UV) disinfection was added. The study periods were defined as follows: the baseline period (August 2016 to January 2018, intensified manual cleaning) and the intervention period (February 2018 to December 2021, addition of PX-UV). Throughout the study periods, all patients were regularly screened for 2DRA to detect acquisition of those pathogens in the ICU. Results The incidence of newly acquired 2DRA significantly declined over time (4.45 per 1,000 patient days in the baseline period to 1.20 in the intervention period, relative risk (RR): 0.27, 95% confidence interval: 0.12-0.61). Notably, horizontal transmission of 2DRA was completely contained, not only in the ICU but also throughout the hospital (Figure). Newly acquired 2DRA events (all wards, monthly) Conclusion Adding PX-UV after through manual terminal cleaning is effective in controlling acquisition of 2DRA in the ICU patients and led to termination of transmission of 2DRA in our hospital. The effectiveness of PX-UV in controlling gram-negative MDROs in the non-US healthcare settings is suggested. Disclosures All Authors: No reported disclosures.

Assessing Sustainability Factors for Rural Household Sanitation Coverage in Bhutan, Kenya, Nepal, and Zambia: A Qualitative Analysis.

Few countries are likely to achieve universal sanitation within the next decade as sustaining household sanitation coverage remains a critical challenge. This study aimed to investigate factors that may have supported or hindered sustainability of sanitation coverage 1-2 years after the completion of an integrated, area-wide sanitation program in 4 countries. We conducted qualitative analyses to identify factors related to the sustainability of sanitation coverage in Bhutan, Kenya, Nepal, and Zambia, 2 years after completion of the Sustainable Sanitation and Hygiene for All program. From November 2019 to March 2020, we conducted focus group discussions and key informant interviews with community members, project implementers, and decision makers. We triangulated the qualitative findings with data from household surveys to characterize subnational sanitation coverage throughout implementation and 1-2 years after. Our data revealed behavioral, contextual, and service delivery factors that were related to the sustainability of sanitation improvements. Service delivery factors included follow-up hygiene promotion, access to construction materials, local government commitment postimplementation, functioning monitoring systems, private sector uptake of supply chain improvements, and capacity for innovation. Contextual and behavioral factors included poverty, soil type, road networks, social cohesion, desire for improved latrines, maintenance and cleaning, and knowledge of sanitation benefits. The presence or absence of sustainability factors identified through this research may have implications on where certain programmatic approaches will work and where adaptations may be required. By comparing sustainability factors with subnational slippage rates, we were able to illustrate how local service delivery systems may respond to barriers and enablers. Understanding the programmatic and contextual factors that either drive or hinder long-term sanitation coverage may allow for greater program impact through adapting implementation based on existing challenges in service delivery and context.

School-based Hygiene Intervention to Prevent HelicObacter Pylori infection among childrEn (SHIP HOPE): protocol for a cluster-randomised controlled trial

IntroductionHelicobacter pylori infection rates are high in China and worldwide, and maintaining good hygiene is effective in preventing H. pylori infection. Childhood is a critical stage for developing good hygiene...

Evolution in the incidence of infectious diseases in the pediatric ENT area during the COVID-19 pandemic

IntroductionSARS COV-2 infection is an emerging disease that has become a global pandemic since the beginning of 2020. To reduce transmission, measures have been imposed by governments such as home confinement, the use of masks, social distancing or promotion of hand hygiene. The aim of this study is to determine if the measures adopted to reduce the COVID-19 pandemic have produced a decrease in the incidence of infectious diseases and their complications in the ENT area in our center. Material and methodsA retrospective descriptive study was carried out in a tertiary hospital of patients aged between 0 and 15 years who required admission due to deep cervical infections, complications derived from acute otitis media (mastoiditis or facial paralysis) or complicated acute sinusitis. ResultsThere is a notable decrease in the number of global admissions in the COVID period (9) compared to the average of the previous 5 years (20.1). Likewise, there are statistically significant differences in the number of admissions for cervical infections (p value=0.027) and complications derived from acute otitis media (p value=0.029). Discussion/conclusionA decrease in the number of admissions caused by complications of infections in the ENT area in paediatric patients has been observed after the start of the COVID-19 pandemic in our environment, this fact could be explained by a global decrease in the number of infections of the upper respiratory tract due to the hygienic measures taken by the COVID-19 pandemic.

EFFECT OF HYGIENE SANITATION AND PROMOTION ON PURCHASE DECISIONS AT FAVELA SUNSET CAFE BOGOR

Cleanliness and sanitation are the most important things that must be considered to ensure that the products served to customers are safe and free from various viruses and bacteria. These issues, Hygiene Sanitation, and promotion must be considered by food and beverage entrepreneurs to increase the interest of buyers. The purpose of this study was to determine whether or not Hygiene Sanitation and Promotion influenced the purchase decisions at Favela Sunset Cafe Paledang, Bogor. The research method used is quantitative research. The data analysis used in this study consisted of multiple linear regression analysis with SPSS V 20.0. The result of the study concluded that the Effect of Hygiene Sanitation and Promotion on Purchase Decisions at Favela Sunset Cafe Paledang Bogor had a positive and significant influence.

Evaluation of water supply, sanitation and hygiene facilities in Ekosodin Community of Ovia North-East LGA, Benin City, Edo State, Nigeria

Globally, poor access to improved water and sanitation remains a major contributing factor to high morbidity and mortality rates among the populace. Thus, access to water supply and sanitation is essential for sustainable development. In this study, a cross sectional descriptive survey method was adopted. Data were collected via questionnaires and observational checklist which were designed to extract information on Water, Sanitation and Hygiene (WASH). The data were then, analysed using Statistical Package for the Social Sciences (SPSS Version 26.0). Four hundred and twenty (420) semi-structured questionnaires were administered to households in Ekosodin Community. Three hundred and ninety seven (397) copies were retrieved and thus analysed. Results indicated that 374 (94.2%) households reported having access to water and that borehole was their main source of water supply. Over 130 (32.7%) household reported not treating their water before use. Types of toilet facilities frequently use by households were water closet system (flush toilet) 243 (61.2%) and pit latrine 85 (21.4%). However, households practice open defecation at low levels 6 (1.5%). Solid waste disposal methods mainly adopted by households are: open dumpsite 224 (56.4%) and burning 150 (37.8%). Majority of the households cleaned their water storage containers every six months or annually. Results further revealed that most of the respondents 382 (96.2%) practice hand washing after toilet 82 (20.65%), before cooking 79 (19.89%), before eating 55 (13.85%) and every other time 94 (23.6%) excluding the aforementioned, after cooking, after eating and after handling children’s faeces. It was observed that 243 (57.9%) houses have no drainage system, 237 (56.4%) have no waste storage facility, 312 (74.3%) have refuse dumpsite and 354 (84.3%) did not have odour of excreta in the surrounding. It was deduced from this study that households have poor access to adequate WASH facilities/services. Hence, it is recommended that water supply infrastructures, sanitation infrastructures and promotion of hygiene should be enhanced in order to improve access to adequate WASH facilities/services in the community.

Evolución de la incidencia de las enfermedades infecciosas del área ORL en edad pediátrica durante la pandemia COVID-19

IntroductionSARS COV-2 infection is an emerging disease that has become a global pandemic since the beginning of 2020. To reduce transmission, measures have been imposed by governments such as home confinement, the use of masks, social distancing or promotion of hand hygiene. The aim of this study is to determine if the measures adopted to reduce the COVID-19 pandemic have produced a decrease in the incidence of infectious diseases and their complications in the ENT area in our center. Material and methodsA retrospective descriptive study was carried out in a tertiary hospital of patients aged between 0 and 15 years who required admission due to deep cervical infections, complications derived from acute otitis media (mastoiditis or facial paralysis) or complicated acute sinusitis. ResultsThere is a notable decrease in the number of global admissions in the COVID period (9) compared to the average of the previous 5 years (20.1). Likewise, there are statistically significant differences in the number of admissions for cervical infections (P = .027) and complications derived from acute otitis media (P = .029). Discussion/conclusionA decrease in the number of admissions caused by complications of infections in the ENT area in paediatric patients has been observed after the start of the COVID-19 pandemic in our environment, this fact could be explained by a global decrease in the number of infections of the upper respiratory tract due to the hygienic measures taken by the COVID-19 pandemic.

Effect of video- assisted teaching on knowledge regarding early detection and prevention of cervical cancer among women

Cancer is the second most common disease in India responsible for maximum mortality with about 0.3 million deaths per year. This is owing to the poor availability of prevention, diagnosis and treatment of the disease. Almost 9 out of 10 deaths occur from cervical cancer in less developed countries. Cancer of the cervix is largely preventable. The risk can be minimized by promotion of sexual risk reduction behavior and genital hygiene. Further prevention can be achieved by screening, using Visual Inspection with Acidic Acid (VIA) or Pap smear test, which can detect precancerous lesions early so as to prevent progress towards invasive cancer by timely treatment. A pre-experimental, One-group pre-test post-test design was undertaken for the study. 300 women were selected as the sample, Non- probability convenient sampling technique was utilized to select the sample from the population. After assessing knowledge video assisted teaching was implemented. After intervention on 7th day the post-test knowledge was assessed. Chi-square was used to measure the association of background variables of patients. ‘t’ test was used to assess the effectiveness of structured interventional programme of the patients. In the comparison between mean pretest and posttest knowledge score it is clear that during the pretest the knowledge score was poor (40%), fair ( 10%), good ( 40%) and excellent ( 10%), and after the administration of video assisted teaching, posttest was done and there was an improvement in the knowledge score of the female by poor (0%), fair (16.7%), good (23.3%) and excellent was( 60%), so there was a great difference in the knowledge score between the pre-test and posttest. The mean pretest knowledge score was 13.67 ± 7.66, while the posttest knowledge score was 23.80 ± 5.53 and the computed t value was found to be 19.105, The difference was found to be statistically significant. There will be significant association between the pretest knowledge score and selected demographic variables at the level of P≤ 0.05. is accepted as there is significant association between pretest knowledge score and selected demographic variables like religion, marital status, Age of women at marriage, no. of times they have conceived, methods of contraception’s, educational status, occupation, kinds of addiction, recurrent infections, history of cancer in family, previous information regarding cancer, history of pap test. The study recommended the utilization of video assisted teaching programme by community health nurses, nurse researchers, nurse administrators, nurse educators and health care professionals to improve knowledge of early detection of cervical cancer.

Community toilets management strategies in promotion of public hygiene in municipality ward of Meru, Kenya

Rapid population growth has significantly contributed to inadequate sanitation facilities especially in slums. The inadequacy in sanitation facilities results to poor hygiene thus promote spread of sanitation-related diseases such as diarrhea. This study investigated sanitation management strategies for promotion of public hygiene in slums. Three slums in Meru Municipality ward, namely, Mjini, Shauri Yako, and Majengo were identified as the target population for the study. Mixed methods approach was adopted in sampling. Each slum was treated as a cluster. Data was collected from 79 heads of households within the clusters and 5 key informants from the Municipality ward who included a municipal manager, assistant chief, Public Health Officer, MEWASS director, and Caritas director. The heads of the households were proportionally selected randomly from the clusters as determined using Fisher’s formula. Qualitative data was collected from the key informants. Quantitative data was analyzed using the Statistical Package for Social Sciences (SPPS) version 25 to generate frequency tables while qualitative data was presented thematically. The findings showed poor sanitation and hygiene status of the slum dwellers due to the lack of good sanitation facilities that could enable them dispose their excreta effectively. The study showed that 86% of the slum population did not access adequate sanitation facilities where 5.1% used flying toilets and other 1.3% used bucket latrines. The correlation between comfortability of toilet users and the use of toilets with flies and odour was 0.351(P=0.000) thus comfortability to use sanitation facilities in the slums depended on the status of the toilets. The correlation between presence of caretakers for slum toilets and maintenance of toilets was 0.478 with a p-value of 0.000. The correlation between willingness to pay for sanitation services and the type of toilets provided was 0.094 (p=0.035). Presence of flush water and absence of flies in toilets registered a correlation coefficient of 0.350 (p=0.000). The study recommended consideration of better strategies to enhance better living conditions amongst the slum dwellers lacking access to adequate sanitation services. Further, the government need to put in place policies and regulations to ensure adequate water supply, sanitation and hygiene to the slum dwellers.

The effect of a large-scale water, sanitation and hygiene intervention in Bangladesh on knowledge, behaviour and health: Findings from an endline programme evaluation.

The Sanitation, Hygiene Education and Water Supply in Bangladesh Programme (SHEWA-B) was a 5-year intervention aiming to improve water, sanitation and hygiene (WASH) practices among 20 million rural residents through community hygiene promoters. This analysis evaluates the impact of SHEWA-B on knowledge, behaviour and childhood diarrhoea outcomes. The evaluation included repeated cross-sectional surveys and health surveillance in matched cohorts in intervention and control clusters. Cross-sectional surveys and structured observations at baseline, midline, and endline assessed the availability of WASH technology, caregiver knowledge and behaviour. Fieldworkers collected monthly health data in a subset of control and intervention households to determine the prevalence of diarrhoea. Of 5091 households surveyed, participants residing in intervention clusters showed minimal improvements in knowledge, reported behaviour, or use of WASH technology compared to the control clusters. During structured observations, intervention households increased more than control households at handwashing before preparing food and after cleaning a baby's anus when comparing endline to baseline, but these changes were not seen when comparing endline to the midline. The prevalence of childhood diarrhoea remained similar in both groups before (10.2% in intervention, 10.0% in control) and after (8.8% in intervention, 11.7% in control) midline changes were made to improve the intervention. Intervention clusters showed no improvement in diarrhoea over time compared to control clusters. SHEWA-B's community-based WASH promotion did not yield the intended impact on knowledge, behaviour or health. Greater priority should be given to approaches that have demonstrated effectiveness. Including rigorous evaluations would broaden the evidence base to support and improve large-scale programmes.

Compliance of Nurses with Hand Hygiene Guidelines in Tripoli University Hospital, 2019

Abstract Background Health care-associated infections (HAIs) result in high morbidity, decreased personal satisfaction, and mortality. Implementing infection prevention and control strategies such as hand hygiene (HH) promotion is critical to reduce the risk of the HAI and protect patients. Aims This study aimed to determine the compliance rate of HH among nurses in Tripoli University Hospital (TUH, previously known as Tripoli Medical Center). Method A cross-sectional study was conducted in different departments at TUH, starting from May 1st to October 31st, 2019. An observational checklist based on the “five moments for hand hygiene” of World Health Organization (WHO) was used. There were 271 nurses who interacted with 1,213 patients, a total of 3,452 HH episodes, and 6,065 cases of HH that were collected in this study, and data were statistically analyzed. Results The overall HH compliance rate was 56.9%. Most of the nurses (86%) preferred to use HH after contact with individual patients and 71.6% after contact with patients' environment. There was, however, low percentage of HH prior to patient contact (35.1%). The compliance rate was higher among nurses of the age group of less than 20 years (60.8%), non-Libyan (60.7%), and those who received formal training (60.5%). Conclusion In general, the HH compliance rate was low among nurses working in TUH. Education is an important factor that impacts the practice of HH pre- and postpatient contact. Wider studies that include assessment of pre- and posteducation courses should be conducted in the future.

How are hygiene programmes designed in crises? Qualitative interviews with humanitarians in the Democratic Republic of the Congo and Iraq

BackgroundHygiene behaviour change programmes are complex to design. These challenges are heightened during crises when humanitarian responders are under pressure to implement programmes rapidly despite having limited information about the local situation, behaviours and opinions—all of which may also be rapidly evolving.MethodsWe conducted in-depth interviews with 36 humanitarian staff involved in hygiene programme design in two crisis-affected settings—one a conflict affected setting (Iraq) and the other amid a cholera outbreak (Democratic Republic of the Congo). Interviews explored decision-making in each phase of the humanitarian project cycle and were thematically analysed.ResultsParticipants considered the design and implementation of hygiene programmes in crises to be sub-optimal. Humanitarians faced sector-specific challenges as well as more general constraints associated with operating within the humanitarian system. Programme-design decisions were made naturalistically and relied heavily on the intuitions and assumptions of senior staff. National organisations were often side-lined from programme design processes despite being in a better position to gather situational data. Consequently, programme design and decision-making processes adopted by humanitarians were similar across the two settings studied and led to similar types of hygiene promotion activities being delivered.ConclusionHygiene programming in crises-affected settings could be strengthened by initiatives targeted at supporting humanitarian staff during the pre-implementation programme design phase. This may include rapid assessment tools to better understand behavioural determinants in crisis-affected contexts; the use of a theory of change to inform the selection of programme activities; and funding mechanisms which encourage equitable partnerships, phased programming, regular adaptation and have programmatic components targeted at sustainability and sector capacity building. Initiatives aimed at sector reform should be cognisant of inter and intra-organisational dynamics, the ways that expertise is created and valued by the sector, and humanitarian habits and norms that arise in response to system constraints and pressures. These micro-organisational processes affect macro-level outcomes related to programme quality and acceptability and determine or limit the roles of national actors in programme design processes.

Prevalence of Insomnia among university students in the United Arab Emirates

The aim of the present study was to determine the prevalence of insomnia among three United Arab Emirates (UAE) university students, of different majors; namely, Ajman University, University of Sharjah and the American University of Sharjah from March 2021 to June 2021, through comparing components of everyday behavioral activities with their sleep patterns and overall sleep quality. The questionnaire was distributed in two forms; online via the Planet Survey Website and paper-based. Three hundred and eighty out of four hundred, with 95% response rate, UAE university students, 48.7% males and 51.3% females, average aged 24 years completed a questionnaire on insomnia that includes sociodemographic, the Pittsburg Sleep Quality Index (PSQI) and lifestyle details. Most of the participants were Muslims (95.5%), 74.5% of them were Arabs, 94.3% were singles and 91.6% were full-time students. The resultant prevalence of insomnia among the students was assessed by three criteria. These are, time to fall asleep, quality of sleep and respondents with and without problem sleeping. With respect to time to fall asleep, 51.8% of respondents needs ≥ 30 minutes to fall asleep, 29.2% of them were females and 22.6% males. Regarding quality of sleep, both genders scored almost identical figures of 19.5% and 2% for fairly and bad quality of sleep respectively. With respect to problem sleeping, 37.9% of respondents were having problem sleeping, 22.4% of them females and 15.5% males. Our results identified some significant relations between some sleep disorders and behavior or diseases. Nightmares had a significant relation with listening to rap music (p<0.031), play with cell phone or tablet before sleeping (p <0.023), drinking tea and coffee (p<0.004), energy drinks (p<0.034) take a medicine to promote sleeping (p <0.017), as well as allergic rhinitis (p<0.009). Whereas falling experience had a significant relation with listening to pop music (p<0.018), play with cell phone or tablet before sleeping (p<0.009) and diseases like hypothyroidism (p<0.009) and diabetes (p<0.009). On the other hand, spinning room experience had a significant relation with cardiac diseases (p<0.019), take a medicine to promote sleeping (p<0.003), hyperthyroidism (p <0.009) and listening to rap music (p<0.015). The results also identified that sleep-walk had a significant relation with listening to rock music (p<0.050), and rap music (p< 0.035) before bed. Whereas sleep-talk had a significant relation with asthma (p<0.048) and hypertension (p< 0.034). This study provides preliminary data on sleep quality and risk factors for insomnia, which may be used to guide sleep hygiene promotion and intervention among university students.

610 A Case Report of Furuncular Myiasis Affecting the Glans Penis of a Young Boy Caused by the Larvae of Cordylobia Anthropophaga (The Tumbu Fly)

Abstract Introduction Cutaneous myiasis is endemic in West Africa, and it is most commonly caused by the larvae of Cordylobia anthropophagia. In English literature, there has been no recorded case of this cutaneous myiasis affecting the glans penis. Its rarity calls for a need to consider this as a differential when looking at furuncular lesions of the glans penis. This awareness is important for practitioners who may come across this case. We report a case of furuncular myiasis of the glans penis due to the larvae of C.anthropophaga of an 11-year-old boy living in Lagos, Nigeria. Case presentation We present an 11-year-old boy who presented to the surgical department with a lesion on his glans penis, initially thought to be a boil. Upon examination, the lesion contained a single larva of C.anthropophaga. It was extracted in the minor theatre with a non-toothed forceps, and the area healed well following discharge. (Pictures of extracted larvae are available upon request). Discussion Although endemic, furuncular myiasis of the glans penis is a very rare condition, likely related to the living circumstance of the patient. An awareness of the clinical features is important so as to prevent misdiagnoses of foruncular lesions that occur on the glans penis, especially in people with identified risk factors. Health education and promotion of good hygiene are important in reducing the incidence of Cordylobia anthropophagia infestation.

The Meaning of "Hygiene" and Its Linked Practices in a Low-Income Urban Community in Bangladesh.

Improving hygiene practices is considered to be the single most cost-effective means of reducing the global health burden of infectious diseases. Hygiene promotion and disease prevention interventions often portray and promote “hygiene” from a biomedical perspective, which may not be optimally effective for achieving their goal of changing people’s behaviors. This study aimed to educe the meaning of hygiene for the residents of a low-income community in Bangladesh and how that meaning shapes their personal hygiene practices. We conducted this study in the Tongi township in Dhaka, Bangladesh, from September 2014 to June 2016. The research team purposively selected 24 households. The team conducted day-long observations using the participant observation approach and in-depth interviews with specific members of the 24 households. The concept of “hygiene” had two separate meanings to the study participants: cleanliness and holiness. The participants reported that cleanliness was required to remove odors, grease, hot spices and dirt. The motivation for cleanliness was to feel fresh, avoid heavy feelings, feel light and feel comfortable. To maintain the holiness of the body, bathing and ablution needed to be performed following particular religious rules/rituals. The motivation of holiness was derived from their accountability to God. The participants also reported that the cleansing processes and methods for the body and the home for cleanliness reasons were also different from those for holiness reasons. The notion of “hygiene” was multidimensional for the residents of the low-income urban community in Bangladesh. Our study participants did not explicitly conceptualize a notion of hygiene that was based on the germ theory of diseases but rather a notion that was based on individual physical comfort and cultural belief systems. Future studies on the prevention of hygiene-related diseases should combine and link the biomedical aspect to religious and cultural rituals to promote improved hygiene practices.

EP-257 A case report of Furuncular myiasis affecting the glans penis of a young boy caused by the larvae of Cordylobia anthropophaga (The Tumbu Fly)

Abstract Introduction Cutaneous myiasis is endemic in West Africa, and it is most commonly caused by the larvae of Cordylobia anthropophagia. In English literature, recorded cases of this cutaneous myiasis affecting the glans penis are rare. This rarity calls for a need to consider this as a differential when looking at furuncular lesions of the glans penis. This awareness is important for practitioners who may come across this case. We report a case of furuncular myiasis of the glans penis due to the larvae of C.anthropophaga of an 11-year-old boy living in Lagos, Nigeria. Case presentation We present an 11-year old boy who presented to the surgical emergency department with a lesion on his glans penis, initially thought to be a boil. Upon examination, the lesion contained a single larva of C.anthropophaga. After sedation of the patient, It was extracted in the mini-theatre with a non-toothed forceps and dressed, and the area healed well. Discussion Although endemic, furuncular myiasis of the glans penis is a very rare condition, likely related to the living circumstance of the patient. An awareness of the clinical features is important to prevent misdiagnoses of foruncular lesions that occur on the glans penis, especially in people with identified risk factors. Health education and promotion of good hygiene are important in reducing the incidence of Cordylobia anthropophagia infestation in endemic regions as well as among frequent travelers to and from endemic areas. Keywords myiasis, cutaneous myiasis, Cordylobia anthropophagia, glans penis, Tumbu fly

Strategies to Improve Dental Hygiene and Oral Health of 5-15-year-old Students: A Systematic Review

School is the most cost-effective and easiest way to access 5-15-year-old children. Owing to the development of permanent teeth, the increasing prevalence of dental caries, and the formation of social life, these children are the main target group in oral hygiene promotion programs. The present study aimed to evaluate the effect of interventional strategies on improving oral health and dental hygiene of 5-15-year-old students. Electronic search in Scopus, PubMed, Science Direct, Springer, and Biomed Central databases was performed using English keywords, and the studies that were conducted on educational interventions to improve oral health, dental hygiene, prevention, and control of caries among students between January 2004 and March 2021 were reviewed. Thirteen selected studies were divided into two categories: educational interventions based on self-care behaviors and prevention services (fluoride varnish and fissure sealant) and educational interventions based on self-care behaviors. Interventions that included continuing the intervention, involved parents and school staff in the program, used a combination of several educational methods and used preventive services were associated with greater success in enhancing knowledge, health behaviors, reducing plaque, and tooth decay. Continuation of group education, combined use of educational programs, follow-up, and the use of behavior change models and provision of preventive services are the best ways to design and plan an intervention to improve oral health and dental hygiene in elementary school students.

Sanitation Pattern and its Impact on Child in Relation to their Diarrheal Disease of two Upazilla under Satkhira District

The sanitation pattern is not so good in rural areas of Bangladesh. About 2.2 million children died of diarrhea disease around the world and these deaths represent approximately 15% of all child deaths under the age of five in developing countries. For this study, two rural areas of Satkhira District of Bangladesh were selected. The information was collected from households that had children under 5 years old. The majority of the locals are illiterate and impoverished. They have a low income and are not well aware of sanitation and children’s diarrhea. Most people use tubewell water for drinking purposes and others use ponds, rivers and hand pump water for domestic purposes. Water, sanitation, and hygiene interventions reduce diarrheal disease on average by between one-quarter and one-third. New sanitary solutions are required, and the process of acquiring latrines and sewers must be facilitated and supported both legislatively and financially. Public authorities must continue to be responsible for the provision of water that is free of fecal contaminants. In the private domain, hygiene promotion should focus on the elimination of human stools from the domestic environment. We should ensure safe sanitation, clean water and a hygienic environment for children and their survival.
 Environ. Sci. & Natural Resources, 13(1&2): 100-109, 2020