Public Tap Research Articles

Helicobacter Pylori Infection: Epidemiological, Clinical and Endoscopic Aspects in Brazzaville

Introduction: Helicobacter pylori infection is a real health problem worldwide. It is the most common chronic bacterial infection in the world, and is particularly prevalent in developing countries. Objective: To determine the frequency of Helicobacter pylori infection and to study the epidemiological, clinical and endoscopic characteristics associated with this infection in Brazzaville. Patients and Methods: This was a descriptive cross-sectional study conducted from January to November 2020, i.e. 11 months. This work focused on 100 symptomatic patients over 18 years old referred for upper GI endoscopy. Gastric biopsies for biological study by urease test and molecular study by real time PCR technique were taken. Results: With a mean age of 46.32 ± 15.20 years, the frequency of Hp infection was 91%, with a female predominance of 53%. The sex ratio was 0.92. The average age was 46.32 ± 15.20 years. Carriage of the infection was more important in households with more than 3 persons, in patients consuming public tap water and in those using both types of sanitary facilities. Endoscopy was indicated for epigastralgia in 93.1% of cases. About 56.14% of the infected patients had normal mucosa versus 12.28% with ulcerated lesions and 22.81% with gastritis. Conclusion: The prevalence of Helicobacter pylori infection is significant in Congo, justifying early detection in order to improve management.

1182. Risk factors for colonization with extended-spectrum cephalosporin resistant and carbapenem resistant Enterobacterales among community adults, Bangladesh: An Antibiotic Resistance in Communities and Hospitals (ARCH) study

Abstract Background Antimicrobial resistant (AMR) organisms are an increasing global health threat that are spreading within communities. Understanding the risk factors for colonization with AMR organisms is critical for implementing prevention and control strategies, particularly in resource-limited settings such as Bangladesh. Methods During 2019, we conducted a population-based observational study in Dhaka (surveillance site of icddr,b). We collected stool samples from randomly selected adults and tested for Enterobacterales with extended-spectrum cephalosporin resistance (ESCrE) and carbapenem resistance (CRE) using selective media followed by VITEK-2 confirmation. Participants completed demographic surveys assessing food consumption, animal contact, sanitation, water sources, and healthcare exposure. We identified factors associated with ESCrE and CRE colonization using bivariable and multivariable logistic regression, adjusting for potential confounders and clustering. Results Of 714 enrolled individuals, 557 (78%) were colonized with ESCrE and 66 (9%) with CRE. In bivariable analysis, factors associated with ESCrE colonization included fresh fruit consumption in the past week (OR 1.8, 95% CI 1.2-2.9), public tap as main source of drinking water compared with basic improved source (OR 3.3, 1.0-11.0), and unimproved toilet (pour/flush to open drain, pit latrine without slab) compared with basic improved toilet (OR 11, 2.9-42.0). Only consumption of fresh fruit was significant in the multivariable analysis (aOR 2.0, 1.3-3.2). Factors associated with CRE colonization in bivariable analysis were hospitalization in the last 3 months (OR 3.2, 1.2-8.6), limited sanitation facility (improved toilet shared with other households) (OR 2.0, 1.0-3.8), and limited hygiene (availability of handwashing facility on premises without soap and/or water) (OR 3.3, 1.4-7.7). The only factor that was significant in multivariable analysis was hospitalization in the last 3 months (aOR 3.0, 1.0-8.7). Conclusion While ESCrE colonization is common in urban communities, hospitals may be contributing to community spread of CRE. Targeted interventions focused on healthcare facilities may be needed to mitigate the transmission of AMR organisms. Disclosures All Authors: No reported disclosures.

Access to basic drinking water services, safe water storage, and household water treatment practice in rural communities of northwest Ethiopia

Protecting water from cross contamination at source and point of use is an important strategy to improve water quality. However, water safety measures at the source and point of use may not be implemented in the rural communities. This community-based cross-sectional study was, therefore, conducted among 1190 randomly selected households in a rural setting of northwest Ethiopia to assess access to basic drinking water services, safe water storage, and household water treatment practices. Water service level was determined using JMP criteria and practices that prevent cross contamination of water at point of use were used to determine safe water storage. Results showed that 23.0% of the households had access to basic water services; 37.0% practiced safe water storage; and 15.4% practiced one or more household water treatment methods. Public taps (54.5%) and protected spring (25.1%) were the common water sources to rural communities in northwest Ethiopia. Boiling (43.2%), chlorination or water guard (26.8%), and plain sedimentation (23.0%) were among the household water treatment methods commonly practiced in the area. In conclusion, rural households in the studied region has low access to basic water services. Safe water storage practice was also low in the area and household water treatment is not commonly practiced.

Water, Sanitation, and Hygiene (WASH) Practices Among Households in Perambalur District: A Cross-Sectional Study.

Background Sanitation, cleanliness, and access to clean water are essential for maintaining human health and well-being. Poor water, sanitation, and hygiene (WASH) practices are linked to diseases that lead to poor health outcomes, such as pneumonia and diarrhea, trachoma, infestations of soil-transmitted helminths, respiratory tract infections, and pulmonary tuberculosis. The aim of this study is to evaluate household WASH practices in the rural and urban field practice areas of the Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, India, and identify the factors that influence them. Methodology We conducted a five-month cross-sectional survey with 278 households in the rural and urban field practice areas of a tertiary care center in Perambalur district. We gathered data using the core questions developed by the World Health Organization-United Nations Children's Fund (WHO-UNICEF) Joint Monitoring Programme (JMP), which is affiliated with UN-Water. Data analysts used a Pearson chi-square test to assess the relationship between WASH practices and several independent covariates, and we regarded P < 0.05 to be statistically significant. Results Amongthe 278 households, 118 respondents were from rural areas and 160 (57.7%) from urban areas. For drinking water, 31.4% of rural households used tube wells or boreholes, while 56.8% of those used public taps. In metropolitan areas, 25.6% of people used bottled water and 54.4% used water from tanker trucks. In terms of sanitation, 25.2% of households lacked a toilet and 72.7% used the flush/pour flush technique. Water, sanitation, and hygiene practices have been found to be associated with a population's socioeconomic status and place of residence. The Pearson chi-square test revealed that the rural population has 99.1% more improved drinking water sources than the urban population, which was statistically significant (P < 0.001). Conclusion In rural areas, nearly 92% of households used improved sources of drinking water compared to only 55% of households in urban areas. On the other hand, just 47.5% of households in the rural area had improved sanitationcompared to 95% of households in the urban area. Therefore, the Indian government should take steps to enhance urban drinking water quality and rural sanitation infrastructure.

Early Childhood Exposures to Fluorides and Child Behavioral Development and Executive Function: A Population-Based Longitudinal Study

It is important to both protect the healthy development and maintain the oral health of the child population. The study examined the effect of early childhood exposures to water fluoridation on measures of school-age executive functioning and emotional and behavioral development in a population-based sample. This longitudinal follow-up study used information from Australia’s National Child Oral Health Study 2012–14. Children aged 5 to 10 y at baseline were contacted again after 7 to 8 y, before they had turned 18 y of age. Percent lifetime exposed to fluoridated water (%LEFW) from birth to the age 5 y was estimated from residential history and postcode-level fluoride levels in public tap water. Measures of children’s emotional and behavioral development were assessed by the Strength and Difficulties Questionnaire (SDQ), and executive functioning was measured by the Behavior Rating Inventory of Executive Function (BRIEF). Multivariable regression models were generated to compare the associations between the exposure and the primary outcomes and controlled for covariates. An equivalence test was also conducted to compare the primary outcomes of those who had 100% LEFW against those with 0% LEFW. Sensitivity analysis was also conducted. A total of 2,682 children completed the SDQ and BRIEF, with mean scores of 7.0 (95% confidence interval, 6.6–7.4) and 45.3 (44.7–45.8), respectively. Those with lower %LEFW tended to have poorer scores of the SDQ and BRIEF. Multivariable regression models reported no association between exposure to fluoridated water and the SDQ and BRIEF scores. Low household income, identifying as Indigenous, and having a neurodevelopmental diagnosis were associated with poorer SDQ/BRIEF scores. An equivalence test confirmed that the SDQ/BRIEF scores among those with 100% LEFW were equivalent to that of those who had 0% LEFW. Exposure to fluoridated water during the first 5 y of life was not associated with altered measures of child emotional and behavioral development and executive functioning.

Water, Sanitation, and Hygiene (WASH) Practices and Outreach Services in Settlements for Rohingya Population in Cox's Bazar, Bangladesh, 2018-2021.

(1) Background: This study aimed to investigate the existing water, sanitation, and hygiene (WASH) policy and practice of the study population and strengthen the evidence base by documenting changes in the WASH policy and practice over 3 years of the Rohingya refugee humanitarian crisis, Cox’s Bazar, Bangladesh. (2) Methods: A cross-sectional surveillance design was followed; the sampling of the study population included the Rohingya refugee population and neighborhood host nationals who required hospitalization soon after seeking care and enrolled into the diarrheal disease surveillance in diarrhea-treatment centers. Throughout the study period of 3 years, a total of 4550 hospitalized individuals constituted the study participants. (3) Results: Among the hospitalized Rohingya refugee population; the use of public tap water increased significantly from 38.5% in year 1 to 91% in year 3. The use of deep tube well water significantly changed from 31.3% to 8.2%, and the use of shallow tube well water reduced significantly from 25.8% to 0.4%. Households using water seal latrine were 13.3% in year 1 and increased significantly to 31.7% in year 3. ORS consumption at home changed significantly from 61.5% in the first year to 82.1% in third year. Multivariable analysis demonstrated patients’ age groups at 5 to 14 years, and 15 years and more, drinking non-tube well water, soap use after using toilet, use of non-sanitary toilet facility, father’s and mother’s lack of schooling, and some and severe dehydration were significantly associated with the Rohingya refugee population enrolled into the diarrheal disease surveillance. (4) Conclusion: The findings indicate significant advances in WASH service delivery as well as outreach activities by aid agencies for the Rohingya refugee population living in settlements.

Mineral content variations between Australian tap and bottled water in the context of urolithiasis.

ObjectivesThe objective of this study is to investigate the variations in mineral content of tap drinking water across major Australian cities, compared with bottled still and sparkling water, and discuss the possible implications on kidney stone disease (KSD).Materials and MethodsThe mineral composition of public tap water from 10 metropolitan and regional Australian cities was compared using the drinking water quality reports published from 2019 to 2021 by the respective water service utilities providers. Specifically, average levels of calcium, bicarbonate, magnesium, sodium, potassium, and sulphates were compared with published mineral content data from bottled still and sparkling drinking water in Australia.ResultsThe median or mean (depending on report output) mineral composition was highly variable for calcium (range 1.3 to 20.33 mg/L), magnesium (range 1.1 to 11.2 mg/L), bicarbonate (range 12 to 79 mg/L), sodium (range 3 to 47.1 mg/L), potassium (range 0.4 to 3.23 mg/L) and (sulphates range <1 to 37.4 mg/L). Calcium, magnesium and bicarbonate levels in tap water were lower than in bottled sparkling water. Consumption of 3 L/day of the most calcium rich tap water would fulfil 4.7% of the RDI, compared with 8.7% with bottled sparkling water. Consumption of 3 L of the most magnesium rich tap water would fulfil 8% of the RDI, compared with 13.6% with bottled sparkling water.ConclusionThe mineral content of tap drinking water varied substantially across major Australian city centres. Bottled sparkling water on average provided higher levels of calcium, bicarbonate and magnesium and may be preferred for prevention of calcium oxalate stones. These findings may assist counselling of patients with KSD depending on geographic location in the context of other modifiable risk factors and 24‐h urine analysis results.

A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children.

Cryptosporidiosis is a major cause of diarrhoea in young children in low-and-middle-income countries. New interventions should be informed by evidence pertaining to risk factors and their relative importance. Inconsistencies in the literature may to some extent be explained by choice of methodology, furthermore, most previous risk factor studies compared cryptosporidiosis cases to diarrhoea cases of other aetiologies rather than with controls without diarrhoea. We investigated a broad set of factors in under-2-year-olds presenting with diarrhoea to a hospital and a health center in southwestern Ethiopia. We applied quantitative cut-offs to distinguish between cryptosporidiosis and incidental Cryptosporidium infection or carriage, a hierarchical causal framework to minimize confounding and overadjustment, and a case-case-control design, to describe risk factors for both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Moderate and severe acute malnutrition were strongly associated with both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Previous healthcare attendance and low maternal education were only associated with cryptosporidiosis, whereas unsafe child stool disposal, prematurity and early cessation of exclusive breastfeeding were significantly associated with non-cryptosporidiosis diarrhoea only. By estimation of population attributable fractions, socioeconomic factors-specifically low maternal education-and public tap water use, were apparently more important risk factors for cryptosporidiosis than for non-cryptosporidiosis diarrhoea. Nutritional management of moderate acute malnutrition may be an effective intervention against cryptosporidiosis, particularly if combined with targeted therapy for cryptosporidiosis which, again, may mitigate nutritional insult. Focused caregiver education in healthcare settings and follow-up of children with acute malnutrition may prevent or improve outcomes of future episodes of cryptosporidiosis.

Maximum, minimum and typical concentration of copper, iron, lead and zinc that can be leached in tap water

Lead, copper and iron are the contaminants whose concentrations are most likely to exceed the recommended values ​​due to the corrosion of drinking water distribution system materials. This work studies the maximum, minimum and typical concentration of copper, iron, lead and zinc that can be leached in public tap water in Niamey (Niger). Thus, water samples were taken at the outlet of twelve taps after water stagnation for six hours and after water stagnation for six hours followed by a five-minute drain at maximum flow. For the evaluation of typical concentrations, two half-liters of water are sampled randomly during the day without stagnation or prior emptying. The samples of the first liters taken after a stagnation of 6 hours are more concentrated in metals (from 1 to 12 times) than the samples taken after a draining of 5 minutes. Concentrations of iron and lead generally exceed WHO guideline values. The evaluation of the typical concentration of Cu, Fe, Pb and Zn showed that 91.66% and 16.66% of the analyzed samples exceeded the respective guide values ​​for Pb and Fe. The typical concentrations of Zn and Cu in water taken from the same taps are in line with WHO guideline values.

The &lt;i&gt;Vox&lt;/i&gt; Phenomenon in the Culture of Contemporary Spain

Collective monograph published in Barcelona in 2019 under the title Las respuestas a las 10 grandes preguntas que todos nos hacemos sobre Vox (Answers to the 10 biggest questions we ask about Vox) was edited by John Müller, journalist of the Spanish newspaper El Mundo. John Müller gathered a powerful team of nine researchers and journalists competent in the issue to provide answers to the major questions about the right-wing populist party Vox, which derives its name from the Latin word for voice. The book written in scientific-journalistic style comprises ten chapters, an introduction, and a conclusion. It opens with a sociological image of Vox partisans. The party is traditionally supported by the region of Andalusia where it first made itself known and widely recognized, as well as by the right-wing Spanish electorate. These voters are conservative-minded and disillusioned with the socialists and the People’s Party. The second chapter discusses the history of the Party, starting from its creation on December 17, 2013, by the former members of the People’s Party and its public presentation at a press conference in Madrid on January 16, 2014. Chapter 3 is devoted to the portrayal of the political leadership of the Party with an emphasis on its leader Santiago Abascal Conde. Born in Bilbao in 1976 into a family of prominent politicians, Santiago Abascal followed in his father’s and grandfather’s footsteps and joined the People’s Party, then in opposition. Because of the political work, namely their staunch position against the separation of the Basque Country and Catalonia from Spain, the family was threatened by the terrorist group ETA. The feeling of an imminent threat might account for another vein of Abascal’s political aspirations – the right to defensive gun use and ownership for the Spaniards. In this part of the book, Abascal is depicted as ultra-right and xenophobic, though Abascal denies such allegations. Chapter 4 analyses the reasons for the split in the People’s Party that gave rise to the Vox party. The intraparty struggle revolved around Basque separatism, terrorism, and taxation issues. Further on the authors investigate the ideology of right-wing populism in Spain and explain the reasons for its wide support, the economic policy of neoliberalism, similar to Franco’s one, and tax cuts for large businesses among them. The book is based on Abascal’s public speeches and taps into the works of prominent political scientists.

Water quality of improved water sources and associated factors in Kibuku District, Eastern Uganda.

Globally, billions of people still lack access to safe water, including basic drinking water services, particularly in sub-Saharan Africa. We analyzed water quality for improved water sources and associated factors in Kibuku district, Eastern Uganda. The mixed-methods study employed included; water quality analysis, a questionnaire survey, and key informant interviews conducted in the months of April–June 2020. A total of 249 improved water sources were sampled for analysis of bacteriological quality, pH, and electrical conductivity. This was followed by a sanitary and people’s attitudes survey at all the water sources visited. Among the water sources, 62.3% deep boreholes, 63.5% public tap stands, 14.3% rain-water harvesting tanks, and 28.6% protected springs had zero thermotolerant coliforms with 63.8% having acceptable pH levels (6.5–8.5) and 35.3% having acidic levels (less than 6.4). Furthermore, 96.3% deep boreholes, 99.1% public tap stands, all (100%) rain-water harvesting tanks, and 50% protected springs had their turbidity levels in the acceptable range (less than 5NTUs). Additionally, only 22.1% of improved water sources had electrical conductivity in the acceptable range (less than 300 microSiemens). Among the 249 participants, majority (91.2%) had low knowledge levels about various methods that can be used in improving the quality of water. Generally, water sources had poor quality of water which was attributed to agricultural activities, dirty water collection containers, and poor attitude to water chlorination. The Ministry of Health, Ministry of Water and Environment, and other agencies need to design sustainable and feasible models for water treatment for low resourced setting.

Impact of water dispenser establishment on drinking water availability and health status of peri-urban community

Declining water level, owing to indiscriminate exploitation of ground water, most of the areas of Patna, Biharis facing water crisis during summer season. In this line, several initiatives have been undertaken by different Govt. organizations, companies, NGOs and other foundations. This study is focussed on assessing the impact of water dispenser on availability and accessibility of fresh drinking water, health-related aspects and sustainability. The survey was conducted in Suitha village located in sub-district Phulwarisharif of Patna district in Bihar. A total 80 households, selected through random sampling were interviewed by using a semi-structured interview schedule. Results showed that after establishment of the water dispenser, majority (62.5%) of the respondents use this facility and the dependency on public tap reduced considerably. Moreover, purchasing of water from market was completed ended after the intervention. Earlier, water was used in housework, drinking, bathing and others work but after the intervention, it is only being used for drinking and household purpose. It was found that gender is an important variable in use of water from the water discharge unit. Overall reduction of 6.11 per cent on medical expenses was observed and no patients were affected from water borne diseases like cholera and diarrhoea since the intervention. Most of the respondents(40%) were highly satisfied with the water dispenser installation.

If you Build it, will they come? Use of Rural Drinking Water Systems in the Peruvian Amazon

While organisations across the world struggle to extend access to the 522 million living in rural areas without clean water, those who do have access do not necessarily use it. This paper explores why, within areas that have public taps with treated water, some individuals continue to use water from untreated sources. We focus on non-use of available rural water supply systems as well as inconsistent use, a phenomenon typically overlooked. Based on surveys in 12 rural communities with water systems in the Peruvian Amazon and qualitative interviews, this study finds community meeting attendance is important for consistent use as attendance increases social influence and reinforces information about the importance of clean water. Non-users are more likely to be those living furthest from the water source and with lower levels of education. Findings point to ways in which community approaches to heath interventions may be more likely to reach some – those with stronger ties to communities, who live closer and have higher levels of education – than others.

Cholera outbreak caused by drinking unprotected well water contaminated with faeces from an open storm water drainage: Kampala City, Uganda, January 2019

BackgroundKampala city slums, with one million dwellers living in poor sanitary conditions, frequently experience cholera outbreaks. On 6 January 2019, Rubaga Division notified the Uganda Ministry of Health of a suspected cholera outbreak in Sembule village. We investigated to identify the source and mode of transmission, and recommended evidence-based interventions.MethodsWe defined a suspected case as onset of profuse, painless, acute watery diarrhoea in a Kampala City resident (≥ 2 years) from 28 December 2018 to 11 February 2019. A confirmed case was a suspected case with Vibrio cholerae identified from the patient’s stool specimen by culture. We found cases by record review and active community case-finding. We conducted a case–control study in Sembule village, the epi-center of this outbreak, to compare exposures between confirmed case-persons and asymptomatic controls, individually matched by age group. We overlaid rainfall data with the epidemic curve to identify temporal patterns between rain and illnesses. We conducted an environmental assessment, interviewed village local council members, and tested water samples from randomly-selected households and water sources using culture and PCR to identify V. cholerae.ResultsWe identified 50 suspected case-patients, with three deaths (case-fatality rate: 6.0%). Of 45 case-patients with stool samples tested, 22 were confirmed positive for V. cholerae O1, serotype Ogawa. All age groups were affected; persons aged 5–14 years had the highest attack rate (AR) (8.2/100,000). The epidemic curve showed several point-source outbreaks; cases repeatedly spiked immediately following rainfall. Sembule village had a token-operated water tap, which had broken down 1 month before the outbreak, forcing residents to obtain water from one of three wells (Wells A, B, C) or a public tap. Environmental assessment showed that residents emptied their feces into a drainage channel connected to Well C. Drinking water from Well C was associated with illness (ORM–H = 21, 95% CI 4.6–93). Drinking water from a public tap (ORM–H = 0.07, 95% CI 0.014–0.304) was protective. Water from a container in one of eight households sampled tested positive for V. cholerae; water from Well C had coliform counts ˃ 900/100 ml.ConclusionsDrinking contaminated water from an unprotected well was associated with this cholera outbreak. We recommended emergency chlorination of drinking water, fixing the broken token tap, and closure of Well C.

Water, sanitation, and hygiene practices in secondary schools in the Buea Health District of Cameroon

This study assessed water, sanitation and hygiene practices in public and private secondary schools in Buea. A cross-sectional descriptive study was conducted from November 2017 to June 2018 in Buea. Students from Baptist High School Buea, Government Bilingual High School Muea, Buea, Government Technical High School Molyko, Buea and Summerset Secondary School Buea were assessed on water, sanitation and hygiene practices. Data were collected using questionnaire and direct observations. A total of 384 students were sampled, and probability proportionate to size was used to determine the sample size per school. The statistical software SPSS V20 and Microsoft Excel were used to analyze the data. Statistical significance was set at p < 0.05. Majority, 290 (75.5%), of the students were from public secondary schools; most, 314 (81.1%), of the students were from schools with secured space (fence). Using public tap as the main source of water was significantly associated with the type of school (X2=62.239, P=0.000). A greater proportion 285 (98.2%)[95%CI:96-99] of public secondary schools and 68 (72.2%)[95%CI:62-81] of private secondary schools do not have basic WASH facilities (wash stand, wash hand bolls, soap) closer to the toilet for use by the students. A greater percentage, 126 (43.6%)[95%CI:38-49], of students from public secondary schools and a majority, 59 (62.6%)[95%CI:52-73], from private secondary schools said water scarcity is the reason why they do not wash their hands after using the toilet. The results of this study show that there is inadequate water supply, poor sanitation and hygiene practices within the study area. Schools associations should collaborate and make available facilities like soap and toilet tissues and even construction of modern toilets in schools to foster the practice of hygiene activities. Key words: Water, sanitation, hygiene, students, private and public secondary schools.

Radioactive waste management ethics and public policy: a precautionary approach

Abstract. The focus of the project is on how to regulate risky technologies, both old (such as nuclear waste management) and new (such as geoengineering). Thus, the project is aimed at contributing to a better understanding of the ethical, political, and socio-economic aspects of radioactive waste management-related risks. The goal of the project is to contribute to the current discussions on the case of the expansion of the Hungarian Nuclear Power Plant. The Paks II project allows us to present how to set up procedures where some radioactive waste-related risks will not derail decision-makers and how they can be held accountable by the public. The case of Paks II is also compelling; as of today there are only 19 countries in the world that are in the process of new reactor building (World Nuclear Association, 2021). The project is aimed at providing and defending a precautionary approach to radioactive waste management because it involves high levels of uncertainty and the possibility of causing irreversible harm on a global scale. When investigating procedural principles of radioactive waste management policies by three types of precautionary approaches, the project will look at risks that stem from the displacement of politics in public consultations in relation to large infrastructural projects. The practices of the emerging era of public engagement tap into the current debates on democratic politics in political theory with the emergence of deliberative democracy (Bohman and Rehg, 1997; Dryzek, 2000; Gutmann and Thompson, 2009), and radical democracy (Laclau and Mouffe, 2001; Mouffe, 1999, 2000). Specific attention will be paid to the fragmentation of public along with technical and non-technical, local and national, site-specific and general issues, and the role of different political platforms (public exhibition events, consultation documents, and public engagement sessions) in the way in which the political is displaced from the arena of public inquiries to legal challenges and debates about boundaries and geographies.

What are the determinants of childhood infections in India's peri-urban slums? A case study of eight cities.

BackgroundRespiratory Tract Infections (RTIs) and Gastro-Intestinal (GI) infections are the leading causes of child mortality and morbidity. This study investigates the associations between the individual, household and slum-level determinants of children’s health and vulnerability to RTIs and GI infections in peri-urban slums in India; an area of research interest at the Childhood Infections and Pollution Consortium.MethodsThe 2015–16 Indian National Family Health Survey was used for data analysis on children aged 0–5 years. NFHS-4 includes data on slums in eight Indian cities, including Delhi, Meerut, Kolkata, Indore, Mumbai, Nagpur, Hyderabad, Chennai. The outcome variables, having fever and cough (FeCo) and diarrhoea in the last two weeks, were used to define the phenotype of infections; for this analysis fever and cough were measures of RTIs and diarrhoea was used to measure GI infections. Exposures considered in this study include variables at the individual, household and slum level and were all informed by existing literature. Multilevel models were used to estimate the association between exposures and outcomes variables; a prior of Cauchy distribution with a scale of 2.5 was selected when building the multilevel logistic models.ResultsThe total sample size of the number of children included in the analysis was n = 1,424. Data was imputed to account for missingness, and the original and imputed sample showing similar distributions. Results showed that diarrhoea and FeCo were both found to be more present in younger children than older children by a few months. In fixed effects, the odds of developing FeCo were higher if the mother perceives the child was born smaller than average (AOR 4.41, 1.13–17.17, P<0.05) at individual level. On the other hand, the odds of the diarrhoea outcome were lower if the child was older (AOR 0.97, 0.96–0.98, P<0.05) at individual level, and household’s water source was public tap or standpipe (AOR 0.54, 0.31–0.96, P<0.05) at household level.ConclusionThe determinants of health, both social and related to health care, at all levels demonstrated linkages to child morbidity in RTIs and GI infections. The empirical evidence highlights the need for contextualised ideas at each level, including one health approach when designing interventions to improve child health.

Socio-Economic Inequalities in Access to Drinking Water among Inhabitants of Informal Settlements in South Africa.

While evidence from several developing countries suggests the existence of socio-economic inequalities in the access to safe drinking water, a limited number of studies have been conducted on this topic in informal settlements. This study assessed socio-economic inequalities in the use of drinking water among inhabitants of informal settlements in South Africa. The study used data from “The baseline study for future impact evaluation for informal settlements targeted for upgrading in South Africa.” Households eligible for participation were living in informal settlements targeted for upgrading in all nine provinces of South Africa. Socio-economic inequalities were assessed by means of multinomial logistic regression analyses, concentration indices, and concentration curves. The results showed that the use of a piped tap on the property was disproportionately concentrated among households with higher socio-economic status (concentration index: +0.17), while households with lower socio-economic status were often limited to the use of other inferior (less safe or distant) sources of drinking water (concentration index for nearby public tap: −0.21; distant public tap: −0.17; no-tap water: −0.33). The use of inferior types of drinking water was significantly associated with the age, the marital status, the education status, and the employment status of the household head. Our results demonstrate that reducing these inequalities requires installing new tap water points in informal settlements to assure a more equitable distribution of water points among households. Besides, it is recommended to invest in educational interventions aimed at creating awareness about the potential health risks associated with using unsafe drinking water.

Cholera outbreak in Forcibly Displaced Myanmar National (FDMN) from a small population segment in Cox's Bazar, Bangladesh, 2019.

Bangladesh experienced a sudden, large influx of forcibly displaced persons from Myanmar in August 2017. A cholera outbreak occurred in the displaced population during September-December 2019. This study aims to describe the epidemiologic characteristics of cholera patients who were hospitalized in diarrhea treatment centers (DTCs) and sought care from settlements of Forcibly Displaced Myanmar Nationals (FDMN) as well as host country nationals during the cholera outbreak. Diarrhea Treatment Center (DTC) based surveillance was carried out among the FDMN and host population in Teknaf and Leda DTCs hospitalized for cholera during September-December 2019. During the study period, 147 individuals with cholera were hospitalized. The majority, 72% of patients reported to Leda DTC. Nearly 65% sought care from FDMN settlements. About 47% of the cholera individuals were children less than 5 years old and 42% were aged 15 years and more. Half of the cholera patients were females. FDMN often reported from Camp # 26 (45%), followed by Camp # 24 (36%), and Camp # 27 (12%). Eighty-two percent of the cholera patients reported watery diarrhea. Some or severe dehydration was observed in 65% of cholera individuals. Eighty-one percent of people with cholera received pre-packaged ORS at home. About 88% of FDMN cholera patients reported consumption of public tap water. Pit latrine without water seal was often used by FDMN cholera individuals (78%). Vigilance for cholera patients by routine surveillance, preparedness, and response readiness for surges and oral cholera vaccination campaigns can alleviate the threats of cholera.

Analisis Kebutuhan Sarana dan Prasarana Kawasan Kumuh di Kabupaten Sambas

As a result of the COVID-19 Pandemic Outbreak, proper living for slum dwellers has become increasingly difficult, the income level of the population has decreased so that areas where slum areas were not identified at first may increase the spread of their territory. According to the Decree of the Regent of Sambas Number 872 / BAPPEDA of 2014 concerning the Determination of the Location of Housing and Slum Settlements in Sambas Regency, the slum settlement area covering an area of ​​75.77 ha is spread over 3 sub-districts covering 4 villages. Namely Pendawan Village, Tanjung Bugis Village in Sambas District, Penjajab Village, Penjajab District and Sekura Village, Sekura District. Of the 4 villages that occupy the largest area for slum areas is Tanjung Bugis Village with an area of ​​23.05 ha (30.42%). This study aims to identify the factors that cause slum areas in Sambas Regency, identify facilities and infrastructure, especially environmental roads, garbage, wastewater and housing, analyze the needs for facilities and infrastructure from the data obtained in the form of roads, to, clean water and housing. This research was conducted deductively, so that the researchers departed from theory to go into the field in conducting data searches which were then expected to analyze the facilities and infrastructure needs of the slum area in Sambas City. .From the results of this study, it is found that the factors that cause slum are insufficient income of Rp. 500,000 - Rp. 1,000,000.00, the last education is very low elementary school (elementary school) and the number of families between 3-5 people. Meanwhile, from the analysis of the need for facilities and infrastructure, appropriate technology is needed for community water sources that still use public taps, environmental roads use concrete rebates but many are still damaged, drainage channels are not there if the water is not smooth or jammed while the trash can is not owned, especially TPS (Temporary Disposal Site) for garbage.