Safe Disposal Research Articles

A multisectoral approach to medication safety in Kuwait using the take-back campaign

Background: The take-back campaign, which focuses on enhancing public awareness, safe medication disposal practices, stakeholder engagement and patient participation was used to promote medication safety in Kuwait. Aim: To evaluate the effectiveness of the take-back campaign in promoting medication safety in Kuwait. Methods: The campaign was implemented systematically through several stages of planning, communication and coordination among several stakeholders. This social media campaign encouraged individuals from the participating healthy cities to bring unwanted medications to designated collection centres. Returned medications were categorized based on the British National Formulary and data analysis was conducted using Excel. Consultations were held at the collection sites to increase patient confidence in medication compliance and safety. The medications were sorted and disposed safely. Results: The take-back campaign lasted 56 hours over a period of one month. It successfully engaged 405 households and collected 1005 kg of medication, comprising 7648 items, over a period 6 working days. Fifty-seven percent of the medications collected through the campaign originated from the Ministry of Health and 43% from the private sector. Fifty-two percent had expired and 59% were in solid dosage form. Painkillers comprised the largest group (18%) among the returned medications. Conclusion: The take-back campaign effectively raised awareness about medication safety and provided a safe disposal mechanism for unused and expired medications. This campaign has provided a foundation for future initiatives and contributed significantly to improving medication safety and public health outcomes in Kuwait.

NON-CARCINOGENIC VCI SOLUTION FOR LONG TERM METAL PROTECTION

Corrosion is a dangerous and extremely costly problem. Because of it, buildings and bridges can collapse, oil pipelines break, chemical plants leak, and bathrooms flood. Corroded electrical contacts can cause fires and other problems, corroded medical implants may lead to blood poisoning, and air pollution has caused corrosion damage to work around the world. Corrosion threatens the safe disposal of radioactive waste that must be stored in containers for tens of thousands of years. When reduction and oxidation take place on different kinds of metal in contact with one another, the process is called galvanic corrosion. In electrolytic corrosion, which occurs most commonly in electronic equipment, water or other moisture becomes trapped between two electrical contacts that have an electrical voltage applied between them. The result is an unintended electrolytic cell. VCI is the generic term for “volatile corrosion inhibitor” a revolutionary technology that simplifies corrosion protection and is ideal for keeping enclosed void spaces (e.g., packages, equipment internals, or structural metal cavities) rust-free. Keywords: Corrosion; VCI; Rust.

KNOWLEDGE, ATTITUDE, AND PRACTICE ABOUT STORAGE AND SAFE DISPOSAL OF UNUSED MEDICINES AMONG MEDICAL AND DENTAL PERSONNEL: ECOPHARMACOVIGILANCE PERSPECTIVE

Objective: This study aimed to evaluate the knowledge, attitudes, and practices related to the storage and safe disposal of unused medicines among students at MGM Medical and Government Dental College, Indore, marking the first such assessment among this population. Method: A cross-sectional survey, approved by the Institutional Ethics Committee, utilized a questionnaire-based approach. Medical and dental students provided 509 responses, yielding a response rate of 96%. The pre-validated questionnaire, administered through Google Forms, encompassed sociodemographic details and sections on knowledge, attitudes, and practices. Statistical tools were employed for the analysis of response frequencies. Results: A response rate of 96% was achieved, with 509 participants providing insights. While participants exhibited awareness regarding medication expiry, storage conditions, and environmental contamination, a significant knowledge gap existed concerning standardized medication disposal methods. Despite a high acknowledgment (above 80%) of the reduction in efficacy post-expiry, safe drug disposal practices were found to be lacking. Conclusion: The prevailing practice of storing medicines at home until expiry, followed by disposal in the trash, persists despite awareness of the hazards associated with pharmaceuticals in the environment. This underscores a deficiency in knowledge and the absence of secure disposal methods. Respondents expressed a preference for evidence-based and environmentally friendly approaches to dispose of unwanted medications.

An Exploratory Study of Food Waste in the Hospitality Industry of Pokhara

One-third of the global food production is wasted globally. Food production is a resource intensive process and safe disposal of food wasted requires additional resources. In tourism industry food is just more than fulfillment of basic needs. Food is linked with the experience. Food wastage in hospitality is accepted as a major challenge with multifaced consequences and awareness to address the issue of food waste is also increasing. In the context of developing countries like Nepal the topic is still under-studied. Therefore, this study is focused on owners and managers perspective on food wastage in tourism industry of Pokhara with the objectives of identifying current composition and causes of food waste and established approaches to mitigate it. This study was carried out with key informants’ in-depth interview and on-site observations. Unrealistic expectations, unsustainable consumption patterns, lack of general public awareness and management limitations on wastage controlling were major themes identified by the study. The findings call for quantitative study in mass scale to know the exact situation of the food waste in hospitality industry of Pokhara.

Study on Ultra-Long-Distance Transportable Concentration Gradient of Coal Gangue Slurry with Different Gradations

Coal gangue, the primary solid waste generated during the coal mining process, is typically disposed of on the surface, where it gradually accumulates to form gangue piles that significantly contaminate the surrounding environment. Filling technology has been widely employed for the safe and efficient disposal of coal gangue due to its sustainability, safety, and efficiency. However, there is still a lack of theoretical research on the concentration of gangue slurry in long-distance filling pipeline transportation. Therefore, a calculation model of the ultra-long-distance transportable concentration of coal gangue slurry with different grades was constructed based on the static anti-segregation performance and Bingham model. In addition, the relevant parameters of the calculation model of the ultra-long-distance transportable concentration of coal gangue slurry in this mine were determined using the 8 km pipeline transport of coal gangue slurry in one mine as the technical background. It was subsequently demonstrated that the yield stress, plastic viscosity, and mass concentration of the various grades of gangue slurry in this mine exhibit an increasing exponential function, while the slurry density and mass concentration exhibit an increasing linear function, and the mass concentration and actual flow rate correspond to a quadratic polynomial increment. Finally, the minimum and maximum concentrations for different grades of gangue slurry that can be transported over long distances in this mine were determined. This work provides theoretical and practical guidance on how to select the concentration of gangue slurry for long-distance pipeline transport.

Treatment of chromium-containing sludge using sintering and ironmaking combined technology: A risk-reducing strategy for environmental impact

The efficient, safe and eco-friendly disposal of the chromium-containing sludge (CCS) has attracted an increasing concern. In this study, Co-processing of CCS was developed via employing sintering and ironmaking combined technology for its harmless disposal and resource utilization. Crystalline phase and valence state transformation of chromium (Cr), technical feasibility assessment, leaching risk, characteristics of sintered products, and pollutant release during CCS co-processing were investigated through a series of laboratory-scale sintering pot experiments and large scale industrial trials. The results showed that the content of Cr(VI) in sintered products first increased then decreased with increasing temperature ranges of 300 °C–800 °C, and reached a maximum of 2189.64 mg/kg at 500 °C. 99.99% of Cr(VI) can be reduced to Cr(III) at above 1000 °C, which was attributed to the transformation of the Cr(VI)-containing crystalline phases (such as, MgCrO4 and CaCrO4) to the (Mg, Fe2+)(Cr, Al, Fe3+)2O4. The industrial trial results showed that adding 0.5 wt‰ CCS to sintering feed did not have adverse effects on the properties of the sintered ore and the plant's operating stability. The tumbler index of sinter was above 78% and the leaching concentrations of TCr (0.069 mg/L) was significantly lower than the Chinese National Standard of 1.0 mg/L (GB5085.3–2007). The TCr contents of sintering dust and blast furnace gas (BFG) scrubbing water were less than 0.19 wt‰ and 0.11 mg/L, respectively, which was far below the regulatory limit (1.5 mg/L, GB13456-2012). The mass balance evaluation results indicated that at least 89.9% of the Cr in the CCS migrated into the molten iron in the blast furnace (BF), which became a useful supplement to the molten iron. This study provided a new perspective strategy for the safe disposal and resource utilization of CCS in iron and steel industry.

Microbial Application in Heavy Metal Removal from Pharmacological Industrial Effluent

In industrial effluents, significant amounts of metallic cations such as zinc, copper, iron, manganese, lead, nickel, and cadmium are present. Long-term irrigation with these effluents increases the amount of organic carbon and heavy metals in the soil, increasing the likelihood that they will enter the food chain and, eventually, result in significant bioaccumulation. Many techniques for the treatment and disposal of metal-containing wastes, such as ion exchange, reverse osmosis, in flotation, and evaporation, have been developed in order to reduce metal pollution issues. The main disadvantages of conventional treatments are low efficiency at low concentrations of heavy metals, expensive handling, and safe disposal of toxic sludge. In light of this, an effort has been made to investigate how tannery affects the growth of green gram.

Water, sanitation, and hygiene factors associated with nutrition status among children under five years in Ewaso Narok Wetland, Laikipia County, Kenya

Water, sanitation, and hygiene factors associated with nutrition status among children under five years in Ewaso Narok Wetland, Laikipia County, Kenya

Soil Stabilization Using Agricultural Waste (Wheat Husk, Rice Husk and Sugarcane Straw)

Abstract: For civil engineers, the safe disposal of both hazardous and non-hazardous waste is a challenge. This is because just a few states can securely deposit agricultural trash. This study includes studies on the safe disposal of agricultural wastes such as wheat husk (WH), rice husk (RH), and sugarcane straw (SCS). In this study, attempts were undertaken to improve soil quality by employing WH, RH, and SCS. The primary goal of ground improvement is to increase shear strength and reduce soil compressibility.The investigation was done utilizing the expansive soil by taking variable volumes, which are then mixed with the different stabilized material for Atterberg limit tests and California bearing ratio (CBR) test. These tests are tested and proven using the standard tests IS 2720, and it is ultimately decided that the test results improve the geotechnical qualities of the soil.

The public’s perceptions and behaviours towards household disposal of medicines and its effect on the environment: a cross-sectional survey study

Abstract Introduction Over a billion National Health Service (NHS) prescription medicines are issued by pharmacists in England every year at a cost of over £9 billion; however, a substantial proportion of these are never taken, with an estimated wastage of approximately £300 million. [1] Unwanted medicines should be returned to pharmacies for their disposal via a suitable waste contractor. This prevents inappropriate disposal which can lead to surface water contamination, harm to aquatic life and antimicrobial resistance, with pharmaceuticals also being present in drinking water worldwide. [2] Due to the magnitude of medicines which are never used by patients and their potential to impact negatively on the environment, there is a need to better understand the public’s perceptions and behaviours towards medicines disposal. Aim This study aimed to identify the public’s perceptions and behaviours related to the disposal of unwanted household medicines. Methods Data was collected through an anonymous self-completion on-line questionnaire containing closed questions distributed via X (formally Twitter). This was open for answers from the 19th December 2018 to 6th March 2019 to participants over the age of 18. Responses were coded and analysed using descriptive statistics. Results A total of 447 respondents completed the questionnaire, of which 65.5% (n=293) were female and 34.5% (n=154) were male. The age of participants ranged from 37.6% (n=164) being 18 - 34, 68.2% (n=207) being 35 - 54 years, and 17 % (n=76) being 55 years old and over. Unwanted medicines were returned to pharmacies by 30.5% (n=136) of respondents with a further 34% (n=152) disposing of these alongside household waste. Of the latter, 43.4% (n=66) threw solid preparations in the rubbish bin, with the disposal of liquids down the sink or toilet being carried out by 30.2% (n=46). Only 37.1% (n=168) of respondents reported receiving information on safe disposal of medicines, with almost half of these (49.4%, n=83) having this from a pharmacist. However, while 64.4% (n=292) were aware that they could return medicines to pharmacies, only 48.6% (n=142) of these reported to do so. Most participants (61.7%, n=275) stated that they would be interested in learning more about the impact of medicines on the environment, with 19.9% (n=89) being somewhat interested, and 16.3% (n=72) having no interest. Conclusion This study identified that the public’s behaviour when disposing of unwanted medicines contributes to pollution caused by pharmaceuticals. Returning medicines to pharmacies avoids this and could be better promoted by raising awareness and educating those who want to learn more about medicines and the environment. Pharmacists are a source of information about disposal of medicines and providers of a service to enable the public to do so, and can contribute to managing the way that pharmaceuticals are disposed of and their environmental impact. A small sample size and geographical area were limitations of this study, which could be overcome by further researching issues identified in this survey.

Impact of Educational Intervention on Pharmaceutical Waste Management in a Tertiary Care Teaching Hospital-Healthcare Staff Centered Study

Expired and unused medicines are potentially toxic substances that should be managed effectively to avoid accumulation of potentially toxic pharmaceuticals in the hospital and environment. This study aimed to identify and assess the disposal practices of pharmaceutical waste at tertiary care teaching hospital. A cross-sectional prospective questionnaire study was conducted for a period of six months at tertiary care teaching hospital with a sample size of 120. Healthcare professionals above the age of 18 years were included in the study. Data from the questionnaire was analyzed using appropriate statistical tools and Chi-square test. A pre and post educational intervention study was conducted among 120 participants. The study found that 90.83% (109) participants were under the age group of 18-25 years. Among them 77.5% (93) were female and 22.5% (27) were male. Before intervention only 80.8% (97) participants were aware of different types of bags used to dispose pharmaceutical waste, whereas after educational intervention 97.5% (117) are aware of bags used to dispose pharmaceutical waste (x2=0.000<0.001). Before intervention 55.83% (67) of participants were known of drug takeback system, after intervention 99.16% (119) known of drug takeback system (x2=0.000<0.001). Majority of the study participants agreed that safe pharmaceutical disposal practice is an important concern in both pre and post study. Hence awareness and concern regarding the problem is high. It was observed that the knowledge of healthcare staff about pharmaceutical waste management was good. We found that educational programs can improve staff awareness level on pharmaceutical waste management.

Toxoplasma gondii in a Remote Subsistence Hunting-Based Indigenous Community of the Peruvian Amazon

Toxoplasma gondii is a ubiquitous zoonotic protozoan parasite that infects a wide variety range of warm-blooded animals. This study describes the epidemiological scenario of T. gondii in an indigenous community that relies on subsistence hunting in a well-conserved and isolated area of the Peruvian Amazon. The high seropositivity against T. gondii in humans (83.3% IgG and 6.1% IgM), wild mammals (30.45%, 17 species), peri-domestic rodents (10.0% Rattus sp.), and domestic animals (94.1% dogs and 100% cats) indicates the existence of a sylvatic cycle in the community under study. Individual age was found to be positively associated with IgG detection against T. gondii but not with IgM. It is estimated that each family consumed 5.67 infected animals per year with terrestrial species having higher infective rates than arboreal species. The main risk factors included improper handling and cooking of wild meat, poor hygiene practices, and feeding uncooked offal to domestic animals. This scenario results in a continuous process of infection and reinfection within the indigenous community with cats, dogs, and peri-domestic animals becoming infected through the ingestion of infected raw viscera. Our results emphasize the need to promote safe food handling practices and disposal of waste materials from hunted animals in such communities.

Harnessing Geothermal Energy Potential from High-Level Nuclear Waste Repositories

The disposal of high-level nuclear waste (HLW) has been one of the most challenging issues for nuclear energy utilization. In this study, we have explored the potential of extracting decay heat from HLW, taking advantage of recent advances in the technologies to utilize low-temperature geothermal resources for the co-generation of electricity and heat. Given that geothermal energy entails extracting heat from natural radioactivity within the Earth, we may consider that our approach is to augment it with an anthropogenic geothermal source. Our study—for the first time—introduces a conceptual model of a binary-cycle geothermal system powered by the heat produced by HLW. TOUGHREACT V3.32 software was used to model the heat transfer resulting from radioactive decay to the surrounding geological media. Our results demonstrate the feasibility of employing the organic Rankine cycle (ORC) to generate approximately 108 kWe per HLW canister 30 years after emplacement and a heat pump system to produce 81 kWth of high-potential heat per canister for HVAC purposes within the same timeframe. The proposed facility has the potential to produce carbon-free power while ensuring the safe disposal of radioactive waste and removing the bottleneck in the sustainable use of nuclear energy.

Green biocatalyst for decolorization of azo dyes from industrial wastewater: Coriolopsis trogii 2SMKN laccase immobilized on recycled brewer's spent grain.

This study presents an innovative approach for the reuse and recycling of waste material, brewer's spent grain (BSG) for creating a novel green biocatalyst. The same BSG was utilized in several consecutive steps: initially, it served as a substrate for the cultivation and production of laccase by a novel isolated fungal strain, Coriolopsis trogii 2SMKN, then, it was reused as a carrier for laccase immobilization, aiding in the process of azo dye decolorization and finally, reused as recycled BSG for the second successful laccase immobilization for six guaiacol oxidation, contributing to a zero-waste strategy. The novel fungal strain produced laccase with a maximum activity of 171.4 U/g after 6 days of solid-state fermentation using BSG as a substrate. The obtained laccase exhibited excellent performance in the decolorization of azo dyes, both as a free and immobilized, at high temperatures, without addition of harmful mediators, achieving maximum decolorization efficiencies of 99.0%, 71.2%, and 61.0% for Orange G (OG), Congo Red, and Eriochrome Black T (EBT), respectively. The immobilized laccase on BSG was successfully reused across five cycles of azo dye decolorization process. Notably, new green biocatalyst outperformed commercial laccase from Aspergillus spp. in the decolorization of OG and EBT. GC-MS and LC-MS revealed azo-dye degradation products and decomposition pathway. This analysis was complemented by antimicrobial and phytotoxicity tests, which confirmed the non-toxic nature of the degradation products, indicating the potential for safe environmental disposal.

Pathogen inactivation from faecal waste via black soldier fly treatment

Sustainable development goal 6.2 advocates for increasing access to equitable and adequate hygiene and sanitation for all by 2030, and its indicator target is to raise the proportion of the population using safely managed sanitation. On the contrary, it is approximated that only 54% of people globally have access to safely managed sanitation, while 2.4 billion lack access. Recent innovations have however seen the development of low-cost technologies that can be customized depending on the region. The container based sanitation (CBS) is one of the options for safely managing the waste compared to conventional sewerage systems that are expensive. However, the need for emptying and transportation of filled fecal sludge (FS) containers on daily basis, leads to high operational costs and increases the operational exposures risks to fecal pathogens amongst the CBS operators. The study determined the performance efficiency of Black Soldier Fly Larvae in inactivation of E.coli via seeded container based sanitation- Urine diverting dry toilet model. Sample was transported to the lab for analysis of E.coli after every 3 days from Seeded households and samples from Non seeded households in replication. One gram of sample was used in serial dilution up to factor 5.The inoculum was plated in Tryptone Bile Glucuronic (TBX) agar for enumeration according to manufacturer’s instructions. Plates with 30-300 colonies were considered viable for counting. The study used statistical analysis IBM SPSS software from the sets of experiments. The E.coli (CFU/ml) mean varied between 7.3±1.3 and 10.1±2.8 for Seeded treatments while non-seed treatments ranged between 7.5±1.6 and 10.4±3.2. A significant variation occurred between the two treatments at p<0.05(SH and NH). Findings from this study showed that there was reduction of E.coli coliforms with Bioconversion of organic waste using the BSF technology has been noted to reduce the E.coli load and reducing the volume of the bio-waste. Sanitation policy makers can apply the findings of this study in formulation of policies on safe handling and disposal of fecal matter from onsite sanitation facilities.

Urbanization impact on groundwater quality of selected rural and urban areas in Ondo State, Nigeria using Water Quality Index

Groundwater is the primary source of water in Ondo state, Nigeria, the study area for the research. However, there has been a rising concern in recent times with regard to the contamination of this important water source as a result of urbanization. This study quantified 13 physicochemical parameters (Turbidity, Conductivity, pH, Mg2+ Hardness, Ca2+ Hardness, Total hardness, Alkalinity, Chloride, Nitrate, Sulphate, Phosphate, Total Dissolved Solids (TDS) and Total Suspended Solids (TSS)) in ten groundwater samples collected from dug wells in urban and rural study areas and compared them with the WHO drinking water standards. The comparison reveals that 30.8% of the parameters had levels above the World Health Organisation (WHO) standard limits in the study areas, while 69.2% were within the recommended limits. Water Quality Index (WQI) computations were also carried out which revealed that 60% of samples from the urban study area were of good quality and 40% were poor, while in the rural, 80% of the samples were good and the remaining 20% were poor. Based on the statistical and WQI results, groundwater in the urban study area is generally of lower quality than that of the rural. Possible factors influencing this include surface sealing, seepage of domestic and industrial effluents into aquifers and over-exploitation of groundwater, which characterize urbanized areas. The study thus recommends regular monitoring of groundwater quality, integration of effective systems for safe sewage disposal and strategic city planning of urbanized zones to maximize runoffs for groundwater recharge to improve groundwater quality.

Sustainable use of composted sewage sludge: Metal(loid) leaching behaviour and material suitability for application on degraded soils

Composted sewage sludge was investigated as a promising material for the reclamation or remediation of degraded sites. Using sewage sludge as soil amendment provides environmental benefits and risks while supporting circularity and waste minimisation. This study aims to comprehensively assess the suitability of locally available low-cost sludge treatment for sustainable and environmentally safe topsoil disposal in a brownfield area affected by coal mining. A nine-month composting was conducted before field application to the soil environment. The objectives were to assess: (i) composting time-dependent and pH-dependent metal(loid) leachability from composted sludges, (ii) the effect of sludges on metal(loid) leachability from soil over the first six months, and (iii) metal(loid) plant uptake during the first vegetation season as well as the bioaccumulation and translocation factors. The set of standardised leaching experiments confirmed the positive effect of compost maturity, i.e. despite some fluctuations over time, metal(loid) availability from the final composts was very low. Some metals showed unusual pH-dependent behaviour with the highest leachability at pH 8 due to excessive release of dissolved organic matter from the not-yet-stabilised matrix. Ecotoxicity testing confirmed the safety of the final composts for further soil application. The sludge-amended plots displayed similar metal(loid) leaching and pH evolution in time compared to the control biomass-amended plot. However, plant species (Artemisia vulgaris L.) that formed the natural vegetation cover of the experimental plots showed cumulative metal(loid) uptake. Cadmium and zinc were identified as the critical metals possibly related to the applied sludges, yielding high bioaccumulation and translocation factors. Yet, the quality of the compost feedstock, heterogeneity, and background values of the brownfield site need to be considered. Nevertheless, soil respiration indicated no adverse effects on soil health six months after sludge application. Overall, the composted material demonstrated potential suitability for remediation application in the studied area.

Fabrication and characterizations of screw pine root fiber reinforced soy composite as sustainable green composite

AbstractScrew pine root fibers are engineering fibers that have yet to be explored in terms of its chemistry with bio‐resin in biodegradable composites to replace nonbiodegradable thermoplastics used in packaging, automobiles, furniture, and industrial sectors. Screw pine root fibers are reinforced with soy, poly(vinyl alcohol), and soy‐poly(vinyl alcohol) resin systems in this work to create a variety of composites. Composites demonstrated highest amount of tensile strength at around 39.7 MPa, 37.6 MPa of flexural property, along with an impact strength around 12.4 kJ/m2. The thermal solidity of the optimized material was determined to be 235°C. After 24 hours of immersion, the composite had the lowest water absorption of 18.4%. All composites were shown to be biodegradable, losing about 54.2%–72.9% of their original mass after 60 days in soil burial. Unique characteristics such as the use of low‐cost agricultural materials, water‐based resin, stable composite, and properties such as moderately strong, safe disposal after service periods make these manufactured composites market feasible as consumer‐friendly/ecofriendly green products.Highlights Screw pine root fibers were extracted from waste roots and used as reinforcement. The tensile strength of the composite was achieved as 39.7 MPa. The water absorption of hybrid composite was found 30.8% after 24 h. After 60 days under soil burial, composite lost 67.5% of its original weight Developed composites can be good alternant for nondegradable thermoplastic.

Unsafe child feces disposal and childhood wasting among under five children in Myanmar

Background: Wasting is a major public health problem among under five children in developing countries, including Myanmar. The distribution of wasting and its associated factors are not well known in Myanmar. Objectives: This study aimed to examine the wasting prevalence and identify the association between child feces disposal and wasting among under-five children in Myanmar. Methods: A cross-sectional study was conducted on 1,207 under five children in Myanmar from September to December 2022. This study employed a multistage random sampling method with structured questionnaires and anthropometric measures. The World Health Organization's (WHO) definition and growth standards were used to determine the wasting. Multivariable logistic regression was performed to identify the association. An adjusted odds ratio with a 95% confidence interval and a p-value <0.05 was used to define statistical significance. Results: The prevalence of childhood wasting among under five children in Myanmar was 11.10% (95% CI: 9.45 to 13.00). This study revealed that children from unsafe child feces disposing families were 94 % more likely to be wasted (AOR=1.94, 95% CI: 1.22 to 3.09; p-value 0.005). Other covariates to childhood wasting were water shortage (AOR=2.17, 95% CI: 1.13 to 4.16; p-value 0.02), less than four handwashing steps of mother (AOR=3.20, 95% CI: 1.93 to 5.32; p-value <0.001), located in hilly region (AOR=2.27, 95% CI: 1.53 to 3.37; p-value <0.001), boys (AOR=2.80, 95% CI: 1.86 to 4.23; p-value <0.001), birth interval less than 3 years (AOR=1.84, 95% CI: 1.10 to 3.11; p-value 0.02), and eating more than 4 times per day (AOR=3.19, 95% CI: 1.93 to 5.27; p-value <0.001). Conclusion: This study showed a high prevalence of wasting among under five children in Myanmar. Improving the safe child feces disposal practices of mothers would be a critical intervention to reduce under five children's wasting. 

Mechanism study of the effect of superplasticizers in alkali-activated materials containing sludge

To realize the safe disposal of solid waste containing heavy metals, sewage sludge jointly with slag and metakaolin was used to prepare alkali-activated materials (AAMs), and the effect mechanism of polycarboxylate acid superplasticizer (PCE), naphthalene superplasticizer (NS) and aliphatic superplasticizer (AS) in AAMs were studied. The results showed that both the fluidity and strength of AAMs decreased with the addition of sludge. For the NaOH + Na2SiO3 activated mortar specimen, the incorporation of sludge can reduce their fluidity and strength from 206 mm and 80.25 MPa to 193 mm and 42.43 MPa, respectively. However, the addition of superplasticizers into sludge-containing AAMs leads to a reduction of 3–9% of the fluidity. Interestingly, it can enhance the strength of the AAMs, especially the NS and AS, which increase the strength by approximately 25%. This is attributed to the increase of particle dispersion by superplasticizers. However, the free water released in the process is reabsorbed by the sludge, which increases the local alkali concentration and promotes the activation of the activity. The dispersed sludge particles can play the role of physical filling, making the structure denser. HIGHLIGHTS Sludge is adverse effects on both the fluidity and strength of alkali-activated materials (AAMs). The addition of superplasticizers (SPs) increases the strength of AAM with sludge. SPs do not affect improving the fluidity of AAMs with sludge, even slightly bad. The dispersion effect of SPs on the sludge is beneficial to promote its activity in AAMs.