Safe Sanitation Research Articles

Application of machine learning in sanitation management prediction: Approaches for achieving sustainable development goals

Due to lack of understanding about the different conditions of sanitation systems and complexity, mostly in Asia and Africa, the occurrence of unsafely managed sanitation still exists, leading to severe environmental and health impacts. Because of the complexity of this problem, machine learning tools were applied to develop an effective model for health protection and safe sanitation management as a promising way to approach sustainable development goals. This study aimed to examine the incidences of ineffective sanitation management on the prevalence of diarrhea infections using machine learning tools. The prevailing conditions for safely sanitation management were identified, and the effective model to protect the impacts of ineffective sanitation management on the prevalence of diarrhea infections was proposed. Based on information collected from about 1000 households with relatively high diarrhea infections during the period of 2017–2021, factors relating to sanitation facilities for health protection and safe sanitation management were examined. Diarrhea infections and no diarrhea infection were recognized based on actual conditions of the surveyed households and incidences from ground-based observation. Classification tree model as J48 in WEKA was applied for analytic predictive tool using 70:30 ratio of training and validating dataset. The findings showed that the tree model obtained from the training data was with 73% accuracy prediction, while that from the validation data was with 70% accuracy. The correlation of personal hygiene (such as washing hand before meal and drinking water from natural water sources) and sanitation facilities (such as open defecation and distance from on-site sanitation facilities to open drains or storm sewer) was significant with inverse relationship for safely sanitation management and public health protection.

Water, Sanitation, and Hygiene (WASH) practices among residents of different slum settlements in a ward of Kolkata: A mixed-methods study.

Access to safe water, sanitation, and hygiene (WASH) is the most basic need for mankind. Poor WASH practices are associated with various waterborne diseases, especially in developing countries such as India. The aim of the study was to assess WASH practices among residents of different slum settlements in a ward of Kolkata, identify the factors associated with WASH practice, and explore the barriers faced by the families and municipal staff in providing adequate WASH services to the community. An observational study, cross-sectional in design with a convergent parallel mixed-methods approach, was conducted in different slum settlements in a ward of Kolkata. Quantitative data were collected by face-to-face interview, spot observation, and measuring the living area, door, and window spaces. Key informant interviews were conducted with the medical officer, ward vector-control coordinator, and municipal waste handlers, in addition to in-depth interviews with respondents who had unsatisfactory WASH practices. SPSS version 25.0 was used to analyze the quantitative data. Qualitative data were analyzed thematically using Atlas.ti 22. The overall WASH practices were considered satisfactory in 58.8% of the households. Education of the respondents up to the secondary level, presence of overcrowding, and inadequate ventilation in the house had statistically significantly higher odds of unsatisfactory practice. Poor living conditions, difficulty in collecting and storing water, waterlogging, blocked sewage drains, common toilets for men and women, and lack of motivation were the primary obstacles identified by the residents. Unsatisfactory WASH practices were observed among a high proportion of the slum population. Community engagement and education regarding WASH in communities is strongly recommended along with improvement of infrastructure and capacity building.

Public spending and rural development in Nigeria

The concerns of modern development have been on the need to boost living conditions which involves reducing poverty, unemployment, and inequality. Statistics has proved that these indices are quite high in the rural areas hence, the need to put up the needed actions to facilitate rural development. In this paper, we explored the role of public spending in fostering rural development in Nigeria from 2000 to 2020. The public spending on economic services and that of social and community services were considered, while the key rural development indicators captured were people practising open defecation, access to drinking water (both basic and safely managed), access to sanitation (both basic and safely managed), and access to electricity. The analysis was conducted using the ordinary least squares estimation technique. Findings of the study indicated that public spending on social community services substantially reduced the proportion of rural Nigerians practicing open defecation; and it increases the proportion of rural Nigerians having access to safe drinking water, sanitation, and electricity. This made the study to conclude that public spending is potent in driving rural development in Nigerian hence, the need for increased spending on social and community services in the country.

A tale of two towns: Water provision and management in the towns of Beaufort West and Vanrhynsdorp, c. 1900–1970

The Karoo region of South Africa receives some of the lowest annual precipitation in South Africa. The towns of Beaufort West and Vanrhynsdorp share a history of unreliable water supplies, coupled with extreme poverty that left a large section of the population of these towns with little to no access to safe water and sanitation infrastructure. Vanrhynsdorp and Beaufort West had low populations and limited permanent infrastructure during the 19th century. As the 20th century progressed, agricultural market price drops, droughts, the opening of railway lines and the promise of better living conditions spurred on by local business pushed larger numbers of people towards the rural towns. This led to the rapid expansion of populations in rural towns that lacked the financial and practical means to accommodate the rising need for larger permanent water sources and supply infrastructure (often in the form of groundwater). This article will compare how Beaufort West and Vanrhynsdorp developed divergent water provision systems between 1900 and 1970. These two case studies represent a glimpse into the history of water provision struggles of towns in the arid interior during the first half of the 20th century.Contribution: This article focusses on South African water history, and specifically on the problematics of water procurement to towns and communities in the arid Karoo region amid failing water infrastructure and recurring droughts. It augments the historical knowledge on strategies to provide water to rural communities under conditions of duress. The article falls within the scope of New Contree’s scientific focus as it throws more light on the historical infrastructure challenges that two rural communities faced and what strategies they have implemented to overcome such challenges.

Enhancing quality of life, public health, and economic development in the Global South through waterborne disease prevention with ultraviolet C light-emitting diode technology

Waterborne diseases pose a significant public health challenge in the Global South, attributed to inadequate access to clean water, insufficient sanitation infrastructure, and poor water treatment systems. These factors contribute to the contamination of water sources with microbial pathogens, placing individuals at a heightened risk of contracting waterborne diseases. Waterborne diseases in the Global South are caused by various bacterial pathogens, parasites, and viruses, with factors such as climate change, water scarcity, and human pollution influencing their proliferation. Vulnerable populations, including children, pregnant women, and immunocompromised individuals, bear the brunt of these diseases, resulting in preventable deaths and hindering socioeconomic development due to health-care costs. Traditional methods for combating these diseases have limitations, leading to the need for alternative water disinfection strategies, such as ultraviolet C light-emitting diodes (UVC LEDs). This review examines both the current state of waterborne diseases in the Global South (i.e., disease prevalence, causes, and public/systemic impacts) and the current landscape of UVC LED technology for water disinfection. Through the lens of this multi-focus review, we also explore the potential widespread implementation of UVC LED technology for water disinfection as a method of combating waterborne diseases to improve public health outcomes. Regulatory frameworks for UVC LED water treatment systems in the Global South remain limited. To address this limitation, we recommend an essential implementation framework that includes legislation, partnerships, sustainability, affordability, industrial and environmental standards, and robust evaluation protocols. Finally, we provide a substantial overview of the future directions and research opportunities in UVC LED technology and water treatment mechanisms aiming for promising public health outcomes. Embracing UVC LED technology can help address persistent disease challenges and improve public health in regions with limited infrastructure, thereby moving closer to achieving the United Nation’s Sustainable Development Goals and emphasizing the significance of universal access to improved WASH (safe water, sanitation, and hygiene) conditions.

Uncovering the linkage between sustainable development goals for access to electricity and access to safely managed drinking water and sanitation services

Efforts to improve access to electricity and access to water and sanitation often go hand in hand, as they are essential components of sustainable development. By ensuring access to electricity, communities can have improved access to safe and reliable water supply and sanitation services, leading to better health outcomes, enhanced livelihoods, and overall development. This study investigates the effects of access to electricity on access to safely managed drinking water and sanitation services in 19 African countries from 2000 to 2020. Driscoll-Kraay standard errors and IV-GMM estimation techniques are used to estimate the relationship. The results show that access to electricity is positively associated with the percentage of people using safely managed clean water and sanitation services. The results also show that access to safely managed clean water and sanitation facilities in urban and rural areas turns out to be increased as far as access to electricity increases. The findings indicate that access to electricity reduces urban-rural inequalities in access to clean water and sanitation facilities. The sub-regional analyses conducted reveal that these findings are robust across SSA countries. Lastly, the findings reveal that GDP per capita, globalization, FDI and urbanization are channels through which access to electricity contributes to increasing access to safely managed water and sanitation services. African governments should implement policies that highlight the transformative potential of reliable electricity supply in ensuring sustainable and equitable access to clean water and proper sanitation facilities to safeguard public health and well-being.

HEALTH COMMUNICATION STRATEGY FOR ENDING OPEN DEFECATION IN A RIVERSIDE COMMUNITY: A CASE STUDY IN MALANG DISTRICT, INDONESIA

Objective: Goal 6.2 of the SDGs emphasizes the importance of safe sanitation and ending open defecation in promoting health and well-being. This study analyzes health communication strategies for ending open defecation (OD) in a riverside community and identifies communication elements impeding the outcome.
 
 Methodology:. Using a qualitative approach, the data were collected through a forum group discussion (FGD), in-depth interviews, and observations. Fourteen people attended the FGD, including village government leaders, community and religious leaders, health cadres, people with OD habits, a midwife. Eight people were interviewed, including the head of the primary health center, the head of the environmental health division at Malang District Health Office, village government leaders, community and religious leaders, a sanitarian, and people with OD habits.
 
 Findings: The triggering method was combined with a customized communication strategy to promote OD behavior change. The study identifies challenges to achieving promotion objectives, such as villagers' distrust of some assisting team members due to a lack of training or workshops, the 'no subsidy' messages were ineffective because the local government granted latrine for the poor before, the use of face-to-face communication as a sole channel was found ineffective due to unreliable sources and a large number of participants, there is no regulation to sustain behavioral change.
 
 Suggestions: This study recommends training or workshops for community members who serve as the triggering team, encouraging self-built latrines through a financing plan and latrine models tailored to villagers' capabilities and preferences, combining face-to-face communication with villagers' preferred media, and issuing a regulation governing penalties for offenders.

Impact of disinfectant on the electrical outputs of urine-fed ceramic and membrane-less microbial fuel cell cascades

The application of microbial fuel cells in sanitation has demonstrated feasibility in supplying electricity and providing safety in underserved communities, especially at toilet blocks. Two different designs of urine fed MFC cascades, ceramic MFCs (c-MFC) and self-stratifying MFCs (s-MFC), have been employed in large-scale feasibility studies. As part of a pre-commercialisation approach, this study verified the resilience of each design when a commercial disinfectant was introduced into the system. Five different conditions, varying in concentrations (24.2 mM–604.5 mM) and the total volume (50–500 mL) of sodium hypochlorite disinfectant introduced, were tested. Upon adding the disinfectant, both types of MFC-cascades exhibited rapid power drops with response times lower than 5 min in all tested conditions, followed by relatively swift recovery times of up to 250 min. The volume of disinfectant introduced had a greater impact on power output than its concentration or dose. Comparing the two designs, the c-MFC demonstrated a much larger voltage drop, up to 0 mV, and shorter recovery time compared to the s-MFC under most test conditions, mainly attributed to the presence (c-MFC) or absence (s-MFC) of a membrane. Overall, both types of MFCs exhibited strong resilience to sodium hypochlorite additions, thereby highlighting the commercial potential of the technology towards safe off-grid sanitation.

Regional epidemiological features of infectious diseases with fecal-oral transmission in the socialist republic of Vietnam

Aim: To identify regional epidemiological features of infectious diseases spread by fecal-oral transmission and the factors influencing them in four regions of Vietnam.Materials and methods: Retrospective epidemiological analysis of data of 10 infectious diseases spread by fecal-oral transmission in Vietnam for the period 2017-2022. Maps of incidence by province was created using the QGIS 3.28 program. Correlation coefficients between the incidence of the studied diseases and socio-economic factors were established.Results: It was revealed that the incidence of the 10 studied diseases was 443.1±113.5 0 /0000 and tends to decrease. The highest incidence was recorded in Tay Nguyen. Cases of diarrheal syndrome (330.1±73.8 0 /0000) and enteroviral vesicular stomatitis (HMFD) (93.6±33.4 0 /0000) accounted for 95.65% of all registered cases. Diarrhea is distributed mainly among children under 4 years of age (1090.3±384.8 0 /0000) and 5-9 years old (60.9±18.5 0 /0000). Regional epidemiological features of diarrhea and HMFD are shown. The highest incidence of the HMFD was recorded among children under 4 years of age in Dong Thap (4635.8 0 /0000) and Ho Chi Minh City (4210.5 0 /0000), and the highest incidence of diarrheal syndrome was in Kon Tum (2621.2 0 /0000), Thai Binh (2556.6 0 /0000) and Dien Bien (1461.9 0 /0000). Relationships were established between the incidence of diarrhea and levels of access to safe water (rSpearman = – 0.393; p = 0.001), to the sanitation system (rSpearman = – 0.267; p = 0.035), average monthly income (rSpearman = – 0.424; p = 0.001), poverty levels (rSpearman = 0.403; p = 0.001).Conclusion: The high incidence of infectious diseases spread by fecal-oral transmission in Vietnam is due to the high incidence of diarrhea and HMFD. A high incidence of diarrhea is typical for provinces with low levels of access to safe water and sanitation systems, high levels of poverty and low average monthly income. Incidence of HMFD is high among children under 4 years old, especially in the southern provinces with high population density in the summer and autumn seasons.

Assessment of current water, sanitation, and hygiene (WASH) practices in the third and ninth districts of N'Djamena, Chad.

Access to safe drinking water, sanitation, and hygiene in Chad's cities, especially N'Djamena, is a persistent and significant challenge. This study aimed to assess current practices in water, sanitation, and hygiene in N'Djamena's third and ninth districts. We surveyed 395 households, conducted water source identification, and analyzed seven water samples at the National Water Laboratory. Temperature, ammonium, total coliforms, and aerobic flora values exceeded World Health Organization (WHO) guidelines. Ammonium and temperature averaged 0.7 mg/L and 30.1-31.93 °C, respectively. Bacterial contamination (>100 MPN/100 mL) exceeded the WHO's 0 MPN/100 mL guidelines, rendering the water unfit for consumption. Survey results indicate that 78.7% use hand pumps, 21.1% have tap water access, and 0.2% rely on rivers for water. Regarding toilets, 92.8% have traditional models, 2.9% have modern facilities, and 4.3% practice open defecation. 95% dispose of untreated wastewater into nature, with only 5% using septic tanks. For solid waste, 72% use illegal dumpsites, 18% rely on public services, and 10% burn waste. Finally, 95.5% of households wash their hands with clean water and soap after using the toilet. It is crucial to treat drinking water and implement proper hygiene and sanitation measures to safeguard the population's health in the studied area.

Evaluation of psychosocial factors affecting faecal sludge desludging practice compliance in Bekasi City

Desludging operators have important role in on site sanitation to achieve safe sanitation. Desludging practice have to comply with the principles of safe sanitation and regulations to maintain the health and safety of the worker, the community, and the environment. However, the implementation of desludging sometimes does not comply with safe sanitation principle and regulation. This study aims to identify the compliance of faecal sludge desludging with regulation and safe sanitation principle. Furthermore, Theoretical Domains Framework (TDF) is applied to explore psychosocial factors of the operators that affect desludging practice. Questionnaire assessing desludging practice and psychosocial factors based on TDF was given to 32 desludging operators that works in local government and private desludging services in Bekasi City. Desludging practice in Bekasi City were not comply desludging practice procedure. From desludging procedure compliance, only 56% of the respondents claimed to have carried out the desludging practice in accordance with the procedures, low percentage also found in the worker’s safety procedure especially in wearing Personal Protective Equipment (PPE) eventhough mostly do not do high risk action in emptying. Related to faecal sludge disposal procedure, high percentage (84%) of workers always discharge to Faecal Sludge Treatment Plant (FSTP), while some small amount (16%) often follow the discharge procedure. Spearman’s Rank Correlation analysis was used to determine domains in TDF that significantly affecting desludging practice compliance. From the correlation analysis, Knowledge (ρ = 0.505; P =0.003), Beliefs about consequences (ρ =0.473; P = 0.006), and Environmental context and resources (ρ =0.389; P = 0.028) are statistically significant affecting desludging practice.

Multi-dimensional poverty and health outcomes in Ghana

There is evidence on the social gradient in health in multiple settings. Recent research is increasingly focused on linkages between multidimensional poverty and health to capture and ascertain the role of non-monetary factors on individuals' health. In this paper, using the 2018/19 wave of the Ghana Socioeconomic Panel Survey (GSEPS) and the country's newly introduced multidimensional poverty index, bivariate correlations and regression analyses are carried out to explore associations between household multidimensional poverty and a series of health outcomes, including physical and mental health. There is evidence of significant subgroup differences across the country by gender, rural/urban residence, education, and region. Regression analyses consistently indicate that poorer mental and physical health outcomes are positively and significantly correlated with greater multidimensional poverty. Robustness tests indicate that deprivations in electricity access, safe sanitation and education are particularly relevant. Findings suggest the importance of a more equal geographical distribution of social amenities and infrastructure, as well as adequate targeting of policies to reduce health inequalities across the country and achieve a more equitable and inclusive distribution of resources within the country.

Development and validation of instrument to measure citywide inclusive sanitation (CWIS Scale) for Low-and Middle-Income Countries (LMICs)

Universal access to safe and adequate sanitation is a critical public health and environmental issue, particularly in low-income urban areas. The Citywide Inclusive Sanitation (CWIS) approach seeks to address the challenge of meeting the universal access to sanitation for all, including the most vulnerable groups. The six key criteria in CWIS are: (1) equity; (2) safety; (3) sustainability; (4) responsibility; (5) accountability; and (6) Resource Planning and Management. This study aimed to develop and validate survey instruments for CWIS measurement in urban areas of Low- and Middle-Income Countries (LMICs). First, we specified the domains based on the six CWIS criteria by, adding the vulnerability criterion to the equation. We developed candidate items for each domain by reviewing the relevant literature. Face validity was determined through cognitive interviews, and content validity was determined through the evaluation of two experts. We added, removed, merged, and rephrased items based on the results of cognitive interviews and feedback from subject matter experts. We piloted the instrument and conducted statistical analysis to ensure the validity and reliability of the ‘scales and indices. The CWIS survey modules address a recognized need for greater emphasis on inclusive sanitation. We provide researchers and policymakers with tools to measure CWIS sub-constructs in a valid and reliable manner to generate data for improved targeting, design, implementation, and evaluation of strategies to improve sanitation access for vulnerable and marginalized urban citizens.

Cholera resurgence in Africa: assessing progress, challenges, and public health response towards the 2030 global elimination target.

Global efforts to combat epidemic cholera outbreaks have witnessed tremendous feats over the decades. However, sporadic outbreaks in regions, particularly across African states, mask these advancements. This regressive trend is frequently fuelled by factors retarding efforts towards optimal environmental sanitation and personal hygiene, which include ingesting infected food, drinking contaminated waters, and engaging in unhealthy environmental practices such as indiscriminate waste and sewage disposal and poor toilet practices. The ongoing efforts to achieve the Global Taskforce on Cholera Control (GTFCC) targets of a 90% reduction in cases and deaths by 2030, even in the wake of continuous outbreaks across various African regions, as reported by the World Health Organization (WHO) face a significant threat. One such effort, among others, is the AFRICHOL project, an enhanced cholera surveillance consortium launched in Africa over a decade ago as part of the GTFCC at WHO to monitor and fast-track the GTFCC's 2030 targets. It is tasked with supporting the implementation of research-based strategies for combating cholera in Africa. The prequalified oral cholera vaccines - Dukoral, Shanchol, and Euvichol - and those with recombinant DNA technology have also emerged as remarkable strides. In the face of this progress, challenges persist. Climate change, including extreme weather events and the lack of safe water, sanitation, and hygiene facilities, acts as a multiplier, amplifying existing challenges and hindering progress. Porous borders with inefficient disease surveillance networks among member states also facilitate the inter-territorial spread of the disease. Despite ongoing challenges, global targets are achievable provided strong institutional infrastructure and additional evidence-based public health initiatives are promulgated and enacted. The Global Roadmap to Ending Cholera Outbreaks by 2030 is a resourceful tool for advancing this fight and eradicating cholera.

Cholera outbreak trends in Nigeria: policy recommendations and innovative approaches to prevention and treatment.

Cholera, an acute diarrheal infection from ingesting contaminated food or water, remains a significant public health threat in Nigeria, especially in areas lacking safe water and sanitation. Characterized by severe watery diarrhea, cholera can cause dehydration and death if untreated. Historical data shows cholera's endemic nature in Nigeria, with notable outbreaks since 1970, including major ones in 1991, 1999, 2010, 2018, and 2024. According to a descriptive study in Nigeria, the 1991 outbreak reported 59,478 cases and 7,654 deaths, with a Case Fatality Ratio (CFR) of 12.9%. In 2010, there were 41,787 cases and 1,716 deaths, with a CFR of 4.1% across 18 states, mainly affecting impoverished communities and children. The 2018 outbreak had 43,996 cases and 836 deaths, with a CFR of 2% in 20 states, a 240% increase from 2017. By mid-2024, there were 1,579 suspected cases and 54 deaths (CFR 3.4%) in 32 states. This paper evaluates cholera trends in Nigeria and proposes effective preventive and treatment strategies. Policy recommendations highlight the need for improved WASH infrastructure, enhanced surveillance, and rapid response mechanisms. Innovative approaches like case-area targeted interventions (CATI) and increased public health education are crucial for mitigating future outbreaks and achieving the goal of reducing cholera deaths by 90% by 2030.

Mozambique public investment in the water and sanitation sector and the targets of SDG6.

Many developing countries may not reach the targets of providing access to safe water sources and sanitation services for all by 2030. Census data from Mozambique show that the country's population is one of fastest growing in the Sub-Saharan region. Between the 2007 and 2017 censuses more than seven million people were added to the total population. By 2030 about 11 million people will be added to Mozambique's population. This will pose a huge challenge for the water and sanitation services. Access to these services is a fundamental requirement for the wellbeing of individuals and the development of nations. The last data from a Survey on Mozambique Family Budgets (IOF 2019/20), show that 55.7% of a total population has access to safe water sources. In contrast, access to sanitation services (31% of the population), has not kept pace with the progress made in water access. In this study, based on data from the General State Account of Mozambique, which includes the description of the annual investment made by the government and using the results of the Family Budget Surveys, it can be seen that if the average percentage values of public investment of 2009 to 2021 are the same in the following years as regards the water and sanitation sector, Mozambique will not reach the Sustainable Development Goals 6 targets in 2030.

Prevalence of Open Defecation Practice and Associated Factors Among Households in Geshiyaro Project Implementation Sites in Ethiopia: A Cross-Sectional Study.

Open defecation is a significant global challenge, impacting public health, environmental sanitation, and social well-being, especially in low- and middle-income countries like Ethiopia. It is the second-largest cause of disease burden worldwide by facilitating the spread of germs that cause diarrhea diseases. Studies examining open defecation practices are insufficient, especially in areas implementing Ethiopia's Geshiyaro project. Therefore, this study aimed to assess the status of open defecation practice and associated factors in the study area. A community-based cross-sectional study was conducted from June to July 2023. The total number of households included in this study was 7995. A structured questionnaire and observational checklist were used to collect data. Descriptive and multivariate logistic regression analyses were performed using STATA version 16. The study found that 16.5% of households practiced open defecation. The following factors were significantly associated with the occurrence of open defecation: residence (AOR = 1.56, 95% CI: 1.26-1.92), education (AOR = 0.59, 95% CI: 0.49-0.72), age (AOR = 0.53, 95% CI: 0.41-0.69), knowledge on diarrhea prevention (AOR = 1.32, 95% CI: 1.17-1.50), marital status (AOR = 1.61, 95% CI: 1.32-1.97), and awareness creation about WASH services (AOR = 1.96, 95% CI: 1.71-2.25). On the other hand, no significant association was observed between the occurrence of open defecation and the household's income (AOR = 1.07, 95% CI: 0.93-1.23) or the head of household sex (AOR = 0.94, 95% CI: 0.78-1.12). Open defecation remains a critical public health concern in Ethiopia's Geshiyaro project sites. Various factors influencing this practice have been identified. Targeted interventions are needed to enhance access to safe sanitation facilities and promote awareness of WASH services, aligning with SDG 3 target 3, and SDG 6 target 2.

Navigating the nutritional paradox: The impact of sustainable development targets on childhood wasting and overweight prevalence.

In 2015, the United Nations member states endorsed the 2030 Agenda for Sustainable Development to chart a path towards a better future for all. Childhood malnutrition, particularly wasting, remains a critical global health challenge, disproportionately affecting children under five in low- and middle-income countries. This study evaluates the impact of achieving selected Sustainable Development Goal (SDG) targets on reducing childhood malnutrition, with a specific focus on wasting and overweight. Utilizing multi-country DHS datasets, this study analyzed data from 138,782 children under five across 27 countries, nested within 13,788 neighborhoods. We simulated the predicted prevalence of wasting and overweight as selected SDG-related health inputs and determinant indicators reached their target values. Our findings reveal a baseline prevalence of 6.3% for wasting and 4.3% for overweight among the children studied. Progress towards the SDGs can potentially decrease wasting prevalence by a quarter (25%), translating to a reduction from 6.3% to 4.7%. This significant reduction in wasting is more pronounced in rural areas (29%) than in urban settings (7%). Conversely, a 14% increase in overweight prevalence was observed, with rural areas experiencing a higher rise (15%) than urban areas (13%). The study also highlighted variations in access to safe sanitation, improved water sources, healthcare services, income, maternal employment, and education levels, underscoring the complex interplay between these factors and malnutrition outcomes. Notably, the reduction in wasting prevalence was mainly attributable to input determinants rather than direct health inputs, suggesting the importance of broader socioeconomic factors in combating malnutrition. Achieving SDG targets presents a significant opportunity to mitigate wasting, particularly in rural communities. However, the uneven distribution of improvements underscores the need for targeted interventions in less affected areas. The concurrent rise in overweight prevalence, points to the emerging challenge of addressing the dual burden of malnutrition. This necessitates integrated, multi-sectoral strategies considering the diverse health determinants and nutritional status.

Detection of Salmonella species by Automated Blood Culture Method in Suspected Cases of Enteric Fever

Background: Enteric fever caused by Salmonella species is a systemic febrile illness that can be fatal since its characterization in 1880. Enteric fever may remain asymptomatic carrier and sometimes fatal that it can be difficult to diagnose based on symptoms alone because they are similar to those of other febrile disorders. In developing countries, enteric fever is common global health problem due to poor standard of personal hygiene, contaminated food, inadequate safe water and sanitation. Methods: This is a cross-sectional study that was conducted in the Microbiology Department of Rajshahi Medical College Hospital for one year from January 2021 to December 2021 to identify Salmonella species by Automated Blood Culture (Fastidious Antibiotic Neutralization method) followed by subculture in MacConkey’s agar, Xylose lysine deoxycholate agar, and Salmonella Shigella agar media in suspected enteric fever cases. This study included suspected cases of enteric fever as determined by the physician who fulfilled the inclusion and exclusion criteria. Results: Among 127 suspected cases of enteric fever 64(50.39%) culture positive bacteria isolated by automated blood culture (FAN) method and out of that Salmonella species 38 (59.37%) and others bacteria 26(40.63%) following subculture in MacConkey’s agar, Xylose lysine deoxycholate agar and Salmonella Shigella agar media. Regarding gender, the majorities (61.4%) of culture-positive patients were male, and the majority (65.35%) came from rural areas. Conclusion: Especially for patients who have received antibiotics, we propose that the automated blood culture approach followed by subculture could be employed as a novel diagnostic method for typhoid fever. TAJ 2023; 36: No-2: 71-76

Health Risk Assessment of Nitrate in Drinking Water with Potential Source Identification: A Case Study in Almaty, Kazakhstan.

Infant mortality in Kazakhstan is six times higher compared with the EU. There are several reasons for this, but a partial reason might be that less than 30% of Kazakhstan's population has access to safe water and sanitation and more than 57% uses polluted groundwater from wells that do not comply with international standards. For example, nitrate pollution in surface and groundwater continues to increase due to intensified agriculture and the discharge of untreated wastewater, causing concerns regarding environmental and human health. For this reason, drinking water samples were collected from the water supply distribution network in eight districts of Almaty, Kazakhstan, and water quality constituents, including nitrate, were analyzed. In several districts, the nitrate concentration was above the WHO and Kazakhstan's maximum permissible limits for drinking water. The spatial distribution of high nitrate concentration in drinking water was shown to be strongly correlated with areas that are supplied with groundwater, whereas areas with lower nitrate levels are supplied with surface water sources. Based on source identification, it was shown that groundwater is likely polluted by mainly domestic wastewater. The health risk for infants, children, teenagers, and adults was assessed based on chronic daily intake, and the hazard quotient (HQ) of nitrate intake from drinking water was determined. The non-carcinogenic risks increased in the following manner: adult < teenager < child < infant. For infants and children, the HQ was greater than the acceptable level and higher than that of other age groups, thus pointing to infants and children as the most vulnerable age group due to drinking water intake in the study area. Different water management options are suggested to improve the health situation of the population now drinking nitrate-polluted groundwater.