Smallest Administrative Unit Research Articles

How far away do you keep your equines? Estimation of the equine population’s spatial distribution in France

It is essential to have an accurate picture of the spatial distribution of equines to be able to monitor equine health events effectively. In France, this information is only available for certain categories of live equines kept in professional structures and for dead equines removed by renderers. This limits the surveillance, prevention and control methods able to be used to prevent the spread of equine diseases. Our study aimed to provide a realistic estimate of the spatial distribution of the French equine population at the detailed scale of the French commune (France’s smallest administrative unit). For this purpose, we adapted the Bayesian method used by Lo Lacono et al., based on the distance between the owner’s location and the location of his/her equines, and on the percentage of urban coverage. To assess whether the location of dead equines could be representative of the location of live equines, the distribution of distances between equines and owners was calculated from a sample of live equines on the one hand, and a sample of dead equines on the other, both accurately located. We also tested two different assignment methods for locating equines: Method 1 assigned to each owner a single holding commune, while Method 2 allowed more variability in holding communes for owners associated with multiple equines. A marked difference was observed between Methods 1 and 2 regardless of the sample used, with only 2.4% and 4.3% respectively of the communes having the same number of equines. Conversely, little difference was observed in the results whether the live or dead equine sample was used, with approximately 45% of the communes having the same number of equines. Regarding differences in spatial distribution, Method 1 based on the live equine sample estimated higher local densities of equines without considering urban areas. In contrast, Method 2 provided more dispersed maps, with low densities in the densest urban areas. In conclusion, dead equines appeared to be representative of live equines and some of our estimates are consistent with the information collected by the French horse and riding institute (IFCE). These results now have to be compared with field data to test their relevance.

The spatiotemporal dimension of population change in Ireland: visualisation of growth and shrinkage in Irish Electoral Divisions (1986–2016)

ABSTRACT Population shrinkage has gained attention from academics and policymakers in recent years, due to the long-term implications the phenomenon has for public service delivery and the viability of urban and rural communities. We visualise the socio-temporal evolution of population shrinkage and growth, utilising a spatially rectified dataset containing population data from seven Census of Population covering the 1986–2016 period in the Republic of Ireland. Spatial changes in population distribution are visualised in a map that classifies small administrative units using a spatial typology distinguishing between those experiencing population growth or shrinkage, across the 30-year period. The temporal dimensions of these developments are considered in a sequence of inset maps that apply the same typology to identify the intercensal changes. Overall, the map facilitates the visual communication of long-run population trends, the identification of areas experiencing limited or no growth, and indicates the relative consistency of these trends over time.

Prevalence of and factors associated with acute diarrhea among children under five in rural areas in Ethiopia with and without implementation of community-led total sanitation and hygiene

BackgroundSince Ethiopia has been implemented the Community-Led Total Sanitation and Hygiene (CLTSH) approach to control incidence of diarrhea, few studies have compared the prevalence of diarrhea and associated factors in rural areas that have implemented this approach with those that have not implemented it, and none have examined it in the district of Menz Gera Midir in the Amhara Region of Ethiopia. This study addressed this gap.MethodA community-based comparative cross-sectional study was conducted among 224 children under five in three randomly selected rural kebeles (the smallest administrative units in Ethiopia) where CLTSH had been implemented and 448 similar children in three other randomly selected rural kebeles where CLTSH had not been implemented during February and March, 2020. Data were collected using a structured questionnaire and an on-the-spot observational checklist. Data were analyzed using three different binary logistic regression models with 95% confidence interval (CI): the first model (Model I) was used for CLTSH-implementing kebeles, the second model (Model II) for non-CLTSH-implementing kebeles, and the third model (Model III) for pooled analysis of CLTSH-implementing and non-implementing kebeles. To control confounders, each multivariable logistic regression model was built by retained variables with p < 0.25 from the bi-variable logistic regression analysis. From the adjusted multivariable analysis of each model, variables with p-values < 0.05 were declared factors significantly associated with acute diarrhea.ResultsThe prevalence of acute diarrhea among children under five from households in kebeles that had implemented CLTSH was 10.6% (95% CI:6.6–14.7%) and among those that had not implemented CLTSH 18.3% (95%CI:14.8–22.2%). In CLTSH-implementing areas, use of only water to wash hands (AOR: 3.28; 95% CI:1.13–9.58) and having a mother/caregiver who did not wash their hands at critical times (AOR: 3.02; 95% CI:1.12–8.12) were factors significantly associated with acute diarrhea. In non-CLTSH-implementing areas, unimproved water source (adjusted odds ratio [AOR]: 2.81; 95% CI:1.65–4.78), unsafe disposal of child feces (AOR: 2.10; 95% CI:1.13–3.89), improper solid waste disposal (AOR: 1.95; 95% CI:1.12–3.38), and untreated drinking water (AOR: 2.33; 95% CI:1.21–4.49) were factors significantly associated with acute diarrhea. From the pooled analysis, not washing hands at critical times (AOR: 2.54; 95% CI:1.59–4.06), unsafe disposal of child feces (AOR: 2.20; 95% CI:1.34–3.60) and unimproved water source (AOR: 2.56; 95% CI:1.62–4.05) were factors significantly associated with the occurrence of acute diarrhea while implementation of CLTSH was a preventive factor (AOR: 0.24; 95%: 0.20–0.60) for the occurrence of acute diarrhea.ConclusionThe prevalence of acute diarrhea among under-five children in Menz Gera Midir District was lower in kebeles where CLTSH had been implemented than in kebeles where CLTSH had not been implemented. Therefore, we recommend that governmental and non-governmental sectors increase implementation of CLTSH programs, including improving handwashing at critical times, promoting safe disposal of child feces and enhancing the availability of improved water sources.

Perimeter confinements of basic health zones and COVID-19 incidence in Madrid, Spain

BackgroundA unique policy of perimeter closures of Basic Health Zones (small administrative health units) was implemented in the Autonomous Community of Madrid from September 21st 2020 to May 23rd 2021 to face the COVID-19 pandemic.AimTo assess the impact of local perimeter confinements on the 14-days cumulative incidence of SARS-CoV-2 during the second wave of the pandemic in Madrid, Spain.MethodsWe compare the errors in estimation of two families of mathematical models: ones that include the perimeter closures as explanatory covariables and ones that do not, in search of a significant improvement in estimation of one family over the other. We incorporate leave-one-out cross-validation, and at each step of this process we select the best model in AIC score from a family of 15 differently tuned ones.ResultsThe two families of models provided very similar estimations, for a 1- to 3-weeks delay in observed cumulative incidence, and also when restricting the analysis to only those Basic Health Zones that were subject to at least one closure during the time under study. In all cases the correlation between the errors yielded by both families of models was higher than 0.98 (±10− 3 95% CI), and the average difference of estimated 14-days cumulative incidence was smaller than 1.49 (±0.33 95% CI).ConclusionOur analysis suggests that the perimeter closures by Basic Health Zone did not have a significant effect on the epidemic curve in Madrid.

POS-308 THE TREND IN THE INCIDENCE OF CHRONIC KIDNEY DISEASE IN THE CHRONIC KIDNEY DISEASE OF UNCERTAIN AETIOLOGY (CKDU) AFFECTED NORTH CENTRAL PROVINCE OF SRI LANKA

Chronic Kidney Disease (CKD) of uncertain origin (CKDu) has affected North Central Province (Anuradhapura and Polonnaruwa district) of Sri Lanka. The cause is still unknown. The objective of this study was to describe the trend in the incidence of CKD/CKDu in Divisional Secretariat (DS) areas (smaller administrative units) of North Central Province (Anuradhapura and Polonnaruwa districts) of Sri Lanka.

Water and Latrine Services and Associated Factors among Residents of Negele Town, Southeast Ethiopia: A Cross-Sectional Study.

Background Access to at least a basic water service, improved sanitation, and hygiene contribute to the human health and socioeconomic development of a country. This study was conducted to assess the water and latrine service coverage and related factors among dwellers of Negele town, southeast Ethiopia. Method Two Kebeles (small administrative units) were randomly selected from each of the three zones of the town to collect data via questionnaires from randomly selected household heads (380), interviews of purposely selected key informants (40), and personal observations employing a cross-sectional survey design from March to May 2018. A Chi-square test was conducted to examine the association between various demographic factors and having latrine/tap water. Result Latrine coverage of the town was low (45%) mainly due to shortage of land or funds and expansion of illegal houses. The available latrines were poor in hygiene. Water service (solely tap water) coverage was very low (7.6%) as a result of deficient water sources and nonfunctioning pipelines. The zones, age, educational status, marital status, and family size of the participants were statistically significantly associated with having latrine or tap water, p < 0.05. The administration of the town has planned to build four public toilets and raise its water supply coverage to about 70% by 2019/2020. Conclusion Coverage of latrine and water services of Negele town were so low, implying that it is not on track to achieve the United Nations (UN) sustainable development goal target 6.1 and 6.2. The administration of the town should provide land to residents and search for fund sources for the construction of standardized private and public toilets. Utilizing various water sources, maintaining nonfunctional, and constructing new pipelines should be promoted to improve the water service coverage of the town targeting the national and UN sustainable development goals.

Prevention of mother-to-child transmission screening among pregnant women in southern Ethiopia from the perspective of the current WHO recommendation.

Objective:The aim of this study was to assess HIV screening for prevention of mother-to-child transmission service utilization and associated factors among pregnant women in Hadiya zone, Southern Ethiopia.Methods:The study was conducted in a community setting and was cross-sectional with a multistage sampling technique. A total of 613 women were selected randomly from 29 kebeles (the smallest administrative unit next to the district). Data were collected using a standardized interviewer-administered questionnaire. After being coded, reviewed, and entered into Epi-data, the data were exported to SPSS Version 21. Frequencies, percentages, graphs, and means and standard deviations were used to show descriptive data. In bivariate analysis, a p-value of 0.25 was utilized to identify candidate variables for multivariable logistic regression analysis. The statistical significance level was established at 0.05, and the strength of the association was measured using an adjusted odds ratio.Results:A total of 613 pregnant women out of 630 who were eligible, were included in our study. Among them, 276 (45%; 95% CI: 41.1–48.8) were tested for HIV. HIV screening was associated with secondary and higher maternal educational level (AOR = 5.01, 95% CI: (3.08–8.16)), number of antenatal care visits four and higher (AOR = 4.25, 95% CI: 2.41–7.51), distance from health facility (AOR = 1.93, 95% CI: 1.24–3.101), and male partner involvement (AOR = 1.88, 95% CI: 1.31–2.69).Conclusion:Less than half of the pregnant women included in our study had been tested for HIV; which was quite lower than the national requirement that every pregnant woman be tested during a visit. Only those who had a higher level of education, who regularly took antenatal care, who were not far away from the health facility, and whose partner was involved in antenatal care, were more susceptible to being tested. Thus, actions such as female education and increasing accessibility of the service should be prioritized.

DISTRIBUTION AND IDENTIFICATION OF ANTHRACNOSE OF PAPAYA CAUSED BY COLLETOTRICHUM GLOEOSPORIOIDES IN THE CENTRAL RIFT VALLEY OF ETHIOPIA

Papaya (Carica papaya L.) is one of the most important fruit crops in Ethiopia. Despite its importance, papaya production is hampered by different biotic and abiotic factors. Among biotic factors, anthracnose is an important disease, causing serious damage to papaya, especially in the postharvest stage. The surveys were conducted in eight kebeles (smallest administrative unit) of three districts (Adama, Adamitulu Jidokombolcha, and Dugda) in the East Shewa Zone of the Oromia regional state, Ethiopia from August to September 2016 and August to September 2021, to assess the prevalence, incidence, and severity of papaya anthracnose disease. Disease incidence and severity on leaves and fruits were determined using random sampling techniques. Cultural and morphological characterization of the causal agent of papaya anthracnose was also done. The survey results showed that all the eight kebeles assessed during 2016 and 2021 were affected by papaya anthracnose disease. The overall mean incidences of the disease were 63.9% on the leaves and 40.3% on the fruits while average disease severities were 24.8% and 22.8%, respectively. Disease incidences in different kebeles ranged from 60 to 66.7% on leaves and from 30 to 48.9% on fruits. Disease severity also varied from 21.1 to 29.8% on leaves and from 20 to 26.7% on fruits. Disease incidences and severities were generally higher in Wolda Kelina kebele. In 2021, the assessment result indicated that in Dugda and Adamitulu Jidokombolcha districts anthracnose was a major papaya production constraint. Based on field symptomatic assessment as well as cultural and morphological characterization, Colletotrichum gloeosporioides was identified as the causal agent of the disease threatening papaya production in the surveyed areas. These findings provide information on the magnitude of the damage due to papaya anthracnose disease and will be useful to devise disease management strategies. It is necessary to investigate the reactions of the available papaya cultivars against the pathogen and select disease tolerant papaya materials.

The language problem of minorities in a homogeneous state.

In this paper, I aim at presenting the language situation of some regional minorities in Poland: Silesians (Ślązacy), Kashubians (Kaszubi) and the residents of Wilamowice. Protection of language minorities is extremely important from the point of view of cultural development of countries. Throughout a long period of its existence, Poland has been a multi-cultural country populated by representatives of different national, regional and ethnic groups. However, the national and ethnic situation of Poland changed radically after the Second World War. Today Poland is one of the most homogenous states not only in Europe but also worldwide. However, Poland is not free from the discussion about minority rights. Shaping a strong regional identity, which was particularly true for the Silesians and Kashubians and residents of Wilamowice, was a social and cultural phenomenon, completely unknown in the long history of Poland. The Act on national and ethnic minorities and on the regional languages dated January 6, 2005, allows to use of Kashubian language as a “supporting language” before the municipality authorities, the smallest ad-ministrative unit. The other obvious point of this description concerns the demanding of similar linguistic rights by Silesians. The study also highlights the efforts of the residents of Wilamowice to preserve their unique language.

Contribution of the Characteristics of Farmers to use of Coping Strategies towards Household Food Security

A study was carried out at each of three flood affected reverine villages of three upazilas (small administrative unit) under Jamalpur district in Bangladesh during September, 2011 to May, 2012 to find out the contribution of the characteristics of the farmers to the use of coping strategies towards household food security practiced by the farmers during flood. Data were collected from randomly selected 336 respondents both the qualitative and quantitative techniques and analyzed with the help of SPSS. Out of 18 characteristics, 11 had positive, 2 had negative and 5 had no significant relation with coping strategies towards household food security during flood period. Stepwise regression analysis revealed that six variables namely participation in income generating activities (IGAs) (20.1 percent), knowledge on flood coping mechanisms (8.5 percent), cosmopoliteness (6.5 percent), utilization percentage of received credit (2.0 percent), water and sanitation condition (1.6 percent) and year round household food situation (0.8 percent) were the major contributing variables which combindly explained 39.5 percent of total variations. Path analysis revealed that knowledge on flood coping mechanisms had the highest positive direct effects (0.285) and participation in IGAs had highest positive indirect effects (0.169) on coping strategy practices. Considering the relative contribution on the coping strategy practices towards household food security during flood period, based on their direct effects, the six variables could be arranged as follows knowledge on flood coping mechanism &gt; participation in income generating activities &gt; cosmopoliteness &gt; water and sanitation condition &gt; year round household food situation &gt; utilization of received credit.

Dietary diversity and associated factors among children aged 6 to 23\u2009months in Chelia District, Ethiopia

BackgroundAlthough minimum dietary diversity (MDD) is one of the core indicators of a high-quality diet for infants and young children, meeting this dietary diversity standard remains a challenge in Ethiopia. Therefore, adequate information on the status and factors affecting minimum dietary diversity is essential to identify potential strategic interventions. This study to study is to assess DD and associated factors among children aged 6 to 23 months in Chelia District, Ethiopia.MethodsA community-based cross-sectional study was conducted in the seven kebeles of Chelia District from 12th April to April 30th, 2020. Kebele is the smallest administrative unit in Ethiopia. Multistage sampling was used to select 631 participants who had a child aged 6 to 23 months. Data was entered into the Epi data version 3.1 and analyzed using Statistical Package for Social Science (SPSS) version 24. A binary logistic regression was fitted to identify significant factors associated with met MDD at 95% CI and a p-value < 0.05.ResultsLess than one-quarter (17.32%) of infants and young children aged 6 to 23 months had met MDD. The dominant group of foods consumed was composed of grains, roots, and tubers. Children aged18-23 months (AOR = 3.26, 1.36-7.79), mothers aged 35-44 years (AOR = 3.25, 1.38-7.45), housewives as household heads (AOR = 3.41, 1.56-2.37), children of smaller family size (AOR = 3.89, 1.18-12.78), and caregivers who studied grade 9-12 (AOR = 9.98, 5.66-17.10), who received information about food diversity during ANC (AOR = 1.48, 2.21-11.23) and PNC (AOR = 3.94, 2.04-7.63) visit, who travels less than one hour to reach the market (AOR = 2.94, 1.24-6.91) and who had high family income (AOR = 4.12, 1.90-8.19) were significantly associated with meeting MDD.ConclusionDietary diversity among children aged 6 to 23 months in Chelia District is low. It is proposed that caregivers on MDD be educated/trained and encouraged to share information during health service in order to increase the diverse diet and achieve a better dietary diversity score for infants and younger children.

Study the Relationship between Selective Characteristics of Farmers and Their Practicing Coping Strategies towards Household Food Security during Flood Period

A study was carried out at flood affected reverine villages of three upazilas (small administrative unit) under Jamalpur district in Bangladesh during September, 2011 to May, 2012 to explore the relationship, contribution and direct–indirect effect between personal attributes and their coping strategies towards household food security practiced by the farmers during flood. Data were collected from randomly selected respondents and analyzed through both the qualitative and quantitative techniques by using a statistical program. Out of 18 personal, economic, social and psychological characteristics of the farmers, the personal education, housing condition, annual income, annual expenditure, savings, organizational participation, participation in IGAs, cosmopoliteness, environmental awareness, knowledge on flood coping mechanisms and household food security had positive but both credit received and utilization of received credit had negative. In addition, age, family size, training received, risk orientation and involvement in safety net programs are insignificant with coping strategies towards household food security during flood period.

Determining the Coping Strategies towards Household Food Security Practiced by the Farmers in Flood Prone Areas

A study was carried out at each of three flood affected reverine villages of three upazilas (small administrative unit) under Jamalpur district in Bangladesh during September, 2011 to May, 2012 to find out the coping strategies towards household food security practices by the farmers during flood period. Data were collected from randomly selected 336 respondents of 6720 farm families through both the qualitative and quantitative techniques and analyzed with the help of SPSS. A three-point rating scale was used for measuring the coping strategies considering five components such as food preservation, food management, food collection, agricultural products protection and some social aspects. The overall situation about practicing coping strategy had medium to high level where 70.83 percent were practiced high, 29.17 percent medium and none of them were under practiced low coping strategy towards household food security. Based on the above findings, it can be said that still now there is an ample scope for the development workers to work with the flood affected people for creating awareness towards better utilization of existing resources for improving their food situation as well as livelihoods.

Constraints Faced by the Farmers in Practicing Coping Strategies towards Household Food Security during Flood

A study was carried out at each of three flood affected reverine villages of three upazilas (small administrative unit) under Jamalpur district in Bangladesh during September, 2011 to May, 2012 to find out the constraints faced by farmers in practicing coping strategies towards household food security during flood. The qualitative information as obtained from the focus group discussion (FGD) and scored causal diagrams (SCDs) were used to supplement the quantitative data to add new information if necessary in descriptive manner. Priority of constraints are differ from one farmer to another due to cultivated land topography, involvement of family labour in cultivation processes, precautionary measures taken against flood, previous experience, prediction of flood damage etc. ‘Lack of appropriate agricultural rehabilitation program’, ‘improper and inadequate relief distributed by GO/NGO’, ‘high price of agricultural inputs’ and ‘lack of technical knowledge on flood’ were identified as major constraints being faced by farmers in practicing flood coping strategy towards household food security. Lack of flood resistance crop varieties, inadequate organizational (GO/NGO) relief in time, lack of credit, agricultural labour and quality seeds in time (after flood) were found major constraints by almost all categories of farmers for overcoming food crisis created by the whim of nature. Go and NGO can take necessary steps against this adverse situations.

Factors Associated with Attitude towards Wife-Beating among Married Women of the Reproductive Ages in Arba Minch Town, Southern Ethiopia: A Community-Based Cross-Sectional Study.

Evidence from demographic and health surveys in various countries and Ethiopia too showed that more women are generally believed to justify intimate partner violence (IPV) than men do. An attitude that justifies IPV is one of the factors affecting victimization and perpetration from IPV. However, women's justification about the violence and factors affecting the justification are not well documented, particularly by addressing household factors such as household food conditions. Therefore, the present study aims to fill this gap among married women of childbearing age so that evidence can be drawn for holistic interventions. A community-based cross-sectional study was conducted among 696 currently married women of childbearing age (15–49) by using a multistage cluster sampling technique to obtain the women from 11 kebeles (the smallest administrative unit in the government structure of Ethiopia) of Arba Minch town, Southern Ethiopia. Data were collected using a pretested and structured questionnaire. Logistic regression was performed using IBM SPSS version 20. The odds ratio with its 95% confidence interval was used to show the degree of association between the outcome variable and explanatory variables. Nearly two-thirds (59.5%) of the study women justified wife-beating in at least one of the five conditions. A higher odds of justification of wife-beating was observed among women whose marriage was arranged by any other person than the couples themselves, from food-insecure households, with a family size of 5 and above, in the age group of 30–39 years, and whose partner was in the age range of 31–39 years. In contrast, lower odds of justification of wife-beating was observed among women having an age difference of 10 or more years with their partner and those in a household wealth index of middle and higher category. Despite great efforts in realizing gender equality in the country, a higher proportion of women were having the attitude that justifies wife-beating in the five conditions specified to them. Interventions targeting the improvement of women's attitude towards wife-beating should target against the traditional norms of arranged marriage, improve household food conditions, and decrease family size.

A method to define the relevant ego-centred spatial scale for the assessment of neighbourhood effects: the example of cardiovascular risk factors

IntroductionThe neighbourhood in which one lives affects health through complex pathways not yet fully understood. A way to move forward in assessing these pathways direction is to explore the spatial structure of health phenomena to generate hypotheses and examine whether the neighbourhood characteristics are able to explain this spatial structure. We compare the spatial structure of two cardiovascular disease risk factors in three European urban areas, thus assessing if a non-measured neighbourhood effect or spatial processes is present by either modelling the correlation structure at individual level or by estimating the intra-class correlation within administrative units.MethodsData from three independent studies (RECORD, DHS and BaBi), covering each a European urban area, are used. The characteristics of the spatial correlation structure of cardiovascular risk factors (BMI and systolic blood pressure) adjusted for age, sex, educational attainment and income are estimated by fitting an exponential model to the semi-variogram based on the geo-coordinates of places of residence. For comparison purposes, a random effect model is also fitted to estimate the intra-class correlation within administrative units. We then discuss the benefits of modelling the correlation structure to evaluate the presence of unmeasured spatial effects on health.ResultsBMI and blood pressure are consistently found to be spatially structured across the studies, the spatial correlation structures being stronger for BMI. Eight to 22% of the variability in BMI were spatially structured with radii ranging from 100 to 240 m (range). Only a small part of the correlation of residuals was explained by adjusting for the correlation within administrative units (from 0 to 4 percentage points).DiscussionThe individual spatial correlation approach provides much stronger evidence of spatial effects than the multilevel approach even for small administrative units. Spatial correlation structure offers new possibilities to assess the relevant spatial scale for health. Stronger correlation structure seen for BMI may be due to neighbourhood socioeconomic conditions and processes like social norms at work in the immediate neighbourhood.

Prevalence of acute diarrhea and water, sanitation, and hygiene (WASH) associated\xa0factors among children under five\xa0in Woldia Town, Amhara Region, northeastern\xa0Ethiopia

BackgroundDiarrhea among children under five is one of the significant public health concerns in developing countries, such as Ethiopia that is mainly attributed to inadequate water, sanitation and hygiene (WASH) services. Lack of data on the prevalence and factors associated with acute diarrhea in Woldia Town impedes the effectiveness of WASH programs in the area. Therefore, the aim of this study was to investigate the prevalence and WASH-associated factors of acute diarrhea among under-five children in this area. This study will help guide local diarrhea prevention and control programs.MethodsA community-based cross-sectional study was conducted among 485 children under age five from March to June 2018. The study participants were allocated proportionally and then households with children of this age group were selected from each kebele (the smallest administrative unit in Ethiopia) using a systematic random sampling technique. Data were collected from mothers/caregivers of the under-five children using a structured questionnaire and on-the-spot observation checklist. A binary logistic regression model with 95 % CI (confidence interval) was used to measure the association between dependent and independent variables. From the multivariable analysis, variables with a p-value < 0.05 were taken as factors significantly associated with acute diarrhea among under-five children.ResultsThe prevalence of acute diarrhea among the children was 17.6 % (95 % CI: 14.2–21.0 %). Almost two-thirds 307 (63.4 %) of study participants' main source of drinking water was a private tap; 320 (66.1 %) of households used less than 20 l per capita per day. About one-fifth 99 (20.5 %) of households used an improved sanitation facility. Only one-fifth (21.1 %) of the latrines had nearby handwashing facilities. Less than half 225 (46.5 %) of mothers/caregivers had good handwashing practice at critical times. Water consumption of less than 20 l per capita per day (adjusted odds ratio [AOR] = 2.45; 95 % CI: 1.36–5.84), unimproved sanitation facility (AOR = 3.57; 95 %CI: 1.64–6.51), practicing unsafe child feces disposal (AOR = 2.51; 95 % CI: 1.69–4.64), poor handwashing practice at critical times (AOR = 1.85; 95 % CI: 1.34–3.56) and having no information about diarrhea being prevented by handwashing with water and soap (AOR = 3.12; 95 % CI: 1.64–6.27) were significantly associated with acute diarrhea.ConclusionsMore than one in six children under age five had acute diarrhea, a proportion that could be considered relatively high. We recommend that government organizations and concerned stakeholders strengthen urban WASH programs to focus on increasing the availability of sufficient water for adequate daily consumption, and promote safe disposal of child feces and good handwashing practices at critical times. Further effort is needed to sensitize mothers/caregivers about diarrhea prevention through effective WASH activity to reduce the burden of this problem among children under five.

Refined water security assessment for sustainable water management: A case study of 15 key cities in the Yangtze River Delta, China

Water security represents ecological security and a policy priority for sustainable development; however, un-gridded assessment results cannot be used to support urban environmental management decisions. This study proposes a systematic framework to obtain a gridded regional water security assessment, which reflects the regional natural resource, based on the index system derived from the Pressure-State-Response (PSR) model and the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model. The results were applied to sustainable water management. Using 15 key cities in the Yangtze River Delta (YRD) region as a case study to apply the methodology, we found that the comprehensive water security was relatively high and high-value areas were widely distributed, accounting for about two-thirds of the study area. Low-value areas were mainly distributed in central and eastern regions, such as Shanghai, Suzhou, and Nanjing. There was evidence of a water resource shortage during the twelve-month period studied, particularly in August. The proportions of comprehensive water security in each administrative unit and the differences between simulated and target water quality could be used in the spatial planning and the exploration of payments for ecosystem services (PES) mechanism in county-level or smaller administrative units. Despite the premise requirement and the grid resolution problems of the InVEST model, it can be concluded that our assessment method proves capable of matching spatial and temporal differences in water supply and demand at a fine scale, and results can be used to supply useful information for urban management decision making.

A Comprehensive Approach to the Design of a Renewable Energy Microgrid for Rural Ethiopia: The Technical and Social Perspectives

In view of Ethiopia’s significant renewable energy (RE) potential and the dynamic interactions among the components of the Water–Energy–Food (WEF) Nexus, we attempted to incorporate solar and small-scale hydropower into the optimal design of an environmentally friendly microgrid with the primary goal of ensuring the sustainability of irrigation water pumping, while taking advantage of existing infrastructure in various small administrative units (kebele). Any additional generated energy would be made available to the community for other needs, such as lighting and cooking, to support health and food security and improve the general quality of life. The novelty of the study stems from the utilization of in situ social data, retrieved during fieldwork interviews conducted in the kebele of interest, to ascertain the actual needs and habits of the local people. Based on these combined efforts, we were able to formulate a realistic energy demand plan for climatic conditions typical of Sub-Saharan Africa agricultural communities and analyze four different scenarios of the microgrid’s potential functionality and capital cost, given different tolerance levels of scheduled outages. We demonstrated that the RE-based microgrid would be socially and environmentally beneficial and its capital cost sensitive to the incorporation of individual or communal machines and appliances. Ultimately, the social impact investigation revealed the design would be welcomed by the local community, whose members already implement tailor-made solutions to support their agricultural activities. Finally, we argue that extended educational programs and unambiguous policies should be in place before any implementation to ensure the venture’s sustainability and functionality.

Geospatial epidemiology of leprosy in northwest Bangladesh: a 20-year retrospective observational study

BackgroundLeprosy is known to be unevenly distributed between and within countries. High risk areas or ‘hotspots’ are potential targets for preventive interventions, but the underlying epidemiologic mechanisms that enable hotspots to emerge, are not yet fully understood. In this study, we identified and characterized leprosy hotspots in Bangladesh, a country with one of the highest leprosy endemicity levels globally.MethodsWe used data from four high-endemic districts in northwest Bangladesh including 20 623 registered cases between January 2000 and April 2019 (among ~ 7 million population). Incidences per union (smallest administrative unit) were calculated using geospatial population density estimates. A geospatial Poisson model was used to detect incidence hotspots over three (overlapping) 10-year timeframes: 2000–2009, 2005–2014 and 2010–2019. Ordinal regression models were used to assess whether patient characteristics were significantly different for cases outside hotspots, as compared to cases within weak (i.e., relative risk (RR) of one to two), medium (i.e., RR of two to three), and strong (i.e., RR higher than three) hotspots.ResultsNew case detection rates dropped from 44/100 000 in 2000 to 10/100 000 in 2019. Statistically significant hotspots were identified during all timeframes and were often located at areas with high population densities. The RR for leprosy was up to 12 times higher for inhabitants of hotspots than for people living outside hotspots. Within strong hotspots (1930 cases among less than 1% of the population), significantly more child cases (i.e., below 15 years of age) were detected, indicating recent transmission. Cases in hotspots were not significantly more likely to be detected actively.ConclusionsLeprosy showed a heterogeneous distribution with clear hotspots in northwest Bangladesh throughout a 20-year period of decreasing incidence. Findings confirm that leprosy hotspots represent areas of higher transmission activity and are not solely the result of active case finding strategies.