Toilet Hygiene Research Articles

Application of Peer Group Support with the Health Promotion Model Approach in Increasing Perceived Benefit Of Action and Perceived Self Efficacy

<p><em>There are problem related to students health behavior in Islamic boarding school, such as they do not washing their hand before they have their meals, hanging wet clothes in their room, and they do not really care to the toilet hygiene. The aims of this research was to knowing the effect of peer group support to perceived benefit of action and perceived self efficacy by applying students lifestyle management using health promotion model approach. The design was quasy experimental, pre post test control group the population were students who stayed in Islamic boarding school in An Najiyah, As Syafiiyah and Al Jihad Surabaya, and the total sample was 150 student, 75 in control group, 75 in intervention group, the sample taken by simple random sampling. In intervention group they’ve got health education and peer group support while the control only got health education by giving a student lifestyle management module. The independent variable was peer group support and dependent variable were perceived benefit of action and perceived self efficacy. The data taken by questionnaire and was analyzed by Wilcoxon signed test and Mann Whitney test. The result showed that after the treatment, students in intervention group have positive perceive benefit of action was 92% and 100 % have high perceived self efficacy, meanwhile in control group there were 72% students who have negative perceived benefit of action and 60% have low perceived self efficacy. It means that peer group support could change the students perception and increasing self efficacy to set a going lifestyle management based on health promotion model approach. </em></p>

Validation of Medicare Rehabilitation Functional Assessments in Routine Care

Assessment of functional outcomes is currently limited by a lack of large data sets. Functional assessments are included in Medicare rehabilitation assessment files, yet the validity of these measures in routine care is unknown. To evaluate the validity of individual-level routine care functional assessments in Medicare rehabilitation settings compared with criterion-standard National Health and Aging Trends Study (NHATS) research assessments obtained no more than 90 days later. This cross-sectional study of individuals aged 65 years and older used the 2011 to 2015 NHATS linked with Medicare assessment files. Individuals with a discharge assessment from inpatient rehabilitation facilities, skilled nursing facilities, or home health agencies and a criterion-standard NHATS assessment were included. Data analysis was performed June 2019 to November 2019. Summary functional assessment based on independence with eating, toilet hygiene, bathing, dressing, transfers, and mobility or walking. Linear regression was used to assess agreement between the 2 scales, adjusting for time between assessments and rehabilitation setting. A total of 1036 adults aged 65 years and older (671 [64.8%] aged ≥80 years; 670 [64.7%] women; 685 [66.1%] white participants) met the study criteria. The correlation of the assessments was 0.63 (95% CI, 0.59 to 0.66; mean [SD] rehabilitation score, 27.5 [7.2]; mean [SD] NHATS score, 30.5 [10.1]). The correlation increased to 0.66 (95% CI, 0.60 to 0.71) for assessments no more than 30 days apart. The linear regression model adjusting for rehabilitation setting and days between evaluations found the assessments were strongly correlated (β = 1.00 [95% CI, 0.93 to 1.08]; intercept, 0.72 [95% CI, -1.79 to 3.24]; R2 = 0.42). Differences in scores were generally small (mean [SD] of NHATS - rehabilitation score, 2.96 [7.91]), and only 59 assessments (5.7%) differed by more than 2 SDs of the mean difference. Rehabilitation service scores were typically higher than NHATS scores in individuals with lower mean scores; however, the population with lower mean scores was small (156 [15.1%]). In this large sample of older US adults, routine care rehabilitation facility functional assessments had overall moderate correlation with criterion-standard research assessments.

Study of the “Toilet Revolution” Management Model in Tourist Scenic Spots

The “Thirteenth Five-Year Plan” National Tourism Public Service Plan promoted the revolution of public toilets in tourist attractions across the country. Although the size of the toilet is small, it affects each tourist's impression of a scenic spot and the review of service quality. This article selects three 5A-level scenic spots with large passenger traffic in Guangdong Province including Luo-Fu Mountain Scenic Spot in Huizhou, Dan-Xia Mountain Scenic Spot in Shaoguan, and Overseas Chinese Town East Resort in Shenzhen as cases. According to the questionnaires from tourists in the scenic area, we have found some problems in the current public toilets, such as imbalanced bathroom numbers of men and women, unclear toilet signs, difficulty in finding toilets, unsatisfactory toilet hygiene, etc. We proposed a series of constructive solutions for the toilet revolution of Guangdong and even the whole country as references.

Faktor perilaku meningkatkan resiko keputihan

Reproductive health is a complete state of physical, mental and social well-being. Cleanliness of the female area for women is very important because it can make women feel comfortable and can prevent infectious diseases and infections. This research to determine the relationship of behavioral factors (urinary habits, use of irritants, habits during menstruation, use of underwear), and environmental factors (toilet hygiene) with the occurrence of vaginal discharge in students of the Great Achievement Midwifery Academy. This research uses analytic type with cross sectional approach. The sample of this research is 190 students of the Great Achievement Midwifery Academy, bivariate analysis using chi square. It was found that 134 (70.5%) respondents experienced vaginal discharge, there was a significant relationship between the use of irritants and vaginal discharge (p value = 0,000 and OR = 27.7), there was a significant relationship between the habit of urination and vaginal discharge (p value = 0,000 and OR = 34) , there is a significant correlation between the use of underwear with vaginal discharge (p value = 0.002 and OR = 36), there is a significant relationship between menstrual habits and vaginal discharge (p value = 0.006 and OR = 2.9). The use of irritants, urinary habits, underwear and voiding habits are risk factors for vaginal discharge.

Prevalence and Determinants of Stunting Among Adolescent Girls in Ethiopia

PurposeThe purpose of this study was to assess the prevalence of stunting and identify factors associated with it among adolescent girls in Ethiopia. Design and methodsFrom 15,683 women participants of the 2016 Ethiopian Demographic and Health Survey (EDHS), a sub-sample of 3,498 adolescents aged 15−19 years were selected; from which 2,733 adolescents who had a complete response to all variables of interest were retained for analysis. Variables were selected using conceptual framework. We used height-for-age Z-score index (HAZ) growth standards less than ‐2 to identify stunting. We adjusted for weights and sampling design. Bivariable and multivariable regression analysis was carried out. ResultsThe prevalence of stunting was 410(15%); comprising of 353 (12.9%) moderate and 57(2.2%) severe stunting cases. The odds of being stunted among respondents living in Tigray (AOR = 3.38, 95%CI: 1.47, 7.79), Amhara (AOR = 2.66, 95%CI: 1.18, 6.012) and Addis Ababa (AOR = 4.24, 95%CI: 1.84, 9.79) were higher compared to respondents living in Dire-Dawa. Adolescent girls living in rural areas (AOR = 2.29, 95%CI: 1.10, 4.75) had higher odds of stunting compared to those living in urban areas. Adolescent girls from the lowest wealth quintile (AOR = 2.38, 95%CI: 1.56, 9.67) had higher odds of stunting compared to the highest wealth quintile. Respondents who have one child (AOR = 3.33, 95%CI: 5.78, 15.31), and two children (AOR = 4.01, 95% CI: 1.39, 7.73) had higher odds of being stunted compared to those who have no children. The odds of stunting among adolescent girls having no access to safe water supply (AOR = 3.17, 95% CI: 1.21–8.37) and having no access to hygienic toilet (AOR = 1.44, 95% CI: 1.17, 1.95) were higher compared to those having access to safe water supply and hygienic toilets respectively. ConclusionsThe current study revealed that stunting is an important public health problem among adolescent girls in Ethiopia. Practice implicationsHealth care workers should screen nutritional status of adolescent girls and assess the risk factors of stunting giving emphasis to adolescent girls living in rural areas, who are within the lowest wealth quintile, who have children, and those who have no access to safe water supply and have no access to hygienic toilets.

Toilet Hygiene System

In the cutting-edge world, the advances are definitely grown, yet at the same time the cleanliness in our nation is under risk. The main aim is to deliver clean and hygiene toilets. All the toilets should be clean and hygiene. Indian government has introduced the scheme called “Swachh Bharat” (Clean India).[1] Keeping the toilets uncontaminated is the one of the objectives of Clean India scheme. In future, it can show the major part in clean India scheme. In an Existing system, they are focused only on identifying the dirt in the toilets. In that system, we have determined on keeping toilets clean. It can dodge many problems. It may create the consciousness amongst people about the toilet management. Therefore, this development is to use safe and hygienic toilets. Hygiene in public toilets is generally monitored by manual inspection. Data from many cities reveal that manual inspection regime has systemic biases and enforcement is not uniform. Alternatively, hygiene may be monitored by using sensors to measure concentration of gases produced as by-products. However, sensor calibration must be done for each installation separately which increases the cost of such a system. We propose a hybrid hygiene monitoring system that combines user ratings to autocalibrate the gas sensors to produce reliable results. Our algorithm combines both these inputs into a community benchmark hygiene rating.

A mixed-methods study on toilet hygiene practices among Chinese in Hong Kong

BackgroundPublic toilets are a common transmission vector of infectious diseases due to environmental contamination. Research on Chinese people’s hygiene practices in public lavatories are lacking. This study examined Chinese people’s hygiene practices in public lavatories in Hong Kong.MethodsWe conducted qualitative interviews and a self-administered questionnaire survey with local residents from June 2016 to April 2018. Four focus group discussions and three individual interviews informed the design of the questionnaire. We recruited interviewees and survey respondents via social service centers. The interviews and questionnaire focused on the public’s daily practices and hygiene behaviors in public toilets. Content analysis of qualitative data was conducted. Multivariable logistic regressions were used to examine the association between age and toilet hygiene behaviors.ResultsOur qualitative component revealed a range of handwashing practices, from not washing at all, washing without soap, to washing for a longer time than instructions. Other toilet use practices were identified, such as not covering toilet lid before flushing and stepping on toilet seats due to dirtiness, and spitting into toilet bowls or hand basin.Totally, 300 respondents completed the questionnaire. Among them, 212 (70.9%) were female and 246 (86.1%) were aged 65 or below. More than two thirds always washed hands with soap (68.7%) and dried hands with paper towels (68.4%). Up to 16.2% reported stepping on toilet seats and 43.9% never covered the toilet lid before flushing. Over one fourth (26.4%) spit into squat toilets/ toilet bowl. Regression analyses showed that the elderly group were less likely to report stepping on toilet seats (adjusted odds ratio, AOR = 0.17, 95%CI 0.03–0.88), flushing with the toilet lid closed (AOR = 0.40, 0.16–0.96), but more likely to spit into squat toilets/ toilet bowl (AOR = 4.20, 1.50–11.74).ConclusionsHong Kong Chinese’s compliance to hygiene practices in public toilets is suboptimal. Stepping on toilet seat is a unique Chinese practice due to the dirtiness of toilet seats. Spitting practices may increase the risk of airborne infectious diseases and need improvement. Measures are needed to improve toilet hygiene behaviors, including public education campaigns and keeping toilet environment clean.

Socio-economic determinants and environmental hygiene factors of female caregiver burden in two selected low-income communities in Cape Town, South Africa.

IntroductionStudies on female caregiver burden and its determinants in relation to physical environment and social support in low-income and middle-income countries are limited. This study evaluates the relationship between caregiving physical environment, social support and well-being of female caregivers and care recipients in Cape Town, South Africa.MethodsOne hundred (100) each of black African and coloured female caregivers from two different population settlements were randomly selected. Structured questionnaire was employed to gather information from caregivers. Description and correlation analyses were used to examine the association between health status of care recipients, environmental hygiene factors and female caregiver burden.ResultsAbout 49.5% of the female caregivers were between 50-59 years and worked full-time (≥40 hours per week). Better hygiene environment and working conditions are major determinants of caregiver burden and care recipient's physical health. Better hygiene conditions in the kitchen and toilet significantly increased care recipients' and caregivers’ physical health (P<0.05). Diarrhoea was found to be significantly associated with poorer environmental hygiene. Over 50% of the reported diarrhoea cases were among care recipients with poorer kitchen and toilet hygiene. Bad environmental hygiene increased the risk of diarrhoea among care recipients and caregivers. Physical health of the care recipients and social grants influenced the burden on the female caregiver.ConclusionIncrease social grants and attention to environmental conditions of caregiving will improve the physical health and living standard of the care recipients and caregivers.

Exploring Gender Issues and Challenges Faced by Women Bank Employees in Work and Family of Sylhet City, Bangladesh

The study was conducted to evaluate the gender related issues and challenges of women bank employees both in work and with family in Sylhet city in Bangladesh. Data were collected through structured questionnaire from 120 respondent’s sampled using simple random sampling. Data were analyzed using descriptive statistics through SPSS software and ranked the challenges using Garrett ranking method. In case of work, problems regarding management of overtime periods were ranked as first where average Garrett score was 64.87 and the majority (36.7%) of the respondents strongly agreed while (10.8%) strongly disagreed with this problem. The lowest average Garrett score was 77.88 for sexual harassment and majority (49.2%) strongly disagreed while (2.5%) strongly agreed with this problem. On contrary, the highest problem in family was long working hours which had an average Garrett score of 57.26 and majority (50.0%) strongly agreed along with (5.8%) of respondents disagreed with this problem. The lowest problem was pressure from family to leave the job which occupied 75.50 average Garrett score and (49.2%) of respondents strongly disagreed whereas (3.3%) strongly agreed with this problem. Besides, they faced other problems like lack of leave facilities, lack of hygienic toilet facilities, problems in balancing family and job and problems of child rearing. It can be concluded that the challenges they faced in working place were less than they encountered in family. It is recommended that several coping strategies must be implemented by authority and government such as developing day care facilities in every branch of banks which might ensure better childcare and reduce the tension of working mothers, adequate maternity leaves in different private banks, area based job posting and limit long working hours by enacting protective laws in order to ensure their proper development.

Functional parameter measurements in children with ataxia telangiectasia.

To collect preliminary functional data on ataxia telangiectasia and create a disease specific scale: the Ataxia Telangiectasia Functional Scale (ATFS). Retrospective information on patients with ataxia telangiectasia referred to the Assistive Technology Unit was included. Functional mobility scales (the Gross Motor Function Classification System [GMFCS] and the Functional Mobility Scale [FMS]-5, FMS-50, FMS-500) and activities of daily living [ADL] parameters were recorded. We created a 51-point ATFS, that consisted of three ambulation items adapted for ataxia telangiectasia in the frame of FMS (home, school, outdoors), five ADL items, and one schooling item. Twenty-seven participants (17 males, 10 females; mean age 10y 8mo [SD 5y 1mo], range 1y 9mo-25y 6mo), were enrolled; 168 measurements were recorded. Patients walked at a mean age of 1year 4months (SD 5y 4mo) and lost ambulatory capacity at 8years 8months (SD 2y 1mo). GMFCS level and FMS-5, FMS-50, FMS-500 assessments correlated with age (Spearman's correlations r=0.555, -0.617, -0.639, -0.662 respectively, p<0.01 for all), but plateaued after 12years of age. ATFS mean score was 37.46 (SD 7.88) and increased with age (Spearman's correlation r=0.585, p<0.01). The scale showed threestages of disease progression. In this pilot study we show longitudinal functional data of ambulation and ADL skills in ataxia telangiectasia, and created a framework for a functional scale. This functional scale closely approximated disease course, but further validation is required. The Gross Motor Function Classification System and the Functional Mobility Scale are ill-suited for ataxia telangiectasia assessments. Three functional mobility scales (home, school, outdoors) suited to ataxia telangiectasiawere created. The Ataxia Telangiectasia Functional Scale (ATFS) combines mobility and items of activities of daily living. The ATFS closely approximates the three-stage progression of the disorder.

Planned sheltering as an adaptation strategy to climate change: Lessons learned from the severe flooding in Anhui Province of China in 2016

BackgroundEvacuation and sheltering is both a disaster response measure and a strategy to adapt to climate change, and consequently address the Sustainable Development Goals. Research has found that displacement does cause negative health impacts to evacuees, but few studies have observed how planned sheltering might reduce adverse health impacts. This article identifies the good practice and lessons learned from China's response to severe flooding in Anhui province in 2016. MethodsFirst, we identified the key phases for disaster sheltering by analyzing related government reports. We then interviewed 21 relevant professionals in order to identify good practice and lessons learned which could lead to better health outcomes (e.g., reduce fatalities, infectious diseases, and mental health problems). Interviewees were selected through a purposive sampling strategy, which identified emergency management professionals and those who had been assigned evacuation, sheltering, or medical tasks. Finally, thematic analysis and the constant comparative method were used to code, identify, and describe the good practice and challenges during key phases. ResultsGood practice included: using early warning systems to advise communities of risks and enforce evacuation in the flood zone; preparing and using schools as shelters with open-ended periods of operation; and, providing stable shelter accommodations which offered medical and public health services, clean drinking water and food, sanitation, and toilet hygiene through multiagency cooperation. Challenges included: providing mental health services, evaluating intervention effectiveness, managing volunteers, monitoring long-term health effects, and providing economic support. ConclusionsThe unintended negative effects caused by sheltering during extreme weather can be reduced. This requires close cooperation among government entities to establish planned mass shelters with appropriate levels of personal, environmental and healthcare support and to ensure long-term physical and mental health support. Additionally, if disaster mitigation strategies are integrated with climate adaptation plans, we can design more health-oriented and sustainable cities.

Screening for Salmonella typhi Serum Antibodies and Stool Antigen among Undergraduate Students of Babcock University, Ilishan-Remo, Ogun State, Nigeria

Background: Salmonella typhi infection is endemic in Nigeria with varied morbidity and mortality rates.&#x0D; Aim: The aim of this study is to determine the prevalence rate of Salmonella typhi infection among the undergraduate Students of Babcock University, Ilishan-Remo, Ogun State using rapid diagnostic method.&#x0D; Study Design: This is a descriptive-epidemiological survey. &#x0D; Place and Duration of Study: Department of Medical Laboratory Science, Babcock University, Ilishan-Remo, Ogun State, Nigeria, between April and June, 2018. &#x0D; Materials and Methods: Blood and stool specimens were randomly collected from 200 consenting undergraduate Students and screened using Solid Rapid Diagnostic Typhoid (United Kingdom) and Accu-Chek S. typhi antigen (India) Test Kits, respectively according to the manufacturer instruction. &#x0D; Results: Out of the 200 participants screened, 7(3.5%) were positive for S. typhi serum immunoglobulin M antibody (IgM Ab), 68 (34.0%) were positive for S. typhi serum immunoglobulin G antibody (IgG Ab), while 18 (9.0%) were positive for S. typhi stool antigen (SAg). Percentage sero-positivity for S. typhi serum IgG antibody was significantly (P &lt; 0.05) higher among participants who were male (29.0%), 16-20 years (17.0%) and Occupants of Hall 15 (8.0%). Risk factors associated with the occurrence of Salmonella typhi infection in this study include: lack of Typhoid fever vaccination, past history of typhoid fever, drinking of unsafe water and raw cow milk, consumption of beef, poultry and street vended food, as well as poor toilet hygiene.&#x0D; Conclusion: The outcome of this study show that Salmonella typi infection exist among undergraduate Students of Babcock University, Ilishan-Remo, Ogun State; therefore, prompt treatment of all identified cases, in addition to a sustainable implementation of preventive measures is needed to halt the cycle of transmission.

Analyze of Tanjung Api-Api Ferry Port Service Performance South Sumatera, Indonesia

The Government of Indonesia has established a marine infrastructure development program which is the concept of maritime logistics to connect the major ports of the archipelago. This study aims to determine the level of satisfaction of Tanjung Api-Api crossing port, as this can be a reference for improving the quality of services to passengers. During this quality of service has been pretty good, but at certain moments felt less, especially during the holiday season, where there will be accumulation of passengers. The method used in this research is the method of analysis of Importance and Performance Analysis (IPA). From the calculation results, it can be seen that the passenger satisfaction level and the eight factors become the main priority for port management for service enhancement, namely the condition of road access to the port, night lights, street access lighting to night ports, public / mikrolet from port and Conformity of Transportation Tariff, distance and availability of taxi from port and Conformity of Transportation Tariff, Security of crime, Cleanliness of waiting room, air circulation waiting room, and Toilet Hygiene on board, Ship Cleanliness, Availability of worship places on boat, Availability of Wald (Clinic) for sick passenger, Officers quick actions when there is a problem.

Individual-, maternal- and household-level factors associated with stunting among children aged 0-23 months in Bangladesh.

Childhood stunting remains a major public health concern in Bangladesh. To accelerate the reduction rate of stunting, special focus is required during the first 23 months of a child's life when the bulk of growth takes place. Therefore the present study explored individual-, maternal- and household-level factors associated with stunting among children under 2 years of age in Bangladesh. Data were collected through a nationwide cross-sectional survey conducted between October 2015 and January 2016. A two-stage cluster random sampling procedure was applied to select 11 428 households. In the first stage, 210 enumerations areas (EA) were selected with probability proportional to EA size (180 EA from rural areas, thirty EA from urban slums). In the second stage, an average of fifty-four households were selected from each EA through systematic random sampling. Rural areas and urban slums of Bangladesh.ParticipantsA total of 6539 children aged 0-23 months. Overall, 29·9 % of the children were stunted. After adjusting for all potential confounders in the modified Poisson regression model, child's gender, birth weight (individual level), maternal education, age at first pregnancy, nutrition (maternal level), administrative division, place of residence, socio-economic status, food security status, access to sanitary latrine and toilet hygiene condition (household level) were significantly associated with stunting. The study identified a number of potentially addressable multilevel risk factors for stunting among young children in Bangladesh that should be addressed through comprehensive multicomponent interventions.

Prevalence and associated factors of Enterobacteriaceae producing extended spectrum beta-lactamase carriers in Thai rural area, 2018

Background Enterobacteriaceae producing Extended Spectrum beta-lactamase, which resist to Penicillin and Cephalosporins was found to have 65.7% prevalence in rural community in Thailand 2012, higher than that of similar research in other countries. This resistance strain inhabited in lower intestinal tract, which can be found in feces. So, the study of associated factors for ESBL carrier is important for preventing spread and decreasing the prevalence. Methods The sample of this study including 414 volunteers from Phra Phloeng Community, Khao Chakarn District, Sa Kaeow Province samples presented at the time of questionnaire interviewing. This study use quantitative method. Cross-sectional study was designed to identify the prevalence and associated factors of being Enterobacteriaceae ESBL carriers. For specimen collection, volunteers were informed with the protocol of stool collection individually. Fresh stool will be transport to Cary-blair transport media in 2 hours. The transport media were refrigerated in foam box at 2–4 °C and were sent to Bangkok via public van in 12 hours. For laboratory process. We used selective agar as screening test and combination disk as confirmation test. MALDI-TOF was used to identify the species of ESBL colony. Online questionnaire to collect the data in the field. Questionnaire and lab results were matched by SPSS. Descriptive is used to show demographic data and prevalence, while analytic is used to find the relationship between each factor. Results The prevalence of Enterobacteriaceae producing ESBL carriers in Thai rural area, conducted in 455 healthy all ages volunteers is 73.8%. The predominated organism is Escherichia coli, which 337 colonies were isolated (72.6%). The second is Klebsiella pneumoniae (8.0%). We found that Married or living as spouse have more chance to be carriers 3.9 time when compare to those that single or widow or living separately from partner. Those who have education level at elementary school and above have more chance of being carriers 2.7 time when compare to people with education below elementary school. Having domestic mammal in the house have less chance of being ESBL carriers 0.4 time when compare to those that don’t have domestic mammal in their house. Discussion The prevalence of ESBL carriers in Thai rural area is higher than the similar study conducted in 2012, despite the government deliberately control of antibiotic use in both hospital and community started in 2015. Our study found that living in close contact like being spouse which is normally living in the same room, sleep on the same bed, and other intimacy contact is a risk support the idea. The cause of high prevalence could be that ESBL carriers in the area have poor hand and toilet hygiene causing the spread of ESBL from human-to-human- and to-environment rather than antibiotics misuse. Having some education level is a risk factor. We think that because they know if they are sick they should use medicine to cure their illness. However, they do not know how to use medicine properly. Anyway, in this study we did not ask about their behavior of using antibiotics. Further research using qualitative study might be useful in this area. Conclusion The public health protocol of controlling antibiotic use in human and livestock is theoretically response to reduce the new incidence, however is not enough to control the spreading of this germ due to its survival ability in harsh environment. To reduce the prevalence in community we should also focus on control the spreading on both human-to-human and human-to-environment especially farmers who have a chance to contact to community water source, soil and livestock. Intervention like using soap or alcohol gel after using toilet or after doing farm should be raised to the community awareness. Promotion of using toilet even working in the farm is also important issue that need to be put an effort for.

Adaptabilité Biologique Chez Des Enfants Issus De Milieu De Vie Différent

The biological adaptability of the child seems to be realized according to the living conditions that are offered to him. The influence of these conditions on the biophysiological functioning of the child was not sufficiently examined. This paper focuses on comparing the biological adaptability of children living in poorer socio-health conditions to that of their peers from a more appropriate socio-health environment. It covered 189 Ivorian children aged between 6 and 59 months, including 103 from inadequate social and health care settings and 86 that was selected in a relatively adequate sociohealth environment. The examination of the biological adaptability of the two groups of children was done by considering the frequencies of physical diseases. The results show that infants and children who live in an environment that lacks infrastructure for quality drinking water, hygienic toilet for their needs, lost wells or washbasins for sewage disposal, and trashes or covered barrels for the conservation of household garbage have a higher rate of biological miss-adaptabilities than their peers from an environment that offers these possibilities. The rate of malaria (26.4%, 20.6%), intestinal infections (28.4%, 37.4%), anemia (7.5%, 10.9%) in infants and children whose health and social needs are not realized differ significantly from those of their counterparts who have less difficulty achieving theirs (malaria: 19.5%, 18.4%, intestinal infections: 0%, 0%, anemias: 0%, 0%). These results confirm the hypothesis that the structuring of the living environment is a factor that has a variable effect on biological adaptability.

Molecular genotyping of Giardia duodenalis in children from Behbahan, southwestern Iran.

Giardia duodenalis is an intestinal flagellated protozoan that infects humans and several animal species. Giardiasis causing more than 200 million symptomatic infections globally is one of the most common causes of diarrhea in developing countries. Based on molecular studies mainly targeting the small-subunit (SSU) rRNA gene locus of the parasite, eight assemblages (A to H) have been identified in humans and other animal species. The aim of the current study was to evaluate the frequency and molecular diversity of G. duodenalis in children from rural and urban day care centers from Behbahan, southwestern Iran. This cross-sectional study was based on a concentration method for the microscopic detection of G. duodenalis in stool samples of 450 children, aged 1-7years, in Behbahan, southwestern Iran. The survey was conducted from December 2015 to May 2016. PCR methods targeting the SSU rRNA and triose phosphate isomerase (TPI) genes of G. duodenalis were used for the identification and genotyping of the parasite isolates. Based on sucrose flotation and microscopy techniques, 2.7% (12/450) of children were infected with G. duodenalis, of which six (50.0%) were males and the other six (50.0%) were females. Overall, 91.7% (11/12) of the infections were detected in children from rural areas. The SSU rRNA and TPI genes were amplified successfully in nine and eight, respectively, of the Giardia-positive samples at microscopy. Among the eight TPI sequences, assemblage A, sub-assemblage AII, was identified in five of the isolates. The sequences of the three remaining samples were untypable. Although no significantly statistical difference between genotype and clinical symptoms was found, five out of the eight isolates identified as assemblage A were obtained in asymptomatic children. Giardia duodenalis infections were more prevalent in children from rural day care schools, and the predominant assemblage was A, sub-assemblage AII. The higher prevalence of giardiasis in rural areas might be related to differences in personal hygiene habits, parents' education level, source of drinking water, and inadequate hygienic toilet facilities in rural areas.

The challenges of cholera at the 2017 Hajj pilgrimage

The challenges of cholera at the 2017 Hajj pilgrimage

Determinants of childhood stunting in the Democratic Republic of Congo: further analysis of Demographic and Health Survey 2013\u201314

BackgroundPrevalence of child stunting in the Democratic Republic of Congo (DRC) is among the highest in the world. There is a need to systematically investigate how stunting operates at different levels of determination and identify major factors contributing to the development of stunting. The aim of this study was to look for key determinants of stunting in the DRC.MethodsThis study used data from the DRC Demographic Health Survey 2013–14 which included anthropometric measurement for 9030 under 5 year children. Height-for-Age Z score was calculated and classified according to the WHO guideline. The association between stunting and bio-demographic characteristics was assessed using logistic regression.ResultsPrevalence of stunting was much higher in boys than girls. There was a significant rural urban gap in the prevalence of stunting with rural areas having a larger proportion of children living with stunting than urban.Male children, older than 6 months, preceding birth interval less than 24 months, being from lower wealth quintiles had the highest odds of stunting. Several provinces had in particular high odds of stunting. Early initiation of breastfeeding, mother’s age more than 20 years at the time of delivery had lower odds of stunting. The taller the mother the less likely the child was to be stunted. Similarly, mother’s BMI, access to safe water, access to hygienic toilet, mother’s education were found negatively correlated with child stunting in the bivariate logistic regression, but they lost statistical significance in multivariate analysis together with numbers of children in the family and place of residence.ConclusionsChild stunting is widespread in the DRC and increasing prevalence is worrisome. This study has identified modifiable factors determining high prevalence of stunting in the DRC. Policy implementation should in particular target provinces with high prevalence of stunting and address modifiable determinants such as reducing socioeconomic disparity. Nutrition promotion intervention, including early initiation of breastfeeding should be an immediate priority.

A unified framework for developing effective hygiene procedures for hands, environmental surfaces and laundry in healthcare, domestic, food handling and other settings.

Hygiene procedures for hands, surfaces and fabrics are central to preventing spread of infection in settings including healthcare, food production, catering, agriculture, public settings, and home and everyday life. They are used in situations including hand hygiene, clinical procedures, decontamination of environmental surfaces, respiratory hygiene, food handling, laundry hygiene, toilet hygiene and so on. Although the principles are common to all, approaches currently used in different settings are inconsistent. A concern is the use of inconsistent terminology which is misleading, especially to people we need to communicate with such as the public or cleaning professionals.This paper reviews the data on current approaches, alongside new insights to developing hygiene procedures. Using this data, we propose a more scientifically-grounded framework for developing procedures that maximize protection against infection, based on consistent principles and terminology, and applicable across all settings.A key feature is use of test models which assess the state of surfaces after treatment rather than product performance alone. This allows procedures that rely on removal of microbes to be compared with those employing chemical or thermal inactivation. This makes it possible to ensure that a consistent “safety target level” is achieved regardless of the type of procedure used, and allows us deliver maximum health benefit whilst ensuring prudent usage of antimicrobial agents, detergents, water and energy.