Toilet Use Research Articles

Physical inactivity before stroke is associated with dependency in basic activities of daily living 3 months after stroke.

Physical inactivity is a leading risk factor for non-communicable diseases, including stroke. Moreover, physical inactivity before stroke is associated with stroke severity, which, in turn, can cause disability. However, it remains unclear whether physical inactivity before stroke is associated with dependency in basic activities of daily living (ADL). The aim of this study was to evaluate whether physical inactivity before stroke influences ADL dependency 3 months after stroke. This longitudinal study was based on data from three Swedish registries. Patients with acute stroke who were admitted to the Sahlgrenska University Hospital between 9 November 2014 and 30 June 2019 were included in the study. Baseline data were collected from the three stroke units, and self-reported questionnaires were used to collect 3-month follow-up data. Physical inactivity before stroke was the primary independent variable that was self-reported using the Saltin-Grimby physical activity level scale. ADL dependency was a composite measure of three tasks: mobility, dressing, and toilet use. A binary logistic regression analysis was used to explain the association between physical inactivity before stroke and basic ADL 3 months after stroke. In total, 3,472 patients were included in the study. The median age was 75 years, 49% of the patients were physically inactive before stroke, and 75% had a mild stroke. ADL dependency at follow-up was reported to be 32%. Physically inactive patients, compared with physically active patients, had 2.35 times higher odds for ADL dependency 3 months after stroke (odds ratio 2.30 [95% CI 1.89 - 2.80]). The model correctly classified 84% of the patients (the area under the receiver operating characteristic curve was 0.84 [95% CI, 0.83 - 0.86]). The findings of this study suggest that physical inactivity before stroke is associated with dependency in basic ADL 3 months after stroke. In addition, older age, female sex, pre-stroke living conditions, need for help, previous stroke, and admission stroke severity are significant contributors to dependency.

Demographic profile of HIV and helminth-coinfected adults in KwaZulu-Natal, South Africa.

Helminth and HIV infections are endemic among poor populations. Studies investigating the socio-demographic and economic risk factors associated with dual HIV and helminth coinfection are scarce. This study aimed to describe risk factors associated with HIV and helminth coinfections among peri-urban South African adults residing in poorly developed areas with high poverty levels, lack of sanitation and a clean water supply. Adult participants (n = 414) were recruited from clinics in the south of Durban, KwaZulu-Natal, South Africa. Participants' demographic, socio-economic, sanitation and household information, anthropometric measurements and HIV status were collected. Stool samples were donated for coproscopy to detect helminths using the Kato-Katz and Mini Parasep techniques. Blood was collected to confirm participants' HIV status and to determine Ascaris lumbricoides-specific immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) levels to improve microscopy sensitivity. Overall coinfection was 15%, and single helminth and HIV prevalence were 33% and 52%, respectively. Ascaris lumbricoides was predominant (18%). Univariate analysis of variance (ANOVA) showed that coinfection was 11.9% and 19.8%, respectively, among the 18-34 years and 35-59 years age groups (p = 0.0006), 16.4% and 19.9%, respectively, for the no income and < R1000.00 groups (p = 0.0358) and 22.8% and 17.1%, respectively, for the pit or public toilets and toilets not connected to sewage groups (p = 0.0007). Findings suggest that the dual infection with HIV and helminth infections among adults residing in under-resourced areas with poor sanitary conditions is frequent. Older age, poor toilet use and low income are associated with coinfection. More attention is required to break the cycle of coinfections and possible disease interactions. The study highlights the importance of determining and treating helminth infections among adult population during HIV and helminth coinfection and the influence of poor sanitation and socioeconomic status on disease transmission.

Prevalence of Diarrhea, Intestinal Parasites, and Associated Factors Among Under-Five Children in Dabat District, Northwest Ethiopia: Multicenter Cross-sectional Study.

Despite global interventions to prevent and control diarrhea, it remains a public health problem leading to childhood morbidity and mortality majorly in developing countries. According to the World Health Organization, data from 2021 indicated that diarrheal disease is responsible for 8% of deaths in children under the age of 5. In the world, more than 1 billion under-five children live in poverty, social exclusion, and discrimination affected by intestinal parasitic infections and diarrhea disease. In sub-Saharan African countries like Ethiopia, diarrheal diseases and parasite infections continue to cause significant and persistent morbidity and mortality in under-five children. Therefore, the purpose of this study was to assess the prevalence and associated factors of intestinal parasites and diarrheal diseases in children under the age of 5 years in Dabat District, Northwest Ethiopia in 2022. A community-based, cross-sectional study was carried out from September 16 to August 18th 2022. Four hundred households with at least one child under the age of 5 years were recruited by simple random sampling technique. Sociodemographic, clinical, and behavioral factors were also collected using pretested interviewer-administered questionnaires. Data was entered into Epi-data version 3.1 and exported to Statistical Package for Social Science (SPSS) version 25 for analysis. Binary logistic regression was performed to identify factors associated with diarrhea and intestinal parasitic infections. The level of significance was computed at a P-value ⩽ .05. Descriptive statistics such as frequency and other summary statistics were used for describing sociodemographic variables and determining the prevalence of diarrhea and intestinal parasites. Tables, figures, and texts were used to present the findings. The variables having a P-value of less than .2 in the bivariable analysis were entered into the multivariable analysis at a P-value of ⩽.5. According to this study, the prevalence of diarrhea and intestinal parasites among under-five children was 20.8% (95% CI: [16.8-37.8] and 32.5% (95% CI: [28.6, 37.8], respectively. In multivariable logistic analysis at a P-value of ⩽.5, the educational level of mothers (Adjusted odds ratio [AOR]: 3.7, 95% CI: [1.52, 8.95], residence (AOR: 4.7, 95% CI: [1.52, 8.09]), undernutrition (AOR: 3.6, 95% CI: [1.09, 11.3]), latrine availability (AOR:3.9, 95% CI: [1.23, 9.56]), types of the latrine (AOR: 5.9, 95% CI: [3.42, 11.66]), water treatment (AOR = 7.6; 95% CI: [6.4, 12.7]), eating uncooked vegetable or fruits (AOR = 4.6; 95% CI: [1.025, 15.2]), and source of water (AOR = 4.5; 95% CI: [2.32,8.92]) were significantly associated with diarrheal disease. Intestinal parasitic infection was also significantly associated with undernutrition (AOR = 3.9; 95% CI: [1.09, 9.67]), latrine availability (AOR = 2.1; 95% CI:[1.32, 9.32]), types of the latrine (AOR = 2.8; 95% CI: [1.92, 8.12]) residence (AOR = 4.7; 95% CI: [1.52, 8.09]), water treatment, source of water for drinking (AOR = 4.5; 95% CI: [2.32, 8.92]), eating uncooked vegetables or fruits (AOR = 6.7:95% CI: [3.9, 9.8]), and deworming children with anti-parasitic medication (AOR = 2.4; 95% CI: [1.34, 5.62]), washing hands after latrine used (AOR = 2.2: 95% CI: [1.06, 3.86]). The prevalence of diarrhea and intestinal parasite among under-five children was 20.8% and 32.5%, respectively. Undernutrition, latrine availability, types of latrines, residence, eating uncooked vegetables or fruits, and source of water for drinking and water treatment were associated with intestinal parasitic infection and diarrheal disease. Deworming children with antiparasitic medications and washing hands after latrine use was also significantly associated with parasitic infection. Hence, awareness creation activities on latrine utilization and building, keeping personal hygiene, safe water supply, feeding cooked vegetables or fruits, taking anti-parasitic medications, practice hand washing habit after toilet use are strongly recommended.

Expert Judgement on Instrument for Measuring Healthy Lifestyle Knowledges and Behaviors of Senior High School Students in Coastal Area of Tanjungpinang

Healthy lifestyle behavior is the main asset in dealing with various health issues, including for people in the Islands region. Healthy lifestyle behavior implementation must be based on scientific knowledge. An instrument is needed to measure students’ healthy lifestyle behaviour-related science knowldge and students’ lifestyle behavior. This research aims to determine the content validity of the instrument for measuring science knowledge related to healthy living behavior and students’ healthy lifestyle behaviour. This research was quantitative descriptive. The instrument was developed based on 8 main indicators including physical activity, nutritious food consumption, sleep duration, cigarette and alcohol consumption, use of clean water, hand washing habits, use of bathrooms and toilets, and waste disposal culture. The instrument was validated by 8 experts and analyzed using the Aiken Formula (V). The results of this validity test showed that the instrument was valid for aspects of relevance and presentation (V = 0.96), accuracy of language (V = 0.88), and conformity with conceptual and operational definitions (0.94). These results indicate that the instrument can be continued with empirical validity and reliability tests until a valid and reliable instrument is obtained.

A Marked Decline in Taenia solium Taeniasis and Cysticercosis Infections in China: Possible Reasons from the Ecological Determinants Perspective

Taenia solium taeniasis/cysticercosis is an important global food-borne infectious disease transmitted between humans and pigs. According to both national surveys and field investigations, the prevalence of the disease in China has significantly decreased in recent decades. The primary disease control measures are health education and promotion, meat inspection, and chemotherapy. Other factors that influence or fundamentally affect human and pig T. solium taeniasis/cysticercosis have been identified, such as pig farming patterns shift and a revolution in sanitary toilets, which block T. solium transmission routes. Pig farming practices have shifted from backyard to large-scale intensive farming, thus decreasing pig contact with, and consumption of, human excreta. The increased in the use of sanitary toilets has facilitated hygiene by preventing of human excreta from contacting humans, or polluting the environment, feed, or water. The occurrence of human T. solium infections has markedly decreased as a result of these social changes. The objective of this review is to describe the ecological determinants of the cysticercosis decline in China.

Analysis of the livelihood and health of internally displaced persons due to riverbank erosion in Bangladesh

Bangladesh is particularly vulnerable to natural calamities such as flooding, cyclones, droughts, and severe riverbank erosion as a deltaic country. Riverbank erosion brings about terrible consequences such as loss of land, human displacement, social isolation, and physical and mental well-being problems. The study used a mixed-method research approach and a multi-method data collection procedure to analyse the impact of riverbank erosion on livelihood and health. Households of Internally Displaced Persons (IDPs) due to riverbank erosion in Bangladesh's Lakshmipur district were surveyed using a structured questionnaire and an unstructured interview schedule to collect quantitative and qualitative data. Thematic content analysis, and descriptive statistics were applied to identify how riverbank erosion is inextricably linked to the IDPs' socio-economic conditions and well-being vulnerability. The findings show that riverbank erosion is responsible for the IDPs' livelihood uncertainty and substantial health concerns. Uncertainty about livelihood gives rise to socio-economic instability, poverty, diseases, and medical expenses. On top of that, the displaced people faced several difficulties, including no land ownership, living in substandard housing, no access to power, use of unhygienic toilets, social isolation, and anxiety. The research also finds inadequate government or non-governmental master plans for IDPs to overcome miserable conditions. The study results will help policymakers in Bangladesh and elsewhere to better understand the needs of vulnerable riverine communities and to design and implement policies and programmes to improve those communities' capacity to withstand shocks and recover quickly.

노인 뇌졸중 환자의 단속성 안구운동, 일상생활 수행능력 및 인지기능의 상관성

This study aimed to analyze the correlation between saccadic eye movement, activities of daily living, and cognitive function in elderly patients with stroke, that could help establish interventions in clinical settings.&#x0D; This study included 32 elderly patients with stroke who were admitted to a medical center. The King-Devick test (K-D test), Korean version of the Modified Barthel Index (K-MBI), and Korean version of the Montreal Cognitive Assessment (MoCA-K) were used as evaluation tools. The correlation between evaluation scores was analyzed using Pearson’s correlation coefficient.&#x0D; The correlations between the total scores of the K-D test, K-MBI, and MoCA-K were statistically significant (p&lt;0.01).&#x0D; In addition, the K-D test showed statistically significant correlations with personal hygiene, bathing, feeding, toilet, stair climbing, dressing, chair/bed transfer, ambulation, and wheelchair use in the K-MBI and visuospatial/executive, naming, delayed recall, and orientation in the MoCA-K.&#x0D; This study showed a correlation between saccadic eye movement, activities of daily living, and cognitive function in elderly patients with stroke. In the future, such studies with larger sample would help to establish interventions in clinical settings.

Assessment of the Factors Affecting Open Defecation among Slum Dwellers in Lokoja, Kogi State Nigeria

In many of Africa's emerging nations, open defecation continues to pose a serious threat to public health and the environment. 946 million people worldwide still use open defecation, and there are around 2.4 billion people without access to better sanitation. Therefore, the purpose of this study was to investigate the variables that affect open defecation among slum residents in Lokoja Metropolis. The investigation was conducted using a descriptive cross-sectional study design. Lokoja was purposefully chosen because to its metropolitan setting, abundance of slum areas, and inadequate coverage of both family and public latrines. In order to choose the five communities in the slum for the study, simple random sampling was performed. To supplement the home survey, 281 household heads filled out a standardized questionnaire with quantitative information, and in-depth interviews were used to gather qualitative information. Prior to data analysis, all the filled-out questionnaires were cleaned. They were then coded, entered into SPSS, and checked for completeness. Inferential statistics was used to measure the relationship between the dependent and independent variables, and thematic analysis was carried out for the qualitative portion of the study. Descriptive findings were presented as numerical summaries and tables, while inferential statistics was used to measure the relationship between the dependent and independent variables. Majority of the slum dwellers either shared latrines among the households (29.7%) or used public latrines (49.8%). At (mean difference= -0.168, p=0.005), there was a significant correlation between knowledge of open defecation and the practice of it. The study found that households without latrine facilities had greater rates of open defecation. The majority of the residents' households either shared restrooms with other homes or used public restrooms. To prevent open defecation, greater government and landlord initiatives are needed to increase toilet ownership and use at homes, as well as to build more public latrines in the study area.

ESTIMATION OF METHANE EMISSIONS FROM DOMESTIC WASTEWATER IN CAU RIVER BASIN BY 2030

The Cau River basin has recently raised significant concerns about associated pollution issues and their critical role in socio-economic development. This study aims at assessing and forecasting the impacts of domestic wastewater on the generation of greenhouse gas emissions in Cau River basin in 2030. The main methods have been applied in this study including data collection and analysis, synthesization and inheritance method of research documents. Moreover, the study has calculated the amount of greenhouse gases from wastewater in the Cau River basin basin from the use of septic toilets, other toilets and centralized wastewater treatment plant based upon the guidance of the IPCC (2006). The results show that the CH4 gas is mainly generated from the anaerobic treatment of domestic wastewater with total CH4 emissions for the scenario up to 2030 at 234,337.91 Gg CH4/year (accounting for 95.3%) of the total amount (corresponding to 245,818.59 Gg CH4/total kg of BOD) emitted when applying treatment measures.

The impact of access to sanitary toilets on rural adult residents' health: Evidence from the China family panel survey.

Toilet sanitation is related to public health and environmental protection. In the context of the toilet revolution in rural China, an ordered probit regression analysis was conducted to evaluate the impact of access to sanitary toilets on rural residents' health. Using data from the China Family Panel Study (CFPS) in 2014, we found that access to sanitary toilets in rural households significantly improved residents' health, and this finding remained robust across a series of checks. Meanwhile, results of the mechanism analysis showed that preventing feces from contaminating water sources was an important mechanism behind the positive effects of sanitary toilet use on health. We also found that the impact of access to sanitary toilets was more pronounced among female, middle-aged, and low-income people. Toilet revolution plays an important role in ensuring residents' health and protecting water sources, thereby underscoring the need for governments in developing countries to invest in sanitary toilets. In addition, the existing policies and sanitation programs in China need to be improved to promote public health.

Equity in access to safely managed sanitation and prevalence of diarrheal diseases in Bangladesh: a national and sub-national analysis

BackgroundIn Bangladesh, safely managed sanitation (SMS) coverage is low, and diarrheal disease is a significant health problem. This study estimated the inequality in access to SMS facilities at the national and sub-national levels and assessed the prevalence of diarrheal diseases in connection with these improved facilities.MethodsData were extracted from the Bangladesh Demographic and Health Survey, conducted during 2017–2018. SMS was defined as using an improved sanitation facility, which designed to hygienically separate excreta from human contact and include the use of a flush toilet connected to piped sewer system, septic tank, ventilated improved pit latrine, pit latrine with a slab, and composting toilet. The slope index of inequality (SII) and multi-level regression models were used for inequality and risk factors of SMS respectively.ResultsThe national coverage of SMS was 44.0% (45.3% and 43.5% in urban and rural areas, respectively). At the sub-national level, the lowest and highest coverage of SMS was observed in Mymensingh (32.9%) and Chittagong (54.1%) divisions, respectively. The national level SII indicated that wealthy households had access to higher SMS by 60.8 percentage points than poor households. Additionally, greater inequality was observed in rural areas, which was 71.9 percentage points higher in the richest households than in the poorest households. The coverage gap between the rich and poor was highest in the Sylhet division (85.3 percentage points higher in rich than in poor) and lowest in Dhaka (34.9 percentage points). Old and highly educated household heads and richest households had better access to higher levels of adequate sanitation. After adjusting for confounding variables, the prevalence of diarrheal disease was 14.0% lower in the SMS user group than in their counterparts.ConclusionSubstantial inequalities in access to SMS exist at both national and sub-national levels of Bangladesh, with the prevalence of diarrhea being lower among SMS users. These findings may help to prioritize resources for reducing inequality and expanding the coverage of improved sanitation in Bangladesh.

ORIHIME II Study: Background, Treatment Status, and Outcomes of Patients with Acquired Hemophilia A with Low Activities of Daily Living Scores or Undergoing Rehabilitation - a Japanese Health Claims Database Analysis

Background: Acquired hemophilia A (AHA) is a rare disease in which autoantibodies (inhibitors) develop against blood coagulation factor (F)VIII, resulting in significantly reduced FVIII activity, with onset of bleeding symptoms such as sudden subcutaneous hemorrhage and muscular hemorrhage. The database-based study, 'Obtain Real-World Insights of Acquired Hemophilia A Patients in Japan' (the ORIHIME study) first reported data on rehabilitation and activities of daily living (ADL) scores for patients with AHA in Japan, which had previously been scarce (Ogawa et al. Blood 2021). The need to clarify the clinical experience of patients undergoing rehabilitation and patients with low ADL scores, who are considered to have relatively poor treatment and prognosis among AHA patients, has become apparent. This study evaluated the association between patient background, medication use, and outcomes among patients with AHA who underwent rehabilitation or had low ADL scores between April 1, 2008, and October 31, 2021. Methods: The study was conducted using the Medical Data Vision Co., Ltd. database. Patients with a diagnosis of AHA who were hospitalized and were administered immunosuppressants following admission were included. The primary endpoint examined the association of actual rehabilitation practices and total ADL score (measured using the Barthel Index) at discharge with patient background, medication use, and clinical outcomes. Total ADL score was calculated by adding together the scores for each of the following activities: eating, transferring (e.g. from bed to chair and back), ambulating, toilet use, bathing, mobility, stairs, dressing, and control of bladder and bowel movement. A score of 85 or higher corresponds with 'independence with minimal assistance' in the Barthel Index, therefore, in this analysis, participants are categorized by scores of <85 and ≥85 (Sulter et al. Stroke 1999). The risk of infection due to immunosuppressive therapy was a secondary endpoint. Results: Overall, 427 patients were included in this study. The mean (standard deviation [SD]) age of the patients was 76.3 (11.3) years, and 264 (61.8%) were male. A total of 249 patients underwent rehabilitation following admission to hospital. The median (range) time to the start of rehabilitation from the date of admission to hospital was 10.0 (1.0-133.0) days, and a high proportion of patients had a period of <2 weeks between admission to hospital and the start of rehabilitation (n=142/249 [57.0%]). Hemostatic agents used during rehabilitation were bypassing agents in 44 cases, FVIII in two cases, and tranexamic acid in 50 cases. Of the patients who received hemostatic agents, 36/44 (81.8%) patients who received bypassing agents, 2/2 (100.0%) patients who received FVIII, and 38/50 (76.0%) patients who received tranexamic acid started rehabilitation <2 weeks after the date of admission (Table 1). The ADL score at discharge was ≥85 points in 192 patients (45.0%) and <85 points in 186 patients (43.6%). Most patients with an ADL score at discharge of ≥85 (n=144/192 [75.0%]) were discharged from the hospital to home (attending outpatient visits at the same hospital), and for patients with ADL scores of <85 at discharge, the highest proportion of patients were transferred to other hospitals (n=92/186 [49.5%]; Table 2). Conclusions: Hemostatic agents may be necessary to start rehabilitation earlier. Post-discharge outcomes may be related to ADL scores at discharge. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Patient’s experience in nursing care and related factors

Introduction: Improving the quality of care and treatment is a central task of all hospitals and is conducted regularly to meet the patient’s health care needs. Surveying the patient’s experience of care to provide information on patient satisfaction and indicate necessary changes in a process or stage of patient care. Objectives: Determine the average score of the patient’s experience of care and determine the related factors of the patient’s experience of care. Methodology: A descriptive cross-sectional study was conducted with 218 patients treated from Feb 2021 to Nov 2021. Interviewees completed the PEC questionnaire (Patient’s Experience of Care) with scores ranging from 26 - 130 points. Results: The overall score of patient experience of care is 97.37 ± 11.9. The study found a statistically significant relationship between the patient’s experience of care and the patient qualification (p = 0.029) and treatment department (p &lt; 0.001). Conclusion: The average score of patient’s experience of care is high (97.37) but managers need to pay attention and contribute interventions to increase the patient’s experience score thereby increasing the level of satisfaction of care inpatient based on specific contents: nurses publicize drugs with patients (2.94); cleanliness, the convenience of use of toilets and bathrooms (3.38); nurses greet and introduce themselves when interacting with patients (3.40). Key words: experience, nursing care, PEC (Patient’s Experience of Care).

Age Group-Specific Assessment of Changing Seroepidemiology of Hepatitis A Virus Infection in North India.

Introduction Routine immunization against hepatitis A virus (HAV) infection has not been warranted in India, but an epidemiological shift from hyperendemicity to intermediate endemicity has been detected in recent years. The present studywas planned to gather theage group-specificseroprevalence data of hepatitis A IgG antibodies in various age groupsandevaluateany early trends of seroepidemiological shift. Method This was a hospital-based cross-sectional study. The detection of IgG antibodies for hepatitis A was done using an HAV Ab kit (Dia.Pro, Milan, Italy) in sera of individuals from >1 to 80 years of age and consenting to participate. Data on sociodemographic factors and potentially predisposing factors of HAV was collected on a predesigned questionnaire. At the time of final analysis, patients were divided into three groups children one to <18 years, adults ≥18 to <60 years, and old ≥60 to 80 years for comparative analysis. Result A total of 1,250 patients were included in the final analysis (129 children, 928 adults, and 193 old). The male/female ratio of the study participants was 1.4:1. The majority (85%) of them came from rural and semi-urban areas. They generally had lower socioeconomic status (SES) with poor literacy rates. Most of the enrolled cases(n=800/1,250, 64%) reported the use of groundwater, and 58.7% (n=734/1,250) consume water without any purification. Of the study participants,90.8% reported the use of toilets for defecation, and 96.7% of the cases use soap for handwashing after defecation. The majority of adult (90%) and old age (99%) participants were seropositive for anti-HAV IgG antibodies as compared to children (80%). No significant differences were observed in the seropositivity rates and the SES class of the study participants. Conclusion About 20% of children did not have anti-HAV IgG antibodies in the present study, indicating that they are not exposed to HAV. This could bebecause of their better living conditions such as the availability of safe drinking water and improved sanitation and hygiene. We support the current guidelines of the Indian Academy of Pediatrics (IAP), which recommends immunization for hepatitis A vaccination at 12 months of age. Adult vaccination is notneeded in North India.

Knowledge, attitudes, practices and behaviours (KAPB) around water, sanitation and hygiene (WASH) in villagers exposed to schistosomiasis in Zimbabwe

There is paucity of comprehensive studies on social, cultural and behavioural aspects that influence and constrain toilet and borehole adoption and use in rural Africa. The objective of this study was to provide an evidence base to inform policies on increasing end-user adoption of toilets and access to safe water sources. One hundred and twenty-seven households in the Murewa district of Zimbabwe were surveyed via questionnaire to determine the social, cultural and behavioural influences that drive ownership and use of toilets and safe water sources. Rates of the water borne schistosome infection amongst pre-school aged children (PSAC) in the community were determined as a marker of the relationship between water, sanitation and health. The study showed that the community’s water and sanitation (WASH) coverage was as follows: 60.62% had access to toilets and 48% had access to boreholes. Of those with access to toilets 16% of adults and 36% of children did not use the toilets, instead they practiced open defecation. Schistosomiasis prevalence in PSAC was 42.4%, with 13% of schistosome infection being attributed to open defecation and 27% to using river water. In relating WASH to status or wealth symbols, the study showed that 34% of the adults possessed livestock and 30.7% had a mobile phone but did not have a toilet. Reasons for non-uptake of WASH and non-adherence to toilet use included lack of suitable sanitation facilities, lack of cleanliness in existing facilities, cultural factors and sub-optimal health education. An integrative approach is needed to effectively improve uptake and adherence to WASH. The use of context relevant behavioural theories and interventions is required to influence prioritisation and subsequent adherence to WASH facilities.

A Comparative Study to Assess the Knowledge and Practices of Adults Towards use of Latrine Among Rural and Urban Area

One of the biggest challenges in making the country Open Defecation Free is triggering behavioral changes in the population to accept the need for building and using toilets, in reality toilets mean health and economic benefits, and improvements to human dignity, but we need the perception of toilets to match this reality. Keeping clean and disposing of human waste (feces and urine) are necessary for good health. If they are not taken care of in a safe way, our feces and urine can pollute the environment and cause serious health problems, Illnesses caused by germs and worms in feces are a constant source of discomfort for millions of people. More than reducing levels of infection and disease, however, the sanitary importance of toilets offers an increased sense of dignity. To make India open defecation-free, we need to shift the prevailing mindset and attitude about toilet use and change behavior by repositioning the toilet — from a dark, dirty and smelly room to a “happy room,” with perceived status, social and convenience benefits. Both male and female person, adults, who are responsible or decision maker as the head of the family, irrespective of their age, play an important role to improve the sanitation in the family, it will be better in improving health and other conditions of their family members which leads to develop the state as well as country. Materials and Methods: A comparative descriptive research design to find out knowledge and practice of adults towards use of latrine among rural and urban area with a view to develops an .The study conducted on 50samples each from rural and urban area. Data was collected in the month of January to June 2022. Data was collected using structured questionnaire to find out knowledge and practice of adults towards use of latrine among rural and urban area. Results: The data revealed that, the number of adults of rural area was between 20-25 years of age group (28%),26-30(28%),36-40 (28%),and 31-35 yrs. of age group was (14%). and in urban area 31-35 yrs. of age group was(28 %),20-25 &amp;26-30 was (26%) and 36-40 was (20%). More than half of the participants from rural area were female (72%) and from urban area were 54%. Maximum participants from rural area, their educational qualification in between 1-9th class was (50%) and from urban area was higher education (84%). Maximum number of participants from both rural (94%) and urban (82%) having own house land Majority of samples are Housewife (31.66%). Majority of samples from both rural (78%) and urban (90%) were belongs to Hindu religion. Majority of samples from rural area having monthly income between 1001-4000 rupees was (60%) and from urban area was above 7000(66%). Most of the participants were included in other occupation. In rural (52%) and urban (44%). Participants of rural area got majority of health information from health personals (38%) and of urban area from mass media (60%). Statistical Analysis showed that mean of rural adults knowledge regarding use of latrine is (12.24) less than urban adults knowledge regarding use of latrine (20). Mean % of rural adults knowledge regarding use of latrine is (51%) is less than adults residing in urban area (93.18) and mean difference is 32.33%.Standard deviation of rural adults is (4.28) and urban adults is (2.46). Z value is (2.48).Statistical Analysis also showed that mean of rural adults practices regarding use of latrine is (32.78) less than urban adults practices regarding use of latrine (50.32). Mean % of rural adults practices regarding use of latrine is (60.70) is less than adults residing in urban area (93.18) and mean difference is 32.48 .Standard deviation of rural adults is (9.90) and urban adults is (2.48). Z value is (0.95). Conclusion: After the detailed analysis of the study findings showed that knowledge of rural adults is less than knowledge of urban adults regarding use of latrine. The practices of rural adults is less than the practices of urban adults regarding use of latrine. There is a significant association between demographic variables and knowledge and practices of adults towards use of latrine among rural and urban area.

Community toilets management strategies in promotion of public hygiene in municipality ward of Meru, Kenya

Rapid population growth has significantly contributed to inadequate sanitation facilities especially in slums. The inadequacy in sanitation facilities results to poor hygiene thus promote spread of sanitation-related diseases such as diarrhea. This study investigated sanitation management strategies for promotion of public hygiene in slums. Three slums in Meru Municipality ward, namely, Mjini, Shauri Yako, and Majengo were identified as the target population for the study. Mixed methods approach was adopted in sampling. Each slum was treated as a cluster. Data was collected from 79 heads of households within the clusters and 5 key informants from the Municipality ward who included a municipal manager, assistant chief, Public Health Officer, MEWASS director, and Caritas director. The heads of the households were proportionally selected randomly from the clusters as determined using Fisher’s formula. Qualitative data was collected from the key informants. Quantitative data was analyzed using the Statistical Package for Social Sciences (SPPS) version 25 to generate frequency tables while qualitative data was presented thematically. The findings showed poor sanitation and hygiene status of the slum dwellers due to the lack of good sanitation facilities that could enable them dispose their excreta effectively. The study showed that 86% of the slum population did not access adequate sanitation facilities where 5.1% used flying toilets and other 1.3% used bucket latrines. The correlation between comfortability of toilet users and the use of toilets with flies and odour was 0.351(P=0.000) thus comfortability to use sanitation facilities in the slums depended on the status of the toilets. The correlation between presence of caretakers for slum toilets and maintenance of toilets was 0.478 with a p-value of 0.000. The correlation between willingness to pay for sanitation services and the type of toilets provided was 0.094 (p=0.035). Presence of flush water and absence of flies in toilets registered a correlation coefficient of 0.350 (p=0.000). The study recommended consideration of better strategies to enhance better living conditions amongst the slum dwellers lacking access to adequate sanitation services. Further, the government need to put in place policies and regulations to ensure adequate water supply, sanitation and hygiene to the slum dwellers.&#x0D;

Impact of COVID-19 on neighbourhood physical activity in older adults

ABSTRACT Physical activity is critical for older adults’ health and was particularly important during the coronavirus (COVID-19) pandemic. To slow the spread of COVID-19, built environment modifications were introduced in public spaces including one-way walking systems, social distancing, and the restricted use of public toilets and seating. These modifications intended to encourage safe exercise but may have reduced walkability and inadvertently hindered older adults’ physical activity. We aimed to investigate whether Covid-related built environment modifications reduced older adults’ physical activity. We surveyed 282 older adults in the UK using a mixed methods Concurrent Triangulation Design. Physical activity decreased during COVID-19. Older adults believed many Covid-related built environment modifications negatively affected physical activity because of safety or accessibility issues. These negative modifications were more prominent in areas of higher walkability and associated with reduced physical activity. However Covid-related Traffic Reduction and some elements of One-Way Walking Systems were largely considered positive modifications that helped facilitate physical activity. We concluded common Covid-related built environment modifications hindered exercise, reduced walkability, and possibly contributed to reduced physical activity in older adults. If similar modifications are required in the future, older adults’ needs must be accommodated to avoid discouraging physical activity and compromising long-term health.

Demographic disparities in unimproved drinking water and sanitation in Ghana: a nationally representative cross-sectional study

ObjectiveThe government of Ghana has targeted universal access to safe drinking water by 2025 and elimination of open defecation by year 2030. This study explored the use of unimproved drinking...

Insights of School Water Consumption and Sanitation and Hygiene Practices among School Children in Dehiovita, Kegalle District, Sri Lanka

Developing access to safe drinking water, sanitation facilities and hygiene practices can reduce water borne diseases. The present study was carried out in the Dehiovita Zonal Educational zone under the Kegalle District from December 2018 to March 2019 to monitor existing facilities in schools, behavior among students, and for the sustainable development in water, sanitation, and hygiene at the schools. A semi-structured questionnaire was conducted covering students (n=500) from grade 7-13 in 15 schools through a random sampling technique. Data analysis was conducted using SPSS software to compare the responses using graphical presentation. In terms of water consumption behavior, about 73% of respondents use water bottles. Of these, 73%, 43% accounted for using unsafe plastic bottles and 28% accounted for aluminum bottles. Most of the respondents, 50% mentioned that they use water bottles twice daily. In relation to the water purification method used, 45% of students use chlorinated water, whereas 36% do not have purified water. Only 36% of respondents do have a water supply. Regarding the issues of water supply, 62% of respondents stated that they have broken taps, and 54% responded on less treated water. Most respondents, 78% mentioned, that they are unsatisfied with the existing water. With regards to the sanitation behavior among students, 48% of students use the latrine twice while 32% of respondents use the latrine once a day. Most of the respondents, 88% mentioned that they do not use soap after toilet use. 78% of respondents mentioned that the existing sanitation facilities are unsatisfied. Regarding the issues associated with sanitation facilities in schools, 92% of respondents showed the unavailability of soap and 73% of respondents stated that they have old latrines, while 67% stated that there is no cleaning equipment. Given the consideration on menstrual hygiene management (MHM), the usage of sanitation facilities by female students, 28% of respondents use once daily and 26% do not use the sanitation facility. Regarding the issues associated with MHM, 91% of respondents showed that no napkins discarding facility, and 84% mentioned lack of a place to wash, while 72% of students stated the lack of water. In conclusion, it reveals that there exists a higher demand on awareness of water consumption, sanitation and hygiene practices at schools and awareness on disease spreading as there exists poor quality standards of water consumption and sanitation. Thus, it needs careful monitoring of management steps to uplift water consumption, hygiene, and sanitation. The study suggests strengthening school water, sanitation, and hygiene clubs at schools and focus on government funding for utility development.&#x0D; Keywords: Water consumption, School sanitation, Hygiene practices, Dehiovita, Menstrual hygiene management