Unprotected Water Sources Research Articles

Under-nutrition and associated factors among children on ART in Southern Ethiopia: a facility-based cross-sectional study

BackgroundMalnutrition is very common in HIV-infected individuals. Even though data from different settings are necessary to tackle it, pieces of evidence are limited especially in the case of the nutritional status of HIV-infected children. Hence, this study aims to assess the nutritional status and associated factors among children on antiretroviral therapy.MethodsAn institutional-based cross-sectional study was conducted among 383 HIV-positive children in Southern Ethiopia. Data were collected using an interviewer-administered questionnaire and anthropometry measurement. Data were coded and entered into Epi-Data Version 3.1 and analyzed using SPSS Version 25. Bi-variable and multi-variable binary logistic regression models were used to identify factors associated with nutritional status and variables with p-values <0.05 in multi-variable logistic regression were considered as statistically significant.ResultsThe prevalence of wasting among HIV-positive children in Southern Ethiopiaselected Hospitals was 36.3% (95% CI, 31.6–41.0) while stunting on the same study population was 5.5% (95% CI, 3.4–7.8). Rural residence, lack of maternal education, low CD4 counts (< 500), using an unprotected water source, having a non-biological mother and recurrent oral lesion were significantly associated with wasting. Furthermore, history of hospital admission, recurrent oral lesion, low CD4 counts (< 500), advanced WHO clinical stage were statically associated with stunting with p-value < 0.05.ConclusionThis study found that the prevalence of under-nutrition among HIV-positive children in Ethiopia was significantly high. Therefore, timely identification and monitoring of nutritional problems should be necessary to enhance the effectiveness of ART treatment and to prevent further related complications.

Unprotected water sources and low latrine coverage are contributing factors to persistent hotspots for schistosomiasis in western Kenya.

BackgroundEvidence indicates that whereas repeated rounds of mass drug administration (MDA) programs have reduced schistosomiasis prevalence to appreciable levels in some communities referred to here as responding villages (R). However, prevalence has remained high or less than anticipated in other areas referred to here as persistent hotspot villages (PHS). Using a cross-sectional quantitative approach, this study investigated the factors associated with sustained high Schistosoma mansoni prevalence in some villages despite repeated high annual treatment coverage in western Kenya.MethodWater contact sites selected based on observation of points where people consistently go to collect water, wash clothes, bathe, swim or play (young children), wash cars and harvest sand were mapped using hand-held smart phones on the Commcare platform. Quantitative cross-sectional surveys on behavioral characteristics were conducted using interviewer-based semi-structured questionnaires administered to assess water usage/contact patterns and open defecation. Questionnaires were administered to 15 households per village, 50 pupils per school and 1 head teacher per school. One stool and urine sample was collected from 50 school children aged 9–12 year old and 50 adults from both responding (R) and persistent hotspot (PHS) villages. Stool was analyzed by the Kato-Katz method for eggs of S. mansoni and soil-transmitted helminths. Urine samples were tested using the point-of-care circulating cathodic antigen (POC-CCA) test for detection of S. mansoni antigen.ResultsThere was higher latrine coverage in R (n = 6) relative to PHS villages (n = 6) with only 33% of schools in the PHS villages meeting the WHO threshold for boy: latrine coverage ratio versus 83.3% in R, while no villages met the girl: latrine ratio requirement. A higher proportion of individuals accessed unprotected water sources for both bathing and drinking (68.5% for children and 89% for adults) in PHS relative to R villages. In addition, frequency of accessing water sources was higher in PHS villages, with swimming being the most frequent activity. As expected based upon selection criteria, both prevalence and intensity of S. mansoni were higher in the PHS relative to R villages (prevalence: 43.7% vs 20.2%; P < 0.001; intensity: 73.8 ± 200.6 vs 22.2 ± 96.0, P < 0.0001), respectively.ConclusionUnprotected water sources and low latrine coverage are contributing factors to PHS for schistosomiasis in western Kenya. Efforts to increase provision of potable water and improvement in latrine infrastructure is recommended to augment control efforts in the PHS areas.

Literature Review: The Parental Pattern Review with the Wasting Occurrence on Toddlers

Introduction: A wasting case is on the top rank after stunting. In 2018, the waste rate in Indonesia consisted of 10.2%. Objectives: This research aims to review the parental pattern concerning the wasting occurrence of children, especially toddlers. Methods: This research applied a literature study. The data searches were done with journal searching sites, such as Google Cendekia. The applied sample was purposive sampling. Results: Children that did not obtain immunization had 3.3 and 3.8 higher possibilities to suffer stunting and wasting than those who obtained immunization. Children without immunization had risks toward various diseases that actually could be prevented by the vaccine. Most children consumed mealy meals. Toddlers that obtained exclusive breast milk had normal status with a percentage of 80%. The dietary habits before the age of 6 years old had risks because the digesting system could not handle the complex nutrition. Thus, toddlers will be susceptible to allergens of the meals. The unprotected water source but is consumed was 57.65%. Thus, the parental pattern had correlations with the wasting occurrence, especially concerning nutrition, breast milk, immunization, and cleanliness. Conclusions: The parental pattern toward wasting occurrence specifically led to nutrition, breast milk, immunization, and cleanliness occurrences. Lack of food diversity was also the cause of the high-rate prevalence of wasting. Proper breast milk provision by mothers facilitated the nutritional balance for children and it was correlated to wasting occurrence. Lack of proper water source was also correlated to higher wasting conditions.

Spatial pattern and determinants of anemia among women of childbearing age in Nigeria

Background: The risk of anemia in Nigeria is of public health importance, with an increasing number of women of reproductive age being anemic. This study sought to identify the spatial distribution and examine the geographical variation of anemia risk at a regional level while accounting for risk factors associated with anemia among women of childbearing age in Nigeria. The significant interest in spatial statistics lies in identifying associated risk factors that enhance the risk of infection. However, most studies make no or limited use of the data’s spatial structure and possible non-linear effects of the risk factors.Methods: The data used in this study were extracted from the 2015 Nigeria Demographic and Health Survey (NDHS). A full Bayesian semi-parametric regression model was fitted to data to accomplish the aims of the study. Model estimation and the inference was fully Bayesian approach via integrated nested Laplace approximations (INLA). The fixed effects were modeled parametrically; non-linear effects were modeled non-parametrically using second-order random walk priors.Results: Wealth index, level of education, type of residence, and unprotected drinking water source were found to be the risk factors associated with anemia. The risk of anemia was found to vary across different regions, with North Central, North East, and North West regions having the highest number of cases and South East with the least number of cases. The spatial analysis result indicated that statistically high hot-spots of anemia were observed in all the northern parts of the country.Conclusion: The study revealed associations between anemia risk and women residing in rural settlements, wealth index, women with no formal education, and unprotected drinking water sources. Community and household-related change interventions should, therefore, be pertinent to the prevention of anemia. The spatial analysis further revealed a significant anemia risk towards the Northern areas of Nigeria. We propose that interventions targeting women of reproductive age should initially focus on these regions and subsequently spread across Nigeria.

Prevalence and Correlates of Cryptosporidium Infections in Kenyan Children With Diarrhea and Their Primary Caregivers.

Background Cryptosporidium is a leading cause of diarrhea in Sub-Saharan Africa and is associated with substantial morbidity and mortality in young children.Methods We analyzed data from children aged 6–71 months presenting to 2 public hospitals in Western Kenya with acute diarrhea and their primary caregivers, including detection of Cryptosporidium by quantitative polymerase chain reaction (PCR) and immunoassay analysis in stool samples from both children and their caregivers. Associations between potential transmission sources and child/caregiver Cryptosporidium infection were evaluated using prevalence ratios (PRs). Secondary analyses evaluated host and clinical risk factors of child/caregiver Cryptosporidium infection.ResultsAmong 243 child–caregiver pairs enrolled, 77 children (32%) and 57 caregivers (23%) had Cryptosporidium identified by either immunoassay or PCR. Twenty-six of the 243 child–caregiver pairs (11%) had concordant detection of Cryptosporidium. Cryptosporidium infection in children was associated with detection of Cryptosporidium in caregivers (adjusted PR [aPR], 1.8; 95% CI, 1.2 to 2.6; P = .002) and unprotected water source (aPR, 2.0; 95% CI, 1.3 to 3.2; P = .003). Risk factors for Cryptosporidium detection in caregivers included child Cryptosporidium infection (aPR, 2.0; 95% CI, 1.3 to 3.0; P = .002) as well as cow (aPR, 3.1; 95% CI, 1.4 to 7.0; P = .02) and other livestock ownership (aPR, 2.6; 95% CI, 1.1 to 6.3; P = .03) vs no livestock ownership. Recent diarrhea in caregivers and children was independently associated with child and caregiver Cryptosporidium infections, respectively.ConclusionsOur results are consistent with the hypothesis that Cryptosporidium transmission can occur directly between child–caregiver dyads as well as through other pathways involving water and livestock. Additional research into caregivers as a source of childhood Cryptosporidium infection is warranted.

Relationship between economic insecurity, inflammation, monocyte activation and intestinal integrity in children living with HIV in Uganda

ABSTRACT We aimed to evaluate differences in socio-economic variables in a Ugandan cohort of children with perinatally acquired HIV (PHIVs), HIV exposed uninfected (HEU) and HIV unexposed uninfected (HIV-) children and their associations with markers of inflammation and intestinal integrity. This is a cross-sectional study in 57 PHIV, 59 HEU and 56 HIV – children aged 2–10 years old enrolled in Uganda. Mean age of all participants was 7 years and 55% were girls. Compared to HEU and HIV – children, PHIVs were more likely to have parents that only completed a primary education, live in a household without electricity and live in poverty (p≤0.034). PHIVs living in poverty had higher IL-6 (p=0.006), those with lack of electricity had higher hsCRP, IL6, sTNFRII and d-dimer (p≤0.048) and PHIVs with an unprotected water source had higher IL6 and d-dimer (p≤0.016). After adjusting for demographic and HIV variables, IL-6 and d-dimer remained associated with lack of electricity and having an unprotected water source only in PHIVs (p<0.019). Our findings suggest that addressing economic insecurity may mitigate the persistent low-level inflammation in HIV that lead to many end organ disease. Longitudinal studies are needed to better understand the impact of socioeconomic factors on HIV inflammation and comorbidities.

Could Water and Sanitation Shortfalls Exacerbate SARS-CoV-2 Transmission Risks?

.SARS-CoV-2, the etiologic agent of COVID-19, is shed in stool. SARS coronaviruses have been detected in wastewater during outbreaks in China, Europe, and the United States. In this perspective, we outline the risk fecal shedding poses at locations without safely managed sanitation, as in most of Nigeria where we work. We believe that feco-oral transmission could occur if community transmission becomes high and sustained in densely populated cities without proper sanitation in Nigeria and many other African and Asian settings. In the absence of basic sanitation, or where existing sanitation is not safely managed, groundwater, which is often drawn up from wells and boreholes for drinking and household use, can become contaminated with enteric bacteria and viruses from fecal matter. Endemic and epidemic transmission of multiple feco-oral pathogens via this route continues to be documented in areas without safely managed sanitation, and, therefore, the risk of SARS-CoV-2 transmission needs to be evaluated, tracked, and forestalled in such settings. We suggest that fecal matter from treatment facilities and recovered patients should be carefully and properly disposed. Furthermore, environmental surveillance of SARS-CoV-2 in wastewater and accumulated human waste, as well as efforts to mitigate the virus’ entry into unprotected household water sources, should be a priority part of the COVID-19 response in settings without safely managed sanitation for the duration of the pandemic.

Prevalence and Determinants of Diarrhea among Under-Five Children in Benna Tsemay District, South Omo Zone, Southern Ethiopia: A Community-Based Cross-Sectional Study in Pastoralist and Agropastoralist Context

Background. Diarrhea is the second leading cause of death among children under-five years globally and accounts for about 1.5 million deaths each year. In low-income countries, children under three years of age experience three episodes of diarrhea on average every year. In Ethiopia, diarrheal disease is one of the common causes of mortality in under-five children. In Benna Tsemay district, pastoralist community lives with lack of clean water, sanitation, and hygiene problems, which increase the risk of childhood diarrhea. Objective. To assess the prevalence and determinant of diarrheal disease among under five children in Benna Tsemay District, South Omo Zone, Southern Ethiopia. Methods. A community-based cross-sectional study was conducted on a sample of 722 under five children selected randomly from eight pastoralists and two agropastoralist kebels. Data were collected using an interviewer-administered questionnaire. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Logic regression was performed to identify the association between diarrheal disease and independent variables. Adjusted odds ratio with 95% confidence intervals (CIs) was used to judge the presence of association. Results. The two-week period prevalence of childhood diarrheal disease in the study was 23.5% (95% CI: 20.4%–26.6%). Diarrheal illness was associated with nonavailability of latrine (AOR: 2.77, 95% CI: 1.66–4.63), faeces seen around the pit hole or floor of latrine (AOR: 2.92, 95% CI: 1.38–6.19), improper kitchen waste disposal (AOR: 2.31, 95% CI: 1.26–4. 24), unprotected drinking water source (AOR: 1.81, 95% CI: 1.14–2.88), mother’s or caretaker’s diarrhea history in the last two weeks (AOR: 6.74, 95% CI: 2.51–18.07), materials used for feeding the child (cup and spoon) (AOR: 0.60, 95% CI: 0.36–0.97), and being unvaccinated for “rotavirus” (AOR: 2.87, 95% CI: 1.86–4.44). Conclusion. Nearly one-fourth of children had diarrheal illness in the preceding two weeks. Water, sanitation and hygiene-related factors, child feeding practice, and children’s vaccination status for rotavirus were the determinants of the occurrence of diarrhea among under-five children. The health office should conduct sustainable health education programs that emphasize on risk of open defecation, waste disposal mechanisms, and child feeding practices and also should strengthen rotavirus vaccination activities. The district administration and partners’ needed to improve water sources.

Binary Logistic Regression Analysis of Variables That Influence Poverty in Central Java

The phenomenon of poverty is a serious problem faced by almost every country in the world. This is because poverty can affect various aspects of people's lives. One of the causes of poverty is due to lack of income and assets to meet basic needs such as food, clothing, housing, health level and acceptable education. In addition, poverty occurs because of the powerlessness of society to get out of the problems it faces. The Central Java regional government incorporated poverty issues into the Regional Medium-Term Development Plan (RPJMD) because Central Java has a high number of poor people. This was done as an effort by the Central Java government to reduce poverty. Therefore, research is needed to find out the variables that most influence poverty in order to assist the government in developing the RPJMD. To find out what factors influence poverty in Central Java with the dichotomous categorical response variable, binary logistic regression analysis was used. The results showed that based on the analysis conducted did not obtain a logistic regression equation model because there were no significant parameters because there were no variables that had a sig value &lt;0.05. Existing variables are Number of Population, Female Head of Household, Number of Children not in School, Number of Disabled Individuals, Number of Chronic Disease Individuals, Unemployment, Non-Electricity Lighting Sources, Unprotected Drinking Water Sources, Kerosene and Wood Cooking Fuels, Location Facilities Defecation (BAB) Not Available, so there are no variables that affect the level of poverty in Central Java Province.

Challenges of Domestic Water Supply in Injibara Town, Ethiopia

This study assesses the major causes and challenges of inadequate quantity and quality of domestic water supply in Injibara town. Study area has the problems of insufficient domestic water supply in both quantity and quality and also distribution system has the major challenges on consumption of water supply. Therefore, the data are collected from study area, which are primary and secondary data by using interview and from various sources. Data analysis of this studying is using frequency analysis by using four phases, which are coding data, discovery of themes, organizing and defining data by code and interpretation of results.The results of this study show that existing water supply has multidimensional problems, such as lack of money and fund, the rapid growth rate of population, loss of water by leakage and lack of power to pump. The current demand and supply of domestic water supply is not balancing with numbers of town population, which is only 28.6% but 71.4% of total communities cannot gate adequate domestic water supply every day. Majority of the town communities use daily domestic water supply from unsafe and unprotected alternative water sources to fulfill their daily water demand from far distance almost 85.8% of total town communities. In study area There is no coordination, participation, and awareness of the population about the aim of water supply for their life by using water direct or indirect. Totally this study concludes as the existing domestic water supply is inadequate for all town communities at current time. This paper recommended that redesign all components of water supply schemes starting from population forecasting up to distribution systems. Keywords: Access of water; demand; distribution; production; Water supply; water tax; Injibara town DOI: 10.7176/CER/12-3-05 Publication date: March 31 st 2020

Preliminary insights regarding water as a transmission vehicle for Cryptosporidium and Giardia in Tigray, Ethiopia

This study was part of a larger One Health project with the aim of investigating the epidemiology of Cryptosporidium and Giardia infections among humans and animals in rural areas of Tigray, Ethiopia. Here we report on the contamination of different drinking water sources in four locations of this region with these Cryptosporidium oocysts and Giardia cysts; 19 samples were from unprotected surface water sources and 18 from protected water sources. A modified version of the standard ISO 15553 technique was used for analysis, and Giardia cysts were detected in 6 of the samples (16%) and Cryptosporidium in two (5%), with one of these samples containing both parasites. The number of Giardia cysts in positive samples ranged from 3 to 22 cysts per 10 L sample, and the number of Cryptosporidium oocysts in positive samples ranged from 1 to 3 oocysts per 10 L sample. Low numbers of parasites and absence of nuclei, as indicated by the absence of DAPI staining, precluded further molecular analyses. We found no association with contamination and whether the water source was protected or not, but there was an association with location, with one location more likely to have a contaminated sample than the others. These preliminary data suggest that this location should be in focus for further parts of this study.

Prevalence of diarrhoea and associated risk factors among children under five years old in Pader District, northern Uganda

BackgroundDiarrhoea remains a major cause of morbidity and mortality in children under 5 years in sub-Saharan Africa. Of the three East African countries, Uganda has the worst mortality rate in children < 5 years, with 22% of these deaths attributed to diarrhoea. For proper planning and implementation of control, an understanding of the prevalence and determinants of the disease is crucial. This study assessed the prevalence of diarrhoea and related risk factors among children < 5 years in Pajule Subcounty, Pader District in northern Uganda.MethodsA cross-sectional survey was conducted in April 2018, covering 244 randomly selected households having children < 5 years old in the study area. A semi-structured questionnaire was used to interview the households about diarrhoeal history in their children in the last 2 weeks preceding the survey, and on the risk factors predisposing children to diarrhoeal infections. Bivariate and multivariate logistic regression analyses with a 95% confidence interval and p < 0.05 was used to identify the risk factors associated with childhood diarrhoeal disease.ResultsWe found a prevalence of diarrhoea of 29.1% [95% CI (23.7–35.0)] among children < 5 years in Pajule Subcounty during the 2 weeks preceding the survey. Use of unprotected water sources, age of child caretaker, child weaning time and family size had significant associations with diarrhoeal morbidity.ConclusionThe prevalence of childhood diarrhoea among children < 5 years of age in rural settings of Pajule Subcounty was higher than the Ugandan national average. Use of unprotected water sources, age of child caretaker, child weaning time and family size were identified as predictors of diarrhoeal occurrence. These findings underscore the need for improving access to clean water and providing community health education as the best methods for fighting childhood diarrhoea in the study area.

Prevalence and associated factors of adolescent undernutrition in Ethiopia: a systematic review and meta-analysis

BackgroundIn Ethiopia, there are different pocket studies that assessed adolescent undernutrition which came up with inconsistent and inconclusive findings. Therefore, estimating the pooled prevalence and associated factors of the adolescent undernutrition using meta-analysis is crucial in Ethiopia.MethodsA systematic review of eligible articles was conducted using preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A comprehensive searching of the literature was made in Pub Med, Scopus, Google, Google Scholar, Cochrane Library and CINAHL. The quality of the articles included in the review was assessed using the Newcastle-Ottawa Scale (NOS) for non-randomized studies in meta-analyses. The pooled prevalence and odds ratio of the associated factors with their 95% confidence interval was computed using STATA version 14 software.ResultsTwenty-two studies were included in the meta-analysis with a total of 17,854 adolescents. Using the random-effects model analysis, the pooled prevalence of stunting and underweight was 20.7% (95% CI: 16.08, 25.33) and 27.5% (95% CI: 17.9, 57.14), respectively. Rural residence, having family size≥5, households with an unprotected water source for drinking and food-insecure household were significant associated factors for adolescent stunting. Early adolescent age (10–14 years), family size≥5, food-insecure household, lack of latrine, WHO diet diversity score < 4, mother educational status (with no formal education) were significant associated factors for adolescent underweight.ConclusionAdolescent undernutrition remains one of the most important public health problems in Ethiopia. Almost a quarter of Ethiopian adolescents were affected by stunting and underweight. Large family size, rural residence and unprotected source of drinking water were the associated factors for adolescent stunting. Similarly, large family size, early age of adolescent, lack of latrine, low dietary diversity score, mother illiteracy, and food insecure household were the associated factors for adolescent underweight. It would be good to give high emphasis on adolescent undernutrition and it is important to address the above mentioned associated factors during adolescent nutritional interventions in Ethiopia.

Copepod survival in water bowls exposed to typical Chadian ambient temperatures

Guinea Worm Disease (GWD), caused by the nematode Dracunculus medinensis, has been detected with increasing incidence among dogs in Chad, Africa. Cyclopoid copepods (freshwater crustaceans) are intermediate hosts for D. medinensis. Currently, the route(s) of D. medinensis transmission to dogs is still unknown but drinking from unprotected water sources would pose a risk. Dogs have access to water dishes provided for domestic animals and depending on the source of water, these dishes could harbor infected copepods, thereby acting as a source of transmission. To determine how long copepods survive in water dishes when exposed to Chadian ambient temperatures (41.1°C), copepods were placed in three different container types (plastic, glass, and metal) and heated to 40°C. Our results indicate that under simulated Chadian temperatures, metal dishes result in the highest rate of copepods death in the shortest period of time (2hrs) and were the only container to reach 100% copepod mortality. Conversely, plastic dishes exhibited the lowest mortality of copepods. These results indicate that the type of dish used when supplying water for animals in Chad is an important consideration in terms of preventing or interrupting transmission of D. medinensis among dogs. Support or Funding Information Funding for this work was provided by The Carter Center, University of Georgia, and NIH MARC Program (Grant Number: 2-T34-GM083980-11). We thank R. Bringolf and R. Ratajczak for providing laboratory space. Copepod Mortality in Different Dish Types during Set Time Intervals'Metal dishes had the highest percentage of copepod mortality in the shortest amount of time.•100% of copepods died in metal dishes after 4hrs of exposure.•Copepod mortality remained <50% in plastic dishes even after 8hrs of exposure to a 40°C heat source. Relationship between water temperature and percentage of copepod mortality.•Water temperature was a significant factor in copepod mortality (t=8.076, P<0.05) This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Contamination Potentials of Household Water Handling and Storage Practices in Kirundo Subcounty, Kisoro District, Uganda.

Introduction Waterborne diseases constitute a major public health burden in developing and underdeveloped countries. Consumption of contaminated water causes health risk to the public, and the situation is alarming in rural areas. The objective of this study was to assess the contamination potentials of different house water handling and storage practices in the Kirundo subcounty, Kisoro District, Uganda. Material and Methods A cross-sectional and descriptive study in which 344 water samples were collected randomly and analysed for bacteriological contamination, total coliforms (TCs) and Escherichia coli per 100 ml, using the Most Probable Number (MPN) technique and reported in terms of CFU/100 ml. Results The 43.2% samples from unprotected water sources had total coliforms and 34.1% had Escherichia coli. In analysed household drinking water, 25% had total coliforms and 8.7% had Escherichia coli. Most drinking water sources were found to have coliform counts above the recommended national and international guidelines. There was a statistically significant difference among water sources with respect to total coliforms and Escherichia coli (p < 0.05). Conclusion The overall results indicated that there is a strong linkage between microbiological water quality and water source sanitation; hence, the protected water source was safer than unprotected water sources. For the unprotected water sources, protection strategies as well as monitoring are recommended for this community.

Organoleptic and palatability properties of drinking water sources and its health implications in Ethiopia: a retrospective study during 2010-2016

Background: This retrospective study aimed to investigate the physicochemical properties of drinking water sources in Ethiopia and compare the water quality with the health-based target. For this purpose, the water quality database of Ethiopian Public Health Institute (EPHI) from 2010 to 2016 was used. Methods: The concentration and other properties of the water samples were analyzed according to the Standard Methods of Water and Wastewater analysis. Quality control and quality assurance were applied in all stages following our laboratory standard operation procedures (SOPs). Results: The concentration of the selected parameters varied based on the type of water sources. The mean concentration of turbidity was higher in spring water (21.3 NTU) compared to tap (12.6 NTU) and well (3.9 NTU) water sources. The mean concentration of total dissolved solids (TDS), electrical conductivity (EC), sodium (Na+), and sulfate (SO4 -2) was found to be higher in spring water sources than tap and well water sources. Comparably, the concentration of hardness, calcium, and magnesium was found to be higher in well water sources than spring and tap water sources. The bivariate analysis indicated that out of 845 analyzed water samples, more than 50% of the samples from Oromia region had turbidity, pH, TDS, hardness, Ca++, K+, and Na+ within an acceptable limit. In addition, the logistic regression analysis showed that water quality parameters were strongly associated with the type of water sources and regional administration at P&lt;0.05. Conclusion: More than 80% of the samples analyzed from drinking water sources were in agreement with WHO guidelines and national standards. However, the remaining 20% specifically, pH (25%), calcium (20%), hardness (18.1%), TDS (15.5%), and turbidity (13.3%) analyzed from improved water sources did not comply with these recommendations. Due to objectionable or unpleasant taste, people may force to look for alternative unprotected water sources that lead to health concerns.

Anemia among Women Attending Antenatal Care at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest Ethiopia, 2017.

Background In Ethiopia, prenatal anemia is a major public health concern affecting both the health of the woman and babies. The World Health Organization recommends to conduct repeated prevalence studies concerning prenatal anemia . However, there is no recent evidence on the magnitude of the prenatal anemia. Therefore, the aim of this study was to determine the prevalence and the associated factors of prenatal anemia among women attending the Antenatal Care Clinic at the University of Gondar Referral Hospital. Methods A facility-based cross-sectional quantitative study was conducted among 362 participants from June 03-July 08, 2017, at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. The systematic random sampling technique was employed. Structured interviewer administered questionnaire was used. Human Immunodeficiency Virus (HIV) screening was conducted. Nutritional status of the participants was assessed. Blood sample was collected by capillary tube . Intestinal parasite was examined by stool wet mount test. HIV serostatus was detected. Anemia was defined as hemoglobin concentration below 11 g/dl. The multivariable logistic regression model was employed to identify associated factors and to control the possible effects of confounders. Result The prevalence of anemia was 22.2% (95% CI: 18.11, 27.1%). The highest odds of anemia were observed among pregnant women with family size of >five [AOR = 3 (95% CI: 1.03, 8.65)], unprotected water source users, [AOR = 4.09 (95% CI: 1.75, 9.55)], HIV infected [AOR = 2.94(95% CI: 1.37, 6.35)], and multigravida women [AOR = 3.5 (95% CI: 1.35, 9.17)]. Conclusion and Recommendations The prevalence of anemia among pregnant women attending the University of Gondar Referral Hospital was a moderate public health problem. Unprotected water source, large family size, Human Immunodeficiency Virus infection, and repeated pregnancies were factors that predicted anemia. Thus, prevention of Human Immunodeficiency Virus infection, family planning utilization, and accessing pure water are recommended.

Drinking Water Supply, Sanitation, and Hygiene Promotion Interventions in Two Slum Communities in Central Uganda.

Poor water, sanitation, and hygiene (WASH) continue to contribute to the high prevalence of diarrhoeal diseases in low-income countries such as Uganda particularly in slums. We implemented a 3-year WASH project in two urban slums in Uganda with a focus on safe drinking water and improvement in sanitation. The project implemented community and school interventions in addition to capacity building initiatives. Community interventions included home improvement campaigns, clean-up exercises, water quality assessment, promotion of drinking safe water through household point-of-use chlorination, promotion of hand washing, and support towards solid waste management. In schools, the project supported health clubs and provided them with “talking compound” messages. The capacity building initiatives undertaken included training of youth and community health workers. Project evaluation revealed several improvements in WASH status of the slums including increase in piped water usage from 38% to 86%, reduction in use of unprotected water sources from 30% to 2%, reduction in indiscriminate disposal of solid waste from 18% to 2%, and increase in satisfaction with solid waste management services from 40% to 92%. Such proactive and sustainable community interventions have the potential to not only improve lives of slum inhabitants in developing countries but also create lasting impact.

Neonatal mortality in East Africa and West Africa: a geographic analysis of district-level demographic and health survey data.

Under-five child mortality declined 47% since 2000 following the implementation of the United Nation's (UN) Millennium Development Goals. To further reduce under-five child mortality, the UN's Sustainable Development Goals (SDGs) will focus on interventions to address neonatal mortality, a major contributor of under-five mortality. The African region has the highest neonatal mortality rate (28.0 per 1000 live births), followed by that of the Eastern Mediterranean (26.6) and South-East Asia (24.3). This study used the Demographic and Health Survey Birth Recode data (http://dhsprogram.com/data/File-Types-and-Names.cfm) to identify high-risk districts and countries for neonatal mortality in two sub-regions of Africa - East Africa and West Africa. Geographically weighted Poisson regression models were estimated to capture the spatially varying relationships between neonatal mortality and dimensions of potential need i) care around the time of delivery, ii) maternal education, and iii) women's empowerment. In East Africa, neonatal mortality was significantly associated with home births, mothers without an education and mothers whose husbands decided on contraceptive practices, controlling for rural residency. In West Africa, neonatal mortality was also significantly associated with home births, mothers with a primary education and mothers who did not want or plan their last child. Importantly, neonatal mortality associated with home deliveries were explained by maternal exposure to unprotected water sources in East Africa and older maternal age and female sex of infants in West Africa. Future SDG-interventions may target these dimensions of need in priority high-risk districts and countries, to further reduce the burden of neonatal mortality in Africa.

Risk factors for schistosomiasis transmission among school children in Gwanda district, Zimbabwe

IntroductionA nationwide cross sectional schistosomiasis survey conducted in 2011 in 280 primary schools found a prevalence rate of 22.7%. This warranted an intervention with Mass Drug Administration at all schools in line with WHO guidelines. This study aimed to identify risk factors for schistosomiasis transmission among Grade 3 children at two primary schools in Gwanda district. MethodsA descriptive cross sectional survey which was part of a larger study on Malaria and Bilharzia in Southern Africa (MABISA) was conducted. Grade 3 children (n=120) attending two purposively selected rural primary schools in Dombo and Ntalale in Gwanda were respondents. Data on socio-demographic characteristics and risk factors which included knowledge and practices were collected using a pretested interviewer administered questionnaire. ResultsOf the 120 children, 98 (81.7%) of the children indicated that they did not consistently use the toilet. The other risk factors for schistosomiasis were bathing and swimming in rivers and dams 80 (66.7%), watering the vegetable gardens using unprotected water sources 77 (64.7%) and crossing rivers on their way to school barefooted 31.7%. History of schistosomiasis cases based on self-reporting indicated that of the 9 children 7 were girls. There was poor knowledge of schistosomiasis among the children with 54% of the children indicating that they had never heard about the disease. Misconceptions on the causes of schistosomiasis which included drinking dirty water, mosquitoes and flies as the causes of schistosomiasis were reported by the children. Parents were cited as the least disseminators of information on schistosomiasis with only 4 out of the 120 children having received information from their parents. ConclusionFrequent contact with unprotected water sources, non-use of the toilet, and lack of information on schistosomiasis could predispose the children to infection. There is need to raise awareness about schistosomiasis in schools and the community to reduce the risk of contracting schistosomiasis due to risky behaviour.