WASH Access Research Articles

Menstrual Hygiene Practices, WASH Access and the Risk of Urogenital Infection in Women from Odisha, India.

Menstrual hygiene management (MHM) practices vary worldwide and depend on the individual’s socioeconomic status, personal preferences, local traditions and beliefs, and access to water and sanitation resources. MHM practices can be particularly unhygienic and inconvenient for girls and women in poorer settings. Little is known about whether unhygienic MHM practices increase a woman’s exposure to urogenital infections, such as bacterial vaginosis (BV) and urinary tract infection (UTI). This study aimed to determine the association of MHM practices with urogenital infections, controlling for environmental drivers. A hospital-based case-control study was conducted on 486 women at Odisha, India. Cases and controls were recruited using a syndromic approach. Vaginal swabs were collected from all the participants and tested for BV status using Amsel’s criteria. Urine samples were cultured to assess UTI status. Socioeconomic status, clinical symptoms and reproductive history, and MHM and water and sanitation practices were obtained by standardised questionnaire. A total of 486 women were recruited to the study, 228 symptomatic cases and 258 asymptomatic controls. Women who used reusable absorbent pads were more likely to have symptoms of urogenital infection (AdjOR=2.3, 95%CI1.5-3.4) or to be diagnosed with at least one urogenital infection (BV or UTI) (AdjOR=2.8, 95%CI1.7-4.5), than women using disposable pads. Increased wealth and space for personal hygiene in the household were protective for BV (AdjOR=0.5, 95%CI0.3-0.9 and AdjOR=0.6, 95%CI0.3-0.9 respectively). Lower education of the participants was the only factor associated with UTI after adjusting for all the confounders (AdjOR=3.1, 95%CI1.2-7.9). Interventions that ensure women have access to private facilities with water for MHM and that educate women about safer, low-cost MHM materials could reduce urogenital disease among women. Further studies of the effects of specific practices for managing hygienically reusable pads and studies to explore other pathogenic reproductive tract infections are needed.

Modern tectonic cracking near the Garlock fault, California

Tectonic strain accumulation along the locked, eastern segment of the Garlock fault is probably sufficient to cause ground cracking and related fissuring at the Naval Weapons Center, China Lake, California. A 7 mm/yr slip rate measured along the western segment of the fault apparently is not being relieved along the 155-km-long eastern segment by creep, and no major earthquakes have occurred along this segment during the past 1,000 ± 500 yr. Therefore, the unrelieved slip available for elastic strain may be between 3.5 and 10.5 m. During 1970, a zone of erosion-modified fissures was observed near the Randsburg Wash Access Road, ∼5 km north of the Garlock fault. The fissures did not significantly enlarge between 1970 and 1983. Following a severe thunderstorm the night of August 18, 1983, two new zones of ground cracks appeared. The first zone included the earlier fissures but also extended to the north and south for a total length of 732 m. The second zone intersected the first near its midpoint, at a 30° angle, and had a total length of 686 m. Analysis of the cracks suggests that the first zone resulted from tensional stresses and that the second resulted principally from shear. The tectonic stress field assumed responsible for the formation of these zones is consistent with that deduced for the western segment of the Garlock fault. The morphology of the cracks indicates that they occurred shortly after the rainfall and flash flooding ceased, and there was probably no causative relationship between them. Trenching studies indicate that the cracks and fissures are a part of a long-term process and that the new cracks are only the latest of a series of events.