Water Handwashing Research Articles

Qualitative drivers of postoperative prophylactic antibiotics use and resistance in Ethiopia.

The World Health Organization (WHO) cautions against unnecessary prolongation of postoperative antibiotics to prevent surgical site infections (SSI), however this practice is still common in many countries. This study aims to describe drivers of prolonged postoperative antibiotic prescribing and clinicians' perspectives on antibiotics resistance and stewardship in Ethiopia. We conducted semi-structured interviews of 16 surgeons and nine surgical ward nurses at three academic referral hospitals in Addis Ababa. Audio recordings were transcribed verbatim and coded. Codes were inductively and iteratively derived between two researchers, tested for inter-rater reliability (IRR), and the codebook was consistently applied to all transcripts. Thematic analysis was performed to understand drivers of prolonged prophylactic antibiotic use in surgical patients. Interviews revealed factors contributing to postoperative prophylactic antibiotics overprescribing, including inadequate infection prevention and control (IPC) practices, wide variability in local prescribing practices, and distrust in the applicability of WHO guidelines. Antimicrobial resistance was also identified as a major concern by staff. Barriers to improving stewardship included a lack of multidisciplinary teamwork to inform prescribing decisions, while solutions included constructing appropriate context-specific guidelines and improving evidence-based practices through input from local stakeholders, including surgeons, clinical pharmacists, and nurses. Study participants perceived that existing evidence and guidelines did not apply in their settings due to high rates of surgical site infections and gaps in perioperative IPC practices (e.g., availability of water for handwashing, sterility breaches). These gaps were a key contributor to prophylactic antibiotic overprescribing, reinforcing the need to strengthen upstream and perioperative surgical antisepsis processes. The findings of this study underscore the importance of engaging multidisciplinary teams in strengthening antimicrobial stewardship efforts, aligning processes to achieve compliance with best practices, and the need for rigorous, contextually appropriate studies from these settings to inform policy.

Bacteriological quality and safety of handwashing water among food establishments in Gondar Town, Northwest Ethiopia

ABSTRACT Unsafe handwashing water (HWW) has been one of the public health concerns in developing nations, including Ethiopia. This study aimed to assess the bacteriological quality and safety of HWW and associated risk factors in food establishments (FEs) (hotels, restaurants, and cafes) in Gondar Town, Northwest Ethiopia. A cross-sectional study was conducted from February to August 2023. Total coliforms (TC) and fecal coliforms (FC) were enumerated using the membrane filtration method. In addition, potentially pathogenic bacteria were isolated from samples that tested positive for coliform. The antibacterial susceptibility profile of the isolated bacteria was also determined using the Kirby–Bauer disk diffusion method. Based on the results, 87.2% (for TC) and 52.9% (for FC) of the HWW did not meet water quality standards. The presence of unlicensed managers, untrained food handlers, and poor knowledge and practices on hygiene among HWW were found to be associated risk factors for FC contamination. All the isolated bacteria were resistant to amoxicillin and tetracycline but susceptible to ciprofloxacin. Moreover, 66–77% of the isolates were multi-drug resistant. Thus, the HWW in FEs of Gonder Town is unsafe for human health, and appropriate measures are needed to control the risks.

Automatic Low-cost Water Level Indicator for Tanks and Hand Washing Water Dispensers in Kitui; Kenya during the Covid 19 Pandemic

In day to day life, millions and millions of liters of water is being wasted through overflowing or excessive usage. In Kitui specifically, water availability by itself a challenge since the area rarely experiences long rainy seasons, has no flowing rivers, the dams are dry and there are only few boreholes available. It is for these reasons that we propose the adaptation of probe sensors to detect the water level in the hand washing water dispensers and storage tanks of the available boreholes in Kitui. The probe sensors detect the water level when they come in contact with them and in return a light emitting diode of the corresponding probe blinks. The system calculates the water level up to 100% by intervals of 25%. Moreover, the system is also connected to a relay switch that automatically turns on or off based on the water level. When each interval is reached, the light emitting diode blinks. At 25% the water level in the tank is lowest and this prompts the buzzer to produce a sound notifying the attenders that the tank needs to be refilled. An automatic refill also takes place due to the additional circuit connection. At 100% the relay goes OFF and water refill stops hence water wastage is avoided.

Community Health Diagnosis: Participatory First Step Field Study in Primary Health among Deprived Community of Chandrapur Municipality of Madhesh Province in Nepal

Background: Community health diagnosis is a continuous process which address the health challenges and needs of a particular community. The health needs of a community are ever changing process which evaluates the success of implementation of any health program as well as the development of the community. The public health is affected by the knowledge and practices of multiple factors like maternal and child health care, family welfare, personal hygiene and sanitation and available health infrastructure and services. These factors indicated the health status of the community. In our knowledge, there might be gap in delivering public health to the community. Hence, the study conducted to assess the different community health parameters of the selected area which included demographic data, maternal and child health, family welfare, daily activities (dinacharya), personal hygiene and sanitation, awareness of COVID-19 and vaccination and health institutions and facilities. Materials and Methods: The study was conducted by face-to-face interview among the 229 household of ward 2 and 8 of Chandrapur Municipality, Rautahat district, Madhesh Province of Nepal, using semi-structured questionnaire with inclusion of community health parameters. The convenient sampling method was used for the study. Verbal informed consent was taken from the respondent as well as the local administrative office before commencing the study. The data was collected in the month of May, 2023. Results and Conclusion: The result showed that the community health status of the study area was satisfactory but still there is huge gap between the needs, services and their utilization. Although maximum children are vaccinated according to EPI, unvaccinated children were also significantly present; whereas, though most of the people used latrine for defecation, open defecation still persisted and some resident still used mud/earth or ash or only water for hand washing. Similarly, in other health related behavior there persisted the unhealthy practices. Conclusion: The various related stakeholder of the community should work efficiently to mitigate the gap between health problems and needs in the community. The health program should be specially planned, implemented and analyzed in the deprived and marginalized area of the society to address the disparity in the social, economic and health needs.

Prevalence and Antimicrobial Resistance of Escherichia coli O157:H7 and Salmonella, and the Prevalence of Staphylococcus aureus in Dairy Cattle and Camels under Pastoral Production System.

Escherichia coli O157:H7, Salmonella and Staphylococcus aureus are common foodborne pathogens. We determined the prevalence of E. coli O157:H7 and Salmonella in feces and milk and the prevalence of S. aureus in milk from dairy cattle and camels in the Borana pastoral community in the Southern Oromia Region of Ethiopia. Paired individual cow composite (pooled from all quarters in equal proportions) milk and fecal samples were collected from cows (n = 154) and camels (n = 158). Samples were cultured on bacterial isolation and identification media. E. coli O157:H7 and Salmonella isolates were further tested for susceptibility against nine antimicrobial drugs. Different risk factors associated with hygienic milking practices were recorded and analyzed for their influence on the prevalence of these bacteria in milk and feces. The prevalence of E. coli O157:H7 and Salmonella in feces were 3.9% and 8.4%, respectively, in cows, and 0.6% and 2.5%, respectively, in camels. E. coli O157:H7 and Salmonella were detected in the composite milk samples of 2.6% and 3.9% of the cows, respectively, and 0% and 1.3% of the camels, respectively. S. aureus was detected in composite milk samples of 33.4% of the cows and 41.7% of the camels. All E. coli O157:H7 (n = 11) and Salmonella (n = 25) isolates from both animal species and sample types were resistant to at least one antimicrobial drug. Multidrug resistance was observed in 70% (7/10) of the E. coli O157:H7 fecal and milk isolates from cows and 33.3% (2/6) of the Salmonella fecal and milk isolates from camels. The prevalence of these bacteria in feces and milk was not affected by risk factors associated with milking practices. Given the very close contact between herders and their animals and the limited availability of water for hand washing and udder cleaning, these bacteria are most likely present in all niches in the community. Improving community awareness of the need to boil milk before consumption is a realistic public health approach to reducing the risk of these bacteria.

Seroprevalence and risk factors for Taenia spp infection in pigs in Kongwa and Songwe districts, Tanzania: A cross-sectional study

Taenia solium porcine cysticercosis (PCC) is widespread in many low- and middle-income countries (LMICs) where free-range pig rearing is common and hygienic standards are subpar. A cross-sectional survey was conducted in 42 villages between June and September 2019 (14 in Songwe district, southwest Tanzania, and 28 in Kongwa district, central Tanzania). Using a commercial Ag-ELISA kit (apDia, Belgium), circulating antigens of Taenia spp in pig serum were identified and used to calculate the PCC seroprevalence. The study recruited 692 randomly selected households, sampling one pig per household. The relationship between each risk factor and the seroprevalence of PCC at the household and village levels was analysed using mixed logistic regression models. The findings showed that approximately 28% of the pigs were reared in free-range settings, the proportion of households with latrines across the districts was 92%. Twenty-seven percent of households with latrines had water and soap available for hand washing. Sixty-seven (9.7%) tested positive for PCC based on Ag-ELISA. The overall seroprevalence in Kongwa and Songwe districts was 7.3% and 14.0% respectively. In addition, the overall village Ag-ELISA positivity was 9.3%, with an interquartile range (IQR) of 4.6% – 14.1%. Increasing the age of the pig (OR = 3.13 95% CI = 1.48 – 6.60; p = 0.003), pig originating from outside the household (OR = 0.5 95% CI = 0.25 – 0.99; p = 0.05), and pigs kept in a household that practised deworming (OR = 2.23 95% CI = 1.08 – 4.61; p = 0.03) were important risk factors associated with PCC positivity. Therefore, the high seroprevalence of PCC, up to 14%, calls for rapid and effective control actions such as vaccination and treatment of pigs against PCC, and public health education emphasises on indoor pig rearing, hygienic practices and regular use of latrines. Our findings also point to a potential danger of Taenia. spp infection indicating the possibility of people carrying the adult parasite Taenia solium not only in the rural communities of Kongwa and Songwe districts but also in the urban areas of Tanzania, where pigs from these areas are transported for consumption. To develop effective management measures, further research on taeniasis and cysticercosis in the human population is required.

Microbial Profile of Fresh and Semicooked Nile Tilapia (Oreochromis niloticus) and Hygienic Practice of Fish Handlers in Hawassa, Ethiopia.

Despite its high nutritional quality, fish is a highly perishable food item. This study aimed at assessing the microbial quality and safety of fresh and semicooked Nile tilapia fish fillets and the food safety practices of fish handlers in Hawassa City. The microbial load of 40 for each of raw and semicooked fillet samples was estimated by the standard plate count method, and the dominant flora as well as common bacterial pathogens were identified following phenotypic procedures. Moreover, a survey was conducted to assess the hygienic conditions and food safety practices of 30 fish handlers. The mean microbial load of the raw fillet samples in log10CFUg-1 was 8.42 for aerobic mesophilic bacteria (AMBC), 2.52 for total coliforms (TCC), and 3.41 for a count of staphylococci (CS). On the other hand, the respective parameters for the semicooked fillets in log10CFUg-1 were 6.68 (AMBC), 2.52 (TCC), and 3.17 (CS). The mean AMBC of all the fresh raw fillet samples exceeded the recommended maximum permissible limits. The mean SC of raw fillets from three of the eight vendors and one semicooked fillet were at a potentially hazardous level (>4 log units). Moreover, Salmonella species were isolated from 30% to 25% of raw and semicooked samples, respectively. The mesophilic bacterial flora of both types of samples was dominated by Bacillus species, Salmonella species, E coli, and Staphylococcus species. Most fish handlers did not practice hygienic food handling and lacked basic sanitation amenities like clean water and soap for hand washing. Moreover, nearly all the fish handlers did not have any formal education. These findings call for public health intervention measures like the provision of training in good hygienic practices and certification for fish vendors in the chain.

Water source and its handling, knowledge and preventive practices of water borne diseases among different communities in Manipur

Background: Most of the ill health affecting humanity especially in developing countries can be traced to lack of safe and wholesome water supply. This study was conducted to assess the various sources of water, to estimate the knowledge and preventive practices of water borne diseases and to determine association of preventive practices with some socio-demographic variables. Methods: A community-based cross-sectional study was conducted among residents aged ≥18 years of Kshetrigao, New Checkon and Mantripukhri of Imphal East District. A pretested, semi structured interview schedule was used. Descriptive and analytical statistics like Chi square test were generated taking a p<0.05 as level of significance. Ethical approval was obtained from the Institutional Ethics Committee. Results: Out of 446 participants, majority buy water for drinking (343, 76.9%) and domestic (244, 54.7%) purposes. Most of the participants (377, 84.5%) knew that water quality can affect health. Almost all participants (439, 98.4%) used soap and water for handwashing. Residents of Mantripukhri perform significantly higher safe preventive practices. Conclusions: Buying was main source of water for both drinking and domestic purposes across all the communities. Increased public health activity like awareness campaigns regarding water borne diseases and its prevention needs to be organised.

Health and Sanitation Condition of Pregnant Women: A Case of Arghakhanchi District

This paper aims to explore the situation of sanitation and changing the behaviour of married Nepalese women of reproductive age (15-49). A concurrent mixed-method (qual-quan) research design was employed in this research under the pragmatism worldview. The data are collected through a questionnaire survey, in-depth interviews, and a transect walk. Arghakhanchi district was selected purposively in this study. Diffusion of innovation theory was applied to understand the factors influencing sanitation and hygiene behavior change. The key research participants were the pregnant women of reproductive age (15-45) in the study. A thematic framework was used to analyze qualitative data, while bivariate analysis was performed to show the association between the background variables of sanitation and the health condition of pregnant women. It was found that most of the women used soap and water for hand washing before each meal and after the toilet. There is the provision of soap at hand washing stations and toilets among the study population. However, sufficient hand washing and toilet facilities were not available and 23% of the women reported being scratchy with the use of soap and water regularly.

Bacterial contamination in the operating room at Hue Central Hospital, 2nd branch

ABSTRACT Objectives: This study aims to evaluate the microbial contamination level and identify bacterial colonization of the operating room in the hospital. Methods: Three sampling procedures were used in this study, which includes swabbing, air sampler and contact agar plate. Collected samples from 8 ORs were transported and microbiologically processed using standard procedures. Bacteria were identified by morphological, biochemical tests and Vitek 2 Compact system. Microbiological criteria were based on recommendation of the Ministry of Health. Results: The incidence of positive cultures was 285/600 (47.50%). The most common isolates were Gram - positive bacteria (98.25%) while low rate of Gram - negative bacteria (1.75%) was surveyed with Pseudomonas sp. (0.7%) and Enterobacter cloacae (1.05%). The water used for surgical hand washing illustrated the existence of Staphylococcus blanc (60%) and each of Pseudomonas sp. and Enterobacter cloacae (20%). Air contamination were observed with Bacillus sp. (46.90%) and Staphylococcus blanc (53.10%). Environmental surfaces were detected 7 species, of which 4 threaten strains including Staphylococcus aureus accounted for 5.55%, followed by Streptococcus β - hemolytic (0.79%), Pseudomonas sp. (0.79%) and Enterobacter cloacae (1.59%). Surgeons’s hand samples were isolated with Bacillus sp. (14.55%) and Staphylococcus blanc (1.81%). The rate samples of ORs surfaces reaching level A and B accounted for 91.49% and 8.51% while none of the samples approach level C and level D. The rate of qualified samples in terms of air, water for surgical hand washing, surfaces of medical instruments and surgeons’ hands was remarkably high with 87.59%, 98.44%, 95.24% and 100%, respectively. Conclusion: Our study showed various bacteria isolated, of which pathogenic species occupied very low percentage. Especially, the rate of samples in the study that meet microbiological standards was remarkably high according to Ministry of Health recommendation.

The impact of wastewater-irrigated urban agriculture on microbial quality of drinking water at household level in Addis Ababa, Ethiopia

ABSTRACT Wastewater irrigation may reintroduce fecal pathogens to households and cause drinking water contamination. The aim of this study was to assess the effect of wastewater irrigation on the quality of drinking water among wastewater-irrigating urban farming households. Drinking water samples from 52 households of farming communities in 19 sampling sites were collected twice at PoS and PoC. The microbial quality of the water was assessed using E. coli counted by membrane filtration. Samples collected from exposed households at PoC were 100% positive for E. coli with mean E. coli at PoC increased 10× from the PoS and 3× higher compared to PoC in the unexposed households. The absence of hand washing water (ATE = 8.14), water storing (ATE = 7.75) and intermittent water supply (ATE = 6.25) were significant factors for the increased E. coli at PoC. Breaking the path of the pathogens from the farm to the house and from PoS to PoC needsintervention.

Adequacy of sanitation and handwashing facilities in public primary schools: case of Tharaka Nithi County, Kenya

Background: Hygiene as practices and conditions contribute to the upholding of population health or prevention of disease outbreak. The implication of sanitation needs to the population tends to weigh heavily on the children population due to their vulnerability to pathogens. Methods: Analytical cross-sectional study design was used and 219 participants in the selected public primary schools participated in the study. Data was collected using administered structured questionnaire, observation and Key Informant Interview. Quantitative data analysis was conducted using SPSS version 26.0 and involved univariate and bivariate analysis. Bivariate analysis was done through logistic regression was used to test the significance of the association between the dependent and independent variables (p<0.05). Qualitative data was analyzed by thematic content analysis. Results: More than three quarter 171 (78.1%) were day school with 40 (18.3%) and 54 (24.7%) of school having between 150-179 boys and 180-209 girls respectively. Slightly less than half 104 (47.5%) of schools had less than 5 toilets for boys and 90 (41.1%) of schools had between 5-10 toilets for girls, 112 (51.1%) of schools had water available for hand washing outside the latrines/toilets. Schools with 120-149 boys and 210-239 girls were more likely to avail water for handwashing outside the toilets. Conclusions: Schools lack sanitary facilities, water, soap and protective clothing, leading to poor sanitation levels, further, schools with scarcity of water and soap for hand washing are at risk of contamination, leading to the spread of diseases like cholera.

Exploring associations between household environmental factors and handwashing with essential agents in sub-Saharan Africa.

3 billion people lack proper home hand hygiene facilities globally. Of these, 1.4 billion (18%) lack soap or water, while 1.6 billion (22%) have neither. This analysis explores the link between living conditions and the use of essential agents in sub-Saharan Africa. This secondary data analysis examines potential associations between the domiciliary environment and the use of essential agents in sub-Saharan Africa. Eighteen demographic and health surveys were used to analyze the association between household environmental factors and handwashing with essential agents. STATA version 16 was used to analyze data from 203,311 households across weighted samples. Using a multivariable multilevel mixed effect logistic regression analysis, it was possible to determine how each independent factor affected the outcome while taking the data clustering into account. The adjusted odds ratio and its associated 95% confidence interval were used to assess the independent factors' statistical significance. Only one in three households 34.84%, practiced handwashing with essential agents, with the highest prevalence in Angola (70.2%) and the lowest in Malawi (6.5%). Educational status [aOR = 1.77; 95%(CI = 1.68-1.86)], female headship[aOR = 1.09; 95%(CI = 1.06-1.2)], household wealth[aOR = 4.08; 95%(CI = 3.84-4.33)], not sharing toilets with other homes[aOR = 1.13; 95%(CI = 1.10-1.17)], having a fixed place for hand washing[aOR = 1.49; 95%(CI = 1.45-1.54)], not having regular access to water [aOR = 0.09; 95%(CI = 0.095-0.10)]and being a rural resident [aOR = 0.85; 95%(CI = 0.82-0.88)] were associated with handwashing. sub-Saharan nations are failing to demonstrate advancements in handwashing practices. There are still a lot of homes without access to basic infrastructure for handwashing and household water sources. For essential agent adoption programs to be successful in an environment with limited resources, Water, Sanitation, and Hygiene measures must be implemented. Furthermore, it is critical to include contextual factors from the current study as well as socio-cultural and psychological characteristics that dissuade people from using essential agents in intervention strategies.

Hygiene practices and exposure to potential hazards among manual faecal sludge evacuators in Ibadan metropolis, Nigeria

The study assessed faecal sludge management methods, hygiene practices and potential health hazards among manual faecal sludge evacuators within Ibadan metropolis. A cross-sectional study was conducted among sixty (60) consented manual faecal sludge evacuators using a validated questionnaire and in-depth interview guide. Hands swab samples were also collected for microbial load count. Quantitative data were analysed using descriptive statistics and t-test at p=0.05. Respondents’ mean age was 48.2±13.3 years, 75.0% had at least primary education, 18.3% had spent more than 19 years on the job. Average monthly income was 22,546.80±3,341.90 NGN (1US$=NGN 416). Only 18.3% reported that they use PPE during emptying while 53.3% reported that they usually do hand washing with water and soap. In-depth interview of participants emphasised that the protective foot wear becomes completely soaked and making movement difficult and slow during the emptying operations. Major hazards reported by the manual evacuators were odour (41.7%), gas fumes/aerosols (18.3%) and dust (6.6%). Salmonella, Shigella and E. coli were isolated from the hand wash water samples from the manual evacuators. Eschericia coli count (cfu/mL) was significantly higher among evacuators without PPE during evacuation (4.1±2.6)×103) compared to their counterpart with PPE during evacuation (1.4±0.8)×103). Feacal sludge management by the manual evacuators was unwholesome while utilization of PPE was low among manual faecal sludge evacuators. Salmonella/shigella and E. coli was higher among evacuators that did not use PPE. Regular use of personal protective equipment and compliance with hygiene standards relating to the work should be enforced among manual fecal sludge evacuators.

Impact of covid-19 pandemic on investments in the water sector in Kenya

The purpose of this study was to establish the impact of Covid-19 pandemic on water investment financing in Kenya. This paper therefore presents an analysis of the investment financing as prioritized in the water sector since the onset of the Covid-19 pandemic. The study was done through an analysis of the Government of Kenya’s capital financing trends in the water sector targeting the counties of Nairobi, Kiambu and Murang’a during the pandemic period. The findings indicate that there was increased funding to the water sector in general. However, most financing was directed towards emergency works geared towards increased access to water for hand washing to curb the spread of the pandemic. In some cases, this resulted to shifting of resources from the long-term planned and ongoing projects to short-term emergency interventions. Such a shift is likely to negatively impact on the progress made towards the attainment of the Kenya’s Vision 2030 at the national level and the sustainable development goals at the global level.

Prevalence of scabies and associated factors among children aged 5-14 years in Meta Robi District, Ethiopia.

Scabies is a public health problem that affects children and elders predominantly. Its burden is higher in resource-poor settings, and scabies has a significant impact on the long-term health of children. In Ethiopia, there is limited information about scabies in children. Therefore, the purpose of this study was to determine the prevalence of scabies and its associated factors among children aged 5-14 years in Meta Robi District, Ethiopia. A community-based cross-sectional study design using a multistage sampling technique was used to collect data from 457 participants by systematic random sampling. Scabies was diagnosed based on the clinical criteria set by the International Alliance for the Control of Scabies (IACS, 2020). The prevalence of scabies among children aged 5-14 years old was 19.26% (95%CI: 17.20-22.52). In addition, over half (54.6%) of identified cases of scabies were of moderate severity. Factors like families' low income (aOR = 2.72; 95%CI: 1.32-5.59), being a male child (aOR = 1.96, 95%CI: 1.61-4.01), using only water for hand washing (aOR = 2.01, 95%CI: 1.84-4.79), having a contact history of scabies/skin lesions (aOR = 4.15, 95%CI: 2.02-13.67), and sharing sleeping beds (aOR = 6.33, 95%CI: 2.09-19.13) were significantly associated with scabies. The study highlights a high prevalence of scabies among children aged 5-14 years in the district. Provision of adequate health education for the community and children about the scabies and delivering mass drug administration to the district is suggested.

Automatic Low-cost Water Level Indicator for Tanks and Hand Washing Water Dispensers in Kitui; Kenya during the Covid 19 Pandemic

In day to day life, millions and millions of liters of water is being wasted through overflowing or excessive usage. In Kitui specifically, water availability by itself a challenge since the area rarely experiences long rainy seasons, has no flowing rivers, the dams are dry and there are only few boreholes available. It is for these reasons that we propose the adaptation of probe sensors to detect the water level in the hand washing water dispensers and storage tanks of the available boreholes in Kitui. The probe sensors detect the water level when they come in contact with them and in return a light emitting diode of the corresponding probe blinks. The system calculates the water level up to 100% by intervals of 25%. Moreover, the system is also connected to a relay switch that automatically turns on or off based on the water level. When each interval is reached, the light emitting diode blinks. At 25% the water level in the tank is lowest and this prompts the buzzer to produce a sound notifying the attenders that the tank needs to be refilled. An automatic refill also takes place due to the additional circuit connection. At 100% the relay goes OFF and water refill stops hence water wastage is avoided.

Formative Research for the Development of Evidence-Based Targeted Water, Sanitation, and Hygiene Interventions to Reduce Cholera in Hotspots in the Democratic Republic of the Congo: Preventative Intervention for Cholera for 7 Days (PICHA7) Program.

Compared to the general public, household members of cholera patients are at a 100 times higher risk of contracting cholera during the 7-day high-risk period after a cholera patient has been admitted to a health facility for treatment. The Preventative-Intervention-for-Cholera-for-7-days (PICHA7) program aims to reduce household transmission of cholera during this 7-day high-risk period through a health facility-initiated water, sanitation, and hygiene (WASH) program promoting handwashing with soap, water treatment, and safe water storage. The PICHA7 program is delivered to cholera patient households through: (1) a pictorial flipbook delivered by a health promoter; (2) a cholera prevention package (handwashing station, drinking water vessel with lid and tap, and chlorine tablets); and (3) weekly WASH mobile messages sent to patient households in the Democratic Republic of the Congo (DRC). The objectives of this study were to conduct formative research to identify facilitators and barriers of the promoted WASH behaviors for cholera patient households and to tailor the PICHA7 program to target these facilitators and barriers. Formative research included 93 semi-structured interviews with diarrhea patient households and healthcare workers during exploratory research and a pilot study of 518 participants. Barriers to the promoted WASH behaviors identified during exploratory and pilot study interviews included: (1) low awareness of cholera transmission and prevention; (2) unaffordability of soap for handwashing; and (3) intermittent access to water limiting water for handwashing. For intervention development, narratives of the lived experiences of patient households in our study were presented by health promoters to describe cholera transmission and prevention, and soapy water and ash were promoted in the program flipbook and mobile messages to address the affordability of soap for handwashing. A jerry can was provided to allow for additional water storage, and a tap with a slower flow rate was attached to the handwashing station to reduce the amount of water required for handwashing. The pilot findings indicate that the PICHA7 program has high user acceptability and is feasible to deliver to cholera patients that present at health facilities for treatment in our study setting. Formative research allowed for tailoring this targeted WASH program for cholera patient households in the DRC.

User satisfaction with resources and services of Kumasi Technical University Library during the COVID-19 pandemic

A resourceful and well-organized library is an asset to any academic institution and its existence is justified by the extent to which users are satisfied with its resources and services. Nonetheless, globally, library services were affected by the outbreak of the COVID-19 pandemic. This study was therefore focused on determining the level of users’ satisfaction with the resources and services of Kumasi Technical University library during the COVID-19 pandemic. The survey method was employed and a questionnaire was used to collect data. Stratified and convenience sampling techniques were used to select 192 respondents but 169 responses were valid for analysis. The findings revealed that, generally, users were satisfied with the physical facilities, services and COVID-19 protocols in the library, though, the library provided poor online services, did not have discussion rooms, some users were not aware of electronic resources and few users did not follow COVID-19 protocols in the library. The study recommends the provision of discussion rooms, improvement in online services, publicity and training on electronic resources and provision of adequate water for handwashing and hand sanitizer.

Access to Water, Sanitation and Hygiene Services and Other Preventive Measures against COVID-19 among People with Disabilities, Dodoma, Tanzania.

ABSTRACT.Access to Water, Sanitation and Hygiene (WASH) among people with disabilities is a great concern in developing countries. During COVID-19 pandemic in 2020, in addition to other preventive measures the government of Tanzania invested heavily on handwashing facilities in public places. However, the interventions were mostly for the general population. A big question was the appropriateness of the preventive measures to address different kinds of disabilities. The study was conducted to assess access to WASH and other preventive measures against COVID-19 among people with disabilities. This was a qualitative study where a total of 16 key informant interviews and nine focus group discussions were conducted. The study was carried out in seven districts of Dodoma region, Tanzania. Findings show that there were inadequate WASH and other COVID-19 preventive measures designed specifically for people with disabilities against the pandemic. Many people with disabilities experienced challenges in accessing adequate water for handwashing and using handwashing facilities installed for general population. Also they received inadequate health education and timely communication on COVID-19 preventive measures in addition to challenges in keeping distance and accessing and use of face masks and sanitizers. People with mobility, hearing, and vision impairments were mostly affected. There was no representation of people with disability at the national COVID-19 task force. Specific programs for people with disabilities to address access to WASH and other preventive measures against COVID-19 would address most of the identified challenges.