World Health Organization Norms Research Articles

Pharmacognostic Standardization and Physicochemical Evaluation of Premna barbata Wall. Ex Schauer leaves from Western Himalaya

Premna barbata Wall. ex Schauer; belongs to family Lamiaceae. It is a deciduous shrub or a tree. The plant is distributed in the forest area of the eastern and northern parts of India in tropical and subtropical Asia, Africa, Australia and the Pacific Island. It is found in the Shivalik tract and the lower Himalaya. The present work has been undertaken to establish the pharmacognostical parameter of P. barbata leaves. The leaf samples were subjected to organoleptic and microscopic analysis. Physico-chemical properties and fluorescence analysis of the sample under UV were studied as per World Health Organization norms. Hydroalcoholic extract was prepared and subjected to preliminary phytochemical screening and antioxidant activity. Morphological observations revealed that the leaves are simple, petiolate, opposite, reticulate venation, 5.0-5.2 cm long, ovate in shape, entire margin with acute apex. Microscopic analysis showed that the leaves are dorsiventral, uniseriate covering trichomes present on upper and lower epidermis. Vascular bundle existing was of open and bicollateral type and pith was composed of loosely packed, comparatively large round parenchyma cells etc. Parameters like ash and extractive values, moisture content and fluorescent characteristics of the leaf samples were determined and reported. The extract revealed the presence of carbohydrates, glycosides, alkaloids, flavonoids, steroids, triterpenoids, tannins and phenolic compounds. The standardization parameters studied in the present investigation will aid in the identification and will be helpful in maintaining the standard profile of Premna barbata.

World Health Organization Regime Effectiveness in Controlling COVID-19: Case Study of Malaysia, Thailand, and Indonesia

The World Health Organization (WHO) is the only international organization to be given authority by the Charter of the United Nations to promote and protect the health of all people. Then it is not surprising that people look after the response and action of the WHO when COVID-19 cases explode worldwide. Observing the response of the WHO, some analysts criticized the organization for late, incomprehensive, and unsystematic policy. Some even blame the way the organization work, that is reactive rather than predictive, the shortage of the budget, and the decision-making process that is not transparent. This paper intends to analyze the effectiveness of the WHO's rule, norms and regulation in controlling the spread of the COVID-19. It tries to answer the question of how effective the WHO regime is in controlling COVID-19 spread. Using the theory of regime effectiveness, it studies the case of Malaysia, Thailand, and Indonesia. The three countries are chosen because WHO has appreciated Malaysia and Thailand for their compliance with International Health Regulations (2005) (IHR) core capacity requirements and have strong capacity and self-sufficiency in outbreak preparedness and response. Meanwhile, Indonesia faced considerable difficulties at the beginning of the pandemic, but currently Indonesia achieves better performance in controlling the pandemic than that Malaysia and Thailand. Keywords: World Health Organization, International Health Regulation, COVID-19, international regime, effectiveness

Advancing the WHO-INTEGRATE Framework as a Tool for Evidence-Informed, Deliberative Decision-Making Processes: Exploring the Views of Developers and Users of WHO Guidelines.

Background: Decision-making on matters of public health and health policy is a deeply value-laden process. The World Health Organization (WHO)-INTEGRATE framework was proposed as a new evidence-to-decision (EtD) framework to support guideline development from a complexity perspective, notably in relation to public health and health system interventions, and with a foundation in WHO norms and values. This study was conducted as part of the development of the framework to assess its comprehensiveness and usefulness for public health and health policy decision-making. Methods: We conducted a qualitative study comprising nine key informant interviews (KIIs) with experts involved in WHO guideline development and four focus group discussions (FGDs) with a total of forty health decision-makers from Brazil, Germany, Nepal and Uganda. Transcripts were analyzed using MAXQDA12 and qualitative content analysis. Results: Most key informants and participants in the FGDs appreciated the framework for its relevance to real-world decision-making on four widely differing health topics. They praised its broad perspective and comprehensiveness with respect to new or expanded criteria, notably regarding societal implications, equity considerations, and acceptability. Some guideline developers questioned the value of the framework beyond current practice and were concerned with the complexity of applying such a broad range of criteria in guideline development processes. Participants made concrete suggestions for improving the wording and definitions of criteria as well as their grouping, for covering missing aspects, and for addressing overlap between criteria.Conclusion: The framework was well-received by health decision-makers as well as the developers of WHO guidelines and appears to capture all relevant considerations discussed in four distinct real-world decision processes that took place on four different continents. Guidance is needed on how to apply the framework in guideline processes that are both transparent and participatory. A set of suggestions for improvement provides a valuable starting point for advancing the framework towards version 2.0.

Dental Caries and Its Association with Body Mass Index among School Children of Riyadh, Saudi Arabia.

ABSTRACTBackground:Few studies have investigated the relationship of dental caries with obesity among Saudi Arabian population. Hence, this study was conducted to assess the association of obesity with dental caries among school children.Materials and Methods:A cross-sectional, descriptive study was conducted among 12- and 15-year-old government school children of Riyadh. A total of 2247 children were examined from 24 schools of Riyadh. Caries status (decayed, missing, and filled teeth [DMFT]) was recorded according to World Health Organization (WHO) Oral Health Survey 2013. Height and weight measurements were recorded after clinical examination. According to body mass index (BMI) percentiles, the children were classified as underweight, normal weight, overweight, or obese. Chi-square test was used to find association between variables for categorical data. Mean ± standard deviation (SD) was calculated for continuous measurements and to find the difference between the groups unpaired t test/analysis of variance was used. A value of P < 0.05 was considered statistically significant.Results:Dental caries prevalence was 83.7% and mean DMFT was 5.31 ± 3.88 in the study population. A statistically significant difference was found for mean decayed, mean filled teeth, and overall mean DMFT between 12 and 15 years old (P < 0.001), but not for mean missing teeth (P = 0.137). There was no association between BMI categories and mean DMFT for both the age groups.Conclusion:The dental caries was found to be high among the study subjects compared to WHO norms. Older children had higher DMFT values than the younger children and there was no association between dental caries and BMI.

Leisure-Time Physical Activity Participation Trends 2014-2018: A Cross-Sectional Study in Poland.

Objective, the aim is an analysis of sociodemographic factors that had an essential relation with undertaking leisure-time physical activity—LTPA (with particular emphasis on World Health Organization (WHO) health recommendations) by adult Poles from a time-trend perspective. Methods, the paper is based on data retrieved from five large-scale surveys carried out on the representative samples of Poles aged 15–69 in 2014–2018 (n = 7347). In each wave, the Polish long version of the International Physical Activity Questionnaire was used. Results, the participation of Poles in LTPA constantly increases (p < 0.001) and the percentage of people meeting the dose of PA required for health recommendations is growing (on average, met by 43.9% of Polish men and 43.5% of women), which indicates a trend of behaviour of citizens of this country. The probability of realisation of WHO norms was determined by sex, age, place of residence and occupational status. Conclusion: it seems reasonable to develop Polish recommendations and guidelines for specific groups, including females and males, those who live in the villages and in the towns, different age groups: children/adolescents, adults (aged 50 to 59—most vulnerable to physical inactivity), the elderly, and various professional groups (especially farmers and physical workers).

Body mass index profile among school children: an anthropometric study

Background: The study aimed to analyse the trends in the growth pattern of the children in the age group of 3-21 years of both boys and girls using body mass index (BMI). The study also compared the BMI of the sample with the WHO norms and the group average.Methods: A study was conducted in India covering 1728 children 849 boys and 879 girls from LKG grade to +2 grades in the age group of 3-21 years. BMI grades were computed as per WHO 2006 standards (underweight- &lt;18.50, normal- 18.50-24.99, overweight- &gt;25.00 and obese- &gt;30.00). Results were analyzed using percentage and ANOVA.Results: The data shows that 88.9% of children in the age group of 3-8 years are underweight and in 15-21 years of age children are relatively healthy, but are inclined to move to overweight (17.66%) and obesity (7.21%). More of boys (31%) tend to be underweight than girls. Age and gender were found to be significantly related to BMI. The average BMI of the sample group is above the national standards of WHO (World Health Organization) in all the three age groups. Boys are found to be on par with WHO norms while girls exceed the same. Majority of the sample were below the average denoting underweight.Conclusions: Age and gender was significantly related with BMI. Average BMI of the sample was on par with national standard of WHO. BMI was thus found to be an effective tool for predicting the well-being of school children.

Inferred Industrial and Agricultural Activities Impact on Groundwater Quality of Skhira Coastal Phreatic Aquifer in Southeast of Tunisia (Mediterranean Region)

In Tunisia, it has been proven through various previously published studies that agricultural overexploitation and urban and industrial activities increase the risk of groundwater quality deterioration. The present study is a new research to be added to groundwater appraisal and comes to assess groundwater quality of the phreatic Skhira aquifer in relation to surrounding anthropic activities and also tries to evaluate potential risk threatenings of the local population. For that, 20 water well samples covering the phreatic aquifer were analyzed for physical and chemical parameters, major cations and anions, nutrient elements, fluorine, and some trace metal elements. Results show that the area close to the phosphogypsum storage site is the zone which is the most affected by industrial activity. This area corresponds to the upstream part of the aquifer, in terms of the trending flow, and records the highest conductivity values, high H2PO4-, F-, SO42-, and Zn2+ concentrations. Groundwater samples in this area are also characterized by a relatively low hydrogen potential (acid pH). High NO3- are recorded especially upstream of the aquifer and are thought to be caused by high fertilizer use. Overall, most analyzed samples do not meet the World Health Organization norms and therefore are not suitable as drinking waters. In addition, well water use for irrigation represents a medium to high sodicity and alkanization risk. The current study sheds light on the increasing deterioration risk of the aquifer and is an awakening call for decision-makers to imply means for urgent solutions.

DIETARY DIVERSITY AND ANTHROPOMETRIC STATUS OF 6–36 MONTHS OLD CHILDREN OF MUMBAI CITY

Background: Dietary diversity (DD) is an indicator of food security, accessibility, availability, and also a significant predictor of growth. Poor feeding practices are responsible for low DD which affects the nutritional status of child. Objective: The objective of the study was to assess the association of DD with nutritional status of urban slum children. Methodology: Data were collected using structured interview schedule on 823 children from 16 slums of western suburbs of Mumbai city. DD score was calculated using food frequency questionnaire as per Food and Agriculture Organization. Weight and height measurements of all children were taken using standard techniques, and nutritional status was assessed using Z scores in terms of wasting, stunting, and underweight as per the World Health Organization norms. Results: About 5.4% children were severely wasted, 10.2% children were severely underweight, and 24.7% children were severely stunted. About 22.1% children had low DD scores, 41.3% had scores indicating medium diversity, and 36.6% children had high scores for DD. Children who were severely undernourished, i.e. those whose Z scores were ?3 tended to have lower DD scores than their better-nourished counterparts for all three nutritional status indicators - weight for height, weight for age, and height for age. Conclusion: DD plays an important role in improving the nutritional status of child. Therefore, there is need to educate mothers in terms of DD to improve nutritional status of children.

Status of High Body Weight Among Nurse-Family Partnership Children

Increased prevalence of high levels of body weight in early childhood has become a public health concern, given its potential association with adult obesity and related comorbidities. Both socioeconomic status and race-ethnicity are related to increased prevalence. The purpose of this study was to identify additional risk factors common to children of low-income families; and to guide quality improvement initiatives within home visiting programs, potentially fostering more desirable physical development outcomes. A cohort of children (n = 14,318) of all mothers enrolled in Nurse-Family Partnership between 2007 and 2010 was evaluated. Measures consisted of demographics, health behaviors, and physical growth metrics collected by specially educated nurses during the course of home visits that also delivered the program model. Measures of weight (W) versus length (L) were converted to percentiles using the Centers for Disease Control and Prevention-World Health Organization norms with high W/L (≥97.7th percentile) defining a binary outcome. Multiple logistic regression modeling was then used to derive risk models for that outcome. Across each of the four time points for body measures (child's age 6, 12, 18, and 24 months), race-ethnicity, prepregnancy body mass index (BMI), maternal weight gain, and breastfeeding duration emerged as common risk factors. Moderation of weight gain during pregnancy, extending breastfeeding duration, and normalization of BMI before subsequent pregnancies may potentially serve as means of lowering the prevalence of high body weight levels in young children of low-income families served by home visitors.

Air Pollution From Bleaching and Dyeing Industries Creating Severe Health Hazards in Maheshtala Textile Cluster, West Bengal, India

Hazardous bleaching and dyeing units are rapidly increasing in developing countries due to growing global demand of textile products. The aim of the study is to assess long-term respiratory effect of air pollution generated from textile bleaching and dyeing industries on the residents living in such industrial setting. Such types of long-term (2012-2016) studies have been conducted first time in this area. The control area of Chatta and Kalikapur under Maheshtala textile cluster (10.45°N latitude to 75.90°E longitude) has been identified for the study. Ambient air monitoring with particulate matters (PMs; PM2.5 and PM10), NO2, and SO2 of 72 air samples has been done with air sampler machine during different seasons. The concentrations of PM2.5 and PM10 have been found higher than Central Pollution Control Board (India) and World Health Organization norms. Using data on 73 respondents on age, education, occupation, and income, impact on different causes of respiratory ailments has been examined. The survey shows that 67% of total population are having different respiratory complaints. The regression analysis ( R2 = 0.9998) and correlation matrix show that cold, cough, bronchitis, asthma, and chronic obstructive pulmonary disease (COPD) have a strongly significant positive correlation with fever ( r = 0.98, P &lt; 0.05); breathing trouble has a significant strong positive correlation with cold, cough, bronchitis, asthma, COPD, and fever ( r = 0.877, P &lt; 0.05); high blood pressure has a negative correlation with cold and fever ( r = −0.655, P &lt; 0.05); cardiovascular problem has a strong positive correlation with high blood pressure ( r = 0.989, P &lt; 0.05) and strong negative correlation with cold, cough, asthma, bronchitis, and cold-related fever ( r = −0.54, P &lt; 0.05) due to PM2.5 and PM10 concentration. About 56% of villagers who have opted for this occupation have school-level education (class I-IV) with annual income of Rs 60 000 ($870) only. Studies express present scenario of air pollution in the subject area which is still unnoticed and propose to take control of air pollution.

Pharmacognostic standardization and physicochemical analysis of the leaves of Barleria montana Wight & Nees

ObjectiveTo investigate the pharmacognostic features and physiochemical properties of the leaves of Barleria montana Wight & Nees. MethodsThe leaf samples were subjected to organoleptic, microscopic and macroscopic analysis. Physiochemical properties and fluorescence analysis of the sample under UV and daylight were studied as per World Health Organization norms. ResultsMicroscopic analysis showed that the plant possessed dorsiventral leaves, lamina, glandular trichomes, calcium carbonate cystoliths and adaxial epidermis. Physiochemical characters like ash and moisture content, extractive values, foreign matter and fluorescent characteristics of the leaf samples were determined and reported. ConclusionsResults obtained from these studies can be used as reliable markers in the identification and standardization of this plant as a herbal remedy

Community health workers can improve child growth of antenatally-depressed, South African mothers: a cluster randomized controlled trial.

BackgroundMaternal antenatal depression has long-term consequences for children’s health. We examined if home visits by community health workers (CHW) can improve growth outcomes for children of mothers who are antenatally depressed.MethodsA cluster randomized controlled trial of all pregnant, neighbourhood women in Cape Town, South Africa. Almost all pregnant women (98 %, N = 1238) were recruited and assessed during pregnancy, two weeks post-birth (92 %) and 6 months post-birth (88 %). Pregnant women were randomized to either: 1) Standard Care (SC), which provided routine antenatal care; or 2) an intervention, The Philani Intervention Program (PIP), which included SC and home visits by CHW trained as generalists (M = 11 visits). Child standardized weight, length, and weight by length over 6 months based on maternal antenatal depression and intervention condition.ResultsDepressed mood was similar across the PIP and SC conditions both antenatally (16.5 % rate) and at 6 months (16.7 %). The infants of depressed pregnant women in the PIP group were similar in height (height-for-age Z scores) to the children of non-depressed mothers in both the PIP and the SC conditions, but significantly taller at 6 months of age than the infants of pregnant depressed mothers in the SC condition. The intervention did not moderate children’s growth. Depressed SC mothers tended to have infants less than two standard deviations in height on the World Health Organization’s norms at two weeks post-birth compared to infants of depressed PIP mothers and non-depressed mothers in both conditions.ConclusionsA generalist, CHW-delivered home visiting program improved infant growth, even when mothers’ depression was not reduced. Focusing on maternal caretaking of infants, even when mothers are depressed, is critical in future interventions.Trial registrationClinicalTrials.gov registration # NCT00996528. October 15, 2009

WHO's supported interventions on salt intake reduction in the sub-Saharan Africa region.

Reduction of salt intake is an important and cost-effective way for reducing hypertension and the risk of cardiovascular diseases (CVDs). Current global salt intakes are estimated at around 10 g/day, well above the World Health Organization (WHO) recommended level of <5 g/day. The sub-Saharan Africa (SSA) region has a prevalence of hypertension of 46% among adults aged 25 and over and therefore strategies to reduce salt intake are necessary. This requires an understanding of salt intake behaviors in the population along with government commitment to increase awareness and take actions that would create an enabling environment. It is also important to have the food industry and other key stakeholders on board. A review of the developed WHO's norms and guidelines, technical support provided to countries by WHO as well as country initiatives shows that countries in the African region are at different stages in the implementation of salt reduction interventions. For example, South Africa has enacted legislation to make the food industry reduce the salt content of a number of its products while Mauritius is requesting bakery owners to reduce salt in bread. A number of countries are currently undertaking studies to measure salt intake in the populations. Overall progress is slow as the region experiences a double burden of communicable and noncommunicable diseases, competing health priorities and limited resources for health.

Safety versus accessibility in maternal and perinatal care.

This article adds to the debate on appropriate staffing in maternity units. My starting point for assessing staffing norms is the staff required to provide a safe maternity unit. A survey in 12 districts showed that their health facilities were not adequately prepared to perform all the essential emergency services required. Lack of staff was often cited as a reason. To test this notion, two norms (World Health Organization (WHO) and Greenfield) giving the minimum staff required for the provision of safe maternity services were applied to the 12 districts. Assuming the appropriate equipment is available and the facility is open 24 hours a day 7 days a week, at a minimum there need to be ten professional nurses with midwifery/advanced midwives to ensure safety for mother and baby in every maternity unit. The norms indicate that the units should do a minimum of 500-1,200 deliveries per year to be cost-effective. All 12 districts had sufficient staff according to the WHO. When the numbers of facilities with maternity units were compared with Council for Scientific and Industrial Research and WHO norms for number of health facilities per population, a large excess of facilities was found. Per district there were sufficient personnel to perform the number of deliveries for that district using the WHO or Greenfield formulas, but per site there were insufficient personnel. In my view there are sufficient personnel to provide safe maternity services, but too many units are performing deliveries, leading to dilution of staff and unsafe services. A realignment of maternity units must be undertaken to provide safe services, even at the expense of accessibility.

Physical Growth and Nonverbal Intelligence: Associations in Zambia

To investigate normative developmental body mass index (BMI) trajectories and associations of physical growth indicators--height, weight, head circumference (HC), and BMI--with nonverbal intelligence in an understudied population of children from sub-Saharan Africa. A sample of 3981 students (50.8% male), grades 3-7, with a mean age of 12.75 years was recruited from 34 rural Zambian schools. Children with low scores on vision and hearing screenings were excluded. Height, weight, and HC were measured, and nonverbal intelligence was assessed using the Universal Nonverbal Intelligence Test, Symbolic Memory subtest and Kaufman Assessment Battery for Children, Second Edition, Triangles subtest. Students in higher grades had a higher BMI over and above the effect of age. Girls had a marginally higher BMI, although that for both boys and girls was approximately 1 SD below the international Centers for Disease Control and Prevention and World Health Organization norms. When controlling for the effect of age, nonverbal intelligence showed small but significant positive relationships with HC (r = 0.17) and BMI (r = 0.11). HC and BMI accounted for 1.9% of the variance in nonverbal intelligence, over and above the contribution of grade and sex. BMI-for-age growth curves of Zambian children follow observed worldwide developmental trajectories. The positive relationships between BMI and intelligence underscore the importance of providing adequate nutritional and physical growth opportunities for children worldwide and in sub-Saharan Africa in particular. Directions for future studies are discussed with regard to maximizing the cognitive potential of all rural African children.

Hydroxyurea and growth in young children with sickle cell disease.

Growth impairment is a known complication of sickle cell disease. Effects of hydroxyurea (HU) on growth in very young children are not known. Height, weight, BMI, and head circumference (HC) were compared with World Health Organization (WHO) standards in BABY HUG, a multicenter, randomized, double-blinded, placebo-controlled 2-year clinical trial of HU in 193 children 9 to 18 months of age. Anthropometric data were closely monitored and converted to z scores by using WHO standardized algorithms for descriptive analyses. The treatment and placebo groups were compared longitudinally by using a mixed model analysis. At entry, the z scores of BABY HUG children were higher than WHO norms. After 2 years of HU or placebo treatment, there were no significant differences between the groups, except for the mean HC z scores at study exit (HU: +0.8 versus placebo: +1.0, P = .05). Baseline z scores were the best predictors of z scores at study exit. The absolute neutrophil count, absolute reticulocyte count, and total white blood cell count had significant negative correlations with growth measures. Both groups had normal or near normal anthropometric measures during the study. The HC z scores at study entry and exit were slightly greater than WHO norms. Higher baseline white blood cell count, absolute reticulocyte count, and absolute neutrophil count were associated with poorer growth. The significance of the slightly lower HC in the treatment group at study exit is not clear. Trends toward normalization of weight and height and effects on HC will be monitored in ongoing BABY HUG follow-up studies.

Long-Term Follow-Up of Children in the HIVNET 012 Perinatal HIV Prevention Trial

To describe 5-year growth, survival, and long-term safety among children exposed to nevirapine or zidovudine in an African perinatal prevention trial, HIVNET 012. All study children who were alive at the age 18 months were eligible for an extended follow-up study. Children whose families consented were enrolled and evaluated every 6 months from 24 to 60 months. At each visit, history, physical examination, and growth measures were taken. From these measurements, Z scores based on World Health Organization (WHO) standards were computed. Serious adverse event data were collected. Data from the initial and extended follow-up cohorts were included in the analysis. Five hundred twenty-eight study children were alive at the age 18 months, and 491 (426 HIV uninfected and 65 infected) were enrolled into the follow-up study. Both exposed but uninfected children and HIV-infected children were substantially below WHO growth standards for weight and height. Head circumference Z scores for uninfected children were comparable with WHO norms. Five-year survival rates were 93% for uninfected children versus 43% for infected children. Long-term safety and growth outcomes in the 2 study arms were similar. Both infected and uninfected children in the 5-year HIVNET 012 follow-up showed poor height and weight growth outcomes, underscoring the need for early nutritional interventions to improve long-term growth of all infants born to HIV-infected women in resource-limited settings. Similarly, the low 5-year survival among HIV-infected children support the importance of early initiation of antiretroviral therapy. Both peripartum nevirapine and zidovudine were safe.

A comparison between antenatal care quality in public and private sector in rural Hebei, China

AimTo evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector.MethodsWe conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider.ResultsAlmost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals.ConclusionThe quality of ANC in Hebei was poorer than required by China’s national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities.

Geochemistry and quality assessment of groundwater using graphical and multivariate statistical methods. A case study: Grombalia phreatic aquifer (Northeastern Tunisia)

The Grombalia coastal aquifer, situated in Northeastern Tunisia, is a water source for public, agricultural, and industrial supplies in the region. The overexploitation of this aquifer, since 1959, and the agriculture activities led to the degradation, by places, of the water quality. The present study implemented graphical, modeling, and multivariate statistical tools to investigate natural and anthropogenic processes controlling Grombalia groundwater mineralization and water quality for promoting sustainable development. To attempt this goal, groundwater was collected from 33 observation wells in January 2004, and samples were analyzed for 10 physicochemical parameters (temperature, pH, salinity, Na+, Ca2+, K+, Mg2+, Cl−, HCO3−, and SO42−). Hydrochemical facies using Piper diagram indicates a predominance of a mixed facies, of the Na-Cl-HCO3 type, or Na-Ca-Cl-SO4 type, and, with less expansion, Na Cl type. The main factors controlling Grombalia groundwater mineralization seem to be mineral dissolution of highly soluble salts especially, the halite dissolution existing in the surface salty deposits and, with less importance, the ion exchange and reverse ion exchange process with clay minerals existing in the aquifer. The comparison of the major ions of the Grombalia groundwater, with the World Health Organization norms of potability (WHO 2004), reveals that these waters cannot be used for human consumption without any treatment. Most waters of the Grombalia aquifer, with a relatively high salinity, are not suitable for irrigation, in ordinary conditions. Nevertheless, they can be used for permeable soils, with an adequate drainage and applying an excess of leaching water.

Infectious Diseases and Securitization: WHO's Dilemma

The threat posed by infectious diseases has been increasingly framed as a security issue. The UN Security Council's Resolution 1308, which designated HIV/AIDS as a threat to international security, evidenced the securitization process. Using securitization theory as a theoretical tool, this article explores the securitization of infectious diseases in the World Health Organization (WHO). While WHO has tended to securitize infectious diseases since 2000, it has encountered a dilemma in the process because of the inherent asymmetry of interest between developed and developing countries. The act of securitization in WHO currently remains mostly a rhetorical device, since WHO's norms emblematic of securitization have not been backed by operational measures for verification or enforcement due to these asymmetric interests.