Improved latrines minimally impact Schistosoma mekongi transmission in Mekong islands

Schistosoma mekongi and other intestinal helminth infections remain public health concerns in Lao People's Democratic Republic, especially in remote areas where access to sanitation is limited.We performed an experimental study in four villages where latrine construction was coupled with two rounds of mass drug administration (MDA) with praziquantel and albendazole, and compared with two control villages that only received two rounds of MDA. The prevalence of helminth infections before (baseline) and after (follow-up) intervention were compared. Additionally, the prevalence in intervention and control villages were compared 12 months post-intervention. Kato–Katz, formalin-ethyl acetate concentration and Baermann techniques were employed to assess helminth infections.We found infection prevalence of S. mekongi in the intervention and control villages was 28.6% and 1.8%, respectively. The prevalences of other helminth infections were as follows: Opisthorchis viverrini, 79.5% and 71.8%;hookworm, 48.8% and 65.6%;and Strongyloides stercoralis, 43.1% and 38.3%. Other helminth species were detected in less than 5% of the study participants. Latrine intervention coupled with two rounds of MDA in the intervention villages reduced the prevalence of S. mekongi infection by 6.0% (from 28.6% to 22.6%;P < 0.001), O. viverrini infection by 11.3% (from 79.5% to 68.2%;P < 0.001), hookworm infection by 22.6% (from 48.8% to 26.2%;P < 0.001), and S. stercoralis infection by 12.0% (from 43.1% to 31.1%;P < 0.001). The observed reductions were not significantly different when compared to the control villages, where only two rounds of MDA were implemented (P > 0.05). Study participants in both groups commonly engaged in behaviours such as open defecation, bathing in the Mekong River, consuming raw or undercooked fish dishes and walking barefoot. These practices and behaviours are associated with helminth infections. Concluding, this study showed only a marginal impact associated with latrine use in intervention communities. There is a need for longer term studies with integrated interventions, such as effective health education to foster behavioural changes related to open defecation, raw or undercooked food consumption, wearing protected footwear outdoors, and personal hygiene.

Wastewater Management in Third World Cities: Case Study of Cotonou, Benin

Poor wastewater management coupled with lack of sanitation facilities has aggravated the sanitation challenges in developing countries.?This study was aimed at providing information on the current state of sanitation in Cotonou City through surveys. The most common sanitation facilities in the city were septic tanks, latrines and soakaway pits. Mechanical desulging was mainly used (94%) for desludging latrines and septic tanks with a frequency of less than once a year for 73% of the houses;manual desludging was most common for soakaway pits. 84% of sullage generated is disposed without treatment. The only existing stabilization pond plant, managed by a private company SIBEAU, is overloaded;the effluent is poor (up to 2250mg/l BOD5) and does not meet any quality standards. 96% of survey respondents recognise that the sanitation situation in the city is not good;it has to be improved by providing an appropriate and sustainable sanitation management system.

Sanitation Mapping of Groundwater Contamination in a Rural Village of India

Availability of clean water and adequate sanitation facilities are of prime importance for limiting diarrheal diseases. We examined the spatial information on the groundwater quality and sanitation facilities of a village in southern India using Geographic Information System (GIS) tools. Place of residence, position of wells and latrines were mapped and well water samples were tested for microbial contamination (Total Coliform Counts (TCC), Fecal Coliform Counts (FCC) and Fecal Streptococcal Counts (FSC)). A well structured questionnaire was administered to 50 residents of the selected areas to elicit information on water collection, handling and storage. The location and distances of wells from latrines were determined using the Global Positioning System (GPS) device and a tape rule respectively. Data on 170 cases of various water-borne diseases were collected from primary health centers in the study area. Groundwater in the village was found to be microbiologically unfit for consumption. Analysis using direct observations supplemented by GIS maps revealed poor planning, design of the wells and improper siting of wells from latrines which were found to be the possible reasons of groundwater contamination. There was a significant difference in TCC between covered and uncovered wells (p < 0.01) but no significant differences were observed in the FCC, FSC and well covering. The mean distance (6.44 ± 2.37 m) of wells from the latrines in the study area was below the limit (15.24 m or 50 ft) set by United State Environmental Protection Agency (USEPA). TCC and FCC increased with a decrease in distance between the wells and latrines with a significance (p < 0.01). A moderate negative correlation (r = -0.593, r = -0.470) was ensued between the distance from latrine and coliform count. This study accentuates the need to set standards for the siting of wells from latrines and need for treatment.

Faecal Sludge Management in Botswana: A Review of Current Practices and Policies Using the Case of Gaborone Low Income Areas

In the past sanitation was the responsibility of Local Authorities or councils with the Department of Waste Management and Pollution Control (DWMPC). Pollution of groundwater in Botswana is currently forcing the Government of Botswana (GoB) to abandon pit latrine construction and Ventilated Improved Pit (VIP) emptying services in peri-urban areas. Currently Government has embarked on the expensive and unsustainable construction of sewer systems that require peri-urban communities to pay for connection fees. Most rural communities cannot afford these fees and since Botswana is a water scarce country, sewer connection may be costly for the country. This paper aims to review current practices, policies and challenges facing Botswana in Faecal Sludge Management (FSM). A desktop review was carried out to review policies, regulations, guidelines and strategies on waste management. A pretested questionnaire was administered among 50 randomly selected households to assess current practices in sludge management from two suburbs in Gaborone. Key informant interviews were undertaken among water and sanitation stakeholders to establish roles on waste management and faecal sludge management. Despite the disjointed efforts by stakeholders, Botswana has the potential to improve the FSM in the country. Though unsafe, FSM/pit emptying has the potential to provide income and employment to both the rural and urban poor and making it safe may have wider economic benefits.

Assessing School-Based Water, Sanitation and Hygiene (WASH) Facilities in Peri-Urban Settings of Kinshasa, DR Congo

Background: Kinshasa’s peri-urban settings have a low rate of water access, which has significant consequences for the WASH infrastructures in schools and preventative measures against the spread of waterborne diseases and pathogens. This study aimed to assess the availability, functionality, and gender sensitivity of WASH infrastructures of Kinshasa’s peri-urban schools. Methods: A cross-sectional study was performed in three of the four educational provinces of Kinshasa, targeting 165 peri-urban schools. Data were collected using a questionnaire and an observation grid. Results: An overall proportion of 10.9% of schools possessed a water point, and therefore time-consuming water chores are a necessity in 89.1% of schools. Girl students provided 30% of the labor collecting water during punishments. A total of 98.2% of schools had functional latrines of which 3.6% were found hygienic, associated with water reserve next to the latrines (P = 0.040). Only 2.4% of schools displayed posters raising awareness of latrine hygiene, and 3.6% displayed posters on hand hygiene. The ratios of latrines units for girls were 58:1 for toilets and 115:1 for urinals, justifying open defecation and urination reported in 62.4% of schools. Also, 43% of schools had hand-washing facilities whose functionality was significantly associated with the presence of water points in the school’s inner courtyard (P = 0.032), with water (P P Conclusion: The majority of schools had limited drinking water services, which negatively impact the functionality and gender sensitivity of other WASH provisions. The current evidence as a public health concern would raise government and school authorities’ attention to address these environmental threats.

Development of Chrysomya megacephala at constant temperatures within its colony range in Yangtze River Delta region of China

Chrysomya megacephala (Fabricius,1794) is the most abundant and predominant species which arrives and colonizes a cadaver first in most parts of China.Therefore,its growth and development patterns have great implications in the estimation of the minimum postmortem interval (PMImin).In this study,C megacephala was collected from the Yangtze River Delta region and reared at seven constant temperatures ranging from 16 ℃ to 34 ℃.The developmental duration and accumulated degree hours,larval body length and morphological changes of C.megacephala were examined.Furthermore,we constructed three developmental models,isomorphen diagram,isomegalen diagram and thermal summation model,which can be used for estimating PMImin.The developmental durations of C.megacephala at 16 ℃,19 ℃,22 ℃,25 ℃,28 ℃,31 ℃ and 34 ℃ are (794.8 ± 14.7),(533.2 ± 10.1),(377.8 ± 16.8),(280.8 ± 15.1),(218.9 ± 8.5),(190.8 ± 10.1) and (171.8 ± 6.8) h,respectively.The developmental threshold temperature D0 is (11.41 ± 0.32) ℃,and the thermal summation constant K is (3 418.7 ± 137.0) degree hours.Regression analysis was conducted to obtain equations of the variation in larval body length with time after hatching,and variation in time after hatching with body length.Moreover,our study divides the intra-puparial morphological changes of C.megacephala into 11 sub-stages,and provides the time range experienced by each sub-stage.The results of this study provide fundamental development data for the use of C.megacephala in PMImin estimations.

A 12-year follow-up of intestinal schistosomiasis in pre-school-aged children in Assoni Village, Eastern Senegal

Background:To monitor the prevalenee of schistosomiasis in school-aged children(SAC),the National Bilharzia Control Program(PNLB)was set up by the Senegalese authorities;however,geographically isolated Bedik ethnic groups that did not benefit from this program were found to be heavily infected with Schistosoma mansoni.This observation led us to implement a new schistosomiasis control program in 2008 under the aegis of the non-governmental organi-zation wLe KaTcedratwand in partnership with the PNLB/WHO to monitor the prevalence of schistosomiasis in this area.In the village of Assoni,where 100%of SAC were infected,analysis of the stools of pre-school-aged children(PSAC)showed that they were massively infected,so we decided to focus our program on them.

Effects of improved sanitation on diarrheal reduction for children under five in Idiofa,DR Congo:a cluster randomized trial

Background:The lack of safe water and sanitation contributes to the rampancy of diarrhea in many developing countries.Methods:This study describes the design of a cluster-randomized trial in Idiofa,the Democratic Republic of the Congo,seeking evidence of the impact of improved sanitation on diarrhea for children under four.Of the 276 quartiers,18 quartiers were randomly allocated to the intervention or control arm.Seven hundred and-twenty households were sampled and the youngest under-four child in each household was registered for this study.The primary endpoint of the study is diarrheal incidence,prevalence and duration in children under five.Discussion:Material subsidies will be provided only to the households who complete pit digging plus superstructure and roof construction,regardless of their income level.This study employs a Sanitation Calendar so that the mother of each household can record the diarrheal episodes of her under-four child on a daily basis.The diary enables examination of the effect of the sanitation intervention on diarrhea duration and also resolves the limitation of the small number of clusters in the trial.In addition,the project will be monitored through the‘Sanitation Map’,on which all households in the study area,including both the control and intervention arms,are registered.To avoid information bias or courtesy bias,photos will be taken of the latrine during the household visit,and a supervisor will determine well-equipped latrine uptake based on the photos.This reduces the possibility of recall bias and under-or over-estimation of diarrhea,which was the main limitation of previous studies.Trial registration:The study was approved by the Institutional Review Board of the School of Public Health,Kinshasa University(ESP/CE/040/15;April 13,2015)and registered as an International Standard Randomized Controlled Trial(ISRCTN:10,419,317)on March 13,2015.