A systematic scoping review of hygiene behaviors and environmental health conditions in institutional care settings for orphaned and abandoned children

Earlier pubertal timing, not tempo, links time-limited early adversity with psychopathology

Evolutionary-developmental theories propose that early adverse experiences adaptively shift the timing (i.e., onset) and tempo (i.e., rate) of pubertal maturation. Empirical evidence of links between early life adversity and pubertal maturation is mixed, potentially in part because isolating the unique impacts of early environments is challenging. The current accelerated longitudinal study used a quasi-experimental design to examine pubertal maturation among 132 previously-institutionalized (PI), internationally adopted children who experienced a time-limited form of severe early life adversity, compared to 169 non-adopted (NA) children. Based on prior literature, we also assessed whether pubertal timing and/or tempo are pathways by which early adversity relates to later symptoms of psychopathology. At each of three annual sessions, Tanner pubertal staging was determined by nurse exam, and symptoms of psychopathology were captured in a composite of child self-reported internalizing and parent-reported externalizing symptoms. Findings revealed that, only among children at Tanner pubertal stages 3 or below, PI children were more likely to have reached stage 3 compared to NA children, reflective of earlier pubertal timing. No group differences were found for pubertal tempo. In the subsample of children at Tanner stage 3 or lower, earlier pubertal timing was an indirect pathway by which early adversity related to both higher levels and greater longitudinal declines in internalizing and externalizing symptoms of psychopathology, accounting for a small proportion of the total effect of early adversity on psychopathology. Results from this quasi-experimental study add to existing research on associations between early adversity, early pubertal timing, and psychopathology, further suggesting that links may be specific to timing but not tempo. While findings broadly align with recent calls to consider early pubertal maturation as a transdiagnostic risk marker with utility for identifying children who could benefit from early mental health intervention, they also suggest that pubertal timing is unlikely to be a robust target for reducing psychopathology risk in these children.

Caries in orphan children: prevalence and determinants-a systematic review and meta-analysis

BACKGROUND

Orphan children represent a category of children who lost their family support. Their health status is poorer when compared to their parented counterparts. As the most prevalent disease in the world, dental caries is expected to affect orphans greatly. Being vulnerable, health status of orphan children must be monitored and studied; so that health improvement plans would be formulated. Therefore, this systematic review focuses on the extent of the dental caries problem among institutionalized orphan children and its determinants.

METHODS

The review has two outcomes: comparing caries experience of institutionalized children to their parented counterparts, and reviewing the determinants of caries in the exposure group. Two systematic searches (one for each outcome) were run on MedLine via PubMed, Cochrane library, LILACS, Egyptian knowledge bank (EKB) and Google Scholar; beside hand search and searching grey literature.

RESULTS

The searches yielded 17,760, followed by 16,242 records for the first and second outcomes respectively. The full text was screened for 33 and 103 records for the two outcomes respectively; after translating non-English reports. Finally, the review included 9 records to address the first outcome and 21 records for the second. The pooled results showed that the exposure group may show slightly poorer caries experience regarding permanent teeth (pooled mean difference of DMF = 0.09 (-0.36, 0.55)); but they have a much poorer caries experience regarding primary teeth health (pooled mean difference of dmf = (0.64 (-0.74, 2.01)). Meta-analysis of the caries determinants showed that institutionalization increases the risk of caries by 19%. Gender showed slight effect on caries risk with males being more affected; while primary teeth revealed higher risk of caries when compared to permanent teeth.

CONCLUSION

Limited by the heterogeneity and risk of bias of the included studies, meta-analyses concluded that institutionalized orphan children have higher risk of caries. Yet, the institutionalization circumstances were not well-documented in all the included studies. So, the complete picture of the children's condition was not possibly sketched.

TRIAL REGISTRATION

Protocol has been registered online on the PROSPERO database with an ID CRD42023443582 on 24/07/2023.

Assessment of dental caries among a group of institutionalized orphan children compared to parented school children: case-control study

BACKGROUND

It has been well documented that the absence of family support influences the general and oral health of children. Literature regarding the oral health status of institutionalized orphan children, who lost their families' support, especially in Egypt, remains vague. Therefore, the current study was carried out to assess dental caries among two groups of institutionalized orphan children, and compare their results with a group of parented school children in Giza, Egypt.

METHODS

A total of 156 children were included in this study, residing in a non-governmental orphanage, a governmental orphanage, and parented children attending private primary school. Written informed consent was obtained before the start of the study from the legal guardians or the child's parent. The dental examination was carried out as recommended by the WHO. DMF and def indices were used to assess dental caries for primary and permanent teeth. Also, the unmet treatment needs index, care index, and significant caries index were calculated.

RESULTS

The results revealed that mean values for DMF total score were 1.86 ± 2.96, 1.80 ± 2.54, and 0.7 5 ± 1.29 for, non-governmental, governmental orphanages, and school children respectively. While the mean def total scores were 1.69 ± 2.58, 0.41 ± 0.89, and 0.85 ± 1.79 for non-governmental, governmental orphanages, and school children, respectively. There was a high level of unmet treatment needs, especially among orphans. The significant caries index was 2.5, 4.29, and 2.17 for, non-governmental, governmental orphanages, and school children, respectively.

CONCLUSIONS

Within the limitation of this case-control study, the institutionalized orphanage children had a high prevalence of dental caries and worse caries experience compared to parented school children. Effective oral health preventive strategies are required to improve the oral health status and oral health practices of those children.

TRIAL REGISTRATION

The trial was registered on ClinicalTrial.gov (ID: NCT05652231).

Respiratory infectious disease outbreaks among people experiencing homelessness: a systematic review of prevention and mitigation strategies

PURPOSE

People experiencing homelessness (PEH) are at increased risk of respiratory infections and associated morbidity and mortality. To characterize optimal intervention strategies, we completed a systematic review of mitigation strategies for PEH to minimize the spread and impact of respiratory infectious disease outbreaks, including COVID-19.

METHODS

The study protocol was registered in PROSPERO (#2020 CRD42020208964) and was consistent with the preferred reporting in systematic reviews and meta-analyses guidelines. A search algorithm containing keywords that were synonymous to the terms "Homeless" and "Respiratory Illness" was applied to the six databases. The search concluded on September 22, 2020. Quality assessment was performed at the study level. Steps were conducted by two independent team members.

RESULTS

A total of 4468 unique titles were retrieved with 21 meeting criteria for inclusion. Interventions included testing, tracking, screening, infection prevention and control, isolation support, and education. Historically, there has been limited study of intervention strategies specifically for PEH across the world.

CONCLUSIONS

Staff and organizations providing services for people experiencing homelessness face specific challenges in adhering to public health guidelines such as physical distancing, isolation, and routine hygiene practices. There is a discrepancy between the burden of infectious diseases among PEH and specific research characterizing optimal intervention strategies to mitigate transmission in the context of shelters. Improving health for people experiencing homelessness necessitates investment in programs scaling existing interventions and research to study new approaches.

Physical health of care-experienced young children in high-income countries: a scoping review protocol

INTRODUCTION

Care-experienced children have poorer health, developmental, and quality of life outcomes across the lifespan compared to children who are not in care. These inequities begin to manifest in the early years. The purpose of the proposed scoping review is to collate and synthesise studies of the physical health of young care-experienced children. The results of the review will help map the distribution of health outcomes, identify potential targets for intervention, and assess gaps in the literature relating to this group.

METHODS AND ANALYSIS

We will carry out a scoping review of the literature to identify studies of physical health outcomes in care-experienced children. Systematic literature searches will be carried out on the MEDLINE, CINAHL and Web of Science Core Collection databases for items indexed on or before 31 August 2022. Studies will be included where the participants are aged 3 months or greater and less than 6 years. Data elements extracted from included studies will include study objectives, health outcomes, participant demographics, care setting characteristics and bibliographic information. The results of the review will be synthesised and reported using a critical narrative approach. Comparisons between care and non-care populations will be reported if sufficient studies are identified.

ETHICS AND DISSEMINATION

Data will be extracted from publicly available sources, so no additional ethical approval is required. Results will be published in a peer-reviewed journal article. Furthermore, they will be shared in summary reports and presented to local authorities, care organisations and other relevant stakeholders that can influence healthcare policy and procedure relating to young children in care.

Enterobiasis and its risk factors in urban, rural and indigenous children of subtropical Argentina

A cross-sectional survey to assess the prevalence of Enterobius vermicularis infection and its associated factors among the child population of infant, preschool and school age in the urban, rural and indigenous population of Iguazú city, in subtropical Argentina was presented. Additionally, the status of enterobiasis at country level was reviewed and analysed. Enterobius vermicularis presence was assessed employing an oviscopic serial sampling technique. Statistical analysis of socio-demographic determinants was performed by generalized linear mixed models at individual, household and community levels. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used to gather national information about E. vermicularis prevalence spanning the decade 2010–2020. A total of 916 children from 470 families participated. Overall prevalence was 29.8%, with 25.3, 30.7 and 34.2% detected for children inhabiting urban, rural and indigenous villages, respectively. The multi-level analysis showed that the presence of E. vermicularis was mostly determined by individual (e.g. age, playing habits, previous pinworm infection) and household-level factors (e.g. family size, overcrowding conditions). Interestingly, WASH variables, such as waste disposal, analysed at community level were also important. Data were analysed to provide eco-epidemiological features of enterobiasis in a heterogeneous subtropical child population in the same territory but with different socio-sanitary realities. The importance of promoting multi-level actions against the determinants identified, to control this public health problem integratively was evidenced. The scoping review of national data updated the state of knowledge of this parasitosis, identifying risk determinants and gaps in knowledge at country level.

Care and Rearing of Institutionalized Girls in Arequipa, Peru: An Ethnographic Approach

INTRODUCTION

Institutional care for children is a global phenomenon. Despite its advantages, common threats have been described. In Peru, more than 70% of institutionalized children/adolescents have living parents who cannot take care of them. The study aims to understand the care/rearing of institutionalized girls in Arequipa, Peru.

METHODOLOGY

Ethnographic design, with a sample integrated by 27 institutionalized girls. Data collected based on participant observation and semi-structured interviews. The analysis followed the Method of Constant Comparisons.

RESULTS

Five main themes were found: (a) The little house (foster home) is better than my house; (b) They take care of me-even when I am sick-; (c) But . . .; (d) What I have lived is what I am; (e) Happiness fits in this little house.

DISCUSSION

An ethnography of care/rearing practices could be helpful for a better understanding of the dimensions of the life of institutionalized girls living in developing countries.

Water resource management: IWRM strategies for improved water management. A systematic review of case studies of East, West and Southern Africa

OBJECTIVE

The analytical study systematically reviewed the evidence about the IWRM strategy model. The study analysed the IWRM strategy, policy advances and practical implications it had, since inception on effective water management in East, West and Southern Africa.

METHODS

The study adopted the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) and the scoping literature review approach. The study searched selected databases for peer-reviewed articles, books, and grey literature. DistillerSR software was used for article screening. A constructionist thematic analysis was employed to extract recurring themes amongst the regions.

RESULTS

The systematic literature review detailed the adoption, policy revisions and emerging policy trends and issues (or considerations) on IWRM in East, West and Southern Africa. Thematic analysis derived four cross-cutting themes that contributed to IWRM strategy implementation and adoption. The identified four themes were donor effect, water scarcity, transboundary water resources, and policy approach. The output further posited questions on the prospects, including whether IWRM has been a success or failure within the African water resource management fraternity.

Infections and nutritional status of internationally adopted children in France

AIM

In the context of global changes in the epidemiology of internationally adopted children (IACs), the prevalence of infectious diseases and nutritional impairment has not been recently reviewed. Moreover, in France, these characteristics of the children according to their continents of origin and preadoption special needs (SN) status have been incompletely explored.

METHODS

Demographic, infectious data and anthropometric of all the newly arrived IACs seen in a specialised clinic for international adoptees in Paris, France, between 2013 and 2016 were retrospectively reviewed.

RESULTS

Three hundred and fifty IACs [mean age: 3.4 years (±2.7), 204 male] from 39 countries were included; 55% had SN. Ninety-nine patients had at least one infection, 42% being classified as 'serious' (chronic viral infection, tuberculosis or malaria). Chronic viral infection was diagnosed in 26 (7%) patients (HIV: 16 cases, HBV: 5, HCV: 4) and affected especially Asian children (P < .001). The prevalence of stunting, underweight, wasting and microcephaly was, respectively, 25%, 22%, 15% and 8%. Stunting was more frequent in children from Eastern Europe (P = .02), while SN children were more often microcephalic or underweight (respectively P = .03 and .02).

CONCLUSION

The prevalence of serious infections and nutritional impairment remains high in IACs and requires early detection and careful follow-up.

Moistube irrigation technology development, adoption and future prospects: A systematic scoping review

Agriculture is the biggest consumer of fresh water in the world accounting for almost 70% of the water use. The burgeoning world population and increased demands to feed the world requires novel technologies that reconcile water consumption and food security. Moistube is a polymeric semi-permeable membrane irrigation technology that is known to improve water use efficiency and boost yields. The technology is relatively new, hence a lack of comprehensive literature regarding Moistube irrigation (MTI) technology warrants empirical investigation of the existing literature. The study performed a systematic review guided by the Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) and the scoping studies methodological framework to compile an evidence-based literature review on Moistube irrigation. The study performed search queries in the following over-arching and comprehensive databases for grey literature: Google Scholar, Science Direct, Research Gate, CAB direct, All Journals, CNKI, FAO, SCOPUS, Web of Science, and UKZN-EFWE. DistillerSR software was used for screening, data extraction and data charting. Article screening retained one hundred and 55 (n = 155) articles. Forty-nine articles (n = 49) and information sources were found to be related directly and indirectly to Moistube. Moistube articles (n = 29, 59%) were from China were the technology originated. A bulk of literature reported Moistube irrigation use in the arid regions of China. The review revealed areas for research enquiry into the subject matter. Future research areas were fertigation performance under MTI, effects of waste-water on MTI nanopore plugging, yield response of industrial crops of economic importance under MTI and soil wetting geometries under MTI. This signified the need to perform further research enquiries into the subject matter to improve literature availability. Moistube irrigation technology has a low adoption rate in Africa with reported use in South Africa and Morocco. The technology has massive adoption potential in arid and semi-arid regions of sub-Sahara Africa.

COVID-19: urgent actions, critical reflections and future relevance of 'WaSH': lessons for the current and future pandemics

The COVID-19 pandemic placed hygiene at the centre of disease prevention. Yet, access to the levels of water supply that support good hand hygiene and institutional cleaning, our understanding of hygiene behaviours, and access to soap are deficient in low-, middle- and high-income countries. This paper reviews the role of water, sanitation and hygiene (WaSH) in disease emergence, previous outbreaks, combatting COVID-19 and in preparing for future pandemics. We consider settings where these factors are particularly important and identify key preventive contributions to disease control and gaps in the evidence base. Urgent substantial action is required to remedy deficiencies in WaSH, particularly the provision of reliable, continuous piped water on-premises for all households and settings. Hygiene promotion programmes, underpinned by behavioural science, must be adapted to high-risk populations (such as the elderly and marginalised) and settings (such as healthcare facilities, transport hubs and workplaces). WaSH must be better integrated into preparation plans and with other sectors in prevention efforts. More finance and better use of financing instruments would extend and improve WaSH services. The lessons outlined justify no-regrets investment by government in response to and recovery from the current pandemic; to improve day-to-day lives and as preparedness for future pandemics.

Environmental health conditions in protracted displacement: A systematic scoping review

Adequate environmental health services are critical for human rights, health, and development, especially in the context of forced displacement. There are more than 70 million forcibly displaced persons worldwide, most in protracted situations, having been displaced for more than two years. Some live in camps or informal settlements, but most live in urban areas. Environmental health services are important in the transition from emergency response to sustainable development in these settings, but evidence on environmental health in displaced populations is disparate and of variable quality. We conducted a systematic scoping review of environmental conditions, exposures, and outcomes in protracted displacement settings; obstacles to improvement in environmental health services; and recommendations made for improvement. We included 213 publications from peer-reviewed and grey literature databases. Data were extracted on environmental health topics including water, sanitation, hygiene, overcrowding, waste management, energy supply, vector control, menstrual hygiene, air quality, and food safety. Most studies present data from low- and lower-middle income countries. Northern Africa and Western Asia and Sub-Saharan Africa are the most-represented regions. There is substantial evidence on water, sanitation, and crowding, but few studies report findings on other environmental health topics. Water-related disease, parasites, and respiratory infections are frequently cited and studies report that services often fail to meet international standards for humanitarian response. The most frequent obstacles and recommendations are institutional, political, or implementation-related, but few studies provide concrete recommendations for improvement. Our review compiles and characterizes the research on environmental health in protracted displacement. We recommend including displaced populations in international environmental health policy and monitoring initiatives, and bridging from humanitarian response to sustainable development by preparing for long-term displacement from the early stages of a crisis.

A systematic scoping review of environmental health conditions in penal institutions

Adequate environmental health conditions in penal institutions are necessary to protect and promote the health of prisoners and prison workers. We conducted a scoping systematic review to: describe the environmental health conditions in penal institutions and the associated exposures and health outcomes; identify effective approaches to prevent environmental health concerns; and identify evidence gaps on environmental health in penal institution populations. PubMed, Web of Science, EBSCOhost, Scopus, and ProQuest were searched. Peer-reviewed studies that reported original data and on environmental health conditions and/or exposures in penal institutions were included. Seventy-three studies met these criteria. The most common risk factor identified was contaminated food and/or beverages prepared or handled in the institution's kitchen. Overcrowding, inadequate ventilation, and a lack of, or sharing of, soap and other hygiene products increased the risk of adverse health outcomes. Common responses included isolating infectious patients, educating prisoners and prison staff on improved sanitation and hygiene practices, improving ventilation, and disinfecting contaminated surfaces and/or water sources. Inadequate environmental health conditions in penal institutions are common, and adversely impact the health of prisoners and prison staff, yet are preventable. Few studies have been conducted in low- and middle-income countries, biasing our results. The development and implementation of national guidelines for essential environmental health in prisons, monitoring of conditions, and greater accountability of facility managers are needed to secure the health, rights, and well-being of prisoners.