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Swain CK, Rout HS, Jakovljevic M. Health Hazard Among Shrimp Cultivators in India: A Quantitative Burden of Disease Study. Int J Gen Med 2024; 17:1101-1116. [PMID: 38529100 PMCID: PMC10962463 DOI: 10.2147/ijgm.s449364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
Background The lack of focus on the health status of shrimp cultivators by previous studies while the production of shrimp has been rising over the years after the introduction of the blue revolution in India. The present study estimated the burden of diseases among shrimp cultivators in India. Methods Primary data were collected by using simple random sampling. The sample size was 357. The classification of diseases were made by using the international classification of diseases, tenth revision (ICD-10), version 2019. Disability-adjusted life years (DALY) were used to measure the health status of shrimp cultivators. DALY is the summation of the burden of disease from mortality and morbidity. Sensitive and uncertainty analysis was used by changing the value of the parameter and method, respectively. Results The burden of disease among shrimp cultivators in 2020 ranges from 101.03 DALY based on equal age weightage, without discount rate, and potential life expectancy (DALY0,0,PLE) to 84.02 DALY based on unequal age weightage, discount rate, and standardized life expectancy (DALY1,0.03,SLE). The burden of disease per 100,000 shrimp cultivators was 28,477.74 DALY and 23,600.84 DALY when calculated by using DALY0,0,PLE and DALY1,0.03,SLE method, respectively. The higher burden of diseases from non-communicable diseases was followed by injury and communicable diseases for both methods. The disease burden from mortality was more than two-thirds of the total burden of disease and the rest from morbidity. The burden of disease among shrimp cultivators was sensitive to parameter changes because it changes between 92.10 DALY and 63.03 DALY with the change in the parameter. Uncertainty in the burden of disease among them was due to method variation, which ranges from 120.03 DALY to 74.06 DALY. Conclusion The higher burden of non-communicable diseases, and the lower burden of communicable, and injuries per 100,000 shrimp cultivators compared to the national level in India.
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Affiliation(s)
- Chandan Kumar Swain
- Department of Analytical & Applied Economics, Utkal University, Vani Vihar, Bhubaneswar, Odisha, 751 004, India
| | - Himanshu Sekhar Rout
- Department of Analytical and Applied Economics & RUSA Centre of Excellence in Public Policy and Governance, Utkal University, Vani Vihar, Bhubaneswar, Odisha, 751 004, India
| | - Mihajlo Jakovljevic
- UNESCO - The World Academy of Sciences (TWAS), Trieste, Italy
- Shaanxi University of Technology, Hanzhong, Shaanxi, 723099, People’s Republic of China
- Department of Global Health Economics and Policy, University of Kragujevac, Kragujevac, Serbia
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Kim JH, Tack B, Fiorino F, Pettini E, Marchello C, Jacobs J, Crump J, Marks F. Examining geospatial and temporal distribution of invasive non-typhoidal Salmonella disease occurrence in sub-Saharan Africa: a systematic review and modelling study. BMJ Open 2024; 14:e080501. [PMID: 38485477 PMCID: PMC10941155 DOI: 10.1136/bmjopen-2023-080501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Invasive non-typhoidal Salmonella (iNTS) disease is a significant health concern in sub-Saharan Africa. While our knowledge of a larger-scale variation is growing, understanding of the subnational variation in iNTS disease occurrence is lacking, yet crucial for targeted intervention. METHOD We performed a systematic review of reported occurrences of iNTS disease in sub-Saharan Africa, consulting literature from PubMed, Embase and Web of Science published since 2000. Eligibility for inclusion was not limited by study type but required that studies reported original data on human iNTS diseases based on the culture of a normally sterile site, specifying subnational locations and the year, and were available as full-text articles. We excluded studies that diagnosed iNTS disease based on clinical indications, cultures from non-sterile sites or serological testing. We estimated the probability of occurrence of iNTS disease for sub-Saharan Africa on 20 km × 20 km grids by exploring the association with geospatial covariates such as malaria, HIV, childhood growth failure, access to improved water, and sanitation using a boosted regression tree. RESULTS We identified 130 unique references reporting human iNTS disease in 21 countries published from 2000 through 2020. The estimated probability of iNTS occurrence grids showed significant spatial heterogeneity at all levels (20 km × 20 km grids, subnational, country and subregional levels) and temporal heterogeneity by year. For 2020, the probability of occurrence was higher in Middle Africa (0.34, 95% CI: 0.25 to 0.46), followed by Western Africa (0.33, 95% CI: 0.23 to 0.44), Eastern Africa (0.24, 95% CI: 0.17 to 0.33) and Southern Africa (0.08, 95% CI: 0.03 to 0.11). Temporal heterogeneity indicated that the probability of occurrence increased between 2000 and 2020 in countries such as the Republic of the Congo (0.05 to 0.59) and Democratic Republic of the Congo (0.10 to 0.48) whereas it decreased in countries such as Uganda (0.65 to 0.23) or Zimbabwe (0.61 to 0.37). CONCLUSION The iNTS disease occurrence varied greatly across sub-Saharan Africa, with certain regions being disproportionately affected. Exploring regions at high risk for iNTS disease, despite the limitations in our data, may inform focused resource allocation. This targeted approach may enhance efforts to combat iNTS disease in more affected areas.
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Affiliation(s)
- Jong-Hoon Kim
- International Vaccine Institute, Gwanak-gu, Seoul, Republic of Korea
| | - Bieke Tack
- Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Fabio Fiorino
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Department of Medicine and Surgery, LUM University "Giuseppe Degennaro", Bari, Italy
| | - Elena Pettini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | - Jan Jacobs
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - John Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Florian Marks
- Epidemiology Unit, International Vaccine Institute, Seoul, Republic of Korea
- Department of Medicine, University of Cambridge, Cambridge, UK
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Adu Sarfo E, Tweneboah R. Mineral wealth paradox: health challenges and environmental risks in African resource-rich areas. BMC Public Health 2024; 24:724. [PMID: 38448855 DOI: 10.1186/s12889-024-18137-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 02/17/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Africa is blessed with vast arable land and enriched with valuable natural resources encompassing both renewable (like water, forests, and fisheries) and non-renewable (such as minerals, coal, gas, and oil). Under the right conditions, a natural resource boom should serve as an important driver for growth, development, and the transition from cottage industry to factory output. However, despite its wealth, Africa is often associated with the notion of a resource curse. Negative outcomes are often linked with mineral wealth. This paper investigates the causes of adverse health outcomes in resource-rich regions. The study provides empirical support for the natural resource curse with particular emphasis on the environmental health risks in Africa. We explore the multifaceted connections among mineral deposits, environmental risks, conflict events and population dynamics, shedding light on the complexities of resource-rich areas. RESULTS We amalgamate georeferenced data pertaining to 22 specific mineral deposits with information on the prevalence of reliance on compromised infrastructures at a spatial resolution of 0.5∘ × 0 . 5 ∘ for all of Africa between 2000 and 2017. Through comprehensive econometric analysis of environmental health risk factors, including reliance on contaminated water sources, open defecation, unimproved sanitation, particulate matter concentration, and carbon concentration, we uncover the intricate pathways through which mineral deposits impact public health. Our findings revealed the significant role of in-migration in mediating environmental health risks. Moreover, we found that the activities of extractive companies amplify certain environmental risks including reliance on unimproved sanitation and practices and particulate matter concentration. Conflict events emerge as a key mediator across all environmental health risks, underlining the far-reaching consequences of instability and violence on both local communities and the environment. CONCLUSION The study contributes to the discourse on sustainable development by unraveling the nuanced associations between mineral wealth and health challenges. By drawing attention to the intricate web of factors at play, we provide a foundation for targeted interventions that address the unique environmental and health challenges faced by mineral-rich communities.
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Affiliation(s)
- Emmanuel Adu Sarfo
- Faculty of Economic Sciences, National Research University Higher School of Economics, 20 Myasnitskaya Street, 101000, Moscow, Russia
- Department of Mathematics and Statistics, Youngstown State University, 1 University Plaza, OH 44555, Ohio, USA
| | - Rabbi Tweneboah
- Faculty of Economic Sciences, National Research University Higher School of Economics, 20 Myasnitskaya Street, 101000, Moscow, Russia.
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Qin A, Qin W, Hu F, Wang M, Yang H, Li L, Chen C, Bao B, Xin T, Xu L. Does unequal economic development contribute to the inequitable distribution of healthcare resources? Evidence from China spanning 2001-2020. Global Health 2024; 20:20. [PMID: 38443966 PMCID: PMC10913684 DOI: 10.1186/s12992-024-01025-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/26/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND There is a dearth of research combining geographical big data on medical resource allocation and growth with various statistical data. Given the recent achievements of China in economic development and healthcare, this study takes China as an example to investigate the dynamic geographical distribution patterns of medical resources, utilizing data on healthcare resources from 290 cities in China, as well as economic and population-related data. The study aims to examine the correlation between economic growth and spatial distribution of medical resources, with the ultimate goal of providing evidence for promoting global health equity. METHODS The data used in this study was sourced from the China City Statistical Yearbook from 2001 to 2020. Two indicators were employed to measure medical resources: the number of doctors per million population and the number of hospital and clinic beds per million population. We employed dynamic convergence model and fixed-effects model to examine the correlation between economic growth and the spatial distribution of medical resources. Ordinary least squares (OLS) were used to estimate the β values of the samples. RESULTS The average GDP for all city samples across all years was 36,019.31 ± 32,029.36, with an average of 2016.31 ± 1104.16 doctors per million people, and an average of 5986.2 ± 6801.67 hospital beds per million people. In the eastern cities, the average GDP for all city samples was 47,672.71 ± 37,850.77, with an average of 2264.58 ± 1288.89 doctors per million people, and an average of 3998.92 ± 1896.49 hospital beds per million people. Cities with initially low medical resources experienced faster growth (all β < 0, P < 0.001). The long-term convergence rate of the geographic distribution of medical resources in China was higher than the short-term convergence rate (|βi + 1| > |βi|, i = 1, 2, 3, …, 9, all β < 0, P < 0.001), and the convergence speed of doctor density exceeded that of bed density (bed: |βi| >doc: |βi|, i = 3, 4, 5, …, 10, P < 0.001). Economic growth significantly affected the convergence speed of medical resources, and this effect was nonlinear (doc: βi < 0, i = 1, 2, 3, …, 9, P < 0.05; bed: βi < 0, i = 1, 2, 3, …, 10, P < 0.01). The heterogeneity between provinces had a notable impact on the convergence of medical resources. CONCLUSIONS The experiences of China have provided significant insights for nations worldwide. Governments and institutions in all countries worldwide, should actively undertake measures to actively reduce health inequalities. This includes enhancing healthcare standards in impoverished regions, addressing issues of unequal distribution, and emphasizing the examination of social determinants of health within the domain of public health research.
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Affiliation(s)
- Afei Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Wenzhe Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Fangfang Hu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Meiqi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
| | - Haifeng Yang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Lei Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Chiqi Chen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Binghong Bao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Tianjiao Xin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China.
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China.
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Song Y, Zeng M, Wang X, Shi P, Fei M, Zhu J. Hierarchical Engineering of Sorption-Based Atmospheric Water Harvesters. Adv Mater 2024; 36:e2209134. [PMID: 37246306 DOI: 10.1002/adma.202209134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/02/2023] [Indexed: 05/30/2023]
Abstract
Harvesting water from air in sorption-based devices is a promising solution to decentralized water production, aiming for providing potable water anywhere, anytime. This technology involves a series of coupled processes occurring at distinct length scales, ranging from nanometer to meter and even larger, including water sorption/desorption at the nanoscale, condensation at the mesoscale, device development at the macroscale and water scarcity assessment at the global scale. Comprehensive understanding and bespoke designs at every scale are thus needed to improve the water-harvesting performance. For this purpose, a brief introduction of the global water crisis and its key characteristics is provided to clarify the impact potential and design criteria of water harvesters. Next the latest molecular-level optimizations of sorbents for efficient moisture capture and release are discussed. Then, novel microstructuring of surfaces to enhance dropwise condensation, which is favorable for atmospheric water generation, is shown. After that, system-level optimizations of sorbent-assisted water harvesters to achieve high-yield, energy-efficient, and low-cost water harvesting are highlighted. Finally, future directions toward practical sorption-based atmospheric water harvesting are outlined.
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Affiliation(s)
- Yan Song
- National Laboratory of Solid State Microstructures, College of Engineering and Applied Sciences, Jiangsu Key Laboratory of Artificial Functional Materials and Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, 210008, P. R. China
| | - Mengyue Zeng
- National Laboratory of Solid State Microstructures, College of Engineering and Applied Sciences, Jiangsu Key Laboratory of Artificial Functional Materials and Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, 210008, P. R. China
| | - Xueyang Wang
- National Laboratory of Solid State Microstructures, College of Engineering and Applied Sciences, Jiangsu Key Laboratory of Artificial Functional Materials and Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, 210008, P. R. China
| | - Peiru Shi
- National Laboratory of Solid State Microstructures, College of Engineering and Applied Sciences, Jiangsu Key Laboratory of Artificial Functional Materials and Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, 210008, P. R. China
| | - Minfei Fei
- National Laboratory of Solid State Microstructures, College of Engineering and Applied Sciences, Jiangsu Key Laboratory of Artificial Functional Materials and Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, 210008, P. R. China
| | - Jia Zhu
- National Laboratory of Solid State Microstructures, College of Engineering and Applied Sciences, Jiangsu Key Laboratory of Artificial Functional Materials and Collaborative Innovation Center of Advanced Microstructures, Nanjing University, Nanjing, 210008, P. R. China
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Colston JM, Fang B, Houpt E, Chernyavskiy P, Swarup S, Gardner LM, Nong MK, Badr HS, Zaitchik BF, Lakshmi V, Kosek MN. The Planetary Child Health & Enterics Observatory (Plan-EO): A protocol for an interdisciplinary research initiative and web-based dashboard for mapping enteric infectious diseases and their risk factors and interventions in LMICs. PLoS One 2024; 19:e0297775. [PMID: 38412156 PMCID: PMC10898779 DOI: 10.1371/journal.pone.0297775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 01/12/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Diarrhea remains a leading cause of childhood illness throughout the world that is increasing due to climate change and is caused by various species of ecologically sensitive pathogens. The emerging Planetary Health movement emphasizes the interdependence of human health with natural systems, and much of its focus has been on infectious diseases and their interactions with environmental and human processes. Meanwhile, the era of big data has engendered a public appetite for interactive web-based dashboards for infectious diseases. However, enteric infectious diseases have been largely overlooked by these developments. METHODS The Planetary Child Health & Enterics Observatory (Plan-EO) is a new initiative that builds on existing partnerships between epidemiologists, climatologists, bioinformaticians, and hydrologists as well as investigators in numerous low- and middle-income countries. Its objective is to provide the research and stakeholder community with an evidence base for the geographical targeting of enteropathogen-specific child health interventions such as novel vaccines. The initiative will produce, curate, and disseminate spatial data products relating to the distribution of enteric pathogens and their environmental and sociodemographic determinants. DISCUSSION As climate change accelerates there is an urgent need for etiology-specific estimates of diarrheal disease burden at high spatiotemporal resolution. Plan-EO aims to address key challenges and knowledge gaps by making and disseminating rigorously obtained, generalizable disease burden estimates. Pre-processed environmental and EO-derived spatial data products will be housed, continually updated, and made publicly available for download to the research and stakeholder communities. These can then be used as inputs to identify and target priority populations living in transmission hotspots and for decision-making, scenario-planning, and disease burden projection. STUDY REGISTRATION PROSPERO protocol #CRD42023384709.
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Affiliation(s)
- Josh M. Colston
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
| | - Bin Fang
- Department of Civil and Environmental Engineering, University of Virginia, Charlottesville, Virginia, United States of America
| | - Eric Houpt
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
| | - Pavel Chernyavskiy
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
| | - Samarth Swarup
- Biocomplexity Institute, University of Virginia, Charlottesville, Virginia, United States of America
| | - Lauren M. Gardner
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Malena K. Nong
- University of Virginia College of Arts & Sciences, Charlottesville, Virginia, United States of America
| | - Hamada S. Badr
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Benjamin F. Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Venkataraman Lakshmi
- Department of Civil and Environmental Engineering, University of Virginia, Charlottesville, Virginia, United States of America
| | - Margaret N. Kosek
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
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Zhu Y, Che R, Zong X, Wang J, Li J, Zhang C, Wang F. A comprehensive review on the source, ingestion route, attachment and toxicity of microplastics/nanoplastics in human systems. J Environ Manage 2024; 352:120039. [PMID: 38218169 DOI: 10.1016/j.jenvman.2024.120039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/04/2023] [Accepted: 12/25/2023] [Indexed: 01/15/2024]
Abstract
Microplastics (MPs)/nanoplastics (NPs) are widely found in the natural environment, including soil, water and the atmosphere, which are essential for human survival. In the recent years, there has been a growing concern about the potential impact of MPs/NPs on human health. Due to the increasing interest in this research and the limited number of studies related to the health effects of MPs/NPs on humans, it is necessary to conduct a systematic assessment and review of their potentially toxic effects on human organs and tissues. Humans can be exposed to microplastics through ingestion, inhalation and dermal contact, however, ingestion and inhalation are considered as the primary routes. The ingested MPs/NPs mainly consist of plastic particles with a particle size ranging from 0.1 to 1 μm, that distribute across various tissues and organs within the body, which in turn have a certain impact on the nine major systems of the human body, especially the digestive system and respiratory system, which are closely related to the intake pathway of MPs/NPs. The harmful effects caused by MPs/NPs primarily occur through potential toxic mechanisms such as induction of oxidative stress, generation of inflammatory responses, alteration of lipid metabolism or energy metabolism or expression of related functional factors. This review can help people to systematically understand the hazards of MPs/NPs and related toxicity mechanisms from the level of nine biological systems. It allows MPs/NPs pollution to be emphasized, and it is also hoped that research on their toxic effects will be strengthened in the future.
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Affiliation(s)
- Yining Zhu
- School of Environment, Nanjing Normal University, Nanjing, Jiangsu, 210023, China; Key Laboratory for Soft Chemistry and Functional Materials of Ministry of Education, Nanjing University of Science and Technology, Nanjing, Jiangsu, 210094, China
| | - Ruijie Che
- School of Environment, Nanjing Normal University, Nanjing, Jiangsu, 210023, China; Key Laboratory for Soft Chemistry and Functional Materials of Ministry of Education, Nanjing University of Science and Technology, Nanjing, Jiangsu, 210094, China
| | - Xinyan Zong
- School of Environment, Nanjing Normal University, Nanjing, Jiangsu, 210023, China; Key Laboratory for Soft Chemistry and Functional Materials of Ministry of Education, Nanjing University of Science and Technology, Nanjing, Jiangsu, 210094, China
| | - Jinhan Wang
- School of Public Health, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Jining Li
- School of Environment, Nanjing Normal University, Nanjing, Jiangsu, 210023, China; Key Laboratory for Soft Chemistry and Functional Materials of Ministry of Education, Nanjing University of Science and Technology, Nanjing, Jiangsu, 210094, China
| | - Chaofeng Zhang
- Sino-Jan Joint Lab of Natural Health Products Research, School of Traditional Chinese Medicines, China Pharmaceutical University, Nanjing, Jiangsu, 210009, China
| | - Fenghe Wang
- School of Environment, Nanjing Normal University, Nanjing, Jiangsu, 210023, China; Key Laboratory for Soft Chemistry and Functional Materials of Ministry of Education, Nanjing University of Science and Technology, Nanjing, Jiangsu, 210094, China.
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Kim JH, Choi J, Kim C, Pak GD, Parajulee P, Haselbeck A, Park SE, Mogasale V, Jeon HJ, Browne AJ, Owusu-Dabo E, Rakotozandrindrainy R, Bassiahi AS, Teferi M, Lunguya-Metila O, Dolecek C, Pitzer VE, Crump JA, Hay SI, Marks F. Mapping the incidence rate of typhoid fever in sub-Saharan Africa. PLoS Negl Trop Dis 2024; 18:e0011902. [PMID: 38408128 DOI: 10.1371/journal.pntd.0011902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 03/26/2024] [Accepted: 01/04/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND With more than 1.2 million illnesses and 29,000 deaths in sub-Saharan Africa in 2017, typhoid fever continues to be a major public health problem. Effective control of the disease would benefit from an understanding of the subnational geospatial distribution of the disease incidence. METHOD We collated records of the incidence rate of typhoid fever confirmed by culture of blood in Africa from 2000 to 2022. We estimated the typhoid incidence rate for sub-Saharan Africa on 20 km × 20 km grids by exploring the association with geospatial covariates representing access to improved water and sanitation, health conditions of the population, and environmental conditions. RESULTS We identified six published articles and one pre-print representing incidence rate estimates in 22 sites in 2000-2022. Estimated incidence rates showed geospatial variation at sub-national, national, and regional levels. The incidence rate was high in Western and Eastern African subregions followed by Southern and Middle African subregions. By age, the incidence rate was highest among 5-14 yo followed by 2-4 yo, > 14 yo, and 0-1 yo. When aggregated across all age classes and grids that comprise each country, predicted incidence rates ranged from 43.7 (95% confidence interval: 0.6 to 591.2) in Zimbabwe to 2,957.8 (95% CI: 20.8 to 4,245.2) in South Sudan per 100,000 person-years. Sub-national heterogeneity was evident with the coefficient of variation at the 20 km × 20 km grid-level ranging from 0.7 to 3.3 and was generally lower in high-incidence countries and widely varying in low-incidence countries. CONCLUSION Our study provides estimates of 20 km × 20 km incidence rate of typhoid fever across sub-Saharan Africa based on data collected from 2000 through 2020. Increased understanding of the subnational geospatial variation of typhoid fever in Africa may inform more effective intervention programs by better targeting resources to heterogeneously disturbed disease risk.
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Affiliation(s)
- Jong-Hoon Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Jungsoon Choi
- Department of Mathematics, Hanyang University, Seoul, Republic of Korea
| | - Chaelin Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Gi Deok Pak
- International Vaccine Institute, Seoul, Republic of Korea
| | | | | | - Se Eun Park
- International Vaccine Institute, Seoul, Republic of Korea
- Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | | | - Hyon Jin Jeon
- International Vaccine Institute, Seoul, Republic of Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar
| | - Annie J Browne
- Malaria Atlas Project, Telethon Kids Institute, Perth, Australia
| | - Ellis Owusu-Dabo
- Malaria Atlas Project, Telethon Kids Institute, Perth, Australia
| | - Raphaël Rakotozandrindrainy
- School of Public Health, Kwame Nkrumah University of Science and Technology, Laing Building Complex J.W. Acheampong CI, Kumasi, Ghana
| | | | - Mekonnen Teferi
- Armauer Hansen Research Institute, ALERT Compound Zenebework, Addis Ababa, Ethiopia
| | - Octavie Lunguya-Metila
- Department of Microbiology, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
- Department of Medical Biology, Microbiology Service, University Teaching Hospital, Ave De L'hopital, Kinshasa, Democratic Republic of the Congo
| | - Christiane Dolecek
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Virginia E Pitzer
- Department of Epidemiology of Microbial Diseases, New Haven, Connecticut, United States of America
- Yale Institute for Global Health, New Haven, Connecticut, United States of America
| | - John A Crump
- Centre for International Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Simon I Hay
- Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, Washington, United States of America
- Department of Health Metrics Sciences, University of Washington, Seattle, Washington, United States of America
| | - Florian Marks
- International Vaccine Institute, Seoul, Republic of Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
- School of Public Health, Kwame Nkrumah University of Science and Technology, Laing Building Complex J.W. Acheampong CI, Kumasi, Ghana
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
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Malembaka EB, Bugeme PM, Hutchins C, Xu H, Hulse JD, Demby MN, Gallandat K, Saidi JM, Rumedeka BB, Itongwa M, Tshiwedi-Tsilabia E, Kitoga F, Bodisa-Matamu T, Kavunga-Membo H, Bengehya J, Kulondwa JC, Debes AK, Taty N, Lee EC, Lunguya O, Lessler J, Leung DT, Cumming O, Okitayemba PW, Mukadi-Bamuleka D, Knee J, Azman AS. Effectiveness of one dose of killed oral cholera vaccine in an endemic community in the Democratic Republic of the Congo: a matched case-control study. Lancet Infect Dis 2024:S1473-3099(23)00742-9. [PMID: 38246191 DOI: 10.1016/s1473-3099(23)00742-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/07/2023] [Accepted: 11/21/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND A global shortage of cholera vaccines has increased the use of single-dose regimens, rather than the standard two-dose regimen. There is sparse evidence on single-dose protection, particularly in children. In 2020, a mass vaccination campaign was conducted in Uvira, an endemic urban setting in eastern Democratic Republic of the Congo, resulting in largely single-dose coverage. We examined the effectiveness of a single-dose of the oral cholera vaccine Euvichol-Plus in this high-burden setting. METHODS In this matched case-control study, we recruited individuals with medically attended confirmed cholera in the two cholera treatment facilities in the city of Uvira. The control group consisted of age-matched, sex-matched, and neighbourhood-matched community individuals. We recruited across two distinct periods: Oct 14, 2021, to March 10, 2022 (12-17 months after vaccination), and Nov 21, 2022, to Oct 18, 2023 (24-36 months after vaccination). Study staff administered structured questionnaires to all participants to capture demographics, household conditions, potential confounding variables, and vaccination status. The odds of vaccination for the case and control groups were contrasted in conditional logistic regression models to estimate unadjusted and adjusted vaccine effectiveness. FINDINGS We enrolled 658 individuals with confirmed cholera and 2274 matched individuals for the control group. 99 (15·1%) individuals in the case group were younger than 5 years at the time of vaccination. The adjusted single-dose vaccine effectiveness was 52·7% (95% CI 31·4 to 67·4) 12-17 months after vaccination and 44·7% (24·8 to 59·4) 24-36 months after vaccination. Although protection in the first 12-17 months after vaccination was similar for children aged 1-4 years and older individuals, the estimate of protection in children aged 1-4 years appeared to wane during the third year after vaccination (adjusted vaccine effectiveness 32·9%, 95% CI -30·7 to 65·5), with CIs spanning the null. INTERPRETATION A single dose of Euvichol-Plus provided substantial protection against medically attended cholera for at least 36 months after vaccination in this cholera-endemic setting. Although the evidence provides support for similar levels of protection in young children and others in the short term, protection among children younger than 5 years might wane significantly during the third year after vaccination. FUNDING Wellcome Trust and Gavi, the Vaccine Alliance.
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Affiliation(s)
- Espoir Bwenge Malembaka
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA; Centre for Tropical Diseases and Global Health (CTDGH), Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Patrick Musole Bugeme
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA; Centre for Tropical Diseases and Global Health (CTDGH), Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Chloe Hutchins
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Hanmeng Xu
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Juan Dent Hulse
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Maya N Demby
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Karin Gallandat
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Jaime Mufitini Saidi
- Ministère de la Santé Publique, Hygiène et Prévention, Zone de Santé d'Uvira, Uvira, Democratic Republic of the Congo
| | | | | | | | - Faida Kitoga
- Rodolphe Merieux INRB-Goma Laboratory, Goma, North Kivu, Democratic Republic of the Congo
| | - Tavia Bodisa-Matamu
- Rodolphe Merieux INRB-Goma Laboratory, Goma, North Kivu, Democratic Republic of the Congo
| | - Hugo Kavunga-Membo
- Rodolphe Merieux INRB-Goma Laboratory, Goma, North Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, INRB, Kinshasa, Democratic Republic of the Congo
| | - Justin Bengehya
- Ministère de la Santé Publique, Hygiène et Prévention, Division Provinciale de la Sante' Publique du Sud-Kivu, Bukavu, Democratic Republic of the Congo
| | - Jean-Claude Kulondwa
- Ministère de la Santé Publique, Hygiène et Prévention, Division Provinciale de la Sante' Publique du Sud-Kivu, Bukavu, Democratic Republic of the Congo
| | - Amanda K Debes
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA
| | - Nagède Taty
- PNECHOL-MD, Community IMCI, Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Elizabeth C Lee
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Octavie Lunguya
- Institut National de Recherche Biomédicale, INRB, Kinshasa, Democratic Republic of the Congo; Service of Microbiology, Department of Medical Biology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Justin Lessler
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA; University of North Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniel T Leung
- Division of Infectious Diseases and Division of Microbiology and Immunology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Oliver Cumming
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Daniel Mukadi-Bamuleka
- Rodolphe Merieux INRB-Goma Laboratory, Goma, North Kivu, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, INRB, Kinshasa, Democratic Republic of the Congo; Service of Microbiology, Department of Medical Biology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jackie Knee
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrew S Azman
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA; Geneva Centre for Emerging Viral Diseases and Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.
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10
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Singer BJ, Coulibaly JT, Park HJ, Andrews JR, Bogoch II, Lo NC. Development of prediction models to identify hotspots of schistosomiasis in endemic regions to guide mass drug administration. Proc Natl Acad Sci U S A 2024; 121:e2315463120. [PMID: 38181058 PMCID: PMC10786280 DOI: 10.1073/pnas.2315463120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/13/2023] [Indexed: 01/07/2024] Open
Abstract
Schistosomiasis is a neglected tropical disease affecting over 150 million people. Hotspots of Schistosoma transmission-communities where infection prevalence does not decline adequately with mass drug administration-present a key challenge in eliminating schistosomiasis. Current approaches to identify hotspots require evaluation 2-5 y after a baseline survey and subsequent mass drug administration. Here, we develop statistical models to predict hotspots at baseline prior to treatment comparing three common hotspot definitions, using epidemiologic, survey-based, and remote sensing data. In a reanalysis of randomized trials in 589 communities in five endemic countries, a regression model predicts whether Schistosoma mansoni infection prevalence will exceed the WHO threshold of 10% in year 5 ("prevalence hotspot") with 86% sensitivity, 74% specificity, and 93% negative predictive value (NPV; assuming 30% hotspot prevalence), and a regression model for Schistosoma haematobium achieves 90% sensitivity, 90% specificity, and 96% NPV. A random forest model predicts whether S. mansoni moderate and heavy infection prevalence will exceed a public health goal of 1% in year 5 ("intensity hotspot") with 92% sensitivity, 79% specificity, and 96% NPV, and a boosted trees model for S. haematobium achieves 77% sensitivity, 95% specificity, and 91% NPV. Baseline prevalence is a top predictor in all models. Prediction is less accurate in countries not represented in training data and for a third hotspot definition based on relative prevalence reduction over time ("persistent hotspot"). These models may be a tool to prioritize high-risk communities for more frequent surveillance or intervention against schistosomiasis, but prediction of hotspots remains a challenge.
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Affiliation(s)
- Benjamin J. Singer
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA94304
| | - Jean T. Coulibaly
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Swiss Tropical and Public Health Institute, Basel, Allschwil4123Switzerland
- University of Basel, Basel4001, Switzerland
| | - Hailey J. Park
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA94304
| | - Jason R. Andrews
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA94304
| | - Isaac I. Bogoch
- Department of Medicine, University of Toronto, Toronto, ONM5S 1A8, Canada
| | - Nathan C. Lo
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA94304
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11
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Ahmed KY, Ogbo FA, Tegegne TK, Dalton H, Arora A, Ross AG. Interventions to improve the nutritional status of children under 5 years in Ethiopia: a systematic review. Public Health Nutr 2023; 26:3147-3161. [PMID: 37905557 PMCID: PMC10755407 DOI: 10.1017/s1368980023002410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 09/22/2023] [Accepted: 10/25/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE To conduct a systematic review of experimental or quasi-experimental studies that aimed to improve the nutritional status of children under 5 years of age in Ethiopia. DESIGN Embase, MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, and Academic Search Database were used to locate peer-reviewed studies, and Google Scholar and Open Dissertation were used to locate grey literatures. All searches were conducted between 2000 and November 2022. SETTING Ethiopia. PARTICIPANTS Pregnant women and mothers with children aged 0-59 months. RESULTS Ten cluster randomised controlled trials (RCT), six quasi-experimental studies and two individual RCT were included. Out of the identified eighteen studies, three studies targeted pregnant mothers. Our findings showed that almost two-thirds of published interventions had no impact on childhood stunting and wasting, and more than half had no impact on underweight. Some behaviour change communication (BCC) interventions, food vouchers, micronutrient supplementation and quality protein maize improved stunting. Similarly, BCC and fish oil supplementation showed promise in reducing wasting, while BCC and the provision of quality protein maize reduced underweight. Additionally, water, sanitation and hygiene (WaSH) interventions provided to pregnant mothers and children under 2 years of age were shown to significantly reduce childhood stunting. CONCLUSION Future childhood nutritional interventions in Ethiopia should consider adopting an integrated approach that combines the positive effects of interdependent systems such as BCC, food supplemental programmes (e.g. boosting protein and micronutrients), health interventions (e.g. strengthening maternal and childcare), WaSH and financial initiatives (e.g. monetary support and income schemes).
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Affiliation(s)
- Kedir Y Ahmed
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
- Riverland Academy of Clinical Excellence (RACE), Riverland Mallee Coorong Local Health Network, SA Health, Government of South Australia, Berri, SA, Australia
| | - Teketo Kassaw Tegegne
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Hazel Dalton
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Orange, NSW, Australia
| | - Amit Arora
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
- School of Health Sciences, Western Sydney University, Campbelltown Campus, NSW, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
- Health Equity Laboratory, Campbelltown, NSW, Australia
| | - Allen G Ross
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
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12
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Ahmed A, Sayeed A, Tanwi TS, Saha N, Hanson M, Protyai DA, Hossain AT, Ahmed A, Rahman F, Akter E, Nusrat N, Badsha MS, Rahman A, Islam MK, Alam MS, Nahar Q, Arifeen SE, Rahman AE, Tahsina T. Trends and inequity in improved sanitation facility utilisation in Bangladesh: Evidence from Bangladesh Demographic and Health Surveys. BMC Res Notes 2023; 16:303. [PMID: 37908017 PMCID: PMC10619219 DOI: 10.1186/s13104-023-06555-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 10/05/2023] [Indexed: 11/02/2023] Open
Abstract
Improved sanitation is indispensable to human health. However, lack of access to improved sanitation remains one of the most daunting public health challenges of the twenty-first century in Bangladesh. The aim of the study was to describe the trends in access to improved sanitation facilities following the inequity gap among households in different socioeconomic groups in Bangladesh. Data from the Bangladesh Demographic and Health Survey (BDHS) 2007, 2011, 2014, and 2017-18 were extracted for this study. Inequity in access to improved sanitation was calculated using rich-poor ratio and concentration index to determine the changes in inequity across the time period. In Bangladesh, the proportion of households with access to improved sanitation increased steadily from 25.4% to 45.4% between 2007 and 2014, but slightly decreased to 44.0% in 2017-18. Age, educational status, marital status of household head, household wealth index, household size, place of residence, division, and survey year were significantly associated with the utilisation of improved sanitation. There is a pro-rich situation, which means that utilisation of improved sanitation was more concentrated among the rich across all survey years (Concentration Index ranges: 0.40 to 0.27). The government and other relevant stakeholders should take initiatives considering inequity among different socioeconomic groups to ensure the use of improved sanitation facilities for all, hence achieving universal health coverage.
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Affiliation(s)
- Anisuddin Ahmed
- Department of Women's and Children's Health, Uppsala University, 75205, Uppsala, Sweden.
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
| | - Abu Sayeed
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Tania Sultana Tanwi
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Nondo Saha
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Molly Hanson
- Department of Women's and Children's Health, Uppsala University, 75205, Uppsala, Sweden
| | | | - Aniqa Tasnim Hossain
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Ali Ahmed
- Western Sydney University, Penrith Campus, Sydney, Australia
| | - Fariya Rahman
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Ema Akter
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Nowrin Nusrat
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Md Shawon Badsha
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Afruna Rahman
- Infectious Disease Division (IDD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | | | - Md Shah Alam
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Quamrun Nahar
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Shams El Arifeen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Ahmed Ehsanur Rahman
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Tazeen Tahsina
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
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13
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Selby R, Jeyam A, Tate A, Kebede F, Downs P. Potential mitigating role of ivermectin on the spread of Chlamydia trachomatis by Musca sorbens. PLoS Negl Trop Dis 2023; 17:e0011662. [PMID: 37883529 PMCID: PMC10602231 DOI: 10.1371/journal.pntd.0011662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/13/2023] [Indexed: 10/28/2023] Open
Abstract
Trachoma is the world's most frequent cause of blindness from an infectious agent. The disease caused by infection is associated with lack of access to sanitation and low hygiene standards. Trachoma is controlled through the Surgery, Antibiotics, Facial cleanliness, and Environmental improvement (SAFE) strategy, which delivers azithromycin (AZM) mass drug administration (MDA) in endemic areas. The putative vector Musca sorbens principally reproduce in human faecal matter left in the environment due to open defecation. Ivermectin (IVM) is on the WHO's essential medicines list and is administered as preventative chemotherapy against two neglected tropical diseases (NTDs)-onchocerciasis, as an annual or bi-annual treatment, and lymphatic filariasis, as an annual treatment in combination with albendazole. Ivermectin has a known inhibitive effect on insects that reproduce in dung. To assess if IVM could be a viable vector control tool against M. sorbens, this study evaluates existing data from trachoma, onchocerciasis and lymphatic filariasis mass drug administration (MDA) operations in Ethiopia. Persistent and recrudescent trachoma in evaluation units (EUs) were examined for whether AZM MDA in EUs was accompanied by IVM MDA, and whether co-administration was associated with greater likelihood of trachoma control. Results show an association suggesting that EUs that received both IVM and AZM MDA benefit from improved control of trachoma in persistent or recrudescent areas, when compared to EUs that received AZM MDA. This initial investigation supports the potential for ivermectin's use to support SAFE. Findings warrant further work to validate ivermectin's impact on M. sorbens reproduction through controlled lab and field-based studies.
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Affiliation(s)
- Richard Selby
- Sightsavers international, 35 Perrymount Road, Haywards Heath, West Sussex, United Kingdom
| | - Anita Jeyam
- Sightsavers international, 35 Perrymount Road, Haywards Heath, West Sussex, United Kingdom
| | - Andrew Tate
- Sightsavers international, 35 Perrymount Road, Haywards Heath, West Sussex, United Kingdom
| | | | - Philip Downs
- Sightsavers international, 35 Perrymount Road, Haywards Heath, West Sussex, United Kingdom
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14
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Saxena D, Bajpai PK, Srivastava DK, Shukla SK, Jain PK, Takhelchangbam N. Estimation of Access to Safe Drinking Water to Households in Etawah District: A Cross-Sectional Study. Cureus 2023; 15:e47154. [PMID: 38021943 PMCID: PMC10652157 DOI: 10.7759/cureus.47154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2023] [Indexed: 12/01/2023] Open
Abstract
CONTEXT Unsafe drinking water causes diarrheal disease and environmental enteropathy. The quality of water is determined by its physical, chemical, and biological characteristics. Water sources have a significant impact on household members' health, particularly children. To combat this, India is committed to providing household tap connections to ensure the delivery of safe drinking water with the "Jal Jeevan Mission." AIMS This study aims to estimate the access to safe drinking water and the physical and chemical qualities of water (qualitatively) in the urban and rural areas of Etawah district, India. SETTINGS AND DESIGN A cross-sectional study was conducted in Etawah district from January 2020 to December 2021. The study subjects were the eldest female of the family. A total of 312 females were included. The data collected were analyzed using IBM SPSS Statistics for Windows, version 25 (released 2017; IBM Corp., Armonk, New York, United States) for descriptive analysis. RESULTS In the present study, 76.3% (238/312) of households in the urban and rural areas had access to safe drinking water (here, the meaning of the word "safe" is based on its operational definition). A total of 130 (83.3%) households in rural areas and only 21 (13.5%) in urban areas had private supply as the primary water source. The physical and chemical qualities of water were within the requirement (acceptable limit) and permissible limit in all the study areas, so the water is considered safe for drinking. CONCLUSIONS This study reported that 76.3% (238) households had access to safe drinking water according to the operational definition. The major public source of drinking water was public-supplied tap water, and in private sources, submersible or boreholes were the most common.
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Affiliation(s)
- Deepanshi Saxena
- Community Medicine, Sarojini Naidu Medical College, Agra, IND
- Community Medicine, Uttar Pradesh University of Medical Sciences, Etawah, IND
- Medicine, King George's Medical University, Lucknow, IND
| | | | - Dhiraj K Srivastava
- Community Medicine, Uttar Pradesh University of Medical Sciences, Etawah, IND
| | - Sushil K Shukla
- Community Medicine, Uttar Pradesh University of Medical Sciences, Etawah, IND
| | - Pankaj K Jain
- Community Medicine, Uttar Pradesh University of Medical Sciences, Etawah, IND
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15
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Kikuchi M. Influence of sanitation facilities on diarrhea prevalence among children aged below 5 years in flood-prone areas of Bangladesh: a multilevel analysis. Environ Sci Pollut Res Int 2023; 30:97925-97935. [PMID: 37603245 PMCID: PMC10495509 DOI: 10.1007/s11356-023-29373-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 08/13/2023] [Indexed: 08/22/2023]
Abstract
Although the improvement of sanitation facilities has been a major contributor to improving public health, it is not guaranteed to prevent negative health outcomes. This is especially true in areas affected by severe natural disasters, such as flooding or extreme rainfall. Previous studies have examined the association between catastrophic natural disasters and negative health outcomes. However, studies on disaster-prone areas are limited. This study focused on the impact of flood risks and examined whether the improvement of sanitation facilities would be sufficient to suppress the prevalence of diarrhea in flood-prone areas. Two secondary datasets including geodata on flood-prone areas were used for the analysis: one each was obtained from the Bangladesh Demographic and Health Survey and Bangladesh Agricultural Research Council. Two models with categorizations of sanitation facilities based on containment type and excreta flow were applied for analysis. Results showed that the severe flood-prone areas and "diffused" type of sanitation, where the feces are diffused without any containment, had significant positive associations with diarrhea prevalence; however, the interaction between them was negative. Moderate flood-prone areas had a significant positive association with diarrhea prevalence; however, the interaction with unimproved sanitation, which includes containment without clear partition from feces, was significantly negative. These findings indicate that improved sanitation or containment type of sanitation may not positively contribute to the prevention of diarrhea in these severe- and moderate-flood prone areas. The urgent need for alternative sanitation technologies should be addressed in flood-prone regions.
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Affiliation(s)
- Michiko Kikuchi
- Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa City, Chiba Prefecture, 277-8561, Japan.
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16
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Geleijnse J, Rutten M, de Villiers D, Bamwenda JT, Abraham E. Enhancing water access monitoring through mapping multi-source usage and disaggregated geographic inequalities with machine learning and surveys. Sci Rep 2023; 13:13433. [PMID: 37596313 PMCID: PMC10439218 DOI: 10.1038/s41598-023-39917-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 08/02/2023] [Indexed: 08/20/2023] Open
Abstract
Monitoring safe water access in developing countries relies primarily on household health survey and census data. These surveys are often incomplete: they tend to focus on the primary water source only, are spatially coarse, and usually happen every 5-10 years, during which significant changes can happen in urbanisation and infrastructure provision, especially in sub Saharan Africa. In this work, we present a data-driven approach that utilises and compliments survey based data of water access, to provide context-specific and disaggregated monitoring. The level of access to improved water and sanitation has been shown to vary with geographical inequalities related to the availability of water resources and terrain, population density and socio-economic determinants such as income and education. We use such data and successfully predict the level of water access in areas for which data is lacking, providing spatially explicit and community level monitoring possibilities for mapping geographical inequalities in access. This is showcased by applying three machine learning models that use such geographical data to predict the number of presences of water access points of eight different access types across Uganda, with a 1km by 1km grid resolution. Two Multi-Layer-Perceptron (MLP) models and a Maximum Entropy (MaxEnt) model are developed and compared, where the former are shown to consistently outperform the latter. The best performing Neural Network model achieved a True Positive Rate of 0.89 and a False Positive Rate of 0.24, compared to 0.85 and 0.46 respectively for the MaxEnt model. The models improve on previous work on water point modeling through the use of neural networks, in addition to introducing the True Positive - and False Positive Rate as better evaluation metrics to also assess the MaxEnt model. We also present a scaling method to move from predicting only the relative probability of water point presences, to predicting the absolute number of presences. To challenge both the model results and the more standard health surveys, a new household level survey is carried out in Bushenyi, a mid-sized town in the South-West of Uganda, asking specifically about the multitude of water sources. On average Bushenyi households reported to use 1.9 water sources. The survey further showed that the actual presence of a source, does not always imply that it is used. Therefore it is no option to rely solely on models for water access monitoring. For this, household surveys remain necessary but should be extended with questions on the multiple sources that are used by households.
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Affiliation(s)
- Jan Geleijnse
- Department of Water Management, Delft University of Technology, Mekelweg, 2628 CD, Delft, The Netherlands.
- UNICEF, Nairobi, Kenya.
| | - Martine Rutten
- Department of Water Management, Delft University of Technology, Mekelweg, 2628 CD, Delft, The Netherlands
| | - Didier de Villiers
- Department of Water Management, Delft University of Technology, Mekelweg, 2628 CD, Delft, The Netherlands
| | | | - Edo Abraham
- Department of Water Management, Delft University of Technology, Mekelweg, 2628 CD, Delft, The Netherlands
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17
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Lee D, Gibson JM, Brown J, Habtewold J, Murphy HM. Burden of disease from contaminated drinking water in countries with high access to safely managed water: A systematic review. Water Res 2023; 242:120244. [PMID: 37390656 DOI: 10.1016/j.watres.2023.120244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 07/02/2023]
Abstract
The vast majority of residents of high-income countries (≥90%) reportedly have high access to safely managed drinking water. Owing perhaps to the widely held perception of near universal access to high-quality water services in these countries, the burden of waterborne disease in these contexts is understudied. This systematic review aimed to: identify population-scale estimates of waterborne disease in countries with high access to safely managed drinking water, compare methods to quantify disease burden, and identify gaps in available burden estimates. We conducted a systematic review of population-scale disease burden estimates attributed to drinking water in countries where ≥90% of the population has access to safely managed drinking water per official United Nations monitoring. We identified 24 studies reporting estimates for disease burden attributable to microbial contaminants. Across these studies, the median burden of gastrointestinal illness risks attributed to drinking water was ∼2,720 annual cases per 100,000 population. Beyond exposure to infectious agents, we identified 10 studies reporting disease burden-predominantly, cancer risks-associated with chemical contaminants. Across these studies, the median excess cancer cases attributable to drinking water was 1.2 annual cancer cases per 100,000 population. These median estimates slightly exceed WHO-recommended normative targets for disease burden attributable to drinking water and these results highlight that there remains important preventable disease burden in these contexts, particularly among marginalized populations. However, the available literature was scant and limited in geographic scope, disease outcomes, range of microbial and chemical contaminants, and inclusion of subpopulations (rural, low-income communities; Indigenous or Aboriginal peoples; and populations marginalized due to discrimination by race, ethnicity, or socioeconomic status) that could most benefit from water infrastructure investments. Studies quantifying drinking water-associated disease burden in countries with reportedly high access to safe drinking water, focusing on specific subpopulations lacking access to safe water supplies and promoting environmental justice, are needed.
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Affiliation(s)
- Debbie Lee
- Water, Health and Applied Microbiology (WHAM) Lab, Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA, United States; Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, United States
| | - Jacqueline MacDonald Gibson
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, NC, United States
| | - Joe Brown
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jemaneh Habtewold
- Water, Health and Applied Microbiology (WHAM) Lab, Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, United States
| | - Heather M Murphy
- Water, Health and Applied Microbiology (WHAM) Lab, Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA, United States; Water, Health and Applied Microbiology (WHAM) Lab, Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, United States.
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18
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Wannigama DL, Amarasiri M, Hongsing P, Hurst C, Modchang C, Chadsuthi S, Anupong S, Phattharapornjaroen P, Rad S. M. AH, Fernandez S, Huang AT, Vatanaprasan P, Jay DJ, Saethang T, Luk-in S, Storer RJ, Ounjai P, Devanga Ragupathi NK, Kanthawee P, Sano D, Furukawa T, Sei K, Leelahavanichkul A, Kanjanabuch T, Hirankarn N, Higgins PG, Kicic A, Singer AC, Chatsuwan T, Trowsdale S, Abe S, McLellan AD, Ishikawa H. COVID-19 monitoring with sparse sampling of sewered and non-sewered wastewater in urban and rural communities. iScience 2023; 26:107019. [PMID: 37351501 PMCID: PMC10250052 DOI: 10.1016/j.isci.2023.107019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/31/2023] [Accepted: 05/30/2023] [Indexed: 06/24/2023] Open
Abstract
Equitable SARS-CoV-2 surveillance in low-resource communities lacking centralized sewers is critical as wastewater-based epidemiology (WBE) progresses. However, large-scale studies on SARS-CoV-2 detection in wastewater from low-and middle-income countries is limited because of economic and technical reasons. In this study, wastewater samples were collected twice a month from 186 urban and rural subdistricts in nine provinces of Thailand mostly having decentralized and non-sewered sanitation infrastructure and analyzed for SARS-CoV-2 RNA variants using allele-specific RT-qPCR. Wastewater SARS-CoV-2 RNA concentration was used to estimate the real-time incidence and time-varying effective reproduction number (Re). Results showed an increase in SARS-CoV-2 RNA concentrations in wastewater from urban and rural areas 14-20 days earlier than infected individuals were officially reported. It also showed that community/food markets were "hot spots" for infected people. This approach offers an opportunity for early detection of transmission surges, allowing preparedness and potentially mitigating significant outbreaks at both spatial and temporal scales.
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Affiliation(s)
- Dhammika Leshan Wannigama
- Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, Japan
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Center of Excellence in Antimicrobial Resistance and Stewardship, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, WA, Australia
- Biofilms and Antimicrobial Resistance Consortium of ODA receiving countries, The University of Sheffield, Sheffield, UK
- Pathogen Hunter’s Research Collaborative Team, Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Mohan Amarasiri
- Laboratory of Environmental Hygiene, Department of Health Science, School of Allied Health Sciences, Graduate School of Medical Sciences, Kitasato University, Kitasato, Sagamihara-Minami, Kanagawa 252-0373, Japan
| | - Parichart Hongsing
- Mae Fah Luang University Hospital, Chiang Rai, Thailand
- School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Cameron Hurst
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, QLD, Australia
- Statistics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Charin Modchang
- Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
- Centre of Excellence in Mathematics, MHESI, Bangkok 10400, Thailand
- Thailand Center of Excellence in Physics, Ministry of Higher Education, Science, Research and Innovation, 328 Si Ayutthaya Road, Bangkok 10400, Thailand
| | - Sudarat Chadsuthi
- Department of Physics, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Suparinthon Anupong
- Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | - Phatthranit Phattharapornjaroen
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Institute of Clinical Sciences, Department of Surgery, Sahlgrenska Academy, Gothenburg University, 40530 Gothenburg, Sweden
| | - Ali Hosseini Rad S. M.
- Department of Microbiology and Immunology, University of Otago, Dunedin, Otago 9010, New Zealand
- Center of Excellence in Immunology and Immune-Mediated Diseases, Chulalongkorn University, Bangkok 10330, Thailand
| | - Stefan Fernandez
- Department of Virology, U.S. Army Medical Directorate, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Angkana T. Huang
- Department of Virology, U.S. Army Medical Directorate, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Dylan John Jay
- Pathogen Hunter’s Research Collaborative Team, Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Thammakorn Saethang
- Department of Computer Science, Faculty of Science, Kasetsart University, Bangkok, Thailand
| | - Sirirat Luk-in
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Robin James Storer
- Office of Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Puey Ounjai
- Department of Biology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Naveen Kumar Devanga Ragupathi
- School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, WA, Australia
- Department of Chemical and Biological Engineering, The University of Sheffield, Sheffield, UK
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Phitsanuruk Kanthawee
- Public Health major, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Daisuke Sano
- Department of Frontier Sciences for Advanced Environment, Graduate School of Environmental Studies, Tohoku University, Sendai, Miyagi, Japan
- Department of Civil and Environmental Engineering, Graduate School of Engineering, Tohoku University, Sendai, Miyagi, Japan
| | - Takashi Furukawa
- Laboratory of Environmental Hygiene, Department of Health Science, School of Allied Health Sciences, Graduate School of Medical Sciences, Kitasato University, Kitasato, Sagamihara-Minami, Kanagawa 252-0373, Japan
| | - Kazunari Sei
- Laboratory of Environmental Hygiene, Department of Health Science, School of Allied Health Sciences, Graduate School of Medical Sciences, Kitasato University, Kitasato, Sagamihara-Minami, Kanagawa 252-0373, Japan
| | - Asada Leelahavanichkul
- Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, Japan
- Translational Research in Inflammation and Immunology Research Unit (TRIRU), Department of Microbiology, Chulalongkorn University, Bangkok, Thailand
| | - Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Dialysis Policy and Practice Program (DiP3), School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Peritoneal Dialysis Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Nattiya Hirankarn
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Center of Excellence in Immunology and Immune-Mediated Diseases, Chulalongkorn University, Bangkok 10330, Thailand
| | - Paul G. Higgins
- Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- German Centre for Infection Research, Partner site Bonn-Cologne, Cologne, Germany
| | - Anthony Kicic
- Wal-Yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
- Centre for Cell Therapy and Regenerative Medicine, Medical School, The University of Western Australia, Nedlands, WA 6009, Australia
- Department of Respiratory and Sleep Medicine, Perth Children’s Hospital, Nedlands, WA 6009, Australia
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | | | - Tanittha Chatsuwan
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Center of Excellence in Antimicrobial Resistance and Stewardship, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sam Trowsdale
- Department of Environmental Science, University of Auckland, Auckland 1010, New Zealand
| | - Shuichi Abe
- Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Alexander D. McLellan
- Department of Microbiology and Immunology, University of Otago, Dunedin, Otago 9010, New Zealand
| | - Hitoshi Ishikawa
- Yamagata Prefectural University of Health Sciences, Kamiyanagi, Yamagata 990-2212, Japan
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19
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Steele AD, Armah GE, Mwenda JM, Kirkwood CD. The Full Impact of Rotavirus Vaccines in Africa Has Yet to Be Realized. Clin Infect Dis 2023; 76:S1-S4. [PMID: 37074434 PMCID: PMC10116555 DOI: 10.1093/cid/ciad017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
Africa bears the brunt of diarrheal mortality globally. Rotavirus vaccination rates are high across the continent and demonstrate impact on diarrheal disease reduction. Nevertheless, there is room for significant improvement in managing rotavirus vaccine coverage, in access to recognized public services such as appropriate medical care, including oral rehydration therapy and improved water and sanitation.
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Affiliation(s)
- A Duncan Steele
- Enteric and Diarrheal Diseases, Global Health, Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - George E Armah
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Jason M Mwenda
- VPD Surveillance, World Health Organization (WHO) Regional Office for Africa (WHO/AFRO), Brazzaville, Republic of Congo
| | - Carl D Kirkwood
- Enteric and Diarrheal Diseases, Global Health, Bill & Melinda Gates Foundation, Seattle, Washington, USA
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20
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Haeuser E, Nguyen JQ, Rolfe S, Nesbit O, Fullman N, Mosser JF. Assessing Geographic Overlap between Zero-Dose Diphtheria–Tetanus–Pertussis Vaccination Prevalence and Other Health Indicators. Vaccines (Basel) 2023; 11:vaccines11040802. [PMID: 37112714 PMCID: PMC10144604 DOI: 10.3390/vaccines11040802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/17/2023] [Accepted: 03/29/2023] [Indexed: 04/08/2023] Open
Abstract
The integration of immunization with other essential health services is among the strategic priorities of the Immunization Agenda 2030 and has the potential to improve the effectiveness, efficiency, and equity of health service delivery. This study aims to evaluate the degree of spatial overlap between the prevalence of children who have never received a dose of the diphtheria–tetanus–pertussis-containing vaccine (no-DTP) and other health-related indicators, to provide insight into the potential for joint geographic targeting of integrated service delivery efforts. Using geospatially modeled estimates of vaccine coverage and comparator indicators, we develop a framework to delineate and compare areas of high overlap across indicators, both within and between countries, and based upon both counts and prevalence. We derive summary metrics of spatial overlap to facilitate comparison between countries and indicators and over time. As an example, we apply this suite of analyses to five countries—Nigeria, Democratic Republic of the Congo (DRC), Indonesia, Ethiopia, and Angola—and five comparator indicators—children with stunting, under-5 mortality, children missing doses of oral rehydration therapy, prevalence of lymphatic filariasis, and insecticide-treated bed net coverage. Our results demonstrate substantial heterogeneity in the geographic overlap both within and between countries. These results provide a framework to assess the potential for joint geographic targeting of interventions, supporting efforts to ensure that all people, regardless of location, can benefit from vaccines and other essential health services.
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Affiliation(s)
- Emily Haeuser
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USA
| | - Jason Q. Nguyen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USA
| | - Sam Rolfe
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USA
| | - Olivia Nesbit
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USA
| | - Nancy Fullman
- Department of Global Health, School of Medicine and School of Public Health, University of Washington, Seattle, WA 98195, USA
| | - Jonathan F. Mosser
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA 98195, USA
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21
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Al-Kassab-Córdova A, Silva-Perez C, Robles-Valcarcel P, Bendezu-Quispe G, Ortiz AI, Benites-Zapata VA. Spatial and socioeconomic inequalities in the access to safe drinking water in Peruvian households. J Water Health 2023; 21:525-535. [PMID: 37119152 DOI: 10.2166/wh.2023.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Access to safe drinking water has increased in Peru over the last decades, from 47% (2008) to 52% (2018). Nevertheless, such access would differ according to socioeconomic and regional factors. Thus, this study aimed to assess the socioeconomic inequality in the access to safe drinking water and identify its spatial distribution. We conducted a cross-sectional study based on the secondary data analysis of the 2021 Peruvian Demographic and Health Survey. Access to safe drinking water was a dummy variable categorised as safe if the residual chlorine concentration was ≥0.5 mg/L. Nationwide, 29.22% of households had access to safe drinking water. A pro-rich inequality in access to safe drinking water was observed. The spatial distribution was clustered. Significant hotspots were found in the south and centre of the country; however, cold spots were found in most areas. SaTScan analysis identified 32 and 63 significant clusters at high and low risks of having access to safe drinking water, respectively. In conclusion, approximately one out of four Peruvian households has access to safe drinking water, which was mostly concentrated among the wealthier households. Intra- and interdepartmental inequalities in access to safe drinking water were found, with several high-risk clusters.
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Affiliation(s)
- Ali Al-Kassab-Córdova
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Peru E-mail:
| | - Claudia Silva-Perez
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | - Guido Bendezu-Quispe
- Centro de Investigación Epidemiológica en Salud Global, Universidad Privada Norbert Wiener, Lima, Peru
| | - Amado Insfrán Ortiz
- Faculty of Agrarian Sciences, National University of Asunción, San Lorenzo University Campus, km 10, Asunción 1618, Paraguay; Forest Ecology and Restoration (FORECO) Group, Life Sciences Department, University of Alcalá, Alcalá de Henares, Madrid 28871, Spain
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22
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Bennett A, Demaine J, Dorea C, Cassivi A. A bibliometric analysis of global research on drinking water and health in low- and lower-middle-income countries. J Water Health 2023; 21:417-438. [PMID: 37338321 PMCID: wh_2023_293 DOI: 10.2166/wh.2023.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Heightened interest in drinking water research in recent decades has been aimed at narrowing the knowledge gaps surrounding water and health in a global pursuit to provide safely managed drinking water services to populations who continue to lack access. This study used bibliometrics and network analysis to produce a global overview of publications and groups that have contributed to research on drinking water and health in low- and lower-middle-income countries (LLMICs). The United States and the United Kingdom, which have historically dominated the field based on the production and impact of scientific literature, remain at the center of international collaborative research partnerships with emerging countries. However, in recent years, the volume of publications produced by India has surpassed that of the United States while Bangladesh is ranked third for the strongest international collaborations. Iran and Pakistan are also emerging as major producers of research, yet publications out of these countries and India remain disproportionately restricted behind paywalls. Contamination, diarrheal disease, and water resources are the themes that characterize the majority of research on water and health. These findings may be used to accelerate equitable, inclusive research in the realm of water and health, thereby enabling gaps in global drinking water inequalities to be filled.
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Affiliation(s)
- Alexa Bennett
- Global Health, McMaster University, Hamilton, ON, Canada E-mail:
| | | | - Caetano Dorea
- Civil Engineering, University of Victoria, Victoria, BC, Canada
| | - Alexandra Cassivi
- École supérieure d'aménagement du territoire et de développement regional Quebec, Université Laval, Montreal, QC, Canada
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23
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Suprenant MP, Nyankesha E, Moreno-Garcia R, Buj V, Yakubu A, Shafique F, Zaman MH. Assessing the relationship between operationally defined zero-dose communities and access to selected primary healthcare services for children and pregnant women in emergency settings. PLoS One 2023; 18:e0281764. [PMID: 36795706 DOI: 10.1371/journal.pone.0281764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
In this study the authors examine the relationship between "zero-dose" communities and access to healthcare services. This was done by first ensuring the first dose of the Diphtheria Tetanus and Pertussis vaccine was a better measure of zero-dose communities than the measles-containing vaccine. Once ensured, it was used to examine the association with access to primary healthcare services for children and pregnant women in the Democratic Republic of Congo, Afghanistan, and Bangladesh. These services were divided into: a) unscheduled healthcare services such as birth assistance as well as seeking care and treatment for diarrheal diseases and cough/fever episodes and b) other scheduled health services such as antenatal care visits and vitamin A supplementation. Using recent Demographic Health Survey data (2014: Democratic Republic of Congo, 2015: Afghanistan, 2018: Bangladesh), data was analyzed via Chi Squared analysis or Fischer's Exact Test. If significant, a linear regression analysis was performed to examine if the association was linear. While the linear relationship observed between children who had received the first dose of the Diphtheria Tetanus and Pertussis vaccine (the reverse to zero-dose communities) and coverage of other vaccines was expected, the results of the regression analysis depicted an unexpected split in behavior. For scheduled and birth assistance health services, a linear relationship was generally observed. For unscheduled services associated with illness treatments, this was not the case. While it does not appear that the first dose of the Diphtheria Tetanus and Pertussis vaccine can be used to predict (at least in a linear manner) access to some primary (particularly illness treatment) healthcare services in emergency/ humanitarian settings, it can serve as an indirect measure of health services not associated with the treatment of childhood infections such as antenatal care, skilled birth assistance, and to a lesser degree even vitamin A supplementation.
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24
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Nickerson TR, Antonio EN, McNally DP, Toney MF, Ban C, Straub AP. Unlocking the potential of polymeric desalination membranes by understanding molecular-level interactions and transport mechanisms. Chem Sci 2023; 14:751-770. [PMID: 36755730 PMCID: PMC9890600 DOI: 10.1039/d2sc04920a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022] Open
Abstract
Polyamide reverse osmosis (PA-RO) membranes achieve remarkably high water permeability and salt rejection, making them a key technology for addressing water shortages through processes including seawater desalination and wastewater reuse. However, current state-of-the-art membranes suffer from challenges related to inadequate selectivity, fouling, and a poor ability of existing models to predict performance. In this Perspective, we assert that a molecular understanding of the mechanisms that govern selectivity and transport of PA-RO and other polymer membranes is crucial to both guide future membrane development efforts and improve the predictive capability of transport models. We summarize the current understanding of ion, water, and polymer interactions in PA-RO membranes, drawing insights from nanofiltration and ion exchange membranes. Building on this knowledge, we explore how these interactions impact the transport properties of membranes, highlighting assumptions of transport models that warrant further investigation to improve predictive capabilities and elucidate underlying transport mechanisms. We then underscore recent advances in in situ characterization techniques that allow for direct measurements of previously difficult-to-obtain information on hydrated polymer membrane properties, hydrated ion properties, and ion-water-membrane interactions as well as powerful computational and electrochemical methods that facilitate systematic studies of transport phenomena.
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Affiliation(s)
- Trisha R. Nickerson
- Department of Chemical and Biological Engineering, University of Colorado BoulderBoulderCO 80309USA
| | - Emma N. Antonio
- Department of Chemical and Biological Engineering, University of Colorado BoulderBoulderCO 80309USA,Materials Science and Engineering Program, University of Colorado BoulderBoulderCO 80309USA
| | - Dylan P. McNally
- Materials Science and Engineering Program, University of Colorado BoulderBoulderCO 80309USA
| | - Michael F. Toney
- Department of Chemical and Biological Engineering, University of Colorado BoulderBoulderCO 80309USA,Materials Science and Engineering Program, University of Colorado BoulderBoulderCO 80309USA,Renewable and Sustainable Energy Institute, University of Colorado BoulderBoulderCO 80309USA
| | - Chunmei Ban
- Materials Science and Engineering Program, University of Colorado Boulder Boulder CO 80309 USA .,Department of Mechanical Engineering, University of Colorado Boulder Boulder CO 80309 USA
| | - Anthony P. Straub
- Materials Science and Engineering Program, University of Colorado BoulderBoulderCO 80309USA,Department of Civil, Environmental and Architectural Engineering, University of Colorado BoulderBoulderColorado 80309USA
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Lowery CM, Saavedra-Garcia L, Diez-Canseco F, Cárdenas MK, Miranda JJ, Taillie LS. Sugar-sweetened beverage purchases in urban Peru before the implementation of taxation and warning label policies: a baseline study. BMC Public Health 2022; 22:2389. [PMID: 36539775 PMCID: PMC9764463 DOI: 10.1186/s12889-022-14762-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Sugar-sweetened beverage consumption is associated with obesity and chronic disease. In 2018, Peru increased the tax on high-sugar beverages (≥6 g of sugar per 100 mL) from 17 to 25%, yet little is known about pre-existing beverage trends or demographic characteristics associated with purchases in the country. The aim of this study was to explore beverage purchasing trends from 2016 to 2017 and examine variation in purchase volume by sociodemographic characteristics among urban households in Peru. METHODS This study used monthly household purchase data from a panel of 5145 households from January 2016-December 2017 from Kantar WorldPanel Peru. Beverage purchases were categorized by type and tax status under the 2018 regulation (untaxed, lower-sugar taxed, high-sugar taxed). To assess beverage purchasing trends, per-capita volume purchases were regressed on a linear time trend, with month dummies for seasonality and clustered standard errors. Mean volume purchases by beverage tax status (total liters purchased per month), overall and by key demographic characteristics (education, socioeconomic status, and geographic region), were calculated. Mean volume by beverage type was assessed to identify the largest contributors to total beverage volume. RESULTS The trends analysis showed a decline in total beverage volume of - 52 mL/capita/month (95% CI: - 72, - 32) during the 24-month study period. Over 99% of households purchased untaxed beverages in a month, while > 92% purchased high-sugar taxed beverages. Less than half of all households purchased low-sugar taxed beverages in a month and purchase volume was low (0.3 L/capita/month). Untaxed beverage purchases averaged 9.4 L/capita/month, while households purchased 2.8 L/capita/month of high-sugar taxed beverages in 2017. Across tax categories, volume purchases were largest in the high education and high socioeconomic (SES) groups, with substantial variation by geographic region. The highest volume taxed beverage was soda (2.3 L/capita/month), while the highest volume untaxed beverages were milk and bottled water (1.9 and 1.7 L/capita/month, respectively). CONCLUSIONS Nearly all households purchased high-sugar taxed beverages, although volume purchases of taxed and untaxed beverages declined slightly from 2016 to 2017. Households with high SES and high education purchased the highest volume of taxed beverages, highlighting the need to consider possible differential impacts of the tax policy change by sub-population groups.
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Affiliation(s)
- Caitlin M Lowery
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lorena Saavedra-Garcia
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Francisco Diez-Canseco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María Kathia Cárdenas
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia
| | - Lindsey Smith Taillie
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 123 W Franklin St, Ste 2107, Chapel Hill, NC, 27516, USA.
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Darin E, Kuepie M, Bassinga H, Boo G, Tatem AJ. La population vue du ciel : quand l’imagerie satellite vient au secours du recensement. Population 2022. [DOI: 10.3917/popu.2203.0467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Mkupete MJ, Von Fintel D, Burger R. Decomposing inequality of opportunity in child health in Tanzania: The role of access to water and sanitation. Health Econ 2022; 31:2465-2480. [PMID: 35997640 PMCID: PMC9805148 DOI: 10.1002/hec.4591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 08/05/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Poor child nutrition is a major public health challenge in Tanzania. Large between and within regional nutritional inequalities exist in rural and urban areas. We looked at how locational circumstances hinder children from having an equal opportunity for good nutrition. We used the 2008/09 Living Standards Measurement Study data for Tanzania to identify the part played by water and sanitation in rural and urban inequality of opportunity in child nutrition. We used the dissimilarity index and the Shapley decomposition technique to quantify and decompose inequality of opportunity in nutrition. We find that 16% of the circumstance-driven inequality of opportunity needs to be redistributed for equality of opportunity to prevail. We find that in rural areas, about 42% of the inequality of opportunity in nutrition is due to water and sanitation problems and 22% to child age. In urban areas, we find that the inequality of opportunity is related mainly to the child's sex, price fluctuations and intergenerational factors. The findings suggest that policies to improve water and sanitation coverage could help equalize opportunities for children in rural areas. In urban areas, policies that could help equalize opportunities require incentives to change social norms and behavior around feeding practices and vaccination.
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Affiliation(s)
- Mkupete Jaah Mkupete
- University of Dar es SalaamDar es SalaamTanzania
- Stellenbosch UniversityStellenboschSouth Africa
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Hassan R, Cano J, Fronterre C, Bakhiet S, Fahal A, Deribe K, Newport M. Estimating the burden of mycetoma in Sudan for the period 1991-2018 using a model-based geostatistical approach. PLoS Negl Trop Dis 2022; 16:e0010795. [PMID: 36240229 PMCID: PMC9604875 DOI: 10.1371/journal.pntd.0010795] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 10/26/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022] Open
Abstract
Mycetoma is widespread in tropical and subtropical regions favouring arid areas with low humidity and a short rainy season. Sudan is one of the highly endemic countries for mycetoma. Estimating the population at risk and the number of cases is critical for delivering targeted and equitable prevention and treatment services. In this study, we have combined a large dataset of mycetoma cases recorded by the Mycetoma Research Centre (MRC) in Sudan over 28 years (1991-2018) with a collection of environmental and water and hygiene-related datasets in a geostatistical framework to produce estimates of the disease burden across the country. We developed geostatistical models to predict the number of cases of actinomycetoma and eumycetoma in areas considered environmentally suitable for the two mycetoma forms. Then used the raster dataset (gridded map) with the population estimates for 2020 to compute the potentially affected population since 1991. The geostatistical models confirmed this heterogeneous and distinct distribution of the estimated cases of eumycetoma and actinomycetoma across Sudan. For eumycetoma, these higher-risk areas were smaller and scattered across Al Jazirah, Khartoum, White Nile and Sennar states, while for actinomycetoma a higher risk for infection is shown across the rural districts of North and West Kurdufan. Nationally, we estimated 63,825 people (95%CI: 13,693 to 197,369) to have been suffering from mycetoma since 1991 in Sudan,51,541 people (95%CI: 9,893-166,073) with eumycetoma and 12,284 people (95%CI: 3,800-31,296) with actinomycetoma. In conclusion, the risk of mycetoma in Sudan is particularly high in certain restricted areas, but cases are ubiquitous across all states. Both prevention and treatment services are required to address the burden. Such work provides a guide for future control and prevention programs for mycetoma, highly endemic areas are clearly targeted, and resources are directed to areas with high demand.
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Affiliation(s)
- Rowa Hassan
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum, Sudan
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, United Kingdom
- * E-mail: ,
| | - Jorge Cano
- Expanded Special Project for Elimination of Neglected Tropical Diseases, WHO Regional Office for Africa, Brazzaville, Democratic Republic of the Congo
| | - Claudio Fronterre
- Centre for health informatics, computing, and statistics, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Sahar Bakhiet
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum, Sudan
| | - Ahmed Fahal
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum, Sudan
| | - Kebede Deribe
- Children’s Investment Fund Foundation, Addis Ababa, Ethiopia
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Melanie Newport
- Centre for health informatics, computing, and statistics, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
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Kim S, Cha S, Jin Y. Association between Official Development Assistance for Water and Sanitation and Countries' Needs from 2002 to 2019. Int J Environ Res Public Health 2022; 19:11134. [PMID: 36078845 PMCID: PMC9518171 DOI: 10.3390/ijerph191711134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/22/2022] [Accepted: 09/02/2022] [Indexed: 06/15/2023]
Abstract
Although an enormous amount of aid has been invested in water and sanitation, few studies have analyzed the criteria used by the international community to select recipient countries and allocate official development assistance (ODA). We examined whether ODA has been allocated in proportion to water and sanitation needs and whether this has improved over the past 18 years. For water, 141 low- and middle-income countries (LMICs) and least-developed countries (LDCs) were selected, whereas 104 LMICs and LDCs were chosen for sanitation due to a lack of data. For aid disbursement, we used ODA data from the Organization for Economic Cooperation and Developments (OECD) Creditor Reporting System (CRS) from 2002 to 2019. OECD CRS data on water and sanitation are available from 2002 onward. For water and sanitation coverage, we collected data from the WHO/UNICEF Joint Monitoring Program from 2002 to 2019. We examined annual ODA trends and performed linear regression analysis adjusted for GNI per capita using log-transformed dependent variables. Neither total ODA nor ODA per capita was found to be associated with countries' needs for water and sanitation. For instance, no significant association was detected between at least basic water and sanitation coverage and total ODA per capita in 2019 (log coefficient: 0.002, p = 0.52). The global community needs to determine the reasons for and means of addressing this discrepancy.
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Affiliation(s)
- Sumin Kim
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang 37554, Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Korea
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Seungman Cha
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang 37554, Korea
| | - Yan Jin
- Department of Microbiology, Dongguk University College of Medicine, Gyeongju 38066, Korea
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Were FN, Jere KC, Armah GE, Mphahlele MJ, Mwenda JM, Steele AD. Maintaining Momentum for Rotavirus Immunization in Africa during the COVID-19 Era: Report of the 13th African Rotavirus Symposium. Vaccines (Basel) 2022; 10:vaccines10091463. [PMID: 36146541 PMCID: PMC9503285 DOI: 10.3390/vaccines10091463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
The 13th African Rotavirus Symposium was held as a virtual event hosted by the University of Nairobi, Kenya and The Kenya Paediatric Association on 3rd and 4th November 2021. This biennial event organized under the auspices of the African Rotavirus Network shapes the agenda for rotavirus research and prevention on the continent, attracting key international and regional opinion leaders, researchers, and public health scientists. The African Rotavirus Network is a regional network of institutions initially established in 1999, and now encompassing much of the diarrheal disease and rotavirus related research in Africa, in collaboration with the World Health Organization African Regional Office (WHO-AFRO), Ministries of Health, and other partners. Surges in SARS-CoV2 variants and concomitant travel restrictions limited the meeting to a webinar platform with invited scientific presentations and scientific presentations from selected abstracts. The scientific program covered updates on burden of diarrheal diseases including rotavirus, the genomic characterization of rotavirus strains pre- and post-rotavirus vaccine introduction, and data from clinical evaluation of new rotavirus vaccines in Africa. Finally, 42 of the 54 African countries have fully introduced rotavirus vaccination at the time of the meeting, including the two recently WHO pre-qualified vaccines from India. Nonetheless, the full benefit of rotavirus vaccination is yet to be realized in Africa where approximately 80% of the global burden of rotavirus mortality exists.
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Affiliation(s)
- Frederick N. Were
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi 00625, Kenya
- Kenya Paediatric Association, Nairobi 00100, Kenya
| | - Khuzwayo C. Jere
- Malawi-Liverpool-Wellcome Trust Clinical Research Program, Kamuzu University of Health Sciences, Blantyre 312225, Malawi
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 7BE, UK
| | - George E. Armah
- Noguchi Memorial Institute of Medical Research, University of Ghana, Legon, Accra LG 581, Ghana
| | | | - Jason M. Mwenda
- WHO Regional Office for Africa, Brazzaville P.O. Box 2465, Congo
| | - A. Duncan Steele
- Department of Virology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
- Correspondence: ; Tel.: +1-(206)-915-3677
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Zheng Q, Luquero FJ, Ciglenecki I, Wamala JF, Abubakar A, Welo P, Hussen M, Wossen M, Yennan S, Keita A, Lessler J, Azman AS, Lee EC. Cholera outbreaks in sub-Saharan Africa during 2010-2019: a descriptive analysis. Int J Infect Dis 2022; 122:215-221. [PMID: 35605949 PMCID: PMC9439956 DOI: 10.1016/j.ijid.2022.05.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Cholera remains a public health threat but is inequitably distributed across sub-Saharan Africa. Lack of standardized reporting and inconsistent outbreak definitions limit our understanding of cholera outbreak epidemiology. METHODS From a database of cholera incidence and mortality, we extracted data from sub-Saharan Africa and reconstructed outbreaks of suspected cholera starting in January 2010 to December 2019 based on location-specific average weekly incidence rate thresholds. We then described the distribution of key outbreak metrics. RESULTS We identified 999 suspected cholera outbreaks in 744 regions across 25 sub-Saharan African countries. The outbreak periods accounted for 1.8 billion person-months (2% of the total during this period) from January 2010 to January 2020. Among 692 outbreaks reported from second-level administrative units (e.g., districts), the median attack rate was 0.8 per 1000 people (interquartile range (IQR), 0.3-2.4 per 1000), the median epidemic duration was 13 weeks (IQR, 8-19), and the median early outbreak reproductive number was 1.8 (range, 1.1-3.5). Larger attack rates were associated with longer times to outbreak peak, longer epidemic durations, and lower case fatality risks. CONCLUSIONS This study provides a baseline from which the progress toward cholera control and essential statistics to inform outbreak management in sub-Saharan Africa can be monitored.
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Affiliation(s)
- Qulu Zheng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Francisco J Luquero
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Global Alliance for Vaccines and Immunization (GAVI), Geneva, Switzerland
| | | | | | | | - Placide Welo
- PNECHOL-MD, Community IMCI, Ministry of Health, Democratic Republic of the Congo
| | - Mukemil Hussen
- Disease and Health Events Surveillance and Response Directorate, Ethiopia Public Health Institute, Addis Ababa, Ethiopia
| | - Mesfin Wossen
- Disease and Health Events Surveillance and Response Directorate, Ethiopia Public Health Institute, Addis Ababa, Ethiopia
| | - Sebastian Yennan
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Alama Keita
- Regional Office for West & Central Africa, UNICEF, Dakar, Senegal
| | - Justin Lessler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Corresponding author
| | - Andrew S Azman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Corresponding author
| | - Elizabeth C Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Corresponding author
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Tetteh JD, Templeton MR, Cavanaugh A, Bixby H, Owusu G, Yidana SM, Moulds S, Robinson B, Baumgartner J, Annim SK, Quartey R, Mintah SE, Bawah AA, Arku RE, Ezzati M, Agyei-Mensah S. Spatial heterogeneity in drinking water sources in the Greater Accra Metropolitan Area (GAMA), Ghana. Popul Environ 2022; 44:46-76. [PMID: 35974746 PMCID: PMC9371963 DOI: 10.1007/s11111-022-00407-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
Universal access to safe drinking water is essential to population health and well-being, as recognized in the Sustainable Development Goals (SDG). To develop targeted policies which improve urban access to improved water and ensure equity, there is the need to understand the spatial heterogeneity in drinking water sources and the factors underlying these patterns. Using the Shannon Entropy Index and the Index of Concentration at the Extremes at the enumeration area level, we analyzed census data to examine the spatial heterogeneity in drinking water sources and neighborhood income in the Greater Accra Metropolitan Area (GAMA), the largest urban agglomeration in Ghana. GAMA has been a laboratory for studying urban growth, economic security, and other concomitant socio-environmental and demographic issues in the recent past. The current study adds to this literature by telling a different story about the spatial heterogeneity of GAMA's water landscape at the enumeration area level. The findings of the study reveal considerable geographical heterogeneity and inequality in drinking water sources not evidenced in previous studies. We conclude that heterogeneity is neither good nor bad in GAMA judging by the dominance of both piped water sources and sachet water (machine-sealed 500-ml plastic bag of drinking water). The lessons from this study can be used to inform the planning of appropriate localized solutions targeted at providing piped water sources in neighborhoods lacking these services and to monitor progress in achieving universal access to improved drinking water as recognized in the SDG 6 and improving population health and well-being.
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Affiliation(s)
- Jacob Doku Tetteh
- Department of Geography and Resource Development, University of Ghana, P.O. Box LG 59, Legon-Accra, Ghana
| | - Michael R. Templeton
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | | | - Honor Bixby
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - George Owusu
- Institute of Statistical Social and Economic Research, University of Ghana, Accra, Ghana
| | | | - Simon Moulds
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Brian Robinson
- Department of Geography, McGill University, Montreal, Canada
| | - Jill Baumgartner
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | | | | | | | - Ayaga Agula Bawah
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | - Raphael E. Arku
- Department of Environmental Health Sciences, University of Massachusetts Amherst, Amherst, USA
| | - Majid Ezzati
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Samuel Agyei-Mensah
- Department of Geography and Resource Development, University of Ghana, P.O. Box LG 59, Legon-Accra, Ghana
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Prakash S, Kumar P, Dhillon P, Unisa S. Correlates of access to sanitation facilities and benefits received from the Swachh Bharat Mission in India: analysis of cross-sectional data from the 2018 National Sample Survey. BMJ Open 2022; 12:e060118. [PMID: 35906052 PMCID: PMC9345042 DOI: 10.1136/bmjopen-2021-060118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Equitable and affordable access to improved sanitation facilities is linked to health and is among the priority areas of development programmes in a country like India. This study assesses the level of different sanitation facilities accessed by households and attempts to understand the socioeconomic characteristics of the households that received financial benefits from the Swachh Bharat Mission (Swachh Bharat Abhiyan), a Government of India flagship programme. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS The study extracted data from the 76th round (2018) of the National Sample Survey, consisting of 106 837 households in India. OUTCOME MEASURES Sanitation services and benefits received from the Swachh Bharat Mission in the last 3 years preceding the survey were the two outcome variables of this study. Bivariate and multinomial logistic regression analysis were performed to identify factors associated with the outcome variables. RESULTS Findings show the existence of state and regional disparities, along with rural-urban gaps, in the accessibility of sanitation facilities. Half of the households (52%, n=55 555) had access to safely managed sanitation facilities, followed by basic services (14.8%, n=15 812), limited services (11.4%, n=12 179) and unimproved services/open defecation (21.8%, n=23 290). Limited and unimproved facilities decreased significantly (p<0.001) with increase in economic status, although poor and less educated households received the maximum benefit from the Swachh Bharat Mission. CONCLUSION The mission has been successful in increasing access overall; however, many people continue to lack access to improved sanitation and there remains a need to follow up poor and rural households to determine their usage of and the current state of their sanitation facilities.
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Affiliation(s)
- Srayasi Prakash
- Indian Institute of Health Management Research, Jaipur, Rajasthan, India
| | - Pradeep Kumar
- Department of Survey Research and Data Analytics, International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, India
| | - Preeti Dhillon
- Department of Survey Research and Data Analytics, International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, India
| | - Sayeed Unisa
- Department of Survey Research and Data Analytics, International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, India
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Oppong FB, Boateng D, Senkyire EK, Logo DD. Demographic disparities in unimproved drinking water and sanitation in Ghana: a nationally representative cross-sectional study. BMJ Open 2022; 12:e060595. [PMID: 35863842 PMCID: PMC9310154 DOI: 10.1136/bmjopen-2021-060595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The government of Ghana has targeted universal access to safe drinking water by 2025 and elimination of open defecation by year 2030. This study explored the use of unimproved drinking water and unimproved sanitation and assessed their association with demographic factors. DESIGN This was a secondary data analysis of the 2017 Ghana Maternal Health Survey, a nationally representative cross-sectional survey. Open defecation households were mapped to show regional differences. Weighted logistic regression was used to assess the association of demographic variables with use of unimproved drinking water and unimproved toilet facilities. SETTING Ghana. PARTICIPANTS A total of 26 324 households were included in the analysis. PRIMARY AND SECONDARY OUTCOME MEASURES Use of unimproved drinking water and unimproved toilet facilities. RESULTS Out of the 26 324 households, 8.9% used unimproved drinking water while 81.6% used unimproved sanitation. Open defecation was practised by 15.2% of Ghanaian households, with a prevalence of 58.8%, 6.7% and 12.5% in the Northern, Middle and Coastal zones, respectively. In the multivariate analysis, rural households (p<0.001), households with more than five members (p<0.001), households with heads less than 25 years (p=0.018), male-headed households (p<0.001) and household heads with no/low level of education (p<0.001) were significantly associated with drinking unimproved water. Also, rural households (p=0.002), households in the Northern zone (p<0.001), single-member households (p<0.001), households with heads less than 25 years (p<0.001) and household heads with no/low level of education (p<0.001) were significantly associated with using unimproved toilet facilities. CONCLUSION The target of universal access to safe drinking water by 2025 and elimination of open defecation by 2030 seems impossible to be achieved if appropriate measures are not implemented. We recommend that state authorities, health partners and non-governmental organisations support local-level sanitation plans and strategies.
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Keddy KH, Saha S, Kariuki S, Kalule JB, Qamar FN, Haq Z, Okeke IN. Using big data and mobile health to manage diarrhoeal disease in children in low-income and middle-income countries: societal barriers and ethical implications. The Lancet Infectious Diseases 2022; 22:e130-e142. [DOI: 10.1016/s1473-3099(21)00585-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 08/23/2021] [Accepted: 08/31/2021] [Indexed: 12/28/2022]
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Abstract
Cholera was first described in the areas around the Bay of Bengal and spread globally, resulting in seven pandemics during the past two centuries. It is caused by toxigenic Vibrio cholerae O1 or O139 bacteria. Cholera is characterised by mild to potentially fatal acute watery diarrhoeal disease. Prompt rehydration therapy is the cornerstone of management. We present an overview of cholera and its pathogenesis, natural history, bacteriology, and epidemiology, while highlighting advances over the past 10 years in molecular epidemiology, immunology, and vaccine development and deployment. Since 2014, the Global Task Force on Cholera Control, a WHO coordinated network of partners, has been working with several countries to develop national cholera control strategies. The global roadmap for cholera control focuses on stopping transmission in cholera hotspots through vaccination and improved water, sanitation, and hygiene, with the aim to reduce cholera deaths by 90% and eliminate local transmission in at least 20 countries by 2030.
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Affiliation(s)
- Suman Kanungo
- National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Andrew S Azman
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA; Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | - Jaqueline Deen
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines-Manila, Manila, Philippines
| | - Shanta Dutta
- National Institute of Cholera and Enteric Diseases, Kolkata, India.
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Davis A, Lembo T, Laurie E, Mutua E, Loosli K, Nthambi M, Nimegeer A, Mnzava K, Msoka EF, Nasuwa F, Melubo M, Shirima G, Matthews L, Hilton S, Mshana SE, Mmbaga BT. How public health crises expose systemic, day-to-day health inequalities in low- and-middle income countries: an example from East Africa. Antimicrob Resist Infect Control 2022; 11:34. [PMID: 35164886 PMCID: PMC8842514 DOI: 10.1186/s13756-022-01071-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 01/23/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The current Coronavirus disease pandemic reveals political and structural inequities of the world's poorest people who have little or no access to health care and yet the largest burdens of poor health. This is in parallel to a more persistent but silent global health crisis, antimicrobial resistance (AMR). We explore the fundamental challenges of health care in humans and animals in relation to AMR in Tanzania. METHODS We conducted 57 individual interviews and focus groups with providers and patients in high, middle and lower tier health care facilities and communities across three regions of Tanzania between April 2019 and February 2020. We covered topics from health infrastructure and prescribing practices to health communication and patient experiences. RESULTS Three interconnected themes emerged about systemic issues impacting health. First, there are challenges around infrastructure and availability of vital resources such as healthcare staff and supplies. Second, health outcomes are predicated on patient and provider access to services as well as social determinants of health. Third, health communication is critical in defining trusted sources of information, and narratives of blame emerge around health outcomes with the onus of responsibility for action falling on individuals. CONCLUSION Entanglements between infrastructure, access and communication exist while constraints in the health system lead to poor health outcomes even in 'normal' circumstances. These are likely to be relevant across the globe and highly topical for addressing pressing global health challenges. Redressing structural health inequities can better equip countries and their citizens to not only face pandemics but also day-to-day health challenges.
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Affiliation(s)
- Alicia Davis
- School of Social and Political Sciences/Institute of Health and Wellbeing, University of Glasgow, 27 Bute Gardens-Rm 221, Glasgow, G12 8RS, UK.
| | - Tiziana Lembo
- The Boyd Orr Centre for Population & Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Emma Laurie
- School of Geographical and Earth Sciences, University of Glasgow, Glasgow, UK
| | - Edna Mutua
- School of Social and Political Sciences/Institute of Health and Wellbeing, University of Glasgow, 27 Bute Gardens-Rm 221, Glasgow, G12 8RS, UK
| | - Kathrin Loosli
- The Boyd Orr Centre for Population & Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Mary Nthambi
- The Boyd Orr Centre for Population & Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Amy Nimegeer
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Kunda Mnzava
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences/Bugando Medical Centre, Mwanza, Tanzania
| | - Elizabeth F Msoka
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Fortunata Nasuwa
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Matayo Melubo
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Gabriel Shirima
- Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Louise Matthews
- The Boyd Orr Centre for Population & Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Shona Hilton
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences/Bugando Medical Centre, Mwanza, Tanzania
| | - Blandina T Mmbaga
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Mogaji HO, Johnson OO, Adigun AB, Adekunle ON, Bankole S, Dedeke GA, Bada BS, Ekpo UF. Estimating the population at risk with soil transmitted helminthiasis and annual drug requirements for preventive chemotherapy in Ogun State, Nigeria. Sci Rep 2022; 12:2027. [PMID: 35132144 DOI: 10.1038/s41598-022-06012-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/19/2022] [Indexed: 11/08/2022] Open
Abstract
Soil transmitted helminth (STH) infections are among the most common human infections worldwide with over 1 billion people affected. Many estimates of STH infection are often based on school-aged children (SAC). This study produced predictive risk-maps of STH on a more finite scale, estimated the number of people infected, and the amount of drug required for preventive chemotherapy (PC) in Ogun state, Nigeria. Georeferenced STH infection data obtained from a cross-sectional survey at 33 locations between July 2016 and November 2018, together with remotely-sensed environmental and socio-economic data were analyzed using Bayesian geostatistical modelling. Stepwise variable selection procedure was employed to select a parsimonious set of predictors to predict risk and spatial distribution of STH infections. The number of persons (pre-school ages children, SAC and adults) infected with STH were estimated, with the amount of tablets needed for preventive chemotherapy. An overall prevalence of 17.2% (95% CI 14.9, 19.5) was recorded for any STH infection. Ascaris lumbricoides infections was the most predominant, with an overall prevalence of 13.6% (95% CI 11.5, 15.7), while Hookworm and Trichuris trichiura had overall prevalence of 4.6% (95% CI 3.3, 5.9) and 1.7% (95% CI 0.9, 2.4), respectively. The model-based prevalence predictions ranged from 5.0 to 23.8% for Ascaris lumbricoides, from 2.0 to 14.5% for hookworms, and from 0.1 to 5.7% for Trichuris trichiura across the implementation units. The predictive maps revealed a spatial pattern of high risk in the central, western and on the border of Republic of Benin. The model identified soil pH, soil moisture and elevation as the main predictors of infection for A. lumbricoides, Hookworms and T. trichiura respectively. About 50% (10/20) of the implementation units require biannual rounds of mass drug administration. Approximately, a total of 1.1 million persons were infected and require 7.8 million doses. However, a sub-total of 375,374 SAC were estimated to be infected, requiring 2.7 million doses. Our predictive risk maps and estimated PC needs provide useful information for the elimination of STH, either for resource acquisition or identifying priority areas for delivery of interventions in Ogun State, Nigeria.
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Cooper LV, Bandyopadhyay AS, Gumede N, Mach O, Mkanda P, Ndoutabé M, Okiror SO, Ramirez-Gonzalez A, Touray K, Wanyoike S, Grassly NC, Blake IM. Risk factors for the spread of vaccine-derived type 2 polioviruses after global withdrawal of trivalent oral poliovirus vaccine and the effects of outbreak responses with monovalent vaccine: a retrospective analysis of surveillance data for 51 countries in Africa. Lancet Infect Dis 2022; 22:284-294. [PMID: 34648733 PMCID: PMC8799632 DOI: 10.1016/s1473-3099(21)00453-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/07/2021] [Accepted: 07/20/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Expanding outbreaks of circulating vaccine-derived type 2 poliovirus (cVDPV2) across Africa after the global withdrawal of trivalent oral poliovirus vaccine (OPV) in 2016 are delaying global polio eradication. We aimed to assess the effect of outbreak response campaigns with monovalent type 2 OPV (mOPV2) and the addition of inactivated poliovirus vaccine (IPV) to routine immunisation. METHODS We used vaccination history data from children under 5 years old with non-polio acute flaccid paralysis from a routine surveillance database (the Polio Information System) and setting-specific OPV immunogenicity data from the literature to estimate OPV-induced and IPV-induced population immunity against type 2 poliomyelitis between Jan 1, 2015, and June 30, 2020, for 51 countries in Africa. We investigated risk factors for reported cVDPV2 poliomyelitis including population immunity, outbreak response activities, and correlates of poliovirus transmission using logistic regression. We used the model to estimate cVDPV2 risk for each 6-month period between Jan 1, 2016, and June 30, 2020, with different numbers of mOPV2 campaigns and compared the timing and location of actual mOPV2 campaigns and the number of mOPV2 campaigns required to reduce cVDPV2 risk to low levels. FINDINGS Type 2 OPV immunity among children under 5 years declined from a median of 87% (IQR 81-93) in January-June, 2016 to 14% (9-37) in January-June, 2020. Type 2 immunity from IPV among children under 5 years increased from 3% (<1-6%) in January-June, 2016 to 35% (24-47) in January-June, 2020. The probability of cVDPV2 poliomyelitis among children under 5 years was negatively correlated with OPV-induced and IPV-induced immunity and mOPV2 campaigns (adjusted odds ratio: OPV 0·68 [95% CrI 0·60-0·76], IPV 0·82 [0·68-0·99] per 10% absolute increase in estimated population immunity, mOPV2 0·30 [0·20-0·44] per campaign). Vaccination campaigns in response to cVDPV2 outbreaks have been smaller and slower than our model shows would be necessary to reduce risk to low levels, covering only 11% of children under 5 years who are predicted to be at risk within 6 months and only 56% within 12 months. INTERPRETATION Our findings suggest that as mucosal immunity declines, larger or faster responses with vaccination campaigns using type 2-containing OPV will be required to stop cVDPV2 transmission. IPV-induced immunity also has an important role in reducing the burden of cVDPV2 poliomyelitis in Africa. FUNDING Bill & Melinda Gates Foundation, Medical Research Council Centre for Global Infectious Disease Analysis, and WHO. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Laura V Cooper
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK,Correspondence to: Dr Laura V Cooper, Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London W2 1PG, UK
| | | | - Nicksy Gumede
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Ondrej Mach
- Polio Eradication Department, World Health Organization, Geneva, Switzerland
| | - Pascal Mkanda
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Modjirom Ndoutabé
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Samuel O Okiror
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Alejandro Ramirez-Gonzalez
- Expanded Programme on Immunization, Vaccines, and Biologicals Department, World Health Organization, Geneva, Switzerland
| | - Kebba Touray
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Sarah Wanyoike
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Nicholas C Grassly
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Isobel M Blake
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
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Eliakimu ES, Mans L. Addressing Inequalities Toward Inclusive Governance for Achieving One Health: A Rapid Review. Front Public Health 2022; 9:755285. [PMID: 35127612 PMCID: PMC8811029 DOI: 10.3389/fpubh.2021.755285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 12/27/2021] [Indexed: 12/03/2022] Open
Abstract
Sustainable development goals (SDGs) adopted in 2015 are geared toward sustainable development through various pathways, one being reducing inequality as covered in SDG 10. Inequalities are a threat to health and wellbeing of populations and a planet Earth in which we live. This rapid review aims to identify key issues that are likely to exacerbate inequalities around the six SDGs directly related to One Health, which are SDG 3, 6, 11, 13, 14 and 15, and suggest some actions that may help to address them using inclusive governance taking into account the coronavirus disease of 2019 (COVID-19) pandemic. Informed by the literature on SDGs and using the “inclusive development concept” by Gupta and Vegelin, literature search was done in Google Scholar, PubMed Central, as well as, searching of references in the relevant articles identified using search terms from the six SDGs that are directly related to One Health. In the context of the SDGs, in order to achieve One Health through inclusive governance, and tackle inequalities, the following needs to be considered and addressed: increasing number of armed conflicts; ongoing COVID-19 pandemic; ensuring availability of water and sanitation facilities; improving city and urban areas planning to cope with climate change; improving governance arrangements for addressing climate change factoring gender and human rights; multisectoral planning for conservation of oceans, seas, and marine resources; balancing trade regulation of wildlife trade with conservation efforts; need for a research collaborative involving experts from environmental sciences, wildlife, agriculture and human health to study and develop scientific evidence on contribution of changes in land use practices to occurrence of zoonotic diseases; and need of a legislation for promoting animal welfare to protect public health. Also, inclusion of people with disabilities in the use of digital technologies is critical.
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Affiliation(s)
- Eliudi S. Eliakimu
- Health Quality Assurance Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
- *Correspondence: Eliudi S. Eliakimu ;
| | - Linda Mans
- An Independent Consultant and Researcher in Support of Healthy People and a Healthy Planet, Manskracht, Nijmegen, Netherlands
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Ahmed MS, Islam MI, Das MC, Khan A, Yunus FM. Mapping and situation analysis of basic WASH facilities at households in Bangladesh: Evidence from a nationally representative survey. PLoS One 2021; 16:e0259635. [PMID: 34735535 PMCID: PMC8568162 DOI: 10.1371/journal.pone.0259635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 10/22/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Ensuring water, sanitation, and hygiene (WASH) facilities for households remains a major public health concern in low- and middle-income countries (LMICs). This study investigated the current situation of basic WASH facilities for households in Bangladesh and drew a national coverage map. METHODS We analyzed the publicly available nationally representative 2019 Multiple Indicator Cluster Survey (MICS) dataset that was carried out by the Bangladesh Bureau of Statistics (BBS) with support from the United Nations Children's Emergency Fund (UNICEF). A total of 61,209 households (weighted) were included in the analysis. Both bivariate and multivariate analyses were employed to examine the relationships between independent variables (socio-demographic and economic status) and their distributions over outcome variables (basic water, sanitation, and hygiene). Further, the spatial distribution of WASH facilities at the household level was depicted. RESULTS Coverage of access to basic water facilities at the household level was 99.5% (95% CI 99.4% to 99.6%), sanitation 60.7% (95% CI 60.0% to 61.5%), and hygiene 56.3% (95% CI 55.6% to 57.0%). However, coverage of combined access to all three components was 40.2% (95% CI 39.4% to 40.9%). Among all 64 administrative districts of Bangladesh, we found comparatively lower coverage of WASH facilities in the South and South-East regions and relatively higher in the households of the North and North-Western regions. An adjusted regression model revealed that richest households [AOR = 29.64, 95% CI 26.31 to 33.39], households in the rural areas [AOR = 1.64, 95% CI 1.50 to 1.79], household heads with higher educational attainment [AOR = 2.28, 95% CI 2.09 to 2.49], and households with 5+ family members [AOR = 1.64, 95% CI 1.56 to 1.71] had the higher likelihood to have basic WASH facilities. CONCLUSION Less than half of the Bangladeshi households had access to all three major WASH components (basic water, sanitation, and hygiene facilities); however, variation exists at the individual parameter of basic water, sanitation, and hygiene facilities. A comprehensive WASH approach may reduce the gap and improve the quality of WASH facilities in Bangladesh.
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Affiliation(s)
- Md. Sabbir Ahmed
- Faculty of Nutrition and Food Science, Department of Community Health and Hygiene, Patuakhali Science and Technology University, Patuakhali, Bangladesh
- * E-mail:
| | - Md Irteja Islam
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Camperdown, Sydney, NSW, Australia
- Centre for Health Research and School of Commerce, The University of Southern Queensland, Toowoomba, Queensland, Australia
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Mohakhali, Dhaka, Bangladesh
| | - Manik Chandra Das
- School of Public Health and Life Sciences, University of South Asia, Dhaka, Bangladesh
| | - Arifuzzaman Khan
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- School of Public Health, The University of Queensland, Herston, QLD, Australia
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Australia
| | - Fakir Md Yunus
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
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Lord J, Thomas A, Treat N, Forkin M, Bain R, Dulac P, Behroozi CH, Mamutov T, Fongheiser J, Kobilansky N, Washburn S, Truesdell C, Lee C, Schmaelzle PH. Global potential for harvesting drinking water from air using solar energy. Nature 2021; 598:611-617. [PMID: 34707305 PMCID: PMC8550973 DOI: 10.1038/s41586-021-03900-w] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/11/2021] [Indexed: 11/09/2022]
Abstract
Access to safely managed drinking water (SMDW) remains a global challenge, and affects 2.2 billion people1,2. Solar-driven atmospheric water harvesting (AWH) devices with continuous cycling may accelerate progress by enabling decentralized extraction of water from air3-6, but low specific yields (SY) and low daytime relative humidity (RH) have raised questions about their performance (in litres of water output per day)7-11. However, to our knowledge, no analysis has mapped the global potential of AWH12 despite favourable conditions in tropical regions, where two-thirds of people without SMDW live2. Here we show that AWH could provide SMDW for a billion people. Our assessment-using Google Earth Engine13-introduces a hypothetical 1-metre-square device with a SY profile of 0.2 to 2.5 litres per kilowatt-hour (0.1 to 1.25 litres per kilowatt-hour for a 2-metre-square device) at 30% to 90% RH, respectively. Such a device could meet a target average daily drinking water requirement of 5 litres per day per person14. We plot the impact potential of existing devices and new sorbent classes, which suggests that these targets could be met with continued technological development, and well within thermodynamic limits. Indeed, these performance targets have been achieved experimentally in demonstrations of sorbent materials15-17. Our tools can inform design trade-offs for atmospheric water harvesting devices that maximize global impact, alongside ongoing efforts to meet Sustainable Development Goals (SDGs) with existing technologies.
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Affiliation(s)
- Jackson Lord
- X, The Moonshot Factory, Mountain View, CA, USA.
| | | | - Neil Treat
- X, The Moonshot Factory, Mountain View, CA, USA
| | | | - Robert Bain
- WHO/UNICEF Joint Monitoring Programme, Division of Data, Analytics, Planning and Monitoring, UNICEF, New York, NY, USA
| | | | | | | | | | | | | | | | - Clare Lee
- X, The Moonshot Factory, Mountain View, CA, USA
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Kmush BL, Walia B, Neupane A, Frances C, Mohamed IA, Iqbal M, Larsen DA. Community-level impacts of sanitation coverage on maternal and neonatal health: a retrospective cohort of survey data. BMJ Glob Health 2021; 6:bmjgh-2021-005674. [PMID: 34625456 PMCID: PMC8504178 DOI: 10.1136/bmjgh-2021-005674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/27/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Access to sanitation facilities (toilets or latrines) greatly improves human health. Low community sanitation coverage may lead to increased exposure to pathogens for households both with and without a sanitation facility. Methods We created a retrospective cohort using Demographic and Health Surveys from 1990 through 2018. Using regression with matched women as a random intercept, we assessed the association between community-level sanitation coverage and neonatal mortality (Poisson model, n=1 254 862 live births, 187 datasets), small birth size (logit model, n=1 058 843 live births, 187 datasets) and anaemia (logit model, n=1 304 626 women, 75 datasets). Results Among women with household sanitation, the incidence of neonatal death (incidence rate ratio: 0.85, 95% CI 0.77 to 0.93), the odds of small birth size (OR: 0.81, 95% CI 0.76 to 0.87) and anaemia (OR: 0.82, 95% CI 0.79 to 0.85) were lower for women in communities with 100% sanitation coverage compared with 1%–30% (p≤0.001 for all). There was no difference in neonatal deaths between women in communities with 31%–99% sanitation coverage compared with 1%–30% (p≥0.05). Among women without household sanitation, there were no differences in neonatal mortality by community sanitation (p≥0.05). The odds of small birth size were decreased (OR: 0.91, 95% CI 0.87 to 0.97, p=0.003) for women in communities with 61%–99% sanitation coverage compared with 1%–30%; there was no association with the other community sanitation categories (p≥0.05). The odds of anaemia were increased (OR: 1.08, 95% CI 1.06 to 1.11, p<0.001) for women living in communities with 0% sanitation coverage compared with 1%–30%, but no association with the other community sanitation categories (p≥0.05). Conclusion Community sanitation coverage is associated with improved maternal and neonatal outcomes, particularly among women with household sanitation. This suggests that the impact of sanitation coverage on maternal and neonatal health is underestimated unless the community-level effects are considered.
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Affiliation(s)
- Brittany L Kmush
- Department of Public Health, Syracuse University, Syracuse, New York, USA
| | - Bhavneet Walia
- Department of Public Health, Syracuse University, Syracuse, New York, USA
| | - Anushruta Neupane
- Department of Public Health, Syracuse University, Syracuse, New York, USA
| | - Carolina Frances
- Department of Public Health, Syracuse University, Syracuse, New York, USA
| | | | - Mahwish Iqbal
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
| | - David A Larsen
- Department of Public Health, Syracuse University, Syracuse, New York, USA
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Oskam MJ, Pavlova M, Hongoro C, Groot W. Socio-Economic Inequalities in Access to Drinking Water among Inhabitants of Informal Settlements in South Africa. Int J Environ Res Public Health 2021; 18:ijerph181910528. [PMID: 34639828 PMCID: PMC8507892 DOI: 10.3390/ijerph181910528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/01/2021] [Accepted: 10/03/2021] [Indexed: 11/28/2022]
Abstract
While evidence from several developing countries suggests the existence of socio-economic inequalities in the access to safe drinking water, a limited number of studies have been conducted on this topic in informal settlements. This study assessed socio-economic inequalities in the use of drinking water among inhabitants of informal settlements in South Africa. The study used data from “The baseline study for future impact evaluation for informal settlements targeted for upgrading in South Africa.” Households eligible for participation were living in informal settlements targeted for upgrading in all nine provinces of South Africa. Socio-economic inequalities were assessed by means of multinomial logistic regression analyses, concentration indices, and concentration curves. The results showed that the use of a piped tap on the property was disproportionately concentrated among households with higher socio-economic status (concentration index: +0.17), while households with lower socio-economic status were often limited to the use of other inferior (less safe or distant) sources of drinking water (concentration index for nearby public tap: −0.21; distant public tap: −0.17; no-tap water: −0.33). The use of inferior types of drinking water was significantly associated with the age, the marital status, the education status, and the employment status of the household head. Our results demonstrate that reducing these inequalities requires installing new tap water points in informal settlements to assure a more equitable distribution of water points among households. Besides, it is recommended to invest in educational interventions aimed at creating awareness about the potential health risks associated with using unsafe drinking water.
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Affiliation(s)
- Marieke J. Oskam
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616 6200MD Maastricht, The Netherlands; (M.P.); (W.G.)
- Correspondence:
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616 6200MD Maastricht, The Netherlands; (M.P.); (W.G.)
| | - Charles Hongoro
- Peace and Sustainable Security (PaSS), Developmental, Capable and Ethical State Division, Human Sciences Research Council, 134 Pretorius Street, Private Bag X41, Pretoria 0001, South Africa;
- School of Health Systems and Public Health, University of Pretoria, Private Bag X323, Pretoria 0001, South Africa
| | - Wim Groot
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616 6200MD Maastricht, The Netherlands; (M.P.); (W.G.)
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Senanu BM, Boakye P, Oduro-Kwarteng S, Sewu DD, Awuah E, Obeng PA, Afful K. Inhibition of ammonia and hydrogen sulphide as faecal sludge odour control in dry sanitation toilet facilities using plant waste materials. Sci Rep 2021; 11:17803. [PMID: 34493737 PMCID: PMC8423729 DOI: 10.1038/s41598-021-97016-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/18/2021] [Indexed: 11/15/2022] Open
Abstract
On-site dry sanitation facilities, although cheaper than wet sanitation systems, suffer from high malodour and insect nuisance as well as poor aesthetics. The high odour deters users from utilizing dry sanitation toilets as an improved facility leading to over 20% open defecation in Sub-Saharan Africa. To address this malodour concern, this study first assessed odour levels, using hydrogen sulphide (H2S) and ammonia (NH3) as indicators, on two dry sanitation facilities named T1 and T2. The potential of using biomass (sawdust, rice husk, moringa leaves, neem seeds), ash (coconut husk, cocoa husk) or biochar (sawdust, rice husk, bamboo) as biocovers to remove or suppress odour from fresh faecal sludge (FS) over a 12-day period was investigated. Results showed that the odour levels for H2S in both T1 (3.17 ppm) and T2 (0.22 ppm) were above the threshold limit of 0.05 ppm, for unpleasantness in humans and vice versa for NH3 odour levels (T1 = 6.88 ppm; T2 = 3.16 ppm; threshold limit = 30 ppm limit). The biomasses exhibited low pH (acidic = 5–7) whereas the biochars and ashes had higher pHs (basic = 8–13). Basic biocovers were more effective at H2S emission reduction (80.9% to 96.2%) than acidic biocovers. The effect of pH on suppression of NH3 was determined to be statistically insignificant at 95% confidence limit. In terms of H2S and NH3 removal, sawdust biochar was the most effective biocover with odour abatement values of 96.2% and 74.7%, respectively. The results suggest that biochar produced from locally available waste plant-based materials, like sawdust, can serve as a cost-effective and sustainable way to effectively combat odour-related issues associated with dry sanitation facilities to help stop open defecation.
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Affiliation(s)
- Bernice Mawumenyo Senanu
- Department of Civil Engineering, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi, Ghana
| | - Patrick Boakye
- Department of Chemical Engineering, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi, Ghana.
| | - Sampson Oduro-Kwarteng
- Department of Civil Engineering, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi, Ghana.
| | - Divine Damertey Sewu
- Life Green Technology Co. Ltd., 875 Yuseong-daero, Yuseong-gu, Daejeon, 34158, Republic of Korea.,Department of Chemical and Biological Engineering, Hanbat National University, 125 Dongseo-daero, Yuseong-gu, Daejeon, 34158, Republic of Korea
| | - Esi Awuah
- Department of Civil Engineering, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi, Ghana
| | - Peter Appiah Obeng
- Department of Water and Sanitation, University of Cape Coast, Cape Coast, Ghana
| | - Kobina Afful
- Department of Civil Engineering, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi, Ghana
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46
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Bhattacharjee NV, Schaeffer LE, Hay SI. Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000-2018. Nat Hum Behav 2021; 5:1027-1045. [PMID: 34083753 PMCID: PMC8373614 DOI: 10.1038/s41562-021-01108-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 03/31/2021] [Indexed: 02/07/2023]
Abstract
Exclusive breastfeeding (EBF)-giving infants only breast-milk for the first 6 months of life-is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization's Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030.
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Affiliation(s)
| | - Lauren E Schaeffer
- Medical Teams International, Seattle, WA, USA
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
- Department of Nursing, Adigrat University, Adigrat, Ethiopia.
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47
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Moffa M, Cronk R, Fleming L, Tidwell JB. Measuring household hygiene access and handwashing behaviors: Findings from 14 low- and middle-income countries. Int J Hyg Environ Health 2021; 237:113810. [PMID: 34311417 DOI: 10.1016/j.ijheh.2021.113810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 06/19/2021] [Accepted: 07/15/2021] [Indexed: 11/21/2022]
Abstract
Handwashing with soap (HWWS) is critical for preventing diarrheal and respiratory infections and is an important policy priority to achieve the Sustainable Development Goals (SDGs). We analyzed hygiene data from 36,860 household surveys from rural areas in India, Honduras, and twelve countries in sub-Saharan Africa (SSA). We report descriptive statistics and compare and critique three indicators: (1) access to basic hygiene services, defined as a reported designated handwashing area with observed water and soap at the time of the survey; (2) use of both soap and water during demonstrated handwashing; and (3) reported handwashing both after defecation and before preparing food. Overall, 10% of surveyed households (4% in SSA) had access to basic hygiene services and 48% of respondents (45% in SSA) used both soap and water during demonstrated handwashing. Inconsistencies between these indicators suggest no single indicator can provide a holistic picture of household hygiene; reporting on handwashing infrastructure alone may underestimate household access to soap and water and HWWS behaviors. Across the 14 countries, there was an average 22 percentage point (p.p.) gap (median 20 p.p.) in use of both water and soap during demonstrated handwashing between respondents in the wealthiest and poorest quintiles surveyed. This finding highlights the continued need to emphasize inclusivity aspects of the SDGs. Data around respondents' reported exposure to hygiene promotion showed that respondents rarely heard messaging about cleanliness from faith leaders, revealing an overlooked opportunity to empower faith leaders to promote handwashing in low- and middle-income countries.
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48
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Carrasco-Escobar G, Fornace K, Benmarhnia T. Mapping socioeconomic inequalities in malaria in Sub-Sahara African countries. Sci Rep 2021; 11:15121. [PMID: 34302015 DOI: 10.1038/s41598-021-94601-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/13/2021] [Indexed: 01/05/2023] Open
Abstract
Despite reductions in malaria incidence and mortality across Sub-Saharan (SSA) countries, malaria control and elimination efforts are currently facing multiple global challenges such as climate and land use change, invasive vectors, and disruptions in healthcare delivery. Although relationships between malaria risks and socioeconomic factors have been widely demonstrated, the strengths and variability of these associations have not been quantified across SSA. In this study, we used data from population-based malaria indicator surveys in SSA countries to assess spatial trends in relative and absolute socioeconomic inequalities, analyzed as social (mothers’ highest educational level—MHEL) and economic (wealth index—WI) inequalities in malaria prevalence. To capture spatial variations in socioeconomic (represented by both WI and MHEL) inequalities in malaria, we calculated both the Slope Index of Inequality (SII) and Relative Index of Inequality (RII) in each administrative region. We also conducted cluster analyses based on Local Indicator of Spatial Association (LISA) to consider the spatial auto-correlation in SII and RII across regions and countries. A total of 47,404 participants in 1874 Primary Sampling Units (PSU) were analyzed across the 13 SSA countries. Our multi-country assessment provides estimations of strong socioeconomic inequalities between and within SSA countries. Such within- and between- countries inequalities varied greatly according to the socioeconomic metric and the scale used. Countries located in Eastern Africa showed a higher median Slope Index of Inequality (SII) and Relative Index of Inequality (RII) in malaria prevalence relative to WI in comparison to countries in other locations across SSA. Pockets of high SII in malaria prevalence in relation to WI and MHEL were observed in the East part of Africa. This study was able to map this wide range of malaria inequality metrics at a very local scale and highlighted the spatial clustering patterns of pockets of high and low malaria inequality values.
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49
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Purusothaman DK, Shackleford L, Anderson MAE, Harvey-Samuel T, Alphey L. CRISPR/Cas-9 mediated knock-in by homology dependent repair in the West Nile Virus vector Culex quinquefasciatus Say. Sci Rep 2021; 11:14964. [PMID: 34294769 PMCID: PMC8298393 DOI: 10.1038/s41598-021-94065-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/28/2021] [Indexed: 11/27/2022] Open
Abstract
Culex quinquefasciatus Say is a mosquito distributed in both tropical and subtropical regions of the world. It is a night-active, opportunistic blood-feeder and vectors many animal and human diseases, including West Nile Virus and avian malaria. Current vector control methods (e.g. physical/chemical) are increasingly ineffective; use of insecticides also imposes hazards to both human and ecosystem health. Advances in genome editing have allowed the development of genetic insect control methods, which are species-specific and, theoretically, highly effective. CRISPR/Cas9 is a bacteria-derived programmable gene editing tool that is functional in a range of species. We describe the first successful germline gene knock-in by homology dependent repair in C. quinquefasciatus. Using CRISPR/Cas9, we integrated an sgRNA expression cassette and marker gene encoding a fluorescent protein fluorophore (Hr5/IE1-DsRed, Cq7SK-sgRNA) into the kynurenine 3-monooxygenase (kmo) gene. We achieved a minimum transformation rate of 2.8%, similar to rates in other mosquito species. Precise knock-in at the intended locus was confirmed. Insertion homozygotes displayed a white eye phenotype in early-mid larvae and a recessive lethal phenotype by pupation. This work provides an efficient method for engineering C. quinquefasciatus, providing a new tool for developing genetic control tools for this vector.
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Affiliation(s)
| | - Lewis Shackleford
- Arthropod Genetics, The Pirbright Institute, Ash Road, Pirbright, GU24 0NF, Surrey, UK
| | - Michelle A E Anderson
- Arthropod Genetics, The Pirbright Institute, Ash Road, Pirbright, GU24 0NF, Surrey, UK
| | - Tim Harvey-Samuel
- Arthropod Genetics, The Pirbright Institute, Ash Road, Pirbright, GU24 0NF, Surrey, UK
| | - Luke Alphey
- Arthropod Genetics, The Pirbright Institute, Ash Road, Pirbright, GU24 0NF, Surrey, UK.
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50
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Hernández-Vasquéz A, Rojas-Roque C, Marques Sales D, Santero M, Bendezu-Quispe G, Barrientos-Gutiérrez T, Miranda JJ. Inequalities in access to safe drinking water in Peruvian households according to city size: an analysis from 2008 to 2018. Int J Equity Health 2021; 20:133. [PMID: 34090436 PMCID: PMC8178848 DOI: 10.1186/s12939-021-01466-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Peru is one of the countries with the lowest percentage of population with access to safe drinking water in the Latin American region. This study aimed to describe and estimate, according to city size, socioeconomic inequalities in access to safe drinking water in Peruvian households from 2008 to 2018. METHODS Secondary analysis of cross-sectional data using data from the 2008-2018 ENAHO survey. Access to safe drinking water, determined based on the presence of chlorinated water supplied by the public network, as well as socioeconomic variables were analyzed. A trend analysis from 2008 to 2018, and comparisons between 2008 versus 2018 were performed to understand and describe changes in access to safe drinking water, according to city size. Concentration curves and Erreygers concentration index (ECI) were estimated to measure inequalities in access to safe drinking water. RESULTS In 2008, 47% of Peruvian households had access to safe drinking water, increasing to 52% by 2018 (p for trend < 0.001). For small cities, access to safe drinking water did not show changes between 2018 and 2008 (difference in proportions - 0.2 percentage points, p = 0.741); however, there was an increase in access to safe drinking water in medium (difference in proportions 3.3 percentage points, p < 0.001) and large cities (difference in proportions 12.8 percentage points, p < 0.001). The poorest households showed a decreasing trend in access to safe drinking water, while the wealthiest households showed an increasing trend. In small cities, socioeconomic inequalities showed an increase between 2008 and 2018 (ECI 0.045 and 0.140, p < 0.001), while in larger cities, socioeconomic inequality reduced in the same period (ECI: 0.087 and 0.018, p = 0.036). CONCLUSIONS We report a widening gap in the access to safe drinking water between the wealthiest and the poorest households over the study period. Progress in access to safe drinking water has not been equally distributed throughout the Peruvian population. Promoting and supporting effective implementation of policies and strategies to safe drinking water, including equity-oriented infrastructure development and resource allocation for most vulnerable settings, including emerging small cities, is a priority.
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Affiliation(s)
- Akram Hernández-Vasquéz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 497, Miraflores, 12 Lima, Peru.
| | | | - Denise Marques Sales
- Observatory for Urban Health in Belo Horizonte, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Guido Bendezu-Quispe
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 497, Miraflores, 12 Lima, Peru.,School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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