Tag Archives: child health

Impact of WASH in improving health of school children reviewed

More attention should be given to the assessment of nutrition practices when assessing the impact of WASH on the health of school children. We also don’t know enough about the long term impact of WASH interventions on child health. These are some of the conclusions that researchers from the Center for Global Health and Development at the the University of Nebraska Medical Center (UNMC) drew from a review of the literature [1].

Dr. Ashish Joshi and research assistant Chioma Amadi reviewed the impact of water treatment, hygiene, and sanitary interventions on improving child health outcomes such as absenteeism, infections, knowledge, attitudes, and practices and adoption of point-of-use water treatment.  For their final analysis they selected 15 peer-reviewed English-language studies published between 2009 and 2012 that focused on the effects of access to safe water, hand washing facilities, and hygiene education among school-age children.

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Sanitation and nutrition

In the scramble for attention in post-2015 development agenda discussions, WaterAid and the SHARE programme are highlighting the role of WASH in combating malnutrition. “A successful global effort to tackle under-nutrition must include WASH” is the headline in their new briefing note.

Mentioned in the note, and of special interest, is the forthcoming Cochrane review on “Interventions to improve water quality and supply, sanitation and hygiene practices, and their effects on the nutritional status of children” (DOI: 10.1002/14651858.CD009382).

In the wake of the WaterAid/SHARE briefing note, a new World Bank report on sanitation and stunting [1] is “getting a lot of attention from our nutrition colleagues”, says Eddy Perez of the Water and Sanitation Program (WSP) in an email.

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India: inadequate sanitation costs the equivalent of 6.4 percent of GDP

Cover WSP report Economic Impacts Sanitation India

Inadequate sanitation costs India US$ 53.8 billion, which is equivalent to 6.4 percent of India’s GDP in 2006, according to a new report [1] from the Water and Sanitation Program (WSP).

The study analyzed the evidence on the adverse economic impacts of inadequate sanitation, which include costs associated with death and disease, accessing and treating water, and losses in education, productivity, time, and tourism. The findings are based on 2006 figures, although a similar magnitude of losses is likely in later years.

The report indicates that premature mortality and other health-related impacts of inadequate sanitation, were the most costly at US$ 38.5 billion, 71.6 percent of total impacts, followed by productive time lost to access sanitation facilities or sites for defecation at US$ 10.7 billion, 20 percent, and drinking water-related impacts at US$ 4.2 billion, 7.8 percent.

“The cost is more than I expected,” UNICEF’s water, sanitation and hygiene chief Clarissa Brocklehurst said in an interview with news site Bloomberg. “Yet, if you know the scale of open defecation in India, it’s not all that surprising.”

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Acute diarrhoea prevention: field trial on efficacy of a probiotic

The National Institute of Cholera and Enteric Diseases (NICED), Kolkata has conducted one of the largest double blind, randomized, placebo controlled field trial to determine the effectiveness of a probiotic to prevent acute diarrhoea in children in a community setting of Kolkata. The trial was initiated by the Indian Council of Medical Research (ICMR). NICED is one of the 29 ICMR centres.

Yakult Honsha Co. Ltd, Japan, the collaborator of this trial, produces a probiotic drink, Yakult, which contains the Lactobacillus casei probiotic strain Shirota that was evaluated in the study [1].

The study on 3585 children in the age-group of 1-5 years was done to evaluate the effect of the probiotic in preventing acute diarrhoea. The children were randomly grouped to receive either the probiotic or the placebo (fermented milk drink without the probiotic strain) for a period of 12 weeks and were followed up for another 12 weeks.

The results of the 24-week study revealed that the incidence of diarrhoea was lower in the probiotic group as compared to the placebo. In spite of the fact that the probiotic was given only for 12 weeks it resulted in a significant reduction of diarrhoea episodes by 14 per cent in the probiotic group. Scientists at NICED expect a much better impact if the probiotic was to be given for a longer period of time, stated Dr Neerja Hajela, Head, Science, Yakult Danone India Private Limited.

The study suggests that daily intake of a probiotic drink can play an important role in the prevention of acute diarrhoea in young children in a community setting of a developing country like India, she added.

In India, diarrhoea is reported to be second largest fatal disease after pneumonia. Yakult Danone was keen to find a relief to the dreaded disease, stated Dr. Hajela.

Global statistics place diarrhoea as the second leading cause of death in children younger than 5 years. Nearly one in every five child deaths is due to diarrhoea which kills more children than AIDS, Malaria and Measles combined. According to The Lancet, around 1.5 million of the 9 million child deaths in 2008 were due to diarrhoea with 49 per cent of the deaths occurring in five countries namely India, Nigeria, Democratic Republic of the Congo, Pakistan and China.

[1] Sur, D, … [et al.] (2010). Role of probiotic in preventing acute diarrhoea in children: a community-based, randomized, double-blind placebo-controlled field trial in an urban slum. Epidemiology and infection. Available online 30 Jul 2010. doi:10.1017/S0950268810001780

Contact: Dr. Dipikar Sur, MBBS, M.D., National Institute of Cholera and Enteric Diseases, India. (Email: dipikasur@hotmail.com)

Source: Nandita Vijay, Pharmabiz.com, 26 Aug 2010

World Bank – Water, sanitation and children’s health: evidence from DHS surveys

Water, sanitation and children’s health : evidence from 172 DHS surveys, 2010..  (pdf, 658KB)

World Bank.

This paper combines 172 Demography and Health Survey data sets from 70 countries to estimate the effect of water and sanitation on child mortality and morbidity. The results show a robust association between access to water and sanitation technologies and both child morbidity and child mortality. The point estimates imply, depending on the technology level and the sub-region chosen, that water and sanitation infrastructure lowers the odds of children to suffering from diarrhea by 7-17 percent, and reduces the mortality risk for children under the age of five by about 5-20 percent.

The effects seem largest for modern sanitation technologies and least significant for basic water supply. The authors also find evidence for the Mills-Reincke Multiplier for both water and sanitation access as well as positive health externalities for sanitation investments. The overall magnitude of the estimated effects appears smaller than coefficients reported in meta-studies based on randomized field trials, suggesting limits to the scalability and sustainability of the health benefits associated with water and sanitation interventions.

Child undernutrition, tropical enteropathy, toilets, and handwashing

The impact of sanitation and hygiene on child mortality and health has been underestimated, contends Dr Jean Humphrey in The Lancet of 19 September 2009 [free registration required].

“Of the 555 million preschool children in developing countries, 32% are stunted and 20% are underweight. Child underweight or stunting causes about 20% of all mortality of children younger than 5 years of age and leads to long-term cognitive deficits, poorer performance in school and fewer years of completed schooling, and lower adult economic productivity.”

“A key cause of child undernutrition is a subclinical disorder of the small intestine known as tropical enteropathy”, Dr. Humphrey states, which “is caused by faecal bacteria ingested in large quantities by young children living in conditions of poor sanitation and hygiene”. “Provision of toilets and promotion of handwashing after faecal contact could reduce or prevent tropical enteropathy and its adverse effects on growth”. “The primary causal pathway from poor sanitation and hygiene to undernutrition is tropical enteropathy and not diarrhoea”.

Dr. Humphrey concludes that “that prevention of tropical enteropathy, which afflicts almost all children in the developing world, will be crucial to normalise child growth, and that this will not be possible without provision of toilets”.

Full reference:

Humphrey, J.H. (2009). Child undernutrition, tropical enteropathy, toilets, and handwashing. The Lancet ; vol. 374, no. 9694 ; p. 1032-1035. doi:10.1016/S0140-6736(09)60950-8

In an earlier WHO study, the authors estimated that 860 000 deaths per year in children under five years of age were “caused directly and indirectly by malnutrition induced by unsafe water, inadequate sanitation and insufficient hygiene”. This raises the total number of children that die every year as a result of unsafe water, inadequate sanitation or insufficient hygiene to 2.2 million instead of the 1.4 million usually quoted.

Full reference:

Pruss-Ustun, A.; Bos, R.; Gore, F. and Bartram, J. (2008). Safer water, better health : costs, benefits and sustainability of interventions to protect and promote health. Geneva, Switzerland, World Health Organization (WHO). Read the full report [PDF file].

Angola launches third national de-worming campaign in schools

Over the next month, primary school children in all of Angola’s 18 provinces will receive de-worming tablets as part of a national campaign that is now in its third year. The campaign aims to ensure that the country’s children have better health for better learning.

Parasitic infections, or intestinal worms, can lead to malnutrition, anaemia and slow cognitive development.

In Angola, the school de-worming campaign is led by the Ministries of Health and Education, with support from UNICEF and the World Health Organization. It is part of a broader programme to promote health in Angolan schools; this effort includes the provision of water and latrines, the establishment of hygiene education and health and hygiene clubs, and a school feeding programme.

Read more: Lone Hvass, UNICEF, 24 Sep 2008

Ghana – Poor sanitation poses threat to child survival

More than 15,000 children die in Ghana annually of sanitation related diseases before attaining the age of five, a United Nations Human Development report has revealed.

The diseases include malaria, diarrhoea, typhoid and cholera.

Mr Kweku Quansah, Programme Officer at the Environmental Health Sanitation Directorate of the Ministry of Local Government, Rural Development and Environment disclosed this in Kumasi at the weekend.

He said 72 percent of Ghanaians, representing 18 million of the population, had household latrines, whilst the remaining 18 percent shared toilet facilities.

Mr Quansah was speaking at a seminar on sanitation for media practitioners in the northern sector of the country.

More – Ghana News

Keeping it clean: New landmark study confirms the importance of home and personal hygiene in reducing infectious diseases and infections

“ACCORDING to results from the Hygiene Promotion and Illness Reduction study, children aged five years or under experienced significantly fewer respiratory, gastrointestinal, and skin diseases when their families participated in intensive hygiene education plus the use of hygiene products.

The results of the three year study, which was conducted in impoverished urban communities in South Africa and presented during the 13th International Congress on Infectious Diseases (ICID) held in Kuala Lumpur recently, also show that hygiene education alone offers meaningful improvements in illness reduction compared to no education at the start of the study.

However when effective hygiene products (antibacterial soap, surface cleanser/disinfectant, and skin antiseptic) were used in addition to education, an even greater reduction in the risk of illness was noted”.

[...]

Prof. Eugene Cole

Prof. Eugene Cole

“The study was developed and conducted under the guidance of the Health and Hygiene Promotion Partnership (HPP), a community-based project founded in 2005 by cooperation between Reckitt Benckiser Inc and Brigham Young University [lead investigator Dr Eugene Cole], with members of the participating housing communities, under the approval of the Cape Town City Health Department”.

References:

1. Cole E, Hawkley M, Rubino J, McCue K, Crookston B, and Dixon J. Comprehensive family hygiene promotion in peri-urban Cape Town: Gastrointestinal and skin disease reduction in children under five. 13th ICID; Read abstract no 68.012.

2. Cole E, Crookston B, Rubino J, McCue K, Hawkley M, and Dixon J. Comprehensive family hygiene promotion in peri-urban Cape Town: Reduction of respiratory illness in children under five. 13th ICID; Read abstract no 68.030

Read more: The Star Online (Malaysia), 06 July 2008

See also: Aeysha Kassiem, How to cut infection, Cape Times / IOL,  22 Jul 2008

Cameroon – Diarrhea: a rampant disease among children below 5?

Most kids in Cameroon battle diarrhea from time to time, but the good news is that it’s often caused by infections that don’t last long and usually are more disruptive than dangerous.

Still, it’s important to know what to do to relieve and even prevent diarrhea. In an interview conducted by Elvis Teke, Dr. Serge EMALEU paints a picture of the disease and how it can be controlled.

Elvis Teke: What are the most common causes of Diarrhea?

Dr. Serge EMALEU: Diarrhea — frequent runny or watery bowel movements (poop) — is usually brought on by gastrointestinal (GI) infections caused by viruses, bacteria, or parasites.

The specific germs that cause diarrhea can vary among geographic regions depending on their level of sanitation, economic development, and hygiene. For example, in our country with poor sanitation and where human waste is sometime used as fertilizer often have outbreaks of diarrhea when intestinal bacteria or parasites contaminate crops or drinking water.

Read More – Cameroon RT