Tag Archives: malnutrition

WASHplus Weekly: Focus on WASH-related disesases

Issue 135 February 21, 2014 | Focus on WASH-Related Diseases

This issue contains recent studies and reports on several WASH-related diseases: neglected tropical diseases (NTDs), malnutrition, cholera, diarrhea, fluorosis, and malaria. Some of the resources include: a WASH and NTDs global manual and country reports from the Sightsavers Innovation Fund; an article on the origins of the cholera outbreak in Haiti; a review of evidence linking WASH, anemia, and child growth; Cochrane Reviews on the prevention and control of malaria; and additional studies and resources. weekly

We welcome your suggestions for future issues of the Weekly. Topics for upcoming issues include World Water Day 2014, WASH and nutrition, behavior change, community-led total sanitation, household water treatment, and menstrual hygiene management.

GENERAL/OVERVIEW

Human Health and the Water Environment: Using the DPSEEA Framework to Identify the Driving Forces of DiseaseScience of the Total Environment, 2014. J Gentry-Shields.(Link)

There is a growing awareness of global forces that threaten human health via the water environment. A better understanding of the dynamic between human health and the water environment would enable prediction of the significant driving forces and effective strategies for coping with or preventing them. This report details the use of the Driving Force–Pressure–State–Exposure–Effect–Action (DPSEEA) framework to explore the linkage between water-related diseases and their significant driving forces.

Seasonal Effects of Water Quality: The Hidden Costs of the Green Revolution to Infant and Child Health in India, 2013. E Brainerd. (Link)
This paper examines the impact of fertilizer agrichemicals in water on infant and child health using water quality data combined with data on child health outcomes from the Demographic and Health Surveys of India. The results indicate that children exposed to higher concentrations of agrichemicals during their first month experience worse health outcomes on a variety of measures; these effects are largest among the most vulnerable groups, particularly the children of uneducated poor women living in rural India.

Water, Sanitation and Hygiene: Evidence Paper, 2013. Department for International Development. (Link)
This paper aims to provide an accessible guide to existing evidence, including a conceptual framework for understanding how WASH impacts health and well-being and a description of methods used for ascertaining the health, economic, and social impacts of WASH. It also presents the available evidence on the benefits and cost-effectiveness of WASH interventions.

NEGLECTED TROPICAL DISEASES

WASH and the Neglected Tropical Diseases: A Global Manual for WASH Implementers, 2014. Sightsavers, et al. (Link) | (Blog post)
These manuals are free to download and distribute. New users must create an account to download the manuals, which are divided into disease-specific chapters that describe the transmission cycle, symptoms, and disease burden of the WASH-related NTDs. Each chapter includes information about WASH activities that are most essential to the control of each disease. Maps of disease prevalence are provided to enable identification of disease-endemic communities most in need of sustainable WASH services. Country-specific versions of the manual are available so far for Brazil, Burkina Faso, Cameroon, Chad, Ethiopia, Indonesia, Kenya, Malawi, Mali, Mozambique, Nigeria, Sudan, Tanzania, and Uganda.

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Will data linking open defecation to undernutrition force change?

Will data linking open defecation to undernutrition force change? {Source: Mark Tran, The Guardian, Aug 1, 2013}

Studies show a link between open defecation and stunted development, but merely building toilets may not be the answer

More people have mobile phones than access to toilets, the UN reminded us last week as the general assembly designated 19 November official UN world toilet day.

A humourous anti-open defecation sign at Vulture Peak Buddhist pilgrimage site in Bihar, India. Photograph: Olaf Schubert/Alamy

A humourous anti-open defecation sign at Vulture Peak Buddhist pilgrimage site in Bihar, India. Photograph: Olaf Schubert/Alamy

Six billion of the world’s population of 7 billion have mobile phones. However, only 4.5 billion have access to toilets – meaning that 2.5 billion, mostly in rural areas, do not have proper sanitation. In addition, 1.1 billion people defecate in the open. Sanitation does not get its due. So, the assembly urged member states to encourage behavioural change and implement policies that increase access to sanitation, along with a call to end open defecation, which it deems extremely harmful to public health.

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Extra Food Means Nothing to Stunted Kids With Bad Water

Extra Food Means Nothing to Stunted Kids With Bad Water: Health | Source: Adi Narayan, Bloomberg-Jun 12, 2013 |

Aameena Mohammed gives her 20-month-old daughter Daslim Banu plenty to eat. The girl’s mother supplements breast milk with eggs, soup and rice to help her grow. The extra food doesn’t help. Daslim still weighs only as much as a healthy infant half her age.

Mohammed’s home, in one of the poorest districts of the south Indian city of Vellore, is among the 65 percent of India’s homes without running water and safe sewage disposal. Feces and urine collect next to the doorway in an open drain — the source of odor permeating the tin-roofed shack and of the microbes likely retarding the toddler’s growth.

Polluted water runs through a sewer in the Dharavi slum area of Mumbai, India. Only 26 percent of the 6 billion gallons of sewage generated daily in India is treated.

Polluted water runs through a sewer in the Dharavi slum area of Mumbai, India. Only 26 percent of the 6 billion gallons of sewage generated daily in India is treated.

Scientists increasingly suspect that constant exposure to bacteria, virus and parasite-laden fecal contaminants may be frustrating attempts to end malnutrition. In effect, the best diet-based measures to fight chronic hunger in the developing world are being negated by a failure to meet basic human needs: clean water and sanitation.

The problem exists not just in India. A quarter of children indeveloping countries are underweight, and malnutrition is the root cause of the deaths of more than 2 million children annually, according to the United Nations Children’s Fund inNew York. Worldwide, 870 million people are chronically hungry, almost all of them in developing countries.

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WASHplus Weekly on WASH-Related Diseases

This issue contains recent studies and resources on several WASH-related diseases: cholera, dengue, diarrhea, leptospirosis, neglected tropical diseases, malnutrition, and typhoid. Included are a just-published UNICEF cholera toolkit, an updated review of WASH-related diseases from DfID, typhoid case studies from Bangladesh and Fiji, and other resources. weekly2

The Centers for Disease Control and Prevention suggested the topic for this issue, and we welcome other suggestions for topics. Future issues will focus on menstrual hygiene management, innovation, water point mapping, mobile applications, and WASH in schools; more than 100 past issues of the Weekly are archived on the WASHplus website.

USAID RFA – Research on the Relationship of Population Density and Neighborhood-Level Sanitation

Research on the Relationship of Population Density and Neighborhood-Level Sanitation Access to Fecal-Associated Health Impacts usaidlogo

  • RFA #: WASH2013-001
  • Status: Upcoming
  • Posted: February 25, 2013
  • Questions Due: Comments Due: March 11, 2013

TRAction is anticipating the release of an RFA to support research on the relationship between population density and the impact of water, sanitation, and hygiene interventions on diarrhea and other fecal-associated infections.

Before releasing the RFA for applications, TRAction is asking for program implementers, researchers, and others knowledgeable about the WASH field to provide comments on the RFA. Comments may address other relevant background information or resources that could be included in the RFA, suggestions on research questions or design, application guidelines, or other RFA components that could benefit from a suggested revision.

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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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].