Category Archives: Sanitation and Health

How El Niño forecasts can help prevent cholera deaths in Africa

How El Niño forecasts can help prevent cholera deaths in Africa. The Conversation, May 14, 2017.

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Pit latrine in Dar es Salaam, Tanzania. Access to clean water and sanitation are key to preventing cholera epidemics. D. Schafer, SuSanA/Flickr, CC

Since it first emerged from the Ganges River delta 200 years ago, cholera has killed tens of millions of people around the world. It causes acute diarrhea that can kill quickly without proper treatment. Before the 1970s it was not unusual for healthy adults to die of dehydration within days of infection, despite drinking large amounts of water.

By some estimates, over a billion people worldwide live in areas where there is risk of cholera, and hundreds of thousands die every year. But when people have access to clean water, appropriate treatment or vaccine, the risk of cholera is greatly reduced. With well-trained medical staff and supplies, appropriate and timely treatment of cholera patients can ensure that almost no one dies.

In a recent study, our group sought to understand how weather changes caused by El Niño impact cholera risk in Africa, where most cholera deaths occur. El Niño events can now be forecast as much as a year in advance, so knowing this relationship may help forecast where cholera outbreaks are most likely to occur.

Read the complete article.

Recent news on cholera outbreaks

May 9 – Yemen war: Surge in cholera outbreak kills 34 – WHO – The World Health Organisation says 2,022 suspected cases of cholera and acute watery diarrhoea (AWD) were reported between 27 April and 7 May.

May 9 – IOM Responds as Cholera Outbreak Spreads in South Sudan – Relief agencies are responding to cholera outbreaks across the country, with nine counties currently reporting active transmission, including three in Jonglei alone.

May 9 – Haiti sees decrease in suspected cholera cases – (PAHO) says the number of suspected cholera cases reported in this French-speaking Caribbean country, up to April 8, 2017, has decreased when compared to the same periods in 2015 and 2016.In its latest report, PAHO says to date 4,871 suspected cholera cases have been reported in Haiti, including 69 deaths. This represents a 60 and 61 per cent decrease compared to the 12,373 and 12,226 suspected cholera cases reported during the same period in 2015 and 2016, respectively.

May 5 – As rainy season starts, UN health agency warns of cholera outbreak in drought-hit Somalia – Somalia is suffering from the largest cholera outbreak in the past five years and the number of people killed is expected to double by the end of June, the United Nations health agency. The UN World Health Organization (WHO) reported close to 32,000 cases of cholera, including 618 deaths, since the beginning of the year.

May 6 – Nagpur – After 4 years, cholera makes a comeback –  After a lull of four years, cholera, the deadliest of all water borne diseases has raised its ugly head again. About 31 positive cases of cholera have been recorded between April 1, 2016 and March 31, 2017.

May 1 – Ghana – Health Service reminds regional directors to be alert for cholera outbreak –  The Ghana Health Service has reminded of its cholera alert to all regional health directors and warned of the risk of an outbreak in 2017, has increased by the onset of the rains and potential flooding in some communities.

 

Recent sanitation and health research

Evidence-based approaches to childhood stunting in low and middle income countries: a systematic review. Archives of Diseases in Childhood, May 2017.

Nutrition education and counselling, growth monitoring and promotion, immunisation, water, sanitation and hygiene and social safety net programmes appear to be the most commonly included interventions of an effective package in most low and middle income countries settings. Single interventions reduced stunting only in countries with specific disease burden. Intervention worked best when country, community and programme context were taken into account.

Escherichia coli contamination of child complementary foods and association with domestic hygiene in rural Bangladesh. Tropical Medicine International Health, May 2017.

We found high E. coli contamination in 12% of complementary food samples in rural Bangladeshi households, which is similar to studies from other low-income settings. Lack of water near the food preparation area, longer storage duration, storing food uncovered, temperatures >25 °C in the food storage area, flies captured in food preparation area and hand contact with food while serving were all factors that significantly contributed to high levels of E. coli contamination throughout the year, independent of season. The presence of animals in the compound was associated with an increase in E. coli counts. These findings provide guidance for designing targeted food hygiene interventions.

Impact of the Integration of Water Treatment, Hygiene, Nutrition, and Clean Delivery Interventions on Maternal Health Service Use. (Abstract/order) American Jnl of Tropical Med & Hyg, May 2017.

For women who lived ≤ 2.5 km from the health facility, the estimated odds of health facility delivery (OR = 2.4, 95% CI = 1.5–4.1) and postnatal care visit (OR = 1.6, 95% CI = 1.0–2.6) were higher than for those who lived > 2.5 km away. Compared with baseline, a higher percentage of survey participants at follow-up were able to demonstrate proper handwashing (P = 0.001); water treatment behavior did not change. This evaluation suggested that hygiene, nutritional, clean delivery incentives, higher education level, and geographical contiguity to health facility were associated with increased use of maternal health services by pregnant women

 

 

WASH & healthcare facilities – Water Currents

WASH & healthcare facilities – Water Currents, May 1, 2017

The focus topic for this issue is WASH and health care facilities and contains information on upcoming events; recent publications from USAID, the World Health Organization (WHO), and others; as well as links to key websites. watercurrents

The reports discuss hand hygiene, antimicrobial resistance, access to WASH services, and the treatment and disposal of medical waste. “In the News” features publications and resources from the recent Sanitation and Water for All High Level Meetings in Washington, DC.

Link to the full text.

To End Neglected Tropical Diseases, Start With The Basics Of Clean Water And Sanitation For The World’s Poorest

To End Neglected Tropical Diseases, Start With The Basics Of Clean Water And Sanitation For The World’s Poorest. Huffington Post, April 26, 2017.

Despite ‘unprecedented progress’ further gains depend on water and sanitation, says the World Health Organization 

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Itai Nakoru, 87, from Adengei village, Nakapiripirit District, Karamoja region, Uganda is examined to see if she is fit for eye surgery to treat her trachoma

87-year-old Itai Nakoru, opens her eyes slowly so the doctor can examine them. She’s in excruciating pain because every time she blinks, her eyelashes scratch her corneas.

For the last six years, my eyes have been itching so much, this year, my left eye totally lost sight,” she explains.Itai lives in Uganda’s northeastern Karamoja region. She’s being examined by a doctor to determine if she can have surgery to treat her trichiasis, which is a result of repeated trachoma infection.

This eye disease is caused by the bacterium Chlamydia trachomatis and leads to inflammation, scarring the inside of the eyelid. The eyelids eventually turn inwards causing the eyelashes to scratch the cornea.

Trachoma is the leading cause of preventable blindness in the world, affecting almost two million people globally. In this region of Uganda, trachoma rates are the highest in the country, largely because the area is hot and dusty and sanitation is poor, making it a perfect breeding ground for bacteria.

Read the complete article.

A big-picture look at the world’s worst Ebola epidemic

A big-picture look at the world’s worst Ebola epidemic. Hutch News, April 12, 2017.

International team of scientists show how real-time sequencing and data-sharing can help stop the next outbreak

An international effort to analyze the entire database of Ebola virus genomes from the 2013–2016 West African epidemic reveals insights into factors that sped or slowed the rampage and calls for using real-time sequencing and data-sharing to contain future viral disease outbreaks.

Published online today in the journal Nature, the analysis found that the epidemic unfolded in small, overlapping outbreaks with surprisingly few infected travelers sparking new outbreaks elsewhere, each case representing a missed opportunity to break the transmission chain and end the epidemic sooner.

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Dr. Gytis Dudas, a Mahan Postdoctoral Fellow at Fred Hutchinson Cancer Research Center, is the paper’s lead author. Photo by Bo Jungmayer / Fred Hutch News Service

“We calculated that 3.6 percent of cases traveled, basically meaning that if you were able to focus on those mobile cases and reduce their mobility, you might have had a disproportionate effect on the epidemic,” said computational biologist Dr. Gytis Dudas, a Mahan Postdoctoral Fellow at Fred Hutchinson Cancer Research Center and the paper’s lead author.

The West African Ebola epidemic dwarfed all previous central African outbreaks of the virus, sickening more than 28,000 people and killing more than 11,000 of them.

The 1,610 Ebola virus genomes analyzed by the researchers represented more than 5 percent of the known cases, the largest sample analyzed for a single human epidemic. The analysis is the first to look at how Ebola spread, proliferated and declined across all three countries most affected: Guinea, Sierra Leone and Liberia. Previous analyses focused primarily on either a single country, a limited time frame or used fewer sequences.

Read the complete article.

WHO Trachoma Fact sheet, April 2017

WHO Trachoma Fact sheet, April 2017.

Key facts

  • Trachoma is a disease of the eye caused by infection with the bacterium Chlamydia trachomatis.
  • It is known to be a public health problem in 42 countries, and is responsible for the blindness or visual impairment of about 1.9 million people. Nearly 182 million people live in trachoma endemic areas and are at risk of trachoma blindness.
  • Blindness from trachoma is irreversible.
  • Infection spreads through personal contact (via hands, clothes or bedding) and by flies that have been in contact with discharge from the eyes or nose of an infected person. With repeated episodes of infection over many years, the eyelashes may be drawn in so that they rub on the surface of the eye, with pain and discomfort and permanent damage to the cornea.
  • The World Health Assembly adopted resolution WHA51.11 in 1998, targeting the global elimination of trachoma as a public health problem.
  • The elimination strategy is encapsulated by the acronym “SAFE”: Surgery for advanced disease, Antibiotics to clear C. trachomatis infection, Facial cleanliness and Environmental improvement to reduce transmission.
  • In 2016, more than 260 000 people received surgical treatment for advanced trachoma, and 86 million people were treated with antibiotics. Global-level antibiotic coverage was 47%, a considerable increase compared to the 29% coverage achieved in 2015.