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Water, Sanitation and Hygiene Related Disease

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 July 2018) | Viewed by 36908

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Special Issue Editor

Dr. Susana Vaz Nery

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Guest Editor

Public Health Interventions Research Group, Kirby Institute Level 6, University of New South Wales, Wallace Wurth Building, Sydney, Australia
Interests: neglected tropical diseases; malaria and NTDs control and elimination in developing countries; intervention studies to inform health policy changes for more effective and sustainable disease control strategies; WASH and chemotherapy for NTD control; soil-transmitted helminths

Special Issue Information

Dear Colleagues,

A Topical Collection on “Water, Sanitation and Hygiene Related Disease”, in the International Journal of Environmental Research and Public Health, is being organized. For detailed information on the journal, please refer to https://www.mdpi.com/journal/ijerph.

Appropriate access to water, sanitation and hygiene (WASH) is essential for good health. A considerable amount of disease could be prevented through access to safe water sources, adequate sanitation facilities and appropriate hygiene practices. More than half of the 1.5 million annual deaths attributed to diarrhea are attributable to inadequate WASH. Poor WASH is one of the main underlying causes of under-nutrition, which contributes to 30% of deaths under the age of five. Deficient WASH is also associated with several neglected tropical diseases (NTDs), including intestinal worms, schistosomiasis, Guinea worm disease, and trachoma, which affect millions of people worldwide. Adequate WASH would also improve the quality of care in healthcare settings.

According to the WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) in 2015, while 71% of the population use a safely managed drinking-water service, two billion still use a drinking-water source contaminated with feces. Sixty-eight percent of the population used at least a basic sanitation facility, but 2.3 billion people were lacking access to sanitation and almost 900 million practiced open defecation. Data on handwashing facilities with soap and water was still limited, with coverage varying from 15% in SSA to 76% in Western Asia and Northern Africa.

The 2030 Agenda for Sustainable Development recognize the importance of safe drinking water, effective sanitation, and good hygiene (WASH) both by themselves and as necessity for achieving other SDGs related to health, nutrition, education and gender equality; with several of the 17 SDGs and 169 targets relating to WASH. Target 6.1 aims to achieve universal and equitable access to safe and affordable drinking water for all; while 6.2 aims to achieve access to adequate and equitable sanitation and hygiene for all and end open defecation. Other SDG goals and targets related to WASH, include SDG target 1.4 on universal access to basic services, SDG target 3.9 on the disease burden from inadequate WASH, and SDG target 4.a on basic WASH in schools.

This Special Issue is open to any investigation of WASH and health. It will cover a range of different topics, such as evidence on the impact of WASH on health/disease including NTDs, nutrition, diarrhea, environmental enteropathy; WASH in emergency settings, WASH in schools and WASH in healthcare facilities.

We look forward to your submissions, and putting together a stimulating Special Issue. We welcome reports of new findings, reviews of the literature, opinion papers and policy analysis.

Assoc. Prof. Susana Vaz Nery
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Water sanitation and Hygiene/WASH
Water safety and quality
Sanitation
WASH in Healthcare facilities
School WASH
WASH in Emergencies
WASH and Cholera
WASH and Diarrhea
WASH and NTDs
WASH and Schitosomiasis
WASH and Soil transmitted helminths/Intestinal parasites
WASH and Trachoma
WASH and Guinea worm

Published Papers (6 papers)

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Research

16 pages, 3077 KiB

Open AccessArticle

A Metagenomic Approach to Evaluating Surface Water Quality in Haiti

by Monika A. Roy, Jean M. Arnaud, Paul M. Jasmin, Steve Hamner, Nur A. Hasan, Rita R. Colwell and Timothy E. Ford

Int. J. Environ. Res. Public Health 2018, 15(10), 2211; https://doi.org/10.3390/ijerph15102211 - 10 Oct 2018

Cited by 24 | Viewed by 5357

Abstract

The cholera epidemic that occurred in Haiti post-earthquake in 2010 has resulted in over 9000 deaths during the past eight years. Currently, morbidity and mortality rates for cholera have declined, but cholera cases still occur on a daily basis. One continuing issue is an inability to accurately predict and identify when cholera outbreaks might occur. To explore this surveillance gap, a metagenomic approach employing environmental samples was taken. In this study, surface water samples were collected at two time points from several sites near the original epicenter of the cholera outbreak in the Central Plateau of Haiti. These samples underwent whole genome sequencing and subsequent metagenomic analysis to characterize the microbial community of bacteria, fungi, protists, and viruses, and to identify antibiotic resistance and virulence associated genes. Replicates from sites were analyzed by principle components analysis, and distinct genomic profiles were obtained for each site. Cholera toxin converting phage was detected at one site, and Shiga toxin converting phages at several sites. Members of the Acinetobacter family were frequently detected in samples, including members implicated in waterborne diseases. These results indicate a metagenomic approach to evaluating water samples can be useful for source tracking and the surveillance of pathogens such as Vibrio cholerae over time, as well as for monitoring virulence factors such as cholera toxin. Full article

(This article belongs to the Special Issue Water, Sanitation and Hygiene Related Disease)

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12 pages, 1412 KiB

Open AccessFeature PaperArticle

Shadow Puppets and Neglected Diseases: Evaluating a Health Promotion Performance in Rural Indonesia

by Johanna Kurscheid, Dan Bendrups, Joko Susilo, Courtney Williams, Salvador Amaral, Budi Laksono, Donald E. Stewart and Darren J. Gray

Int. J. Environ. Res. Public Health 2018, 15(9), 2050; https://doi.org/10.3390/ijerph15092050 - 19 Sep 2018

Cited by 10 | Viewed by 5749

Abstract

‘Rama and the Worm’ is a shadow puppet production targeting neglected diseases in Central Java. It is an entertainment-based intervention study to promote health by reducing the impact of parasitic diseases such as soil-transmitted helminths (STH). The study uses traditional Javanese shadow puppetry (wayang kulit) as a vehicle in village communities to disseminate health messages and promote behaviour change to prevent diseases caused, primarily, by inadequate sanitation and poor hygiene. The health education messages contained in the play, although using traditional characters and themes, required the creation of a completely new narrative script, using characters and plot lines familiar to the wayang kulit repertoire, but placing them in new situations that relate specifically to health promotion objectives. The intervention was piloted in a village in Central Java, Indonesia using a pre/post design with both qualitative and quantitative analysis. A total of 96 male and female villagers, aged between 7 and 87 years, provided both baseline and follow up data. Participant knowledge and behaviours related to gastrointestinal and helminth-related disease were assessed before and after the intervention through a questionnaire administered by interview. Results revealed statistically significant improvements in both knowledge (48.6% pre-intervention score vs. 62.8% post-intervention score, p < 0.001) and behaviour (77.4% vs. 80.6%, p = 0.004) related to gastrointestinal and helminth disease. Findings of the study indicate the wayang kulit performance is an effective health education tool. The results provide proof of concept with scaling up the next step forward. The wayang kulit production provides a significant additional component for an integrated, comprehensive approach to reduction and elimination of STH infection. Full article

(This article belongs to the Special Issue Water, Sanitation and Hygiene Related Disease)

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15 pages, 360 KiB

Open AccessArticle

Do Water, Sanitation and Hygiene Conditions in Primary Schools Consistently Support Schoolgirls’ Menstrual Needs? A Longitudinal Study in Rural Western Kenya

by Kelly T. Alexander, Garazi Zulaika, Elizabeth Nyothach, Clifford Oduor, Linda Mason, David Obor, Alie Eleveld, Kayla F. Laserson and Penelope A. Phillips-Howard

Int. J. Environ. Res. Public Health 2018, 15(8), 1682; https://doi.org/10.3390/ijerph15081682 - 07 Aug 2018

Cited by 19 | Viewed by 5577

Abstract

Many females lack access to water, privacy and basic sanitation—felt acutely when menstruating. Water, sanitation and hygiene (WASH) conditions in schools, such as access to latrines, water, and soap, are essential for the comfort, equity, and dignity of menstruating girls. Our study was nested within a cluster randomized controlled pilot feasibility study where nurses provided menstrual items to schoolgirls. We observed the WASH conditions of 30 schools from June 2012–October 2013 to see if there were any changes in conditions, to compare differences between study arms and to examine agreement between observed and teacher-reported conditions. Data came from study staff observed, and school teacher reported, WASH conditions. We developed scores for the condition of school facilities to report any changes in conditions and compare outcomes across study arms. Results demonstrated that soap availability for students increased significantly between baseline and follow-up while there was a significant decrease in the number of “acceptable” latrines. During the study follow-up period, individual WASH indicators supporting menstruating girls, such as locks on latrine doors or water availability in latrines did not significantly improve. Advances in WASH conditions for all students, and menstrual hygiene facilities for schoolgirls, needs further support, a defined budget, and regular monitoring of WASH facilities to maintain standards. Full article

(This article belongs to the Special Issue Water, Sanitation and Hygiene Related Disease)

21 pages, 2523 KiB

Open AccessArticle

Where Children Play: Young Child Exposure to Environmental Hazards during Play in Public Areas in a Transitioning Internally Displaced Persons Community in Haiti

by Danielle N. Medgyesi, John M. Brogan, Daniel K. Sewell, Jean Philippe Creve-Coeur, Laura H. Kwong and Kelly K. Baker

Int. J. Environ. Res. Public Health 2018, 15(8), 1646; https://doi.org/10.3390/ijerph15081646 - 03 Aug 2018

Cited by 22 | Viewed by 4959

Abstract

Globally, gastrointestinal (GI) infections by enteric pathogens are the second-leading cause of morbidity and mortality in children under five years of age (≤5 years). While GI pathogen exposure in households has been rigorously examined, there is little data about young children’s exposure in public domains. Moreover, public areas in low-income settings are often used for other waste disposal practices in addition to human feces, such as trash dumping in areas near households. If young children play in public domains, they might be exposed to interrelated and highly concentrated microbial, chemical, and physical hazards. This study performed structured observations at 36 public areas in an internally displaced persons community that has transitioned into a formal settlement in Haiti. We documented how often young children played in public areas and quantified behaviors that might lead to illness and injury. Children ≤5 years played at all public sites, which included infants who played at 47% of sites. Children touched and mouthed plastic, metal and glass trash, food and other objects from the ground, ate soil (geophagia) and drank surface water. They also touched latrines, animals, animal feces and open drainage canals. Hand-to-mouth contact was one of the most common behaviors observed and the rate of contact significantly differed among developmental stages (infants: 18/h, toddlers: 11/h and young children: 9/h), providing evidence that children could ingest trace amounts of animal/human feces on hands that may contain GI pathogens. These findings demonstrate that water, sanitation and hygiene interventions could be more effective if they consider exposure risks to feces in public domains. Furthermore, this research highlights the need for waste-related interventions to address the broader set of civil conditions that create unsafe, toxic and contaminated public environments where young children play. Full article

(This article belongs to the Special Issue Water, Sanitation and Hygiene Related Disease)

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11 pages, 1673 KiB

Open AccessArticle

Risk of Appendicitis among Children with Different Piped Water Supply: A Nationwide Population-Based Study

by Hao-Ming Li, Shi-Zuo Liu, Ying-Kai Huang, Yuan-Chih Su and Chia-Hung Kao

Int. J. Environ. Res. Public Health 2018, 15(8), 1601; https://doi.org/10.3390/ijerph15081601 - 28 Jul 2018

Cited by 3 | Viewed by 3670

Abstract

Appendicitis is a common surgical condition for children. However, environmental effects, such as piped water supply, on pediatric appendicitis risk remain unclear. This longitudinal, nationwide, cohort study aimed to compare the risk of appendicitis among children with different levels of piped water supply. Using data from Taiwan Water Resource Agency and National Health Insurance Research Database, we identified 119,128 children born in 1996–2010 from areas of the lowest piped water supply (prevalence 51.21% to 63.06%) as the study cohort; additional 119,128 children of the same period in areas of the highest piped water supply (prevalence 98.97% to 99.63%) were selected as the controls. Both cohorts were propensity-score matched by baseline variables. We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) of appendicitis in the study cohort compared to the controls by Cox proportional hazards regression. The study cohort had a raised overall incidence rates of appendicitis compared to the control cohort (12.8 vs. 8.7 per 10,000 person-years). After covariate adjustment, the risk of appendicitis was significantly increased in the study cohort (adjusted HR = 1.46, 95% CI: 1.35, 1.58, p < 0.001). Subgroup and sensitivity analyses showed consistent results that children with low piped water supply had a higher risk of appendicitis than those with high piped water supply. This study demonstrated that children with low piped water supply were at an increased risk of appendicitis. Enhancement of piped water availability in areas lacking adequate, secure, and sanitized water supply may protect children against appendicitis. Full article

(This article belongs to the Special Issue Water, Sanitation and Hygiene Related Disease)

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17 pages, 1588 KiB

Open AccessArticle

Design, Intervention Fidelity, and Behavioral Outcomes of a School-Based Water, Sanitation, and Hygiene Cluster-Randomized Trial in Laos

by Anna N. Chard and Matthew C. Freeman

Int. J. Environ. Res. Public Health 2018, 15(4), 570; https://doi.org/10.3390/ijerph15040570 - 22 Mar 2018

Cited by 23 | Viewed by 9738

Abstract

Evidence of the impact of water, sanitation, and hygiene (WASH) in schools (WinS) interventions on pupil absence and health is mixed. Few WinS evaluations rigorously report on output and outcome measures that allow for comparisons of effectiveness between interventions to be made, or for an understanding of why programs succeed. The Water, Sanitation, and Hygiene for Health and Education in Laotian Primary Schools (WASH HELPS) study was a randomized controlled trial designed to measure the impact of the United Nations Children’s Fund (UNICEF) Laos WinS project on child health and education. We also measured the sustainability of intervention outputs and outcomes, and analyzed the effectiveness of group hygiene activities on behavior change and habit formation. Here, we present the design and intermediate results from this study. We found the WinS project improved the WASH environment in intervention schools; 87.8% of schools received the intervention per design. School-level adherence to outputs was lower; on average, schools met 61.4% of adherence-related criteria. The WinS project produced positive changes in pupils’ school WASH behaviors, specifically increasing toilet use and daily group handwashing. Daily group hygiene activities are effective strategies to improve school WASH behaviors, but a complementary strategy needs to be concurrently promoted for effective and sustained individual handwashing practice at critical times. Full article

(This article belongs to the Special Issue Water, Sanitation and Hygiene Related Disease)

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