Abnormal Gut Integrity is Associated With Reduced Linear Growth in Malawian Children

September 13, 2012 · 0 comments

Abnormal Gut Integrity is Associated With Reduced Linear Growth in Rural Malawian Children. Journal of Pediatric Gastroenterology & Nutrition, June 2012.

Weisz, Ariana J.; Manary, Micah J.; Stephenson, Kevin; Agapova, Sophia; Manary, Faith G.; Thakwalakwa, Chrissie; Shulman, Robert J.; Manary, Mark J.

The aim of this study was to investigate the relationship of environmental enteropathy (EE), as measured by the dual sugar absorption test, to linear growth faltering in 2-5 year old Malawian children. Dietary quality, food insecurity, anthropometry and site-specific sugar testing were measured in 418 children, and anthropometry was reassessed 3 months later.

A linear regression model predicting linear growth was created. Better growth was associated with less urinary lactulose excretion, more clean water usage, not sleeping with animals, and no previous history of malnutrition. 87% of children studied demonstrated evidence of EE. In conclusion, abnormal gut integrity is associated with reduced linear growth in a population of rural African preschool-aged children.

Contribution of Enteric Infection, Altered Intestinal Barrier Function, and Maternal Malnutrition to Infant Malnutrition

September 13, 2012 · 0 comments

Review- Environmental enteropathy: critical implications of a poorly understood condition. Trends in Molecular Medicine, June 2012.

Poonum S. Korpe, William A. Petri Jr. Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA 22908-1337, USA

Environmental enteropathy (also called tropical enteropathy) is a subclinical condition caused by constant fecal–oral contamination and resulting in blunting of intestinal villi and intestinal inflammation. Although these histological changes were discovered decades ago, the clinical impact of environmental enteropathy is just starting to be recognized.

The failure of nutritional interventions and oral vaccines in the developing world may be attributed to environmental enteropathy, as the intestinal absorptive and immunologic functions are significantly deranged. Here we review the existing literature and examine potential mechanisms of pathogenesis for this poorly understood condition

Political economy analysis for water, sanitation and hygiene (WASH) service delivery

September 7, 2012 · 0 comments

Political economy analysis for water, sanitation and hygiene (WASH) service delivery, 2012.

Michelle Kooy, ODI.

Key points

  • ‘Best practice’ models of sector governance rarely work; context-specific responses can be more efficient and more effective
  • This means starting with existing policies, institutions and incentives to develop ‘best fit’ approaches to water, sanitation and hygiene services
  • Political economy analysis helps, particularly  when focused on a specific, clearly defined operational challenge

India – Wastewater re-use for peri-urban agriculture

September 7, 2012 · 0 comments

Wastewater re-use for peri-urban agriculture: a viable option for adaptive water management? Sustain Sci 2012 DOI 10.1007/s11625-012-0178-0

Mathew Kurian, et al.

Urbanization is known to spur land modification in the form of conversion of common land to human settlements. This factor, combined with climate variability, can alter the duration, frequency and intensity of storm drain overflows in urban areas and lead to public health risks. In peri-urban regions where these risks are especiallyhigh it has been argued that, when domestic wastewater is managed, better prospects for freshwater water savings through swaps between urban water supply and irrigated agriculture may be possible. As a consequence of re-use ofdomestic wastewater, expenditure on inorganic inputs by farmers may decline and source sustainability of water supply could be enhanced.

Given the fact that, at present, approximately 20 million ha of land worldwide is being cultivated by re-using domestic wastewater, this paper draws on evidence from India to explore: (1) the economic costs–benefits of wastewater reuse in the context of hypothesized links to climate variability; (2) the role of local farming practices, market conditions and crop variety in influencing wastewater reuse in agriculture; and (3) the role of inter-governmental financing in influencing theselection of technical adaptation options for collection,treatment and disposal of wastewater.

Incidence of Respiratory Virus-Associated Pneumonia in Urban Poor Young Children of Dhaka

September 7, 2012 · 0 comments

Incidence of Respiratory Virus-Associated Pneumonia in Urban Poor Young Children of Dhaka, Bangladesh, 2009–2011. PLoS ONE 7(2) 2012: e32056. doi:10.1371/journal.pone.0032056

Homaira N, Luby SP, Petri WA, Vainionpaa R, Rahman M, et al. (2012)

The study findings demonstrated a high incidence of pneumonia associated with respiratory virus infection among children aged <2 years. These children were under close follow up and received timely treatment and referral services when necessary. Children under such close surveillance are likely to under represent severe illness [46]. Other than influenza, there are no safe and effective vaccines to prevent childhood virus respiratory infections. Our data suggests that influenza infection was prevalent in children aged <6 months old, a group that could benefit from maternal immunization against influenza infection [47]. Further research on developing safe and effective vaccines, especially for RSV, could also play an instrumental role in reducing the disease burden.

In the meantime, in low-income settings research focused on developing cost-effective interventions to address modifiable risk factors such as improved hygienic behavior, air quality, breast feeding practices and nutrition [2], [48], [49], [50] may help reduce the overall burden of respiratory tract infection in children.

Sustainable sanitary landfills for neglected small cities in developing countries

August 30, 2012 · 0 comments

Waste Manag. 2012 Aug 25.

Sustainable sanitary landfills for neglected small cities in developing countries: The semi-mechanized trench method from Villanueva, Honduras.

Oakley SM, Jimenez R. Department of Civil Engineering, Chico State University, California State University, Chico, CA 95929, United States.

Open dumping is the most common practice for the disposal of urban solid wastes in the least developed regions of Africa, Asia and Latin America. Sanitary landfill design and operation has traditionally focused on large cities, but cities with fewer than 50,000 in population can comprise from 6% to 45% of a given country’s total population. These thousands of small cities cannot afford to operate a sanitary landfill in the way it is proposed for large cities, where heavy equipment is used to spread and compact the waste in daily cells, and then to excavate, transport and apply daily cover, and leachate is managed with collection and treatment systems.

This paper presents an alternative approach for small cities, known as the semi-mechanized trench method, which was developed in Villanueva, Honduras. In the semi-mechanized trench method a hydraulic excavator is used for 1-3 days to dig a trench that will last at least a month before it is filled with waste. Trucks can easily unload their wastes into the trench, and the wastes compact naturally due to semi-aerobic biodegradation, after which the trenches are refilled and covered. The exposed surface area is minimal since only the top surface of the wastes is exposed, the remainder being covered by the sides and bottom of the trench. The surplus material from trench excavation can be valorized for use as engineering fill onsite or off.

The landfill in Villanueva has operated for 15years, using a total land area of approximately 11ha for a population that grew from 23,000 to 48,000, with a land requirement of 0.2m(2)/personyear, a cover to waste ratio of 0.2, and an estimated soil surplus of 298,000m(3) that is valorized and used onsite. The landfill has been operated solely by the municipality with an operational cost in 2010 estimated at US$4.60 per ton. A modified water balance analysis at Villanueva shows negligible leachate generation from covered trenches and 700m(3)/yr (60m(3)/hayr) from the two open trenches required for daily operation. If the site were an open dump, however, leachate generation is estimated to be 3900m(3)/hayr and contaminated runoff 5000m(3)/hayr.

A simple model used to estimate dilution of generated leachate based on groundwater flow data and aquifer stratigraphy suggests that the leachate will be diluted by a factor of 0.01 in the aquifer. Leachate contaminants will not accumulate because the aquifer discharges to the Ulua River 2km south of the landfill. While not suitable for all sites, the Villanueva method nevertheless serves as an excellent example of how a small city landfill with natural compaction of waste and attenuation of leachate can be sustainably operated.

Gordon McGranahan – What is the difference between improving sanitation and selling Coca Cola?

August 29, 2012 · 0 comments

Source: SHARE Newsletter, Aug 2012

Gordon McGranahan of SHARE partner IIED is a lead researcher on the SHARE City-Wide Sanitation Project. Here, he outlines his views on the demand problems which lie at the centre of the global sanitary challenge, and why he believes that a sanitation marketing approach based on commercial principles cannot address these problems.  

Introduction

Sanitation marketing has become popular in recent years and, as the latest toolkit on the subject indicates, this is sometimes taken to involve “using commercial marketing techniques to motivate households to build toilets” (Devine and Kullmann 2011) . Most practitioners avoid this narrow interpretation. Indeed, the toolkit just cited devotes a lot of attention to Community Led Total Sanitation (CLTS), an approach which owes far more to the techniques of participatory research than to those of commercial marketing (Kar 2008).

So, what could be wrong with promoting toilets as if they were a consumer good like Coca Cola?

There is a contentious argument against “sanitation marketing”, which its exponents must have already envisaged when they coined the term. Sanitation is viewed by many as a human right that governments have an obligation to provide if people cannot afford it themselves. Getting people who live in poverty to spend more money on sanitation can be seen as an attempt to avoid this responsibility, that if misjudged will drive people further into poverty. While there some truth to this claim, I would like to propose that there are indeed demand problems at the centre of the sanitary challenge, but not generally of the sort conventional marketing can address.

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Prevalence of infantile diarrhea in districts of Nouakchott (Mauritania) in 2008: analysis of local hygiene.

August 22, 2012 · 0 comments

Med Sante Trop. 2012 Aug 21.

Prevalence of infantile diarrhea in districts of Nouakchott (Mauritania) in 2008: analysis of local hygiene.

Sy I, Keita M, Lô B, Tanner M, Cissé G.

Institut national de recherche en santé publique (INRSP), B.P 695 Nouakchott, Mauritanie, Swiss Tropical and Public Health Institute (Swiss TPH), CH-4002, Bâle, Suisse.

In urban areas in Nouakchott, diarrheal diseases present a major public health problem, especially for children and adolescents. In August, 2008, a cross-sectional survey of 300 households in two adjacent districts of the city sought to study correlations between diarrheal disease and environmental health.

The results show that 87 children of all ages had about 139 episodes of diarrhea, for an average prevalence of 14.8% that varied by age (23.6% in children younger than 5 years and 9.7% among children aged 5 to 14 years) and area (16.8% in Tevragh-Zeina and 28.3% in Sebkha).

The univariate analysis indicates that 52% of the diarrhea risk was due to precarious basic hygiene. Studies of the specific causes of diarrheal diseases to help improve their treatment are necessary to supplement these epidemiological results.

New York Times – Cholera Epidemic Envelops Coastal Slums in West Africa

August 22, 2012 · 0 comments

Source: Adam Nossiter, New York Times – Aug 22, 2012

Cholera Epidemic Envelops Coastal Slums in West Africa

DAKAR, Senegal — A fierce cholera epidemic is spreading through the coastal slums of West Africa, killing hundreds and sickening many more in one of the worst regional outbreaks in years, health experts said.

Cholera, transmitted through contact with contaminated feces, was made worse this year by an exceptionally rainy season that flooded the sprawling shantytowns in Freetown and Conakry, the capitals of Sierra Leone and neighboring Guinea.

A health care worker treated Santigie Bundu's dehydrated 7-year-old son, on Aug. 13, at a cholera treatment center in Freetown, Sierra Leone.

In both countries, some two-thirds of the population lack toilets and defecate in the open, a potentially lethal threat in the rainy season because of the contamination of the water supply. Doctors Without Borders said there have been nearly twice as many cholera cases so far this year as there were in the same period in 2007 in Sierra Leone and Guinea.

Already, about 13,000 people suffering from the disease’s often fatal symptoms — diarrhea, vomiting and severe dehydration — have been treated in those two countries, and between 250 and 300 have died, Doctors Without Borders said.

In Sierra Leone, the government last week declared the cholera outbreak a national emergency, while aid workers in Guinea said the peak of the outbreak had not likely been reached. Both countries have been wracked by years of civil and political unrest, with Sierra Leone still recovering from a decade of bloody civil war that drove thousands from rural areas into the city’s slums and Guinea emerging from a half-century of often brutal dictatorship.

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David Winder, WaterAid USA – Urban Water and Sanitation Solutions

August 16, 2012 · 0 comments

Source: Huffington Post, Aug 15, 2012 – David Winder, WaterAid USA 

Urban Water and Sanitation Solutions

Having just returned to New York from Maputo, the capital of Mozambique, I’m reminded how lucky we are in this city to have reliable water and sanitation services. Thanks to investment in water pipes and sewers in the 19th century, diarrheal diseases that ran rife through our city a few generations ago have all but been eliminated, and we take it for granted that safe drinking water is available at the turn of a tap.

As in many other large cities across the developing world, Maputo is facing rapid growth of low income settlements and major challenges in providing the population with access to safe water and sanitation. The latest data (UNICEF/WHO 2012) show that only 77% of Mozambique’s urban population has access to improved water sources. The situation is even grimmer when it comes to sanitation, with only 38% of the urban population having access to safe sanitation.

The country has one of the highest infant mortality rates in the world with 86,000 children dying before their first birthdays every year. Diarrhea is one of the leading causes of child deaths and 44% of children under five are undernourished.

Increased investment in providing access to safe water and improved sanitation dramatically impacts child survival. In low-income areas of cities like Maputo, that is often a complex task. High population density, transient populations and, poor quality housing are part of the problem and present challenges to those striving to improve water and sanitation infrastructure.

Often in low-income urban neighborhoods the provision of piped water to homes is simply too expensive for ordinary families to afford. One way of tackling that problem is by helping local residents band together and negotiate affordable payment plans with water service providers with the help of local NGOs.

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