The limits of nudging: Results of a randomized trial of text messages to promote home-based caregiving and reduce perceptions of stigma for COVID-19 patients in Kenyan informal settlements.

During the early stages of the global COVID-19 pandemic, governments searched for effective means to rapidly disseminate information about how to prevent the disease and care for sick household members. In June 2020, the government of Kenya considered sending text messages, a behavioral nudging approach, to inform and persuade the public to practice home-based care for those who were infected. We conducted a randomized evaluation of simple informational messages compared to messages targeting personal and social benefits for those receiving the messages.

Evaluation of occupational health and safety intervention for the waste and sanitation workers in Bangladesh during COVID-19.

Waste and sanitation workers in South-Asian countries are vulnerable to injuries and diseases, including COVID-19. In Bangladesh, an intervention was implemented during COVID-19 to lower these workers' occupational health risks through training and PPE distribution. We assessed how the intervention affected their occupational health behaviors using a randomized cluster trial in 10 Bangladeshi cities, including seven intervention and three control areas.

Hygiene knowledge and practices and determinants of occupational safety among waste and sanitation workers in Bangladesh during the COVID-19 pandemic.

Waste and sanitation workers provide essential services to society. In most low-and middle-income countries, they are often mistreated and lack access to necessary personal protective equipment (PPE) and hygiene facilities that ensure occupational safety in workplaces. COVID-19 has also imposed serious health risks upon these worker groups.

Principles for increasing equity in WASH research: understanding barriers faced by LMIC WASH researchers.

Introduction: There have long been critiques of colonial legacies influencing global health. With growing public awareness of unjust systems in recent years, a new wave of calls for antiracist and decolonisation initiatives has emerged within the sector. This study examined research inequities in the water, sanitation and hygiene (WASH) sector, centring the perspectives of researchers from low-income and middle-income countries (LMICs), to identify barriers faced by WASH researchers in order to support more equitable changes in this subsector of global health.

Factors associated with safe child feces disposal in Ethiopia, India, and Zambia.

Safe child feces disposal (CFD) is defined as a child or caregiver placing or rinsing child feces into an improved sanitation facility. In low- and middle-income countries (LMICs), 48% of households with children under five report that child feces were safely disposed. Despite its widespread prevalence and harmful health effects, little is known about the determinants of safe CFD.

Measuring household hygiene access and handwashing behaviors: Findings from 14 low- and middle-income countries.

Handwashing with soap (HWWS) is critical for preventing diarrheal and respiratory infections and is an important policy priority to achieve the Sustainable Development Goals (SDGs). We analyzed hygiene data from 36,860 household surveys from rural areas in India, Honduras, and twelve countries in sub-Saharan Africa (SSA). We report descriptive statistics and compare and critique three indicators: (1) access to basic hygiene services, defined as a reported designated handwashing area with observed water and soap at the time of the survey; (2) use of both soap and water during demonstrated handwashing; and (3) reported handwashing both after defecation and before preparing food.

Healthcare provider satisfaction with environmental conditions in rural healthcare facilities of 14 low- and middle-income countries.

Healthcare provider (HCP) satisfaction is important for staff retention and effective health service delivery. Inadequate resources, understaffing, and ineffective organizational structure may reduce HCP satisfaction in low- and middle-income countries (LMICs). Some qualitative studies have described links between environmental conditions and job satisfaction in HCPs; however, few studies have explored this link using survey data.

Gendered economic, social and health effects of the COVID-19 pandemic and mitigation policies in Kenya: evidence from a prospective cohort survey in Nairobi informal settlements.

Objectives: COVID-19 may spread rapidly in densely populated urban informal settlements. Kenya swiftly implemented mitigation policies; we assess the economic, social and health-related harm disproportionately impacting women.

Design: A prospective longitudinal cohort study with repeated mobile phone surveys in April, May and June 2020.

Mobility Patterns During COVID-19 Travel Restrictions in Nairobi Urban Informal Settlements: Who Is Leaving Home and Why.

Nairobi's urban slums are ill equipped to prevent spread of the novel coronavirus disease (COVID-19) due to high population density, multigenerational families in poorly ventilated informal housing, and poor sanitation. Physical distancing policies, curfews, and a citywide lockdown were implemented in March and April 2020 resulting in sharp decreases in movement across the city. However, most people cannot afford to stay home completely (e.

Where Shared Sanitation is the Only Immediate Option: A Research Agenda for Shared Sanitation in Densely Populated Low-Income Urban Settings.

Shared sanitation is not currently accepted within the international normative definitions of "basic" or "safely managed" sanitation. We argue that pro-poor government strategies and investment plans must include high-quality shared sanitation as an intermediate step in some densely populated urban areas. User experience must be considered in establishing the definition of high quality.

Combating COVID-19 in Bangladesh: ideal duration of mandatory quarantine period and policy implications.

Amid this Covid-19 pandemic, it is crucial to have the best possible estimation for essential quarantine days to mitigate the risk of Coronavirus spread. In this article, we aim to better approximate the mandatory quarantine days based on the available published literature. Our review of scientific publications revealed that 14 days of quarantine is nor enough neither effective in restricting the Coronavirus.

Strategies to Connect Low-Income Communities with the Proposed Sewerage Network of the Dhaka Sanitation Improvement Project, Bangladesh: A Qualitative Assessment of the Perspectives of Stakeholders.

In Bangladesh, approximately 31% of urban residents are living without safely managed sanitation, the majority of whom are slum residents. To improve the situation, Dhaka Water Supply and Sewerage Authority (DWASA) is implementing the Dhaka Sanitation Improvement Project (DSIP), mostly funded by the World Bank. This study assessed the challenges and opportunities of bringing low-income communities (LICs) under a sewerage connection within the proposed sewerage network plan by 2025.

Impact of a teacher-led school handwashing program on children's handwashing with soap at school and home in Bihar, India.

Handwashing with soap is an important preventive health behavior, and yet promoting this behavior has proven challenging. We report the results of a program that trained teachers to deliver a handwashing with soap behavior change program to children in primary schools in Bihar, India. Ten intervention schools selected along with ten nearby control schools, and intervention schools received the "School of Five" program promoting handwashing with soap using interactive stories, games, and songs, behavioral diaries to encourage habit formation, and public commitment.

Integrating Face Washing into a School-Based, Handwashing Behavior Change Program to Prevent Trachoma in Turkana, Kenya.

Trachoma is the leading infectious cause of blindness, and facial cleanliness is associated with reduced odds of trachomatous inflammation and infection, but there is little evidence of how to drive this behavior change at scale. We report the results of a program integrating face washing into a school-based handwashing promotion program in Turkana County, Kenya. Children aged 5-15 years participated in an intervention delivered to schools in two phases, along with a third phase receiving the intervention after the evaluation, which served as a control.

Using a theory-driven creative process to design a peri-urban on-site sanitation quality improvement intervention.

Background: Behavior change interventions have been developed by drawing from many different theories using design processes of varying specificity. We describe the development of a behavior change intervention to improve on-site peri-urban sanitation quality in Lusaka, Zambia using the Behavior Centered Design (BCD) framework to explain the results of the process applied to improving the quality of shared peri-urban sanitation and compare them to similar interventions.

Methods: We used the BCD behavioral determinants model to synthesize the data from our literature review and formative research.

Understanding demand for higher quality sanitation in peri-urban Lusaka, Zambia through stated and revealed preference analysis.

Poor peri-urban sanitation is a significant public health problem, likely to become more important as the world rapidly urbanizes. However, little is known about the role of consumer demand in increasing peri-urban sanitation quality, especially for tenants using shared sanitation as only their rental choices can be observed in the market. We analyzed data on existing housing markets collected between 9 Jun and 6 Jul 2017 using the Hedonic Pricing Method (HPM) to capture the percentage of rent attributable to sanitation quality (n = 933).

Basal cell carcinoma of the groin and buttocks: a clinical and histological analysis of a rare presentation of a common tumor.

Background: Basal cell carcinoma (BCC) is a common tumor but rarely presents on nonexposed skin. We sought to identify and characterize the traits of the malignancy over a 10-year period.

Methods: A retrospective chart review of all BCCs between 2007 and 2017 was performed.

Effect of a behaviour change intervention on the quality of peri-urban sanitation in Lusaka, Zambia: a randomised controlled trial.

Background: Poor sanitation in peri-urban areas is a growing public health problem. We tested a scalable, demand-side behaviour change intervention to motivate landlords to improve the quality of shared toilets within their plots.

Methods: We did a residential plot-randomised controlled trial in a peri-urban community in Lusaka, Zambia.

Freshwater microalgae (Schizochytrium sp.) as a substitute to fish oil for shrimp feed.

Micro-algae, Schizochytrium sp., is rich source of docosahexaenoic acid, DHA (66%-lipid with 27%-DHA). Eight nutritionally balanced-diets were formulated: diet 1 (control) consisted of only fish oil (FO); diets 2 and 3 had increasing amounts of algae-meal and soybean oil (SBO) at the expense of FO; diet 4 consisted of a combination of algae meal (37-g/kg), SBO (21-g/kg), and linseed oil (LSO) at 4-g/kg each; diet 5 had microalgae meal at 50-g/kg and equal amounts of LSO and SBO at 8-g/kg; diets 6 and 7 contained equal amounts of algae-meal at 62-g/kg, but with LSO or SBO added at 8-mg/g, respectively; diet 8 contained only algae-meal at 75-mg/g.

Effect of Two Complementary Mass-Scale Media Interventions on Handwashing with Soap among Mothers.

Poor handwashing behavior is a major cause of morbidity and mortality globally. We evaluated two complementary mass-scale media interventions targeting mothers to increase the frequency of handwashing with soap; one using TV advertising, and the other mobile phone messaging. Television Commercials (TVCs): Mothers of 4-12 year-old children (n = 756) were randomly allocated among four arms: Three different branded TVCs and a fourth, control TVC unrelated to handwashing.

Theory-driven formative research on on-site, shared sanitation quality improvement among landlords and tenants in peri-urban Lusaka, Zambia.

Rapid, unplanned urbanization in low-income countries is leading to increasing problems of dealing with human waste. On-site sanitation systems are often rudimentary, unhygienic, and poorly maintained. In-depth, on-site interactive interviews were conducted with 33 landlords and 33 tenants in a neighborhood in peri-urban Lusaka to understand on-site, shared sanitation quality improvement behaviors and preferences.

Clinical evaluation and in-vivo analysis of the performance of a fractional infrared 1550 nm laser system for skin rejuvenation.

: This study was done to demonstrate the safety and efficacy of a novel fractional 1550 nm laser device with a rolling mechanism (FRAX1550 Ellipse Medical, Horsholm, Denmark). : To evaluated the effectiveness of the 1550 nm device for improvement in wrinkles, pigmentation, and texture on a six point (-1 to 4) global improvement scale. : Five female subjects between the ages of 44 and 71 years, with visible wrinkles and/or dyspigmentation were enrolled in the study.