Improved water, sanitation, hygiene and waste services in health-care facilities, Ukraine.

Problem: Water, sanitation and waste infrastructure and services in Ukrainian health-care facilities often fail to meet global and national standards, hindering the provision of safe, quality care. The war has worsened existing problems.

Approach: To incrementally improve water, sanitation, hand hygiene, environmental cleaning and health-care waste practices, the World Health Organization (WHO) is working with the health ministry, the Ukrainian Public Health Centre and regional United States Centers for Disease Prevention and Control (CDC) to implement the Water and Sanitation for Health Facility Improvement Tool (WASH FIT).

Estimating the cost of achieving basic water, sanitation, hygiene, and waste management services in public health-care facilities in the 46 UN designated least-developed countries: a modelling study.

Background: An alarming number of public health-care facilities in low-income and middle-income countries lack basic water, sanitation, hygiene (WASH), and waste management services. This study estimates the costs of achieving full coverage of basic WASH and waste services in existing public health facilities in the 46 UN designated least-developed countries (LDCs).

Methods: In this modelling study, in-need facilities were quantified by combining published counts of public facilities with estimated basic WASH and waste service coverage.

Costs of hand hygiene for all in household settings: estimating the price tag for the 46 least developed countries.

Introduction: Domestic hand hygiene could prevent over 500 000 attributable deaths per year, but 6 in 10 people in least developed countries (LDCs) do not have a handwashing facility (HWF) with soap and water available at home. We estimated the economic costs of universal access to basic hand hygiene services in household settings in 46 LDCs.

Methods: Our model combines quantities of households with no HWF and prices of promotion campaigns, HWFs, soap and water.

Interventions to improve water supply and quality, sanitation and handwashing facilities in healthcare facilities, and their effect on healthcare-associated infections in low-income and middle-income countries: a systematic review and supplementary scoping review.

Introduction: Healthcare-associated infections (HCAIs) are the most frequent adverse event compromising patient safety globally. Patients in healthcare facilities (HCFs) in low-income and middle-income countries (LMICs) are most at risk. Although water, sanitation and hygiene (WASH) interventions are likely important for the prevention of HCAIs, there have been no systematic reviews to date.

Selecting Household Water Treatment Options on the Basis of World Health Organization Performance Testing Protocols.

The World Health Organization's International Scheme to Evaluate Household Water Treatment Technologies serves to benchmark microbiological performance of existing and novel technologies and processes for small-scale drinking water treatment according to a tiered system. There is widespread uncertainty around which tiers of performance are most appropriate for technology selection and recommendation in humanitarian response or for routine safe water programming. We used quantitative microbial risk assessment (QMRA) to evaluate attributable reductions in diarrheal disease burden associated with water treatment technologies meeting the three tiers of performance under this Scheme, across a range of conditions.

Possible Trimethoprim-Sulfamethoxazole-Induced Hemolytic Anemia: A Case Report.

Objective: To report a case of hemolytic anemia in a patient who received trimethoprim/sulfamethoxazole (TMP-SMX) for a urinary tract infection (UTI).

Summary: A 47-year-old woman recently diagnosed with uncomplicated UTI received 3 doses of TMP-SMX. She developed yellowing of the skin and eyes, lethargy, mild abdominal pain, and dry mucous membranes.

Improving water, sanitation and hygiene in health-care facilities, Liberia.

Problem: The lack of proper water and sanitation infrastructures and poor hygiene practices in health-care facilities reduces facilities' preparedness and response to disease outbreaks and decreases the communities' trust in the health services provided.

Approach: To improve water and sanitation infrastructures and hygiene practices, the Liberian health ministry held multistakeholder meetings to develop a national water, sanitation and hygiene and environmental health package. A national train-the-trainer course was held for county environmental health technicians, which included infection prevention and control focal persons; the focal persons acted as change agents.

Daclatasvir (Daklinza): A Treatment Option for Chronic Hepatitis C Infection.

Daclatasvir (Daklinza) for chronic hepatitis C infection.

Recommendations for dealing with waste contaminated with Ebola virus: a Hazard Analysis of Critical Control Points approach.

Objective: To assess, within communities experiencing Ebola virus outbreaks, the risks associated with the disposal of human waste and to generate recommendations for mitigating such risks.

Methods: A team with expertise in the Hazard Analysis of Critical Control Points framework identified waste products from the care of individuals with Ebola virus disease and constructed, tested and confirmed flow diagrams showing the creation of such products. After listing potential hazards associated with each step in each flow diagram, the team conducted a hazard analysis, determined critical control points and made recommendations to mitigate the transmission risks at each control point.

Why "improved" water sources are not always safe.

Existing and proposed metrics for household drinking-water services are intended to measure the availability, safety and accessibility of water sources. However, these attributes can be highly variable over time and space and this variation complicates the task of creating and implementing simple and scalable metrics. In this paper, we highlight those factors - especially those that relate to so-called improved water sources - that contribute to variability in water safety but may not be generally recognized as important by non-experts.

Understanding household behavioral risk factors for diarrheal disease in Dar es Salaam: a photovoice community assessment.

Whereas Tanzania has seen considerable improvements in water and sanitation infrastructure over the past 20 years, the country still faces high rates of childhood morbidity from diarrheal diseases. This study utilized a qualitative, cross-sectional, modified Photovoice method to capture daily activities of Dar es Salaam mothers. A total of 127 photographs from 13 households were examined, and 13 interviews were conducted with household mothers.

Relationship between distance to social gathering facilities and risk of trachoma for households in rural Tanzanian communities.

Few studies have examined the physical isolation of households with trachoma cases. Thus, in this study, we sought to examine the association between household isolation, as measured by distance to social gathering facilities, and risk of trachoma. We hypothesized that households located closer to such facilities would have a decreased risk of trachoma, due to a variety of social, economic, and cultural reasons.

Comparing the effectiveness of shared versus private latrines in preventing trachoma in rural Tanzania.

Sharing latrines is common in sub-Saharan Africa with anecdotal accounts suggesting a link between water-, sanitation-, and hygiene-related disease and poorly maintained communal latrines. This study examines this link by assessing the association between shared latrines compared with private latrines and risk of trachoma. In 2007, as part of a larger case-control study, we conducted a sub-study on latrine sharing in 594 households (92 cases, 502 controls) in seven rural Tanzanian communities.

Assessment of latrine use and quality and association with risk of trachoma in rural Tanzania.

The existing evidence regarding latrines and trachoma is inconclusive. Using more precise sanitation measures we examine the association between use and quality of latrines and risk of trachoma. We conducted a case-control study of 678 households (95 cases, 583 controls) in eight villages in Kongwa District, Tanzania.

Norovirus removal and particle association in a waste stabilization pond.

The presence of norovirus (NoV) genogroup I (GI) and II (GII) was evaluated using real-time reverse transcription polymerase chain reaction (rRT-PCR) in the influent, two midtreatment locations, and final effluent of a three-pond serial waste stabilization pond system from December 2005 through June 2006. Additionally, influent and effluent samples were filtered through a cascade of three membrane filters with sequentially smaller pores to determine the size range of particles with which GI and GII were associated. NoV GI and GII removal occurs primarily in the third pond.