Detecting Enteric Pathogens in Low-Risk Drinking Water in Dhaka, Bangladesh: An Assessment of the WHO Water Safety Categories.

The microbiological quality of water is usually assessed by fecal coliform bacteria, and the presence of as an indicator of fecal contamination is widely recommended by international guidelines. This study aimed to assess the prevalence of diarrheagenic pathogens, in both public and personal domain water sources and examine the reliance on the WHO drinking water risk assessment guidelines. This study was conducted in a low-income urban community in Dhaka, Bangladesh between September 2014 and October 2015.

Introduction of the Personal Domain in Water Sanitation and Hygiene (WASH), a New Approach to Identify Missing Health Impacts.

The water sanitation and hygiene (WASH) sector has provided beneficiaries in low and middle-income countries with latrines and clean water for decades. However, we still need good evidence documenting the expected health impact. This paper investigates why we lack this evidence and ways to move forward.

Influence of Seasonal Hazards on Water, Sanitation, and Hygiene-Related Behavior and Implications for Cholera Transmission in Bangladesh.

Most cholera outbreaks in Bangladesh are seasonal, peaking in the dry and post-monsoon periods. Therefore, we investigated whether changes in water, sanitation, and hygiene (WASH) behavior in three populations in Bangladesh during the year could help explain why these two periods are particular to cholera transmission. The study used a mixed-method design, including a repeated cross-sectional study, focus group discussions, and key informant interviews.

Measuring Water Quantity Used for Personal and Domestic Hygiene and Determinants of Water Use in a Low-Income Urban Community.

There is a paucity of recent research on direct water quantity measurement for personal and domestic hygiene. We aimed to measure the water quantity used for personal and domestic hygiene and to explore the reasons and determinants for variation of water usage. We conducted this study from September 2014 to June 2016 in a low-income urban community in Dhaka.

The Meaning of "Hygiene" and Its Linked Practices in a Low-Income Urban Community in Bangladesh.

Improving hygiene practices is considered to be the single most cost-effective means of reducing the global health burden of infectious diseases. Hygiene promotion and disease prevention interventions often portray and promote "hygiene" from a biomedical perspective, which may not be optimally effective for achieving their goal of changing people's behaviors. This study aimed to educe the meaning of hygiene for the residents of a low-income community in Bangladesh and how that meaning shapes their personal hygiene practices.

Escherichia coli Ingested via Food May Overshadow the Positive Effects of Clean Drinking Water: An Example from Dhaka.

The minimal health impact observed in large-scale water sanitation and hygiene (WASH) intervention studies motivated us to investigate the contribution of contaminated food and drinking water to the total daily Escherichia coli load ingested by the average adult in a low-income, urban area. Leftover food (food left at room temperature for more than 6 hours) from 32 households was collected eight times at 6-week intervals in 2014-2015 in the low-income area of Arichpur, Dhaka, Bangladesh. In total, 117 samples were obtained from four food types: fish, lentils, rice, and vegetables, which comprise approximately 85.

Is It Human or Animal? The Origin of Pathogenic in the Drinking Water of a Low-Income Urban Community in Bangladesh.

This study aimed to investigate the origin of diverse pathotypes of , isolated from communal water sources and from the actual drinking water vessel at the point-of-drinking inside households in a low-income urban community in Arichpur, Dhaka, Bangladesh, using a polymerase chain reaction (PCR). Forty-six percent (57/125, CI 95%: 41-58) of the isolates in the point-of-drinking water and 53% (55/103, CI 95%: 45-64) of the isolates in the source water were diarrheagenic . Among the pathotypes, enterotoxigenic (ETEC) was the most common, 81% (46/57) of ETEC was found in the point-of-drinking water and 87% (48/55) was found in the communal source water.

Cost of illness for severe and non-severe diarrhea borne by households in a low-income urban community of Bangladesh: A cross-sectional study.

The illness cost borne by households, known as out-of-pocket expenditure, was 74% of the total health expenditure in Bangladesh in 2017. Calculating economic burden of diarrhea of low-income urban community is important to identify potential cost savings strategies and prioritize policy decision to improve the quality of life of this population. This study aimed to estimate cost of illness and monthly percent expenditure borne by households due diarrhea in a low-income urban settlement of Dhaka, Bangladesh.

Investigation of the Domestic Reservoirs of Diarrheagenic Escherichia coli in Diarrhea Case Households of Urban Bangladesh.

This study collected rectal swabs from diarrheal patients and in-house environmental samples from low-income households in Dhaka City, Bangladesh, over a 4-month period and investigated these to determine the domestic transmission pathways of Escherichia coli-associated diarrhea. The environmental samples included swabs from four frequently touched surfaces, drinking water and food. Both the rectal swabs and environmental samples were examined for virulence genes characteristic of diarrheagenic E.

Historical and contemporary views on cholera transmission: are we repeating past discussions? Can lessons learned from cholera be applied to COVID-19?

Cholera, a devastating diarrheal disease that caused several global pandemics in the last centuries, may share some similarities with the new COVID-19. Cholera has affected many populations in history and still remains a significant burden in developing countries. The main transmission route was thought to be predominantly through contaminated drinking water.

Developing a forecasting model for cholera incidence in Dhaka megacity through time series climate data.

Cholera, an acute diarrheal disease spread by lack of hygiene and contaminated water, is a major public health risk in many countries. As cholera is triggered by environmental conditions influenced by climatic variables, establishing a correlation between cholera incidence and climatic variables would provide an opportunity to develop a cholera forecasting model. Considering the auto-regressive nature and the seasonal behavioral patterns of cholera, a seasonal-auto-regressive-integrated-moving-average (SARIMA) model was used for time-series analysis during 2000-2013.

Water usage, hygiene and diarrhea in low-income urban communities-A mixed method prospective longitudinal study.

Epidemiological studies considered water use and hygiene practices as central risk factors for diarrhea. Few studies focused on independent association of water quantity with diarrheal diseases. This study aimed to describe the methodological protocol that adapted multidisciplinary and mixed-method research approach to assess how water usage including water quantity influences the attributable risk for diarrhea in a low-income urban community in Bangladesh.

The Cholera Phone: Diarrheal Disease Surveillance by Mobile Phone in Bangladesh.

Existing methodologies to record diarrheal disease incidence in households have limitations due to a high-episode recall error outside a 48-hour window. Our objective was to use mobile phones for reporting diarrheal episodes in households to provide real-time incidence data with minimum resource consumption and low recall error. From June 2014 to June 2015, we enrolled 417 low-income households in Dhaka, Bangladesh, and asked them to report diarrheal episodes to a call center.

Exploring Droughts and Floods and Their Association with Cholera Outbreaks in Sub-Saharan Africa: A Register-Based Ecological Study from 1990 to 2010.

Cholera outbreaks in Africa have been attributed to both droughts and floods, but whether the risk of a cholera outbreak is elevated during droughts is unknown. We estimated the risk of cholera outbreaks during droughts and floods compared with drought- and flood-free periods in 40 sub-Saharan African countries during 1990-2010 based on data from Emergency Events Database: the Office of Foreign Disaster Assistance /Centre for Research on the Epidemiology of Disasters International Disaster Database (www.emdat.

Can Escherichia coli fly? The role of flies as transmitters of E. coli to food in an urban slum in Bangladesh.

Objective: To investigate the transmission of faecal bacteria by flies to food under natural settings.

Methods: Over a period of 2 months, paired (exposed and non-exposed) containers with cooked rice were placed on the ground in kitchen areas in an urban slum area in Dhaka, Bangladesh, and the numbers of flies landing on the exposed rice were counted. Following exposure, the surface of the rice was microbiologically and molecularly analysed for the presence of Escherichia coli and genes of diarrhoeagenic E.

Development and Validation of a Novel Real-time Assay for the Detection and Quantification of .

O1 and O139 has been known for its ability to cause epidemics. These strains produce cholera toxin which is the main cause of secretory diarrhea. non-O1 and non-O139 strains are also capable of causing gastroenteritis as well as septicemia and peritonitis.

Measuring domestic water use: a systematic review of methodologies that measure unmetered water use in low-income settings.

Objective: To present a systematic review of methods for measuring domestic water use in settings where water meters cannot be used.

Methods: We systematically searched EMBASE, PubMed, Water Intelligence Online, Water Engineering and Development Center, IEEExplore, Scielo, and Science Direct databases for articles that reported methodologies for measuring water use at the household level where water metering infrastructure was absent or incomplete. A narrative review explored similarities and differences between the included studies and provide recommendations for future research in water use.

Survival of Vibrio cholerae O1 on fomites.

It is well established that the contamination sources of cholera causing bacteria, Vibrio cholerae, are water and food, but little is known about the transmission role of the fomites (surfaces that can carry pathogens) commonly used in households. In the absence of appropriate nutrients or growth conditions on fomites, bacteria have been known to assume a viable but non-culturable (VBNC) state after a given period of time. To investigate whether and when V.

Drinking cholera: salinity levels and palatability of drinking water in coastal Bangladesh.

Objectives: To measure the salinity levels of common water sources in coastal Bangladesh and explore perceptions of water palatability among the local population to investigate the plausibility of linking cholera outbreaks in Bangladesh with ingestion of saline-rich cholera-infected river water.

Methods: Hundred participants took part in a taste-testing experiment of water with varying levels of salinity. Salinity measurements were taken of both drinking and non-drinking water sources.

How do we sell the hygiene message? With dollars, dong or excreta?

In North and Central Vietnam it is common among farmers to use excreta from the family double vault composting latrine (DVC) as fertilizer in the fields. The official Vietnamese health guidelines stipulate a six-month period of composting before applying excreta to two of their three annual crops. However, farmers in this region cannot afford to follow these guidelines and this paper presents the reasons why.

[Water and sanitation in disaster situations].

When implementing water and sanitation in a disaster situation, it is of crucial importance that the intervention is grounded in the local cultural and socioeconomic context. The assistance provided in the response phase should facilitate short and long-term recovery and sustainable development of the affected community. The new model for disaster management which comprises an integrated continuous risk reduction phase, calls for a cross-disciplinary approach which combines the known life-saving response methods with modern development practices.

Hygiene versus fertiliser: the use of human excreta in agriculture--a Vietnamese example.

The use of human excreta as fertiliser in agriculture is a common practice in parts of South East Asia benefiting production but at the same time a risk factor for increased helminth infections. This paper describes the hygienic handling of human excreta for use in agriculture in Central Vietnam from a practical farming perspective presenting the farmers perceived health risks and benefits of its use. Further, in the study findings are discussed relating to the new Vietnamese guidelines for the use of human excreta in agriculture to their implications on an on-farm context.