BMC Public Health
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Published: June 2019
Background: Unimproved water, sanitation, and hygiene (WASH) behaviors are key drivers of infectious disease transmission and influencers of mental well-being. While WASH is seen as a critical enabler of health, important knowledge gaps related to the content and delivery of effective, holistic WASH programming exist. Corresponding impacts of WASH on mental well-being are also underexplored. There is a need for more robust implementation research that yields information regarding whether and how community-based, demand-side interventions facilitate progressive and sustained adoption of improved sanitation and hygiene behaviors and downstream health impacts. The purpose of this protocol is to detail the rationale and design of a cluster-randomized trial evaluating the impact of a demand-side sanitation and hygiene intervention on sustained behavior change and mental well-being in rural and peri-urban Amhara, Ethiopia.
Methods: Together with partners, we developed a theoretically-informed, evidence-based behavioral intervention called Andilaye. We randomly selected and assigned 50 sub-districts (kebeles) from three purposively selected districts (woredas); half to receive the Andilaye intervention, and half the standard of care sanitation and hygiene programming (i.e., community-led total sanitation and hygiene [CLTSH]). During baseline, midline, and endline, we will collect data on an array of behavioral factors, potential moderators (e.g., water and sanitation insecurity, collective efficacy), and our primary study outcomes: sanitation and hygiene behaviors and mental well-being. We will perform a process evaluation to assess intervention fidelity and related attributes.
Discussion: While CLTSH has fostered sanitation and hygiene improvements in Ethiopia, evidence of behavioral slippage, or regression to unimproved practices in communities previously declared open defecation free exists. Other limitations of CLTSH, such as its focus on disgust, poor triggering, and over-saturation of Health Extension Workers have been documented. We employed rigorous formative research and practically applied social and behavioral theory to develop Andilaye, a scalable intervention designed to address these issues and complement existing service delivery within Ethiopia's Health Extension Program. Evidence from this trial may help address knowledge gaps related to scalable alternatives to CLTSH and inform sanitation and hygiene programming and policy in Ethiopia and beyond.
Trial Registration: This trial was registered with clinicaltrials.gov ( NCT03075436 ) on March 9, 2017.
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http://dx.doi.org/10.1186/s12889-019-7040-6 | DOI Listing |
Narra J
December 2024
Master of Biomedicine Study Program, School of Medicine and Health Sciences, Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia.
Intestinal parasitic infections (IPIs), caused by helminths and/or protozoa, continue to be a significant public health concern in Indonesia. Water access, sanitation, and hygiene practices (WASH) are influential factors for IPIs, especially among children. The aim of this study was to investigate the association between WASH and IPIs among school-aged children.
View Article and Find Full Text PDFParasite Epidemiol Control
February 2025
Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, PO box 13033 Yaoundé, Cameroon.
Background: Urbanization coupled with poverty has promoted the exploitation of risk zones like flood-prone areas in the city of Yaoundé. The overcrowding and poor hygiene observed in these areas are responsible for the unsmiling variations in environmental cleanliness, exploitation of river water for domestic purposes thus putting them at risk for parasitic disease transmissions. This study was conducted in order to assess the risks of human helminthiases outbreaks in relation to water physico-chemical factors in the city of Yaoundé.
View Article and Find Full Text PDFEnviron Sci Technol
January 2025
Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington 98195, United States.
Enteropathogens are major contributors to mortality and morbidity, particularly in settings with limited access to water, sanitation, and hygiene infrastructure. To assess transmission pathways associated with enteropathogen infection, we measured household environmental conditions and assayed 22 enteropathogens using TaqMan Array Cards in stool samples from 276 six-month-old children living in communities along a rural-urban gradient in Northern Ecuador. We utilized multivariable models, risk factor importance, and distance-based statistical methods to test factors associated with infection.
View Article and Find Full Text PDFBackground: Public health is seriously threatened by transmission of zoonotic infection through the food chain. Factors like increasing population, deforestation, high demand for animal protein, and trade of sub-clinically infected animals are the main causes of the spread of infections from asymptomatic animals to humans. Despite several national programs like (The Clean India Mission) prevention of open defecation and water, sanitation, and hygiene (WASH), the incidence of diarrhoeal diseases remains high in India.
View Article and Find Full Text PDFBMC Infect Dis
January 2025
Department of Medical Laboratory Science, College of Health Sciences, Woldia University, P.O. box 400, Woldia, Ethiopia.
Background: Intestinal parasite infections remain a serious public health concern around the world, particularly in countries with inadequate sanitation. The study aims to ascertain the total magnitude of intestinal parasites in diabetes patients throughout the African countries.
Objective: The aim of this systematic review and meta-analysis was to determine the general burden of intestinal parasites among diabetic patients in Africa.
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