We evaluated whether provision and promotion of improved sanitation hardware (toilets and child feces management tools) reduced rotavirus and human fecal contamination of drinking water, child hands, and soil among rural Bangladeshi compounds enrolled in a cluster-randomized trial. We also measured host-associated genetic markers of ruminant and avian feces. We found evidence of widespread ruminant and avian fecal contamination in the compound environment; non-human fecal marker occurrence scaled with animal ownership. Strategies for controlling non-human fecal waste should be considered when designing interventions to reduce exposure to fecal contamination in low-income settings. Detection of a human-associated fecal marker and rotavirus was rare and unchanged by provision and promotion of improved sanitation to intervention compounds. The sanitation intervention reduced ruminant fecal contamination in drinking water and general (non-host specific) fecal contamination in soil but overall had limited effects on reducing fecal contamination in the household environment.

Objective: To evaluate serum concentrations of trace elements in tuberculosis (TB) patients with or with out human immunodeficiency virus (HIV) coinfection before and after anti-TB chemotherapy. Subjects: A total of 155 TB patients, 74 of which were coinfected with HIV, and 31 healthy controls from Gondar, Ethiopia. Methods: Serum levels of copper, zinc, selenium and iron were determined using an inductively coupled plasma mass spectrometer from all subjects at baseline and from 44 TB patients (22 with HIV coinfection) at the end of an intensive phase of anti-TB chemotherapy. Results: Compared with the control group, the concentrations of iron, zinc and selenium were significantly lower (Po0.05) while that of copper and copper/zinc ratio was significantly higher (Po0.05) in the serum of TB patients. TB patients with HIV coinfection had significantly lower serum zinc and selenium concentrations and significantly higher copper/zinc ratio compared to that in TB patients without HIV coinfection (Po0.05). The serum concentration of zinc had significantly increased at the end of intensive phase of anti-TB chemotherapy in patients without HIV coinfection (Po0.05). An increase in serum selenium level was observed in TB patients with or without HIV coinfection after therapy. On the contrary, serum copper concentration and copper/zinc ratio declined significantly after anti-TB chemotherapy irrespective of HIV serostatus (Po0.05). Conclusions:The results indicate that TB patients have altered profile of trace elements in their sera. This warrants the need for further investigations so that strategies for trace elements supplementation can be planned in addition to their potential as diagnostic parameters in monitoring responses to anti-TB chemotherapy.

Abstractobjective This study was conducted to measure the impact of a hygiene intervention on the contamination of weaning food in Bangladesh.methods Sixty households were selected: 30 study and 30 control households. Samples of weaning food were collected from all the 60 households at baseline and examined for faecal coliforms (FC), faecal streptococci (FS) and Clostridium perfringens (CP) following standard procedures. After cooking, food samples were collected on three occasions before feeding. Following Hazard Analysis Critical Control Point (HACCP) procedures, critical control points were determined. The mothers in the 30 study households were then trained for 4 weeks in how to attain the control point conditions. Then, again the food samples were collected and analysed.results At baseline, weaning foods from study and control households were heavily contaminated with FC and FS. The FC and FS counts were 1.84 log 10 and 1.92 log 10 colony-forming unit (cfu)/g, respectively, in the study households, and 0.86 log 10 and 1.33 log 10 cfu/g, respectively, in the control households in the first feeding. After the intervention, the FC and FS counts in study households had dropped to 0.10 log 10 and 0.09 log 10 cfu/g, respectively, a statistically significant reduction (P < 0.001). Monitoring the sustainability of the behaviour change after 3 months showed that the mothers were maintaining food hygiene.conclusions A hygiene intervention following the HACCP approach reduced the weaning food contamination significantly. Awareness building among mothers about weaning food hygiene could be an important intervention for preventing weaning food-related diarrhoea in Bangladesh.keywords weaning food, hazard analysis critical control point, hygiene intervention, diarrhoea, Bangladesh

Point-of-use water treatment with chlorine is underutilized in low-income households. The Zimba, an automated batch chlorinator, requires no electricity or moving parts, and can be installed at shared water points with intermittent flow. We conducted a small-scale trial to assess the acceptability and quality of Zimba-treated municipal water. Fieldworkers collected stored drinking water over a 10-week period from control (n = 24 households) and treatment (n = 30 households) compounds to assess levels of free chlorine and E. coli contamination. Overall, 80% of stored drinking water samples had a safe chlorine residual among treatment households, compared to 29% among control households (P &lt; 0.001). Concentrations of E. coli were lower (mean difference = 0.4 log colony-forming units/100 mL, P = 0.004) in treatment compared to control households. Fifty-three percent of mothers (n = 17), thought the Zimba was easy to use and 76% were satisfied with the taste. The majority of mothers mentioned that collecting water from the Zimba took more time and created a long queue at the handpump. The Zimba successfully chlorinated household stored drinking water; however, further technology development is required to address user preferences. The Zimba may be a good option for point-of-collection water treatment in areas where queuing for water is uncommon.

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