Antimicrobial-Resistant Epidemic Shigella Dysenteriae Type 1 in Zambia: Modes of Transmission

Tuttle, Jessica; Ries, Allen A.; Chimba, Roy M.; Perera, Chandrika; Bean, Nancy H.; Griffin, Patricia M.

doi:10.1093/infdis/171.2.371

Cited by 56 publications

(37 citation statements)

References 8 publications

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“…This finding is consistent with those of the few studies that have been conducted, [9][10][11][12][13][14][15][16] although the effect we observed was more *Countries are grouped based on quintiles of the crude prevalence ratio (PR). Shown are PRs and 95% confidence intervals (CIs) for diarrhea for comparisons of households with shared toilet facilities with households with facilities that are not shared.…”

Section: Discussionsupporting

confidence: 92%

Shared Sanitation and the Prevalence of Diarrhea in Young Children: Evidence from 51 Countries, 2001–2011

Fuller¹,

Clasen²,

Heijnen³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Shared sanitation is defined as unimproved because of concerns that it creates unsanitary conditions; this policy is being reconsidered. We assessed whether sharing a toilet facility was associated with an increased prevalence of diarrhea among children 5 years of age. We use data from Demographic and Health Surveys conducted in 51 countries. Crude and adjusted prevalence ratios (PRs) for diarrhea, comparing children from households that used a shared facility with children from households that used a non-shared facility, were estimated for each country and pooled across countries. Unadjusted PRs varied across countries, ranging from 2.15 to 0.65. The pooled PR was 1.09; differences in socioeconomic status explained approximately half of this increased prevalence (adjusted PR = 1.05). Shared sanitation appears to be a risk factor for diarrhea although differences in socioeconomic status are important. The heterogeneity across countries, however, suggests that the social and economic context is an important factor.

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Section: Discussionsupporting

confidence: 92%

Shared Sanitation and the Prevalence of Diarrhea in Young Children: Evidence from 51 Countries, 2001–2011

Fuller¹,

Clasen²,

Heijnen³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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“…Lack of proper hygiene practices, such as cleaning of drinking water storage vessels and dipping utensils used to remove drinking water from storage vessels, and washing of hands, as well as exposure of drinking water stored in open-top containers to dust and fomites has been shown to contribute to decreased microbial quality of drinking water, in this study as well as in the literature (Blum et al, 1990;Tuttle et al, 1995;Trevett et al, 2005;Onabulo et al, 2011).…”

Section: Discussionsupporting

confidence: 64%

Microbial quality of drinking water from groundtanks and tankers at source and point-of-use in eThekwini Municipality, South Africa, and its relationship to health outcomes

Singh¹,

Lutchmanariyan²,

Wright³

et al. 2013

WSA

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Drinking water quality was investigated at source and corresponding point-of-use in 2 peri-urban areas receiving drinking water either by communal water tanker or by delivery directly from the distribution system to household-based groundtanks with taps. Water quality variables measured were heterotrophic bacteria, total coliforms, E. coli, conductivity, turbidity, pH, and total and residual chlorine. Water quality data were analysed together with an existing epidemiological database to investigate links between microbial quality of drinking water, household demographics, health outcomes, socio-economic status, hygiene and sanitation practices. Groundtank households had better quality drinking water than households using storage containers filled from communal tankers. Uncovered storage containers had the poorest microbial water quality among all storage containers. All stored water did not meet drinking water standards, although mains water did. Households with children under 5 years and using open-topped containers had the poorest water quality overall. Households with groundtanks had the best water quality at point-of-use, but did not have the lowest occurrence of health effects. Although groundtanks were supplied together with urine diversion (UD) toilets and hygiene education, groundtank households showed overall poorer hygiene practices than tanker-supplied households, and some groundtank households with UD toilets preferred to continue using open defecation. Households that practised open defecation had higher levels of E. coli in their drinking water and higher rates of adverse health outcomes. Poorer socio-economic standing and lower educational standard were associated with poorer water quality, poorer hygiene practices and higher rates of diarrhoea and vomiting.

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“…Because household water treatment, safe water storage, and handwashing with soap have all been shown to reduce the risk of diarrhea by ~30-40%, we expect that participants in this program and their families experienced a positive health benefit. [3][4][5][16][17][18] Additionally, maternal handwashing at the time of delivery has been associated with reduced neonatal mortality, suggesting additional protective benefits of this intervention. 19 There are several explanations for the success of this program in changing maternal hygiene behaviors.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Integration of Water Treatment and Handwashing Incentives with Antenatal Services on Hygiene Practices of Pregnant Women in Malawi

Sheth¹,

Russo²,

Menon³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Access to safe drinking water and improved hygiene are important for reducing morbidity and mortality from diarrhea. We surveyed 330 pregnant women who participated in an antenatal clinic-based intervention in Malawi that promoted water treatment and hygiene through distribution of water storage containers, sodium hypochlorite water treatment solution, soap, and educational messages. Program participants were more likely to know correct water treatment procedures (62% versus 27%, P < 0.0001), chlorinate drinking water (61% versus 1%, P < 0.0001), demonstrate correct handwashing practices (68% versus 22%, P < 0.0001), and purchase water treatment solution after free distribution (32% versus 1%, P < 0.0001). Among participants, 72% had at least three antenatal visits, 76% delivered in a health facility, and 54% had a postnatal check. This antenatal-clinic-based program is an effective new strategy for promoting water treatment and hygiene behaviors among pregnant women. Participants had high use of antenatal, delivery, and postnatal services, which could improve maternal and child health.

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Antimicrobial-Resistant Epidemic Shigella Dysenteriae Type 1 in Zambia: Modes of Transmission

Cited by 56 publications

References 8 publications

Shared Sanitation and the Prevalence of Diarrhea in Young Children: Evidence from 51 Countries, 2001–2011

Shared Sanitation and the Prevalence of Diarrhea in Young Children: Evidence from 51 Countries, 2001–2011

Microbial quality of drinking water from groundtanks and tankers at source and point-of-use in eThekwini Municipality, South Africa, and its relationship to health outcomes

Impact of the Integration of Water Treatment and Handwashing Incentives with Antenatal Services on Hygiene Practices of Pregnant Women in Malawi

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