The Impact of Water, Sanitation, and Hygiene Interventions on the Health and Well-Being of People Living With HIV

Yates, Travis; Lantagne, Daniele; Mintz, Eric D.; Quick, Robert

doi:10.1097/qai.0000000000000487

Cited by 18 publications

(25 citation statements)

References 39 publications

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“…People living with HIV have a higher morbidity where there is contaminated water, poor hygiene and sanitation. Programs to improve these also improved morbidity [93].…”

Section: Disastersmentioning

confidence: 99%

Climate Change and Water-Related Infectious Diseases

Nichols

Lake²,

Heaviside

2018

Atmosphere

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Background: Water-related, including waterborne, diseases remain important sources of morbidity and mortality worldwide, but particularly in developing countries. The potential for changes in disease associated with predicted anthropogenic climate changes make water-related diseases a target for prevention. Methods: We provide an overview of evidence on potential future changes in water-related disease associated with climate change. Results: A number of pathogens are likely to present risks to public health, including cholera, typhoid, dysentery, leptospirosis, diarrhoeal diseases and harmful algal blooms (HABS). The risks are greatest where the climate effects drive population movements, conflict and disruption, and where drinking water supply infrastructure is poor. The quality of evidence for water-related disease has been documented. Conclusions: We highlight the need to maintain and develop timely surveillance and rapid epidemiological responses to outbreaks and emergence of new waterborne pathogens in all countries. While the main burden of waterborne diseases is in developing countries, there needs to be both technical and financial mechanisms to ensure adequate quantities of good quality water, sewage disposal and hygiene for all. This will be essential in preventing excess morbidity and mortality in areas that will suffer from substantial changes in climate in the future.Atmosphere 2018, 9, 385 2 of 60 which do not suffer the consequences of extreme events to the same extent [4]. Due to the lifetime of greenhouse gases such as carbon dioxide in the atmosphere, and the timescales associated with ocean warming, even if global CO 2 emissions were curtailed immediately, the effects on the earth's climate, including increasing temperatures and sea level rise would continue for a number of decades before starting to plateau [2]. However, this should be seen as a general call to action to reduce emissions as soon as possible, given that the impacts are likely to extend beyond current conditions and there are indications that economic investment now will be likely to reduce costs later [5]. There is also a need to develop adaptations to cope with changes in climate. Recent research highlighting the health benefits of limiting future temperature rises to the more ambitious target of 1.5 • C rather than 2 • C, in line with the Paris agreement of 2016, further emphasises the need to limit emissions [6].Climate change affects health in a number of ways, and the impacts vary both geographically and between different populations. A growing and ageing population in much of the world means that the proportion of the population who are vulnerable to the effects of climate change will increase in the future [7]. The most direct impacts from climate change are from the effects of high temperatures, and from acute impacts relating to extreme events such as storms, floods and heatwaves. These physical or meteorological stressors can produce direct health effects, such as physical injury, illness, or mental health impacts du...

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“…People living with HIV have a higher morbidity where there is contaminated water, poor hygiene and sanitation. Programs to improve these also improved morbidity [93].…”

Section: Disastersmentioning

confidence: 99%

Climate Change and Water-Related Infectious Diseases

Nichols

Lake²,

Heaviside

2018

Atmosphere

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“…11,20 In 2015, another study reported the health impact of WASH interventions among PLHIV and concluded that both water quality and handwashing interventions reduced morbidity. 12 It also found that PLHIV residing in households with improved water supplies had less diarrheal morbidity and lower prevalence of intestinal parasites, and that having a household sanitation facility (as compared with open defecation or sharing a facility) reduced the risk of diarrhea. 12 The evidence suggests that improved WASH is important for PLHIV; however, numerous barriers limiting access to these services and facilities have been identified.…”

Section: Introductionmentioning

confidence: 96%

“…12 It also found that PLHIV residing in households with improved water supplies had less diarrheal morbidity and lower prevalence of intestinal parasites, and that having a household sanitation facility (as compared with open defecation or sharing a facility) reduced the risk of diarrhea. 12 The evidence suggests that improved WASH is important for PLHIV; however, numerous barriers limiting access to these services and facilities have been identified. Lack of knowledge, attitudes, cost, and debilitating illness have all been noted as factors that inhibit access to or usage of improved WASH services and facilities by PLHIV.…”

Section: Introductionmentioning

confidence: 96%

“…10 Improving drinking water quality, sanitation, and hygiene (WASH) practices among PLHIV have demonstrated health benefits. 11,12 In 2013, a systematic review of seven studies examining the health effects of WASH interventions among PLHIV 11 found that water quality interventions reduced diarrheal illness among PLHIV by 43% (relative risk [RR] = 0.57, 95% confidence interval [CI]: 0.38-0.86). [13][14][15][16][17][18][19] The review included only one study of a handwashing intervention which found a reduction in diarrheal illness of 58% (RR = 0.42, 95% CI: 0.33-0.54) associated with handwashing.…”

Section: Introductionmentioning

confidence: 99%

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Water, Sanitation, and Hygiene Characteristics among HIV-Positive Households Participating in the Global Enteric Multicenter Study in Rural Western Kenya, 2008–2012

Schilling

Awuor

Rajasingham

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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Diarrheal illness, a common occurrence among people living with human immunodeficiency virus (PLHIV), is largely preventable through access to safe drinking water quality, sanitation, and hygiene (WASH) facilities. We examined WASH characteristics among households with and without HIV-positive residents enrolled in the Global Enteric Multicenter Study (GEMS) in rural Western Kenya. Using univariable logistic regression, we examined differences between HIV-positive and HIV-negative households in regard to WASH practices. Among HIV-positive households, we explored the relationship between the length of time knowing their HIV status and GEMS enrollment. No statistically significant differences were apparent in the WASH characteristics among HIV-positive and HIV-negative households. However, we found differences in the WASH characteristics among HIV-positive households who were aware of their HIV status ≥ 30 days before enrollment compared with HIV-positive households who found out their status < 30 days before enrollment or thereafter. Significantly more households aware of their HIV-positive status before enrollment reported treating their drinking water (odds ratio [OR] confidence interval [CI]: 2.34 [1.12, 4.86]) and using effective water treatment methods (OR [CI]: 9.6 [3.09, 29.86]), and had better drinking water storage practices. This suggests that within this region of Kenya, HIV programs are effective in promoting the importance of practicing positive WASH-related behaviors among PLHIV.

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“…4 Episodes of acute, persistent, and recurrent diarrhea are more likely in HIV-infected children, who are at a greater risk of death from an episode of diarrhea than their immunocompetent peers. 5 Inexpensive interventions, such as household-based water, sanitation, and hygiene (WASH) programs, have been reported to reduce diarrhea and improve overall health in HIV-infected individuals 6,7 and at least 1 study of household water treatment documented decreased diarrhea in HIV-infected children less than 2 years old. 8 …”

Section: Introductionmentioning

confidence: 99%

Integrating Household Water Treatment, Hand Washing, and Insecticide-Treated Bed Nets Into Pediatric HIV Care in Mombasa, Kenya: Impact on Diarrhea and Malaria Risk

Sugar¹,

Schilling

Kim

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Introduction:In developing countries, HIV-infected children are at higher risk of morbidity and mortality from opportunistic infections than HIV-uninfected children. To address this problem, the Healthy Living Initiative (HLI) in Mombasa, Kenya distributed basic care packages (BCPs) containing improved water storage vessels, water treatment solution, soap, and insecticide-treated bed nets to prevent diarrhea and malaria in children, and had community health workers (CHWs) make bimonthly home visits to encourage adherence to HLI interventions and antiretroviral (ARV) medicine use.Methods:To evaluate HLI, we enrolled 500 HIV-infected children from Bomu Hospital. In the implementation phase, from February to August 2011, we conducted surveys of caregivers, then provided free BCPs. In the evaluation phase, from September 2011 to August 2012, CHWs recorded observations of BCP use during home visits. We abstracted hospital data to compare diarrhea and malaria episodes, and pharmacy data on ARVs dispensed, between the 12-month preimplementation baseline phase (February 2010–January 2011) and the evaluation phase.Results:The retention rate of children in HLI was 78.4%. In a multivariable logistic regression model adjusting for demographic characteristics, number of CHW home visits, distance to clinic, orphan status, and number of ARVs dispensed, children in HLI had 71% lower risk of diarrhea (relative risk 0.29, P < 0.001) and 87% lower risk of malaria (relative risk 0.13, P = 0.001) during the evaluation phase than the baseline phase; there was no independent association between ARV use and illness.Conclusions:HIV-infected children in HLI were less likely to experience diarrhea and malaria during the evaluation phase than the baseline phase.

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The Impact of Water, Sanitation, and Hygiene Interventions on the Health and Well-Being of People Living With HIV

Abstract: Although research is required to address behavioral aspects, evidence supports that WASH programming is beneficial for PLHIV.

Cited by 18 publications

References 39 publications

Climate Change and Water-Related Infectious Diseases

Climate Change and Water-Related Infectious Diseases

Water, Sanitation, and Hygiene Characteristics among HIV-Positive Households Participating in the Global Enteric Multicenter Study in Rural Western Kenya, 2008–2012

Integrating Household Water Treatment, Hand Washing, and Insecticide-Treated Bed Nets Into Pediatric HIV Care in Mombasa, Kenya: Impact on Diarrhea and Malaria Risk

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