scholarly journals Impact of sampling depth on pathogen detection in pit latrines

2021 ◽  
Vol 15 (3) ◽  
pp. e0009176
Author(s):  
Drew Capone ◽  
Petros Chigwechokha ◽  
Francis L. de los Reyes ◽  
Rochelle H. Holm ◽  
Benjamin B. Risk ◽  
...  
Keyword(s):  
Pathogen Detection ◽  
Water Source ◽  
Maximum Depth ◽  
Enteric Pathogens ◽  
Sampling Depth ◽  
Middle Income ◽  
Reverse Transcription Pcr ◽  
Surface Samples ◽  
Significant Difference ◽  
Sanitation Systems

Wastewater based epidemiology (WBE) is increasingly used to provide decision makers with actionable data about community health. WBE efforts to date have primarily focused on sewer-transported wastewater in high-income countries, but at least 1.8 billion people in low- and middle-income countries (LMIC) use onsite sanitation systems such as pit latrines and septic tanks. Like wastewater, fecal sludges from such systems offer similar advantages in community pathogen monitoring and other epidemiological applications. To evaluate the distribution of enteric pathogens inside pit latrines–which could inform sampling methods for WBE in LMIC settings unserved by sewers–we collected fecal sludges from the surface, mid-point, and maximum-depth of 33 pit latrines in urban and peri-urban Malawi and analyzed the 99 samples for 20 common enteric pathogens via multiplex quantitative reverse transcription PCR. Using logistic regression adjusted for household population, latrine sharing, the presence of a concrete floor or slab, water source, and anal cleansing materials, we found no significant difference in the odds of detecting the 20 pathogens from the mid-point (adjusted odds ratio, aOR = 1.1; 95% confidence interval = 0.73, 1.6) and surface samples (aOR = 0.80, 95% CI = 0.54, 1.2) compared with those samples taken from the maximum depth. Our results suggest that, for the purposes of routine pathogen monitoring, pit latrine sampling depth does not strongly influence the odds of detecting enteric pathogens by molecular methods. A single sample from the pit latrines’ surface, or a composite of surface samples, may be preferred as the most recent material contributed to the pit and may be easiest to collect.

scholarly journals Infrastructure governance in the post-networked city: State-led, high-tech sanitation in Addis Ababa’s condominium housing

2021 ◽  
pp. 239965442110370
Author(s):  
Liza Rose Cirolia ◽  
Tesfaye Hailu ◽  
Julia King ◽  
Nuno F da Cruz ◽  
Jo Beall
Keyword(s):  
Addis Ababa ◽  
Methodological Approach ◽  
Mass Scale ◽  
The State ◽  
Rapid Expansion ◽  
High Tech ◽  
Middle Income ◽  
Lower Middle Class ◽  
City State ◽  
Sanitation Systems

Ethiopia’s mass-scale subsidized housing delivery programme has driven the rapid expansion of middle-income, mid-rise settlements on the outskirts of Addis Ababa, requiring the provision of infrastructure to newly developed areas. In the case of the Kotari housing project, established sanitation systems were deemed inappropriate for the site, resulting in the deployment of novel technology, a Membrane Bioreactor (MBR). Such decentralised technologies contribute to the heterogenous infrastructure configurations which characterise Addis Ababa’s sanitation landscape, reflected not only in material configurations but also in how they are governed. In this paper, we use the concept of ‘infrastructure interfaces’ as an analytical device to identify the key material connection points in the system. Working across scales, we scrutinise the governance arrangements at these critical junctures: the household, the block, the condominium, and the city. Our analysis challenges established understandings of infrastructural heterogeneity driven by the private sector, either through financialized elite infrastructures or informal survivalist practices. In Kotari, the state is the driver and the target is the lower middle class. Centring the state in these infrastructure configurations provides nuance to our understanding of how heterogeneity emerges. Our methodological approach accounts for governance at various scales, providing fresh insights into the relationality of infrastructure, particularly the human/technology interface and infrastructural failures. The case shows the importance of transcending binary readings of infrastructure configurations, such as on/off grid, state/private and formal/informal. Future work on the post-network city must go beyond simply denigrating or valorising alternative modes of service delivery.

scholarly journals p53 Mutation at Serine 249 and Its Gain of Function Are Highly Related to Hepatocellular Carcinoma after Smoking Exposure

2021 ◽  
pp. 1-11
Author(s):  
Huai Wang ◽  
Lu Chen ◽  
Tong Zhou ◽  
Zhongwei Zhang ◽  
Canwei Zeng
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transcriptional Activity ◽  
Direct Sequencing ◽  
Close Correlation ◽  
P53 Mutation ◽  
Gain Of Function ◽  
Reverse Transcription Pcr ◽  
Smoking Exposure ◽  
Significant Difference ◽  
Dose Response Effect

<b><i>Background:</i></b> It has been convincingly suggested that a close correlation exists between the incidence of hepatocellular carcinoma (HCC) and cigarette smoking. However, the underlying effect of smoking on HCC is not clear. <b><i>Methods:</i></b> A binary unconditional logistic regression was used for the data on a total of 300 cases and 612 controls. The approach of functional analysis of separated alleles in yeast and direct sequencing of TP53 mutations were applied to analyze the p53 status in the HCC group. The relationship between p53 mutation at serine 249 (p53-RS) and smoking was assessed. Quantitative reverse transcription PCR was employed for the evaluation to transcriptional activity of p53 and p53-RS. <b><i>Results:</i></b> Smoking was linked to the risk of HCC with an increased dose-response effect. Moreover, among subjects who did not drink, the risks of HCC were significantly increased for smokers between HCC and controls. Besides, there was an increase in the number of HCC in smokers compared to nonsmokers after exclusion of HBV and/or HCV infection. Also, a significant difference was observed in the incidence of p53-RS between smokers and nonsmokers the HCC group. Furthermore, the p53-RS transcriptional activity was significantly increased in tumor tissues. <b><i>Conclusions:</i></b> It strongly demonstrated that tobacco smoking is positively and independently associated with HCC, which may be attributed to p53-RS and its gain of function.

Abstract 11119: Real-Time Nanopore Sequencing for Bacterial Pneumonia After Out-of-Hospital Cardiac Arrest, a Pilot Proof-of-Concept Study

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Alexandra Weissman ◽  
Mariam Bramah Lawani ◽  
Thomas Rohan ◽  
Clifton W CALLAWAY
Keyword(s):  
Patient Care ◽  
Pathogen Detection ◽  
Bacterial Pathogen ◽  
Improve Patient Care ◽  
Antibiotic Administration ◽  
Nanopore Sequencing ◽  
Proof Of Concept ◽  
Chi Square ◽  
Significant Difference ◽  
Improve Patient

Introduction: Pneumonia is common after OHCA but is difficult to diagnose in the first 72 hours following ROSC, this results in early untargeted antibiotic administration based on non-specific imaging and laboratory findings. Antibiotic resistance is rising, is influenced by untargeted antibiotic administration, and can increase patient morbidity and mortality as well as healthcare costs. Precision methods of bacterial pathogen detection in OHCA patients are needed to improve patient care. This proof-of-concept pilot study aimed to assess feasibility of bacterial pathogen sequencing and comparability of sequencing results to clinical culture after OHCA. Methods: Blood and bronchoalveolar lavage (BAL) were obtained from residual clinical specimens collected within 12 hours of ROSC. Bacterial DNA was extracted using the Qiagen PowerLyzer PowerSoil DNA kit, sequenced using the MinION nanopore sequencer, and analyzed with Oxford Nanopore Technologies’ EPI2ME bioinformatics software. Sequencing results were compared to culture results using McNemar’s chi-square statistic. Study-defined pneumonia was based on presence of at least two characteristics within 72 hours of ROSC: fever (temperature ≥38°C); persistent leukocytosis >15,000 or leukopenia <3,500 for 48 hours; persistent chest radiography infiltrates for 48 hours per clinical radiology read; bacterial pathogen cultured. Results: We enrolled 38 consecutive OHCA subjects: mean age 61.8 years (18.0); 16 (42%) female; 25 (66%) White, 7 (18%) Black, 6 (16%) “Other” race; 7 subjects (18%) survived and 31 (82%) died; 16 (42%) subjects had pneumonia. Sequencing results were available in 12 hours while culture results were available in 48-72 hours after collection. There was a non-significant difference in the proportion of the same pathogens identified for each method per McNemar’s chi-square: p = 0.38, difference of 0.095 (-0.095, 0.286). Conclusions: Nanopore sequencing detects pathogenic bacteria comparable to clinical microbiologic culture and in less time. This technology can produce a paradigm shift in early bacterial pathogen detection in OHCA survivors, which can improve patient care. The technology is applicable to other patient populations and for viral and fungal pathogens.

scholarly journals Changes in historical typhoid transmission across 16 U.S. cities, 1889-1931: Quantifying the impact of investments in water and sewer infrastructures

2019 ◽  
Author(s):  
Maile T. Phillips ◽  
Katharine A. Owers ◽  
Bryan T. Grenfell ◽  
Virginia E. Pitzer
Keyword(s):  
Late Summer ◽  
Water Source ◽  
Developed Countries ◽  
The United States ◽  
Water And Sanitation ◽  
Sewer Systems ◽  
Early Fall ◽  
Sanitation Systems ◽  
The Impact

ABSTRACTBackgroundInvestments in water and sanitation systems are believed to have led to the decline in typhoid fever in developed countries, such that most cases now occur in regions lacking adequate clean water and sanitation. Exploring seasonal and long-term patterns in historical typhoid mortality in the United States can offer deeper understanding of disease drivers.MethodsWe fit modified Time-series Susceptible-Infectious-Recovered models to city-level weekly mortality counts to estimate seasonal and long-term typhoid transmission. We examined seasonal transmission separately by city and aggregated by water source. We fit regression models to measure associations between long-term transmission and financial investments in water and sewer systems.ResultsTyphoid transmission peaked in late summer/early fall. Seasonality varied by water source, with the greatest variation occurring in cities with reservoirs. Historical $1 per capita ($25.80 in 2017) investments in construction and operation of water and sewer systems were associated with 8-53% decreases in typhoid transmission, while $1 increases in total value or debt accrued to maintain them were associated with 4-7% decreases.ConclusionOur findings aid in the understanding of typhoid transmission dynamics and potential impacts of water and sanitation improvements, and can inform cost-effectiveness analyses of interventions to reduce the typhoid burden.

Circular frames without x-ray – lessons learned regarding radiation exposure during tibial deformity correction from Low & Middle Income Countries?

2022 ◽  
pp. 004947552110433
Author(s):  
James Shelton ◽  
Sara Dorman ◽  
Yinna Kim ◽  
Phillipa Thorpe ◽  
Badri Narayan ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Deformity Correction ◽  
Treatment Method ◽  
Lessons Learned ◽  
Phnom Penh ◽  
Middle Income ◽  
X Ray ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Significant Difference

Circular frames are a successful way of treating difficult fractures and non-unions. At our institution (CSC) in Phnom Penh, Cambodia, our method differs from developed healthcare systems in that we do not use x-ray to site the frames. A retrospective cohort study was performed between CSC and a UK LRS unit. Demographics, diagnosis, frame type, pre- and post-op deformity, proximal and distal construct alignment comparative to the tibia, and time to union or failure. 70 patients in total were identified and were randomly selected from a hospital in UK. Demographics & deformity were similar and failed to reach significant difference on testing: union rate 70% v. 82%, time to union 9.8 v. 8.5 months, and radiation exposure mean 0 v. 74 cGy/cm2 (range 6.4–326.7). These are startlingly homogenous results considering the differing resources available. We believe that ring fixators are a viable treatment method in austere environments where image intensifiers are unavailable, and demand no unnecessary radiation exposure.

scholarly journals Rainwater as an alternative drinking water source for the Chronic Kidney Disease Of Uncertain etiology (CKDu) prone areas: a case study for Girandurukotte, Sri Lanka

2020 ◽  
Vol 10 (3) ◽  
pp. 539-548
Author(s):  
V. M. Jayasooriya ◽  
V. M. M. Perera ◽  
S. Muthukumaran
Keyword(s):  
Water Quality ◽  
Chronic Kidney Disease ◽  
Drinking Water ◽  
Surface Water ◽  
Sri Lanka ◽  
Kidney Disease ◽  
Water Source ◽  
Drinking Water Source ◽  
Significant Difference ◽  
Uncertain Etiology

Abstract Chronic Kidney Disease of uncertain etiology (CKDu) is a fatal disease that causes death from kidney failure due to unknown risk factors and has already affected more than 400,000 people in the rural agricultural landscape (dry zone) of Sri Lanka. The major drinking source in Sri Lanka is groundwater and it is suspected that the pollution of groundwater sources due to agricultural means has a major impact on CKDu. The primary objective of this study is to determine whether rainwater can be used as an alternative safe drinking water source in Girandurukotte area, Sri Lanka, which is known to be an area endemic for CKDu. The physical, chemical, and biological analyses were performed to compare the water quality parameters of three water sources (groundwater, surface water, and rainwater) for Girandurukotte area. The most common storage tanks in polyethylene (PE) and ferrocement (FC) were compared to assess the influence of the material of rainwater tank on water quality. The results showed that there is a significant difference in rainwater in terms of water quality compared to groundwater and surface water. Rainwater in FC and PE tanks showed significant differences (p &lt; 0.05) for some parameters however, they were still within accepted potable drinking water standards.

scholarly journals Menstrual Hygiene Management and Waste Disposal in Low and Middle Income Countries—A Review of the Literature

2018 ◽  
Vol 15 (11) ◽  
pp. 2562 ◽  
Author(s):  
Myles Elledge ◽  
Arundati Muralidharan ◽  
Alison Parker ◽  
Kristin Ravndal ◽  
Mariam Siddiqui ◽  
...  
Keyword(s):  
Waste Management ◽  
Grey Literature ◽  
Middle Income ◽  
Menstrual Hygiene ◽  
Middle Income Countries ◽  
Menstrual Hygiene Management ◽  
Hygiene Management ◽  
Literature Reviews ◽  
Sanitation Systems ◽  
Low And Middle Income

Menstrual hygiene management (MHM) has gained some attention and several literature reviews have been published. However, both original papers and reviews tend to focus on absorbent access and use and not on the disposal of menstrual waste. This review aims to fill a gap in the water, sanitation and hygiene (WASH) sector by bringing a focus specifically on menstrual hygiene safe disposal in low- and middle-income countries (LMIC). We reviewed published literature since 2002 on menstrual hygiene with a focus on menstrual waste management and menstrual absorbent disposal in LMIC. Database searches were conducted of both peer reviewed literature and grey literature, in addition to hand searching of references of relevant earlier literature reviews. In total 152 articles and reports were identified and 75 met the inclusion criteria and was included in the final review. Existing polices on MHM was also reviewed with a focus on India and South Africa. The review showed that disposal of menstrual waste is often neglected MHM and sanitation value chains, leading to improper disposal and negative impacts on users, the sanitation systems and the environment. Findings call for further research to gain better understandings of MHM waste streams, disposal behaviors, absorbent materials and waste management technologies to deliver health, safety, mobility and dignity for women and girls.

scholarly journals Online Learning Resources Enhanced Teaching and Learning of Medical Mycology among Medical Students in Gulu University, Uganda

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Felix Bongomin ◽  
Bernard Erima ◽  
Richard Kwizera ◽  
Emmanuel I. Odongo-Aginya
Keyword(s):  
Medical Students ◽  
Online Teaching ◽  
Teaching And Learning ◽  
Cross Sectional Study ◽  
Fungal Diseases ◽  
Medical Mycology ◽  
Average Score ◽  
Cross Sectional ◽  
Middle Income ◽  
Significant Difference

Background. The burden of serious fungal diseases has significantly increased in the past few decades; however, the number of health-care workers with expertise in the management of fungal diseases remains low, especially in low- and middle-income countries (LMICs). This study aimed to evaluate the use of freely available online teaching material to enhance teaching and learning of medical mycology among medical students in Gulu University Medical School, Uganda. Methods. We conducted a cross-sectional study among second year medical students undertaking Medical Mycology course on antifungal agents in the department of Medical Microbiology and Immunology in the academic year 2017-2018. The materials were synthesized and peer-reviewed by experts in fungal diseases and were made freely available on the Leading International Fungal Education website (http://www.LIFE-Worldwide.org). A local faculty in the department delivered the lectures, and pre- and posttest scores were evaluated statistically. Results. Sixty medical students participated in the study of which 78% were male. The average score was 41% for the pretest and 52% for the posttest (p<0.0001). There was no significant difference in the scores of males and females. Majority of the students gave an above-average rating for the course material; however, 54% preferred prerecorded videos. Conclusion. Using freely available online materials on medical mycology can enhance teaching and learning of medical mycology. Because of this, there is need to incorporate up-to-date information about the subject into the curriculums of medical schools especially in LMICs.

scholarly journals Mental Health Orientation for Self-Help Group Members: A Feasibility Study

2017 ◽  
Vol 08 (03) ◽  
pp. 395-400
Author(s):  
Basavaraj Shrinivasa ◽  
Navaneetham Janardhana ◽  
Bergai Parthsarathy Nirmala
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Middle Income ◽  
Self Help ◽  
Significant Difference ◽  
After Effect ◽  
Group Members ◽  
The Impact ◽  
Self Help Group

ABSTRACT Background: Treatment gap for mental health care in low- and middle-income (LAMI) countries is very large, and building workforce using the locally available resources is very much essential in reducing this gap. The current study is a preliminary work toward this direction. Materials and Methods: A single group pre- and post-design was considered for assessing the feasibility of Mental Health Orientation (MHO) Program for Self-Help Group members. Assessment of participants’ MHO using Orientation Towards Mental Illness (OMI) scale was undertaken at three levels: baseline assessment before the intervention, after completing 2 days orientation program, and 6 weeks later. Results: Analysis of data resulted in statistically significant mean scores in the domains of areas of causation (F[1.41, 40.7] = 21.7, P < 0.000, ηp 2 = 0.428), perception of abnormality (F[1.27, 36.8] = 15.8, P< 0.000, ηp 2 = 0.353), treatment (F[1.42, 41.3] = 34.8, P < 0.000, ηp 2 = 0.546), and after effect (F[1.36,39.4] = 26.7, P < 0.000, ηp 2 = 0.480). Although the overall mean scores of all the domains of OMI were found to be statistically significantly different, there was no significant difference in the mean scores between post and follow-up assessments on areas of causation (µd = 1.27, P = 0.440) and treatment (µd = 1.00, P = 0.156). Conclusion: Overall, the findings of our study demonstrate that brief MHO program can exert a beneficial effect on bringing about significant change in the orientation of the participants toward mental illness but need to be refreshed over time to make the impact of the program stay longer.

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