scholarly journals Influence of Community-Led Total Sanitation and Water Coverages in the Control of Cholera in Madarounfa, Niger (2018)

2021 ◽  
Vol 9 ◽  
Author(s):  
Julien Graveleau ◽  
Maria Eleanor Reserva ◽  
Alama Keita ◽  
Roberto Molinari ◽  
Guillaume Constantin De Magny
Keyword(s):  
Disease Transmission ◽  
Water Sources ◽  
Sub Saharan Africa ◽  
Strong Impact ◽  
Water And Sanitation ◽  
Sanitation And Hygiene ◽  
Improved Sanitation ◽  
Quality Water ◽  
Sub Saharan ◽  
The Village

Every year, cholera affects 1.3–4.0 million people worldwide with a particularly high presence in Africa. Based on recent studies, effective targeting interventions in hotspots could eliminate up to 50% of cases in Sub-Saharan Africa. Those interventions include Water, Sanitation, and Hygiene (WASH) programs whose influence on cholera control, up to the present, has been poorly quantified. Among the few studies available, D'Mello-Guyett et al. underline how the distribution of hygiene kits is a promising form of intervention for cholera control and that the integration of a WASH intervention at the point of admission of suspected cases is new in cholera control efforts, particularly in outbreaks and complex emergencies. Considering the limited number of studies on Community-Led Total Sanitation (CLTS) and water coverages related to cholera control, the aim of our work is to determine whether these interventions in cholera hotspots (geographic areas vulnerable to disease transmission) have significant impact on cholera transmission. In this study, we consider data collected on 125 villages of the Madarounfa district (Niger) during the 2018 cholera outbreak. Using a hurdle model, our findings show that full access to improved sanitation significantly decreases the likelihood of cholera by 91% (P < 0.0001) compared to villages with no access to sanitation at all. Considering only the villages affected by cholera in the studied area, cholera cases decrease by a factor of 4.3 in those villages where there is partial access to at least quality water sources, while full access to improved water sources decreases the cholera cases by a factor of 6.3 when compared to villages without access to water (P < 0.001). In addition, villages without access to safe water and sanitation are 6.7 times (P < 0.0001) more likely to get cholera. Alternatively, villages with full sanitation and water coverage are 9.1 (P < 0.0001) less likely to get cholera. The findings of our study suggest that significant access to improved water and sanitation at the village level offer a strong barrier against cholera transmission. However, it requires full CLTS coverage of the village to observe a strong impact on cholera, as partial access only has a limited impact.

Utility-small water enterprise partnerships: serving informal urban settlements in Africa

Water Policy ◽  
2004 ◽  
Vol 6 (5) ◽  
pp. 443-452 ◽  
Author(s):  
Cyrus Njiru
Keyword(s):  
Water Utilities ◽  
Sub Saharan Africa ◽  
Water Services ◽  
Water And Sanitation ◽  
Sanitation Services ◽  
Small Water ◽  
Urban Settlements ◽  
Quality Water ◽  
Sub Saharan ◽  
Informal Urban Settlements

Sustainable development cannot be realised when a large proportion of people do not have access to improved water services. Indeed, despite concerted international effort and publicity made in the last two decades to increase coverage of improved water and sanitation services, the number of people without improved water and sanitation services continues to increase. Water utilities are not serving a large proportion of the urban population and small water enterprises (SWEs) have moved to fill the gap. This paper looks at the growing urban water problem and outlines the role played by SWEs in providing water services to those un-served or under-served by water utilities. Typical constraints faced by SWEs are outlined and the rationale for developing utility–SWE partnerships for the benefit of water consumers (customers) is provided. Potential opportunities for developing utility-SWE partnerships are discussed. The paper argues that utility-SWE partnerships can enable SWEs to provide affordable good quality water services to customers, while providing benefit to the utility and thus also assisting the utility to meet its mandate. The paper proposes win–win utility-SWEs partnerships aimed at achieving the objectives of utilities and SWEs while improving water services to customers in informal urban settlements of developing countries, with a focus on sub-Saharan Africa.

Interactions between ecological and socio-economic drivers of Buruli ulcer burden in Sub-Saharan Africa: opportunities for an improved control

2018 ◽  
Author(s):  
Andes Garchitorena ◽  
Matthew H. Bonds ◽  
Jean-Francois Guégan ◽  
Benjamin Roche
Keyword(s):  
Socioeconomic Factors ◽  
Disease Transmission ◽  
Access To Health Care ◽  
Buruli Ulcer ◽  
Mycobacterium Ulcerans ◽  
Sub Saharan Africa ◽  
Aquatic Environments ◽  
Human Populations ◽  
Complex Interactions ◽  
Sub Saharan

This chapter provides an overview of the complex interactions between ecological and socioeconomic factors for the development and control of Buruli ulcer in Sub-Saharan Africa. We review key ecological and evolutionary processes driving the environmental persistence and proliferation of Mycobacterium ulcerans, the causative agent, within aquatic environments, as well as transmission processes from these aquatic environments to human populations. We also outline key socioeconomic factors driving the economic and health burden of Buruli ulcer in endemic regions, revealed by reciprocal feedbacks between poverty, disease transmission from exposure aquatic environments and disease progression to severe stages owing to low access to health care. The implications of such insights for disease control, both in terms of limitations of current strategies and directions for the future, are discussed.

scholarly journals PO 8581 ZOONOTIC VIRAL ANTIGENS SURVEILLANCE IN HEALTHY POPULATIONS LIVING IN LAMBARÉNÉ, GABON

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A58.2-A58
Author(s):  
Emmanuel Bache ◽  
Marguerite M Loembe ◽  
Selidji T Agnandji
Keyword(s):  
Disease Transmission ◽  
Disease Surveillance ◽  
Vaccine Trial ◽  
Viral Rna ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Rt Pcr ◽  
Zoonotic Infections ◽  
Viral Antigens ◽  
Sub Saharan

BackgroundWorldwide, viral zoonotic infections such as filoviruses, flaviviruses, nairoviruses and arenaviruses cause self-limiting to severe diseases. They are endemic in sub-Saharan Africa, causing sporadic outbreaks warranting the development of sustainable surveillance systems. In Gabon, Ebola outbreaks occurred from 1994 to 2002 causing 214 human cases and 150 deaths, while Dengue, Zika and Chikungunya virus outbreaks occurred between 2007 and 2010. Beyond these outbreaks, little is known about the epidemiology. Recently, in collaboration with the Japanese government, the Research and Health Ministries of Gabon supported the implementation of a biosecurity level-3 (BSL-3) laboratory at CERMEL in Lambaréné as a zoonotic disease surveillance unit. Start-off involved antigen detection and characterisation of circulating antibodies to targeted viral antigens in healthy populations. This study reports data from healthy participants (18–50 years) in a phase I rVSV-ZEBOV-GP Ebola vaccine trial.MethodsHundred-six (106) baseline samples were screened for Ebola, Dengue (serotypes) 1–4 and Chikungunya viral RNA by RT-PCR on serum. IgG ELISA on plasma was used to identify antibodies against: Zaire-Ebola-(EBOV-GP and EBOV-VP40), Marburg-(MARV-GP and MARV-VP40), Crimean Congo Haemorrhagic Fever-(CCHFV-GP), Lasa-(LASV-GPC and LASV-NP), Yellow Fever-(YFV-NS1), West-Nile-(WNV-NS1), Zika virus-(ZIKV-NS1), Chikungunya-(CHIKV-VLP) and Dengue-(DENV1-NS1,DENV2-NS1,DENV3-NS1,DENV4-NS1) virus antigens.ResultsNo viral RNA was isolated by RT-PCR in 106 samples. About 9% (10/106), 3% (3/106), 6% (6/106), 24% (25/106), 51% (54/106), 38% (40/106) and 36% (38/106) participants were seropositive for antibodies specific to EBOV-GP, MARV-GP, CCHFV-GP, YFV-NS1, WNV-NS1, ZIKV-NS1 and CHIKV-VLP, respectively. Twelve percent (12%; 13/106) of participants possessed antibodies specific to Zika, Chikungunya and Dengue 1–4 antigens. Six percent (6%; 6/106) of participants were seropositive for EBOV-GP and CCHFV-GP.ConclusionWe found antibodies to viral zoonotic infections among our healthy volunteers. Further assays, including neutralisation assays are being performed to ascertain the specificity of the antibodies. These findings, once confirmed, will provide insights into disease surveillance, vaccine trial designs, evaluation of post-vaccine immune responses, variability in adverse events and overall disease transmission patterns.

scholarly journals Water, sanitation and hygiene (WASH) in sub-Saharan Africa and associations with undernutrition, and governance in children under five years of age: a systematic review

2020 ◽  
pp. 1-28 ◽  
Author(s):  
D. J. Momberg ◽  
B. C. Ngandu ◽  
L. E. Voth-Gaeddert ◽  
K. Cardoso Ribeiro ◽  
J. May ◽  
...  
Keyword(s):  
Systematic Review ◽  
Water Source ◽  
The State ◽  
Sub Saharan Africa ◽  
Human Right ◽  
Poor Child ◽  
Child Undernutrition ◽  
Sanitation And Hygiene ◽  
Health Related ◽  
Sub Saharan

Abstract Associations between different forms of malnutrition and environmental conditions, including water, sanitation and hygiene (WASH), may contribute towards persistently poor child health, growth and cognitive development. Experiencing poor nutrition in utero or during early childhood is furthermore associated with chronic diseases later in life. The primary responsibility for provision of water and sanitation, as a basic service and human right, lies with the State; however, a number of stakeholders are involved. The situation is most critical in sub-Saharan Africa (SSA), where, in 2015, 311 million people lacked a safe water source, and >70% of SSA populations were living without adequate sanitation. The aim of this paper was to conduct a systematic review to investigate the state of literature concerned with WASH and its association with nutritional status, and governance in children from birth to 5 years of age in SSA. Articles were sourced from PubMed Central, Science Direct and ProQuest Social Science databases published between 1990 and 2017. The PRISMA Statement was utilised and this systematic review is registered with PROSPERO (CRD42017071700). The search terms returned 15,351 articles for screening, with 46 articles included. This is indicative of a limited body of knowledge; however, the number of publications on this topic has been increasing, suggesting burgeoning field of interest. Targeted research on the governance of WASH through the identification of the various role players and stakeholders at various levels, while understanding the policy environment in relation to particular health-related outcomes is imperative to address the burden of child undernutrition.

scholarly journals Access to improved sanitation facilities in low-income informal settlements of East African cities

2014 ◽  
Vol 5 (1) ◽  
pp. 89-99 ◽  
Author(s):  
K. Okurut ◽  
R. N. Kulabako ◽  
P. Abbott ◽  
J. M. Adogo ◽  
J. Chenoweth ◽  
...  
Keyword(s):  
Low Income ◽  
Urban Areas ◽  
Informal Settlement ◽  
Informal Settlements ◽  
Sub Saharan Africa ◽  
East African ◽  
Basic Sanitation ◽  
Improved Sanitation ◽  
Joint Monitoring ◽  
Sub Saharan

Throughout Africa, the population in urban areas is increasing rapidly, often exceeding the capacity and the resources of the cities and towns to accommodate the people. In sub-Saharan Africa, the majority of urban dwellers live in informal settlements served by inadequate sanitation facilities. These settlements present unique challenges to the provision of sustainable and hygienic sanitation, and there is insufficient information on access to improved facilities. This paper reports findings of a study undertaken in low-income informal settlements using a mixed methods approach to assess access to sanitation and identify the barriers to household uptake of improved sanitation facilities. More than half of the respondents (59.7%) reported using sanitation facilities that are included in the WHO/UNICEF Joint Monitoring Programme definition of improved sanitation. However, a high proportion of these facilities did not provide access to basic sanitation. Less than 5% of all the respondents did not report problems related to sustainable access to basic sanitation. The findings highlight the urgent need to develop specific and strategic interventions for each low-income informal settlement, to upscale the sustainable access and use of improved sanitation in urban centres.

The paradox of water accessibility: understanding the temporal and spatial dimensions of access to improved water sources in Rwanda

2015 ◽  
Vol 5 (4) ◽  
pp. 553-564 ◽  
Author(s):  
Lydia Osei ◽  
Jonathan Amoyaw ◽  
Godfred Odei Boateng ◽  
Sheila Boamah ◽  
Isaac Luginaah
Keyword(s):  
Drinking Water ◽  
Water Sources ◽  
Regional Disparities ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Logistic Regression Models ◽  
The People ◽  
Spatial Dimensions ◽  
Sub Saharan ◽  
Over Time

According to the United Nations, the world has met the Millennium Development Goal target of halving the proportion of people without access to safe drinking water. However, global figures mask massive disparities between regions and countries, and within countries. For instance, only 64% of the people in sub-Saharan Africa have access to improved water sources. Over 40% of all people globally who lack access to drinking water live in sub-Saharan Africa. Rwanda is used as a case in point in this study. Despite the abundance of water resources in the country, access to improved water sources is limited. Using the Rwandan Demographic and Health Surveys (2000–2010), we examined regional disparities in access to improved water sources. Results from logistic regression models show that overall, access to improved water has declined between 2000 and 2010; except in the western region, where access to water marginally improved. Educated individuals, wealthier and urban dwellers were more likely to have access to improved water sources over time compared to their uneducated, poor and rural counterparts. The persistence of regional disparities in access to improved water over time suggests the need for policy to address insufficient investments in water infrastructure in Rwanda.

scholarly journals LINKING SATELLITE REMOTE SENSING BASED ENVIRONMENTAL PREDICTORS TO DISEASE: AN APPLICATION TO THE SPATIOTEMPORAL MODELLING OF SCHISTOSOMIASIS IN GHANA

2016 ◽  
Vol XLI-B8 ◽  
pp. 215-221
Author(s):  
M. Wrable ◽  
A. Liss ◽  
A. Kulinkina ◽  
M. Koch ◽  
N. K. Biritwum ◽  
...  
Keyword(s):  
Remote Sensing ◽  
Disease Transmission ◽  
Land Surface ◽  
Health Surveys ◽  
Risk Model ◽  
Clinical Symptoms ◽  
Sub Saharan Africa ◽  
Small Scale ◽  
Environmental Predictors ◽  
Sub Saharan

90% of the worldwide schistosomiasis burden falls on sub-Saharan Africa. Control efforts are often based on infrequent, small-scale health surveys, which are expensive and logistically difficult to conduct. Use of satellite imagery to predictively model infectious disease transmission has great potential for public health applications. Transmission of schistosomiasis requires specific environmental conditions to sustain freshwater snails, however has unknown seasonality, and is difficult to study due to a long lag between infection and clinical symptoms. To overcome this, we employed a comprehensive 8-year time-series built from remote sensing feeds. The purely environmental predictor variables: accumulated precipitation, land surface temperature, vegetative growth indices, and climate zones created from a novel climate regionalization technique, were regressed against 8 years of national surveillance data in Ghana. All data were aggregated temporally into monthly observations, and spatially at the level of administrative districts. The result of an initial mixed effects model had 41% explained variance overall. Stratification by climate zone brought the R<sup>2</sup> as high as 50% for major zones and as high as 59% for minor zones. This can lead to a predictive risk model used to develop a decision support framework to design treatment schemes and direct scarce resources to areas with the highest risk of infection. This framework can be applied to diseases sensitive to climate or to locations where remote sensing would be better suited than health surveys.

scholarly journals Data-driven analyses of behavioral strategies to eliminate cysticercosis in sub-Saharan Africa

2021 ◽  
Vol 15 (3) ◽  
pp. e0009234
Author(s):  
Laura A. Skrip ◽  
Veronique Dermauw ◽  
Pierre Dorny ◽  
Rasmané Ganaba ◽  
Athanase Millogo ◽  
...  
Keyword(s):  
Behavioral Interventions ◽  
Human Exposure ◽  
Taenia Solium ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
P Value ◽  
Behavioral Strategies ◽  
Sanitation And Hygiene ◽  
Neurological Morbidity ◽  
Sub Saharan

Background The multi-host taeniosis/cysticercosis disease system is associated with significant neurological morbidity, as well as economic burden, globally. We investigated whether lower cost behavioral interventions are sufficient for local elimination of human cysticercosis in Boulkiemdé, Sanguié, and Nayala provinces of Burkina Faso. Methodology/Principal findings Province-specific data on human behaviors (i.e., latrine use and pork consumption) and serological prevalence of human and pig disease were used to inform a deterministic, compartmental model of the taeniosis/cysticercosis disease system. Parameters estimated via Bayesian melding provided posterior distributions for comparing transmission rates associated with human ingestion of Taenia solium cysticerci due to undercooking and human exposure to T. solium eggs in the environment. Reductions in transmission via these pathways were modeled to determine required effectiveness of a market-focused cooking behavior intervention and a community-led sanitation and hygiene program, independently and in combination, for eliminating human cysticercosis as a public health problem (<1 case per 1000 population). Transmission of cysticerci due to consumption of undercooked pork was found to vary significantly across transmission settings. In Sanguié, the rate of transmission due to undercooking was 6% higher than that in Boulkiemdé (95% CI: 1.03, 1.09; p-value < 0.001) and 35% lower than that in Nayala (95% CI: 0.64, 0.66; p-value < 0.001). We found that 67% and 62% reductions in undercooking of pork consumed in markets were associated with elimination of cysticercosis in Nayala and Sanguié, respectively. Elimination of active cysticercosis in Boulkiemdé required a 73% reduction. Less aggressive reductions of 25% to 30% in human exposure to Taenia solium eggs through sanitation and hygiene programs were associated with elimination in the provinces. Conclusions/Significance Despite heterogeneity in effectiveness due to local transmission dynamics and behaviors, education on the importance of proper cooking, in combination with community-led sanitation and hygiene efforts, has implications for reducing morbidity due to cysticercosis and neurocysticercosis.

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